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DRIVEN TO DISTRACTION : A decade ago, doctors thought attention deficit disorder faded with maturity. Now drugs and coping skills can help adults with ADD comprehend much that had been misunderstood.

August 09, 1995|JULIE BAWDEN DAVIS | SPECIAL TO THE TIMES

For most of his life, Greg Stull found listening to family, co-workers and friends torture. "After a minute or two of struggling to pay attention, I felt as if ants were crawling all over me. I'd have to change the subject or get up and move around," says the computer software engineer, who works in Irvine.

Stull, 33, heard what people said but found even the simplest messages hard to comprehend.

"I tried to listen, but it was impossible for long," he says. "It was like sitting in the back of a flatbed pickup truck going 100 miles an hour down a bumpy dirt road. Remembering information and drawing conclusions from facts was really difficult. I felt stupid for having to try so hard when others didn't seem to have to."

Stull has a condition most people associate with children rather than adults: attention deficit disorder.

He was found to have ADD as a child, and doctors predicted it would disappear as he grew. It didn't, but Stull and those around him assumed that it had. For years, during his late teens and 20s, Stull struggled unknowingly with it. Sheer willpower and determination propelled him through college and into the computer field, but he found it hard to stay at a job.

Five years ago, in frustration, Stull decided to seek help. He confided in his family physician his fear that he might still have the disorder that had plagued him in childhood. His doctor, it turns out, was found to have ADD and knew what specialists would be best for Stull to see.

Behavioral and physiological testing confirmed that Stull had not outgrown ADD. He was taught coping techniques and prescribed Ritalin, the drug most commonly used to treat ADD. The change in his life was dramatic he says: Communicating with his family, friends and co-workers was no longer a chore.

The first childhood diagnosis of this neurological and biochemical condition was made by a British pediatrician in 1902. Until just 10 years ago, doctors thought ADD faded with maturity. They've since found that isn't always the case.

"In the past five years, I've had a gradual onslaught of adult patients afflicted with what we call residual ADD," says psychiatrist Jean-Louis Le Renard, who has a private practice in Huntington Beach and is an assistant clinical professor at UCLA.

"When they find out what is wrong, many adults are very happy to know that there is a name for their suffering and effective treatment is available," he says.

About one-third of children with ADD continue to experience the problem in adulthood, although it often goes undetected or is misdiagnosed as depression or another behavioral problem, according to Le Renard. Other experts put the percentage even higher.

Symptoms of ADD in adulthood are similar to those found in childhood, but they are sometimes more difficult to detect because adults become masters at hiding their problem and coping. ADD can, and usually does, affect all areas of a person's life.

The hallmarks of the condition are extreme distractibility and sometimes destructive impulsiveness. Other symptoms include moodiness, temper flare-ups, depression, disorganization, sleep difficulties, difficulty beginning and completing tasks, fatigue and low stress tolerance.

Estimates vary on the number of people who have the disorder, but many experts concur with statistics compiled by the Ohio-based Attention Deficit Disorder Assn., which show that 5% of Americans, adults and children, have the disorder.

"I don't think ADD has increased in frequency," Le Renard says. "Like many medical conditions, it went unrecognized and left on the sidelines for so many years. We have become more sophisticated and knowledgeable in identifying the problem."

Whatever the numbers, ADD has the distinction of being the fastest-growing mental disturbance diagnosis for adults. As more and more people are diagnosed, the use of Ritalin has skyrocketed. In the past four years, prescriptions for the drug have risen nearly 400%.

It's a statistic that alarms some experts in the field, such as clinical psychologist Richard Bromfield, who is a faculty member of Harvard Medical School in Boston.

"Ritalin is amphetamine related, can be addicting and is still controversial," Bromfield says.

"Inevitably, every good medicine, from antibiotics to Valium, has been widely overprescribed and abused, so why wouldn't that happen with Ritalin?" Bromfield asks. "While all of these drugs are miracles for some people, they can be harmful to individuals who don't warrant them."

Bromfield said he doesn't question the existence of ADD but believes that it is over-diagnosed.

"I think that just 1% to 2% of the population actually has ADD," he says.

*

Psychologist Joan Andrews has worked with many ADD clients, currently at Coastline Counseling Center in Newport Beach and previously as a school district psychologist in Irvine for 12 years.

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