Do ADHD Adults Really Lose 3 Weeks of Work Each Year?

Do ADHD Adults Really Lose 3 Weeks of Work Each Year?

A new study claims they do.

It’s estimated that approximately 70% to 80% of all children will carry their attention problems into adulthood. According to the new study, this could present problems for their employers. The study, published in the Journal of Occupational and Environmental Medicine, found that ADHD adults worked 22.1 days less than other workers each year. Furthermore, the study found that they were unable to carry out normal work activities an average of 8.4 days per year, 21.7 days of reduced work quantity and 13.6 days of reduced work quality.

The study of 7,075 workers in ten countries was performed by the World Health Organization (“WHO”) research consortium at Harvard Medical School in Boston Medicine and partially subsidized by pharmaceutical giant, Eli Lilly. The WHO claims that an average of 3.5 per cent had ADHD.

Strangely enough, adult ADHD workers in the Netherlands actually showed improved job performance – exactly contradictory to all other trends in the study. The researchers explained this as an aberration. Historically, the Netherlands medicates persons for ADHD far less than other countries and has a particularly different perspective on attention problems.

This study tends to corroborate Dr. Joseph Biederman’s work (oddly enough, he’s with Harvard University too) that indicates ADHD adults collectively lose $77 billion each year due to workplace failure.

Dr. Joe Biederman and ADHD

Massachusetts General Hospital (MGH) issued a press release regarding a study performed by Joseph Biederman, MD and colleagues. Biederman is a professor of Psychiatry at Harvard Medical School.  The study finds that the use of stimulant drugs to treat children with ADHD has no effect on their future risk of substance abuse.

This study directly contradicts previous studies which indicate stimulant treatment could increase substance abuse risk.  The authors of the current study (Biederman, et al) maintain that previous studies produced conflicting results because they had several limitations; some only looked at adolescents, although young adults are at the highest risk of substance abuse. The authors argue that other studies did not control for conditions such as conduct disorder that are known to be associated with substance abuse. This is commonly referred to as co-morbidity and is truly the norm for ADHD as ADHD virtually never presents by itself. It is commonly associated with conduct disorder, learning disabilities, dyslexia, etc. The authors also maintain that other studies may have examined the impact on use of only a particular substance.

Biederman, like Russell Barkley, seems to get substantial funding from the pharmaceutical industry. That being disclosed, Biederman’s previous research tended to promote the use of stimulant medication [from www.Sciencedaily.com]:

“Earlier studies under the MGH Psychopharmacology group had suggested that stimulant treatment might actually reduce the risk of substance abuse in ADHD patients, who are at elevated risk to begin with…”

Imagine that! Taking stimulant medication in the same class as cocaine or speed in my early years would prevent me from desiring to use addictive drugs in my later years! Now that’s impressive, Joe. Obviously that was an untenable position, but Joe got the next best result with his try-again research methodology; it may not prevent substance abuse later on, but at least, Dr. Joe maintains, it doesn’t cause it.

“Because stimulants are controlled drugs, there has been a concern that using them to treat children would promote future drug-seeking behavior,” says Dr. Joe, the study’s lead author.

The MTA (Multimodal Treatment of ADHD) found that after three years of drug taking, they couldn’t find any difference in children medicated and children who had done nothing at all. The study’s authors said they witnessed no overall global academic improvement, behavioral improvement, or social improvement. They also found that children in their study had lower overall weight. Height was also less than peers.

What interests me greatly is the fact that when the authors of these studies have close ties to the pharmaceutical industry, their data tends to be skewed in favor of medicine. When there isn’t a close tie, we tend to get contradictory data, which is what one would expect.

I’m not an advocate of medicine, but I’m not an opponent either. It has its place and can help some children in the short-term. It must be supported with cognitive and behavioral interventions to maximize the opportunity for change. 

As far a research goes, all I want is the truth. Nothing skewed. No hidden agendas.

Girls With ADHD and ADD Are Often Overlooked

Girls With ADHD Are Often Overlooked

HealthNewsDigest.com – August 29, 2005 (HealthNewsDigest.com) reports that ADHD likely affects 3% to 7% of the entire child population in the US. However, girls are frequently overlooked because they often do not display hyperactive symptoms.

When teaching at the elementary level, I found this particularly true. Girls with ADHD often were simply daydreamers with poor time management skills. While some did display the outward social and behavioral problems that their male peers did, it was not very frequent.

HealthNewsDigest.com is published by the American Psychological Association. I’ve cited bits of this report and am alarmed by its look and feel. It reads like an endorsement and advertisement for Adderall XR.

Their report, edited down:

The federal Food and Drug Administrations (FDA) recent nod to ADDERALL XR for the treatment of attention deficit hyperactivity disorder (ADHD) in adolescents aged 13 to 17 spotlights an underidentified and under treated population with this disorder, experts tell Health NewsDigest.com.

If left untreated, the symptoms of ADHD can have a profound effect on a child’s life, both inside and outside of a classroom setting.

For Janice Lowder, a quiet, well-behaved child, learning was always stressful.

“My husband and I hired a one-on-one tutor to help Janice with her studies. We also tried to help her, and all dreaded the nightly battle of completing a homework assignment. Janice would get so frustrated with her homework and the fact that she didn’t ‘get it,’ that she would cry,” said her mother Beth Lowder.

“By the time Janice reached the seventh grade, a nurse at her school suggested we talk to a doctor. Janice was diagnosed with ADHD and was started on treatment,” Beth explained.

“I knew my daughter just needed the right help,” said Beth.

By the tenth grade, Janice had improved from a C to a B student but homework was still challenging. In addition, she had low self-esteem and was embarrassed to take her medication at school. Her psychiatrist prescribed Adderall XR®, an extended-release formulation that enabled Janice to take her medication once a day at home.

With continued tutoring and medication, her grades improved.

“She came home from school one day and said, ‘Mom, I’m smart,’” said her mother.

A recent study presented at the American Psychiatric Association annual meeting showed that girls with ADHD demonstrated significant improvement in both behavior and attention with Adderall XR.

“The study suggests that girls with ADHD can benefit from Adderall XR and that this treatment will help them control symptoms all day while they are in the classroom, during after-school activities or doing homework with relatively few side effects,” said Joseph Biederman, M.D., professor of psychiatry, Harvard Medical School and Chief of Pediatric Psychopharmacology at Massachusetts General Hospital. “While ADHD in girls is becoming more recognizable it is still often overlooked, and there is a need for safe and effective treatments that will allow girls to interact more effectively with other children and adults, to concentrate in school and to focus on finishing tasks.”

I’d expect to find a more diluted version in Parents Magazine or Family Journal as an outright advertisement. Makes one wonder who wrote this? Shire Pharmaceuticals?

Turning Adult ADHD Around

ABC News online probes the work of Robert Jergen, and ADHD adult who carefully manages and optimizes his attention difficulties.

What is important to realize in reading this report is that he is a minority; he is one of the very few ADHD adults who successfully manage their attention difficulties. Although his success story is quite moving, it is not the norm as Dr. Joseph Biederman found in his recent study that indicated ADHD adults lose $77 billion yearly to ADHD related job issues.

Also, note the fact that Jergen almost committed suicide because of ADHD. Obviously, what doesn’t kill you will make you stronger. However, one must wonder how many adults haven’t adapted and successfully put an end to their ADHD troubles by suicide.

What can be gleaned readily from Jergen is that ADHD is manageable using a variety of tools. The true question may be what enabled him to succeed where others fail?

ABC’s story:

Robert Jergen writes two books a year, works on several research projects simultaneously and, after finishing a PhD in half the normal time, began a successful teaching career. It takes a special person with special skills to complete such a heavy load, but one would never guess the secret to Jergen’s success.

“I have ADHD,” says Jergen.

ADHD, or attention deficit hyperactivity disorder, is often considered a childhood disorder. Yet an estimated four percent of adults may also suffer from the hyperactivity, inattentiveness and impulsivity that ADHD causes.

With information about this disorder spreading quickly, many adults are suddenly realizing that their previously unexplainable childhood and adult problems may have stemmed from ADHD. Jergen, now in his late 30s, didn’t have a name for his problems until he was 22, and ironically, taking a class on special education.

But, as Jergen explains in his book, The Little Monster, the signs started much earlier.

“As soon as my eyes would pop open after a nap, the crib would start to tremble and [my mother] would always know when the little monster was awake,” says Jergen.

Growing Up Different

The nickname “little monster” was bestowed upon Robert as he destroyed everything in his path; his parents just didn’t understand that he couldn’t control his actions. Jergen describes numerous situations where he would impulsively throw a knife, dismantle a lamp or toss lit matches at a model ship, each time thinking a moment too late, “Now that wasn’t such a good idea.”

It’s not that Jergen didn’t know right from wrong; he just acted without realizing. And being hypersensitive, like many other ADHD children, Jergen’s head is still filled with his mother saying over and over, “Jesus Christ, give me strength! You are such a rotten kid!” even though he is not entirely sure if she ever said it more than once.

It was the constant disappointment and scolding, both at school and at home, and constant comparisons to his athletic, intelligent, sweet brothers that caused a slow slide into depression.

“I always heard, ‘Rob, I love you, but you don’t do what you’re told, you don’t finish what you start, you do things without thinking,’” he says. “And what I grew up hearing was, ‘I really don’t love you, but I would, if you would stop doing this.’”

By eighth grade, Jergen had twice attempted suicide.

The Lowest Point

Jergen’s outlook improved after meeting an accepting group of friends in high school, but the hopelessness returned in college when he fell in with a group who called themselves the “All-American Drinking Team.”

Jergen, typical of those with ADHD, found alcohol to be the one tool that could be used to quiet his head, which helped him concentrate in class, improve his grades and calm his constant anxiety over how he appeared to others. But alcohol also brought out years worth of pent-up rage. So, after an ugly night at a bar, Jergen realized he had to stop drinking.

With the drinking stopped, Jergen’s head became noisy again. And while he loved his job teaching adolescents with special needs, it was the quiet paperwork, long meetings and coworkers angry with his antics that made work miserable. The stress was quickly driving Jergen back to alcohol and depression.

To try to stem the tide, Jergen returned to school, where he last felt most comfortable. It would be here that he would receive an answer to all of his problems.

A Wall of TVs

At the beginning of a master’s program, Jergen’s condition became steadily worse. Rude comments would just pop out of his mouth without him even realizing. He once poked his boss in a thin patch of hair and proclaimed “bald spot!” Unable to concentrate on any of his reading assignments, unable to control his actions or even his mind, Jergen was again considering suicide.

Oddly enough, Jergen would find help in a student, Troy, who had schizophrenia. Jergen was furious one day when he found out that Troy was not taking his medication and lectured him about how smart and successful he could be if only took a little pill every day.

A bell went off in Jergen’s head.

“I thought, ‘you are such a hypocrite. You are just sitting there waiting for death or a white padded room. Maybe there is some drug that you could take to make you normal.’”

This was the beginning of Jergen’s turnaround. After countless therapy sessions, incorrect diagnoses of hypoglycemia and hyperglycemia, an abnormal MRI and EEG (two tests that are commonly used to diagnose ADHD), Jergen happened to attend a support group meeting of ADHD adults for a special education class, when someone said:

“My mind is like a wall of television sets, each on a different channel and I don’t have the remote.”

For the first time, Jergen found a way to describe what was going on in his head. “One second I thought that I was a loser. A freak,” he says. “The next moment I knew that I had ADHD. I wasn’t alone.”

Turning ADHD Around

Most patients with ADHD go through years of trying different types and doses of medications before a successful combination is achieved. For Jergen, after two years of trying various medications with no success, or unbearable side effects, he became resolved to make ADHD work for him, instead of relying on medications to control it.

Jergen is not against medication, and he openly agrees that it can help one focus. “But medications do not teach people to learn, do math or act appropriately,” he says. So, he reminds parents and teachers that one will not just “get better” with medication and advocates behavior therapy to help a person with ADHD learn the organizational and social skills they may not have learned as a child.

For Jergen, however, the goal became to use the hyperactivity of ADHD instead of masking it. “All my problems were when I was trying to slow down, when I was trying to go at everybody else’s pace,” he says.

He became hyper-productive. Jergen kept a log outlining when and where he got the most work done. Then, he designed a work environment that would push out distractions and allow him to remain focused.

For example, Jergen’s office is dimly lit with one bright light shining on his computer, constantly reminding him where his attention should be. Soft music playing in the background blocks any outside noise. A computer game runs on a nearby laptop to give him something to do for a few seconds when his mind begins to wander. If the heavy clouds of ADHD begin to roll into his head anyway, Jergen hops on his treadmill. He has found that a short burst of exercise clears his head and allows his focus to return.

Most importantly, Jergen understands the importance of a strong support system. An honest, encouraging mentor got him through his PhD program and, now, his wife helps to keep him on track, reminding him to take a walk when he seems most on-edge. It is this support system that has helped Jergen build his self esteem after so many years of failures.

There are still problems. Jergen has a hard time staying quiet when his students are taking a test, and not everyone at work is so understanding of his disorder. Even his parents still doubt that he has ADHD, saying instead that he just needs to try harder. Nevertheless, Jergen is currently testing some of his techniques to see if they will help others with ADHD turn their greatest challenge into their greatest advantage.

“Don’t repress ADHD, utilize it,” says Jergen. “ADHD is A-OK.”