Hyperactivity goes long undiagnosed in adults

The Columbus Dispatch

COLUMBUS

Tiffany deSilva helps her clients deal with lost car keys, late bill payments, forgotten appointments — little things that can add up, eventually overwhelming them and frustrating their spouses.

The social worker provides coaching and hands-on organization for people with attention-deficit hyperactivity disorder, who often have difficulty with focus, memory and time management.

The more she worked with her customers, though, the more she realized that she has similar problems: Hyper-focused, she spends 30 minutes on a task when it seems like five; unfocused, she turns off the oven timer and immediately forgets to take out the burning rolls.

“I began to see myself in those people,” she said. “I realized that only people with ADHD think the way I think.”

At 32, the Dublin, Ohio, resident learned that she suffers with the neurobiological disorder she’d never before suspected in herself.

ADHD, a term that has largely replaced the name ADD (attention-deficit disorder), was once considered a childhood affliction that disappeared when kids matured.

But almost two-thirds of the children who had trouble sitting still in class grow up to struggle with the disorder in more-adult ways.

“It’s a very unrecognized, underdiagnosed condition in adults,” said Alan Levy, a North Side psychiatrist. “It absolutely causes havoc in the lives of so many people who struggle with this — both personally and professionally.”

About 4 percent of adults have ADHD, although many, such as deSilva, have unknowingly lived with the disorder for decades.

Some discover they have ADHD, thought to be largely inherited, when their child’s condition is diagnosed. Others learn about it only after treatment for other issues, having assumed that their attention problems stemmed from depression, anxiety or even personality traits.

The symptoms can seem to describe anyone feeling busy and overwhelmed: People with the disorder have trouble focusing, often lose their train of thought, miss deadlines and appointments, drive distractedly and misplace belongings.

But consistently inattentive or impulsive behavior isn’t easily understood by others, said Rob Eldridge, a therapist who runs a biweekly support group for adults with the disorder.

“To the world around us, we seem like we don’t care, like we’re not interested, like we lack motivation or we’re just not trying hard enough,” said Eldridge, who, while studying the disorder in college, learned he has it.

“That’s not true. Most of us spend our entire lives struggling for acceptance.”

Despite his engineering degree, support-group member Don Vreeland hasn’t worked in the field since 1997. He was fired from a product-engineering job, he said, because of poor social skills that can accompany the disorder.

Extremely talkative and energetic, he thinks he can come across as overbearing and obnoxious, sometimes speaking impulsively and out of turn. He unsuccessfully interviewed for engineering jobs for years before giving up.

“I’m Tigger: I bounce around; I’m very interactive, friendly, optimistic,” said Vreeland, 47, of the East Side. “But, at the same time, Tigger’s pretty much alone.

“It hurts because I care very much what people think — and, in fact, too much.”

But focus can also be helped by routine and organization: deSilva sets consistent times for waking up, seeing clients, making dinner, asking her kids to brush their teeth. She is constantly improving her organizational skills, as she’ll never grow out of the disorder.

“Really, what happens is, the older you get, the more you realize what you need to do to function,” she said. “You create habits and systems that support you in being your best.”