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On their terms

Now adults, many in the "ADD generation" are saying no to meds.

December 18, 2006|Melissa Healy | Times Staff Writer

FOR Devin Barclay, life with attention-deficit disorder has been a winding road. And seven years after he quit taking medication for the condition, "it's still winding," he says with a laugh.

But as the 23-year-old navigates his way into adulthood, he's managed to pay the roadside distractions a little less attention. And he's learned a thing or two about getting himself from one destination to the next without taking major detours.

In 1990, when Barclay was 7, he was diagnosed with ADD and began taking Ritalin -- a stimulant medication that he and his parents referred to as "the thinking pill" -- to help him sit still and pay attention in class. Over the next decade, almost 2 million American boys and girls were similarly diagnosed, an unprecedented growth of a medical condition that, before 1990, had been so rarely recognized that the national Centers for Disease Control and Prevention did not even track it.

Today, the children on the leading edge of a wave dubbed by some "the ADD generation" have reached the cusp of adulthood. And as they take on jobs or college, care for themselves away from home, enter into adult relationships and become parents, these newly minted grown-ups are carrying out a massive natural experiment.

It seems like only yesterday they were fidgeting in their seats, sprinting around their classrooms and daydreaming their way through addition and subtraction. Most, just like Barclay, struggled through elementary and middle school on Ritalin as the practice of medicating attention problems in children took off steeply in the United States: Between 1990 and 2005, production of the two stimulant compounds most used to treat ADD -- methylphenidate and amphetamine -- increased seventeenfold and thirtyfold, respectively.

Now many are choosing to do without the drugs that profoundly affected their experience of childhood and school and, in many cases, made it possible for them to learn alongside other kids in mainstream classrooms.

It is one of the first decisions of their adult lives. Mostly, it was parents who dictated whether and when they would start medications to sharpen their focus. But the decision to stay on or go off these drugs is one that these teens and young adults have made for themselves -- with little research to guide them.

Whether the results will be momentous or slight will be more than a personal test for each of them; it is uncharted terrain, also, to researchers in the field of attention problems who are watching intently for answers -- and hoping for better guidance for future generations of ADD sufferers.

American society remains deeply ambivalent about the diagnosis of ADD, a catch-all term used more commonly in the past that includes today's more well-known attention-deficit hyperactivity disorder. (Children diagnosed with ADD typically have difficulty focusing and paying attention. Those with ADHD are physically frenetic as well.)

Almost three decades after the psychiatric profession first detailed the condition in its diagnostic manual, nagging questions remain: Does medicating a child with ADD help that child's well-being in the long term? Are there any negative consequences? And must it be a life-long prescription?

Although most mental health professionals believe that about 2 in 3 children with ADD will continue to contend with the condition as adults, the truth is that "we have very few firm numbers," says Dr. Xavier Castellanos, a leading ADD researcher at New York University.

In short, "There are more questions that are unanswered than are answered," says Lisa L. Weyandt, a psychologist at Central Washington University who studies college-bound kids with ADD. Nobody, she says, knows how these fledglings will fare away from home and neighborhood schools, and whether the medications that appeared to help them in grade school will continue to be of use to them as adults. "They are," Weyandt says, "in uncharted territory."

Schooling in adulthood

One reason that the terrain is unfamiliar is that this is the first generation of ADD kids for whom effective medication and accommodations for those with learning disabilities have made college a widespread possibility. "They're here and they're here in increasing numbers," Weyandt says. Barclay, now a freshman at Ohio State University, is typical of such youths in many respects.

When he was little, he says, his energy was so prodigious that his father had to sit at his bedside at night and hold his eyelids shut to help him fall asleep. "I was always going at 100 miles per hour

Looking back, he acknowledges that Ritalin did help him academically. But he also felt that it blunted his natural sociability, made it "hard to feel passionate about anything." And the same intensity of focus that helped him in class, he believes, impaired his instincts on the soccer field -- a troublesome side effect for a rising soccer star.

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