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Doctors diagnose adults with methods similar to those used with children. Patients are sometimes asked to dig up old report cards for clues to their childhood behavior -- an essential indicator. Many adults seek help only after one of their children is diagnosed. Such was the case with Chuck Pearson of Birmingham, Michigan, who was diagnosed three years ago, at 54. Pearson had struggled for decades in what might be the worst possible career for someone with ADD: accounting. In the first 12 years of his marriage, he was fired from 15 jobs. "I was frightened," says Zoe, his wife of 35 years. "We had two small children, a mortgage. Bill collectors were calling perpetually. We almost lost the house." Chuck admits he had trouble focusing on details, completing tasks and judging how long an assignment would take. He was so distracted behind the wheel that he lost his license for a year after getting 14 traffic tickets. Unwittingly, Pearson began medicating himself: "In my mid-30s, I would drink 30 to 40 cups of coffee a day. The caffeine helped." After he was diagnosed, the Pearsons founded the Adult Attention Deficit Foundation, a clearinghouse for information about add; he hopes to spare others some of his own regret: "I had a deep and abiding sadness over the life I could have given my family if I had been treated effectively."
PERSONALITY OR PATHOLOGY? While Chuck Pearson's problems were extreme, many if not all adults have trouble at times sticking with boring tasks, setting priorities and keeping their minds on what they are doing. The furious pace of society, the strain on families, the lack of community support can make anyone feel beset by ADD. "I personally think we are living in a society that is so out of control that we say, 'Give me a stimulant so I can cope.' " says Charlotte Tomaino, a clinical neuropsychologist in White Plains, New York. As word of ADHD spreads, swarms of adults are seeking the diagnosis as an explanation for their troubles. "So many really have symptoms that began in adulthood and reflected depression or other problems," says psychiatrist Silver. In their best-selling new book, Driven to Distraction, Edward Hallowell and John Ratey suggest that American life is "ADD-ogenic": "American society tends to create ADD-like symptoms in us all. The fast pace. The sound bite. The quick cuts. The TV remote-control clicker. It is important to keep this in mind, or you may start thinking that everybody you know has ADD."
And that is the conundrum. How do you draw the line between a spontaneous, high-energy person who is feeling overwhelmed by the details of life and someone afflicted with a neurological disorder? Where is the boundary between personality and pathology? Even an expert in the field like the University of Chicago's Mark Stein admits, "We need to find more precise ways of diagnosing it than just saying you have these symptoms." Barkley also concedes the vagueness. The traits that constitute ADHD "are personality characteristics," he agrees. But it becomes pathology, he says, when the traits are so extreme that they interfere with people's lives.
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