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Monthly NewsNote
May-June 2008
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ADD Adults Off Medication – Think Again
I have noticed that several adults I have spoken with
recently and who should be on medication are not. This is a
problem for the individual and can negatively affect their
life in many ways. I’d like to discuss the topic,
starting with a few cases to demonstrate the problem.
Jack is a 26 year old carpenter sent in by a friend. He is
impulsive, distractible, poorly organized and cannot think
anything through. He is quite skilled at his trade, but has
trouble completing a job, forgets his expensive tools, and
spends too much money.
History showed that he had been diagnosed with ADHD in 5th
grade and actually treated for a short time with Ritalin.
He knew he had ADHD but never associated his current
problems with his condition. He was anxious to be helped
and we are both working to improve his difficult situation
Quite different is Phil. He is 25 and was diagnosed with
ADD 10 years ago. After a few successful years on
medication he stopped, and soon after dropped out of
college. After a while he started a business which has
become quite successful. As the business grows, however,
the demands of organization, attention to detail, focus,
etc., increase. Since it is a one-man business it falls to
Phil do all these things, and it has become quite difficult
for him. After discussion, he has again decided against
medication. I’m worried about his business and
frustrated by his decision. I hope it works out for him.
A third type of situation is Frank, a 32 year old attorney.
He was diagnosed as a child and used medication effectively
until the end of law school. He then decided he could do
without and stopped. I had never met him until he came in
to discuss medication. While he had done reasonably well,
he felt his distractibility was holding him back. In fact,
he had been struggling since stopping his medication and
should not have done so. His career has picked up since
going back on the stimulant.
I think that there is a rather large group of ADD adults
who were diagnosed as kids, treated for a while, and then
left to their own devices. The families did not understand
or care about the implications of the condition, and the
child was on his own. There were often behavior problems
starting in middle school and early dropout in high school.
Many are unsuccessful, but others end up with specialty
skills such as electrician, air conditioning technician or
carpenter. These are the people I work with now and treat
with medication. It has made a great difference in their
ability to learn, to complete work in an organized way, or
even to play golf.
These people have family doctors and it is very important
that early ADD be asked about as part of a history. This
will allow this group, previously diagnosed when young, to
be referred for evaluation and treatment.
The other group under discussion in this article is
probably more sophisticated. They are aware of ADD and its
effects but at some point decided to stop medication. This
can have significant impact in terms of job advancement,
marital success, etc. People do change their mind. If you
are working with a patient who might be helped by
medication, bring up the topic.
Adults with ADD who have been helped by treatment but who
stopped for some reason are many. A therapist or physician
who works with them might be of great help by discussing
the condition.
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