Finding life amid disorder

Carol Fulton always knew she was different. Impulsive and easily distracted, she read slowly and raced out to tear up the soccer fields at recess.

She grew into an adult who frequently felt embarrassed over her blunders. She’d wax three-quarters of her car and neglect to finish the rest. She’d leave the sugar out of the chocolate chip cookie batter or the baking powder out of the muffins. She’d fill the washing machine with water, add laundry detergent to dissolve, then wander off and forget to add the clothes.

It was a huge relief in her 40s to finally hit the right diagnosis – attention deficit hyperactivity disorder – which mental health professionals now believe afflicts adults as well as children. Researchers say 2 to 4 percent of American adults, as many as 8 million people, have this disorder.

“The awareness is just exponentially more than it was when I started working with adults with ADHD 10 years ago,” says Andrew Forsyth, a Spokane psychologist. He devotes 25 to 30 percent of his practice to working with clients with this disorder.

As the media point attention to ADHD and pharmaceutical companies increase their advertising for the medications that treat it, more adults have begun to seek treatment, he says.

Fulton, a Mead special-education teacher, sought treatment for depression long before she realized she had the disorder. Over the years, she felt propelled to pursue endless exercise – her favorite form of self-medication for the restlessness and disorganization within.

She ended up in psychologist Amy Johnson-Colwell’s office.

“Life is too hard, and I don’t understand why,” Fulton told her.

As they worked together, Johnson-Colwell noticed signs that pointed to a diagnosis of ADHD.

“It fit,” says Fulton, now 46. “It fit like a glove.”

Psychologists find the symptoms may vary. Those who were diagnosed as children, Forsyth says, often continue the same complaints: They’re restless, impatient, inattentive, unsatisfied and impulsive. They make poor choices and display poor judgment.

Those diagnosed as adults, he says, often describe communication difficulties, impatience, anger or mood problems, low self-esteem and a feeling of being unsuccessful in life.

The diagnosis includes sub-categories for people who primarily have symptoms of inattentiveness as well as those whose hyperactivity predominates.

While many people have some of these symptoms, they don’t necessarily have the disorder.

“The hallmark of ADHD would be both the severity and persistence of these problems,” says Forsyth.

Psychologists such as Forsyth and Johnson-Colwell say they use detailed assessment tools to make the right diagnosis. They compile a developmental history, looking for evidence of symptoms in childhood, and they often ask the clients’ spouse or parent to provide additional information.

“Someone in their 40s is not likely to develop this disorder out of the blue,” Forsyth says.

Mariellen Fischer, professor of neurology at Medical College of Wisconsin, and her co-author Russell A. Barkley, have just completed a 13-year longitudinal study of ADHD from childhood into adulthood.

They followed a group of 149 children diagnosed with ADHD, along with 72 neighbor kids without the disorder, and followed up with them at age 21.

They discovered that those with ADHD were far less likely to be in college (21 percent vs. 78 percent) and far more likely to have experienced teen pregnancy (38 percent vs. 4 percent).

Young adults with ADHD were less likely to use contraception and significantly more likely to have unpaid bills, speeding tickets and car accidents.

“They’re significantly poorer drivers in terms of how others rate them,” Fischer says.

Cynthia Hammer, director of a non-profit group called Attention Deficit Disorder Resources in Tacoma, discovered she had the disorder when she was 49. She still sometimes refers to it with its outdated name, attention deficit disorder or ADD.

“When I hear about other people with ADD, I always say I didn’t have a bad case of ADD, but it was bad enough.’ ”

She was easily distracted. On one preschool holiday, she dropped her son off anyway, and he sat on the porch for 2 ½ hours. She always wound up paying for missed haircut appointments. She frequently received driving tickets.

She finds adults with ADHD rarely have a coherent conversation, interrupting or changing the subject when they’re bored. They often lack time management skills, she says, and they seldom learn from their mistakes. She’d slide bread under the broiler for toast and always wind up burning it.

Now 62, she’s found medication and new habits that bring order to her life. She makes lists, plans her day and figures out how much time it will take to reach a destination in advance. She’s more successful than ever before.

“The role I’m in as director of this organization – I never would have been able to manage that,” she says.

Johnson-Colwell notices similar improvements in the lives of her clients.

“One woman said, ‘I’m back. I can think more clearly. I can plan. I can sequence. I can get things done,’ ” Johnson-Colwell says.

The treatment often includes therapy, coaching and referral to a psychiatrist for medications to alter the brain’s chemistry. These drugs affect the neurotransmitters dopamine and norepinephrine.

They include stimulants such as Ritalin, Adderall and Concerta, antidepressants such as Wellbutrin and a newer non-stimulant called Strattera.”There’s like 10 medications out there for ADHD,” says Hammer. “It’s like buying a pair of shoes – (they’re all Nikes), but one will feel better on you than another.”

Johnson-Colwell and others believe that ADHD can also bring positive aspects to a person’s life, such as creativity, high energy and the ability to multi-task.

But Fischer says she and her fellow researchers haven’t verified these benefits.

“We don’t think there are things about the disorder that are gifts,” she says.

Perhaps the person’s other talents and resources help compensate for the disorder. Athleticism is one of Fulton’s. This year, as she takes a leave of absence from the classroom, she’s managing to log 5,000 miles on her bike. She’s also an avid skier.

Her husband helps her finish household chores like the laundry and the vacuuming that she can’t complete, and a good friend helps her shop for clothes.

But Fulton also believes she’s discovered positive aspects of the disorder. One of the most significant has been her unique ability to help special education students with ADHD. Long before she ever suspected her own diagnosis, she says she instinctively knew to seat them close to her, give them plenty of structure, and keep her directions simple.

She also relies on creativity, an “out there” sense of humor, intuition, and quirky ways of solving problems.

The medication she takes cleared up the fog in her brain “like a badly needed pair of glasses.”

As her life continues to improve with treatment, she finds herself completing projects she’s long ignored, reading voraciously and beginning to draw and play the guitar again. She’s also setting up her own business as an academic tutor.

Best of all, she’s happier, more self-confident and finally recognizing she’s smart. “I laugh at myself now,” she says with a smile, “rather than say, ‘God, you’re stupid!’ “