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(July 11, 2006) - - Like many young mothers, Sophie Currier is a busy woman. There's all the family stuff at the Brookline, Mass., home she shares with her partner, Jeremie Gallien, and their 7-month-old son, Theo. There's work, a teaching assistantship for a biochemistry course at Harvard University.
And there's school. After majoring in biology at the Massachusetts Institute of Technology, Ms. Currier got a Ph.D. in neuroscience from Harvard and is on track to get her M.D. a year from now.
The striking thing is that Ms. Currier does all this not only with severe dyslexia – she couldn't read until she was 8 – but with ADHD, or attention deficit hyperactivity disorder, as well.
The impulsivity, inattentiveness and hyperactivity of people with ADHD can limit the quality of their work, get in the way of their relationships, and severely damage their self-esteem.
Researchers used to think that ADHD, which is often accompanied by dyslexia, or problems with reading, was primarily a problem for children. About 8 percent of American children, roughly 4.5 million, have been diagnosed with ADHD.
Researchers also used to think that children would grow out of it.
But it's clear now, as more of those children become adults, that many of the children with ADHD, perhaps more than half, do not grow out of it. That explains why so many adults – currently about 8 million in the United States – have the condition.
Another thing research has made quite clear: ADHD is a biological, inherited disorder. It is not, as had been once thought, "caused by bad parenting or weak character," says Dr. David W. Goodman, a psychiatrist and adult ADHD specialist at Johns Hopkins University School of Medicine who also consults for companies that make ADHD drugs. "It is a neurological condition validated by medical research whose impairments can be reduced by effective treatment."
The sad part is that, unlike children whose teachers often spot the symptoms, many adults do not acknowledge the symptoms in themselves, even when spouses, friends and co-workers try to tell them.
That means that they often do not get diagnosed until their child is diagnosed, Dr. Goodman says.
There's no objective screen such as a blood test for ADHD, but psychiatrists have developed clear-cut criteria for deciding when a person may have it.
Adults with ADHD live lives characterized by "unexplained underachievement," says Dr. Ned Hallowell, a psychiatrist and the co-author of several books on ADHD.
People with ADHD are chronically late, says Dr. Hallowell, who has ADHD. They're disorganized. They lose things. They can't pay attention. They manage money poorly. They can't understand why everybody's always mad at them.
"These people are a pain in the butt," Dr. Hallowell says. "But what I've learned in 25 years of treating them is that when you reframe this in a medical context, a life can turn around. They go on to become the kind of person they are meant to be."
Ms. Currier obviously seems like a high achiever from the outside, but her days are punctuated by the things, both small and big, that she does to overcome her ADHD.
She keeps lists of everything. She sets her clocks ahead so she'll have a prayer of making it anywhere on time. She uses her PDA constantly to remind her of where she needs to be and what she needs to be doing.
"I'm very disorganized," she says. "The biggest thing is distraction. ... I have trouble starting a project, then I have a hard time stopping it."
If you are an adult and think you may have ADHD, there's a lot you can do.
First, don't resist the diagnosis. "People with ADHD are not good self-observers," said Dr. Hallowell. If your child has been diagnosed with ADHD and your spouse, friends, or co-workers suggest that you might have it too, take that seriously.
Then, consider medication. An estimated 80 percent of people with ADHD improve on medications, says Dr. Hallowell, who does not take any money from drug companies.
The U.S. Food and Drug Administration is debating whether to put its most serious "black box" warnings on prescription ADHD drugs because of possible rare cardiovascular and psychiatric side effects, but an advisory panel recently recommended against such a warning.
The drugs most often used are stimulants called methylphenidates (Ritalin and Concerta) that boost dopamine levels, or another class of stimulants called amphetamines (Adderall and Dexedrine) that also boost dopamine and another brain hormone, norepinephrine. A skin patch containing methylphenidates was approved in April.
A different kind of drug called Strattera also works by boosting norepinephrine; the medication carries a "black box" warning saying that suicidal thinking may increase on the drug. A pine-bark extract called Pycnogenol also may help, according to a study in this month's European Child and Adolescent Psychiatry.
But there are nondrug solutions, too. Most important: Get help when you need it.
Sophie Currier made it through MIT – brilliantly – in part because the school paid other students to read books to her and share their class notes.
By the time she was in graduate school, MIT provided computers that scanned books and read them aloud to Ms. Currier. She was also allowed extra time on exams.
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"MIT is a haven for someone like me," says Ms. Currier, who plans to put her education to use by studying the genetics of ADHD, among other neurological disorders. "It was very easy because I was in an environment that supported me."
You can also get a life coach, says Dr. Hallowell, not necessarily a trained mental health professional, but someone who can help you get organized, make lists and check up to make sure you get things done.
Do the little things right, such as always putting your keys in a basket by the door. Find a good accountant to help with money matters. Post reminder signs around your house.
And, as Sophie Currier's father, Richard, puts it, "Marry someone without ADHD."
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