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- By Peter Jaksa, Ph.D.
Shay and Stanley Lipton were sitting in my office describing their nine-year-old son, Brian. "We're getting daily reports from Brian's teacher. He refuses to follow directions and do what he's told, unless it's something that he wants to do. She has to remind him constantly to stop bothering the other kids and get back to work." Even worse, Brian was starting to hate school and seemed increasingly frustrated with himself. He was making many negative comments about himself, such as "I can't do it" and "nobody likes me, I'm a jerk."
Everyone knew that despite his difficulties, Brian was a bright child and quite capable of learning. An evaluation confirmed what the parents suspected: Brian had AD/HD, Combined Type.
During the process of Brian's evaluation and discussions about the biology and genetics of AD/HD, his mother gained some surprising insights of the impact AD/HD can have on the lives of individuals and families over many generations. For the Lipton family, additional evaluations for Shay and her father (as well as the revealing behavior of other family members) became a vivid history of this impact, told along a time chronology that spans more than 60 years.
- It Began with Brian's Grandfather...
Shay's father, Buck, was born in 1940. In grade school, Buck felt frustrated and bored in his classes to the point that he became the class clown, primarily to entertain himself. He could not stay focused long enough to read textbook assignments, complete homework assignments, or study for tests. Failing grades led to truancy, which led to more failing grades.
Shortly after beginning his senior year in high school, Buck stopped going to classes and got a job in an auto repair shop. He loved working on cars and certainly had no problems focusing on that work. When the auto shop closed, Buck went through a number of short-lived jobs - "anything I could find." After six to twelve months in one job he either quit out of boredom or was fired for various reasons. He was never on time, never organized, and quick to get upset and get into conflicts with his bosses and co-workers.
Buck's father pulled some strings to get him a job working on the assembly line at the auto plant where he also worked. Buck found the repetitive, monotonous nature of this work so unbearable that he quit after only one week. This decision led to a very angry confrontation with his understandably embarrassed father, and shortly after Buck moved out of his parents' house.
In his late 20's Buck went to work for his uncle, who needed help managing his commercial landscaping business. He found himself poorly suited for office managerial work due to problems with organization and planning and difficulties managing paperwork. In addition he was, once again, getting bored silly with his job but did not want to quit and betray his uncle's confidence in him.
Buck requested the position of lead salesman for the company and responsibility for training and supervising the sales team. His lively enthusiasm and excellent people skills made him very effective in this new area of responsibility. Within several years he helped build the business into the largest commercial landscaper in the state.
- His Great Uncle Probably Had It Too...
Buck's youngest brother, Barry, went through a childhood that was even more problematic than Buck's. Barry was restless, impulsive, and rebellious. He had a quick temper and got into numerous fights. He was a thrill seeker, for example hitching rides on passing freight train cars and then jumping off after a while.
Barry had problems similar to Buck's when it came to staying focused in class and completing schoolwork. He was expelled in the 11th grade for repeatedly fighting at school and possession of marijuana. He never returned to complete his high school education or obtain a diploma. Relationships with his parents were understandably strained due to his school problems, drinking and drug use, and disregard for rules or consequences.
The family conflicts ended when Barry was drafted into the army. He enjoyed being in the military, was considered very good at his duties, and apparently benefited from the structure that military life provided. Barry's army unit was shipped to Vietnam in 1968, and he was killed in combat later that year. He was 22 years old.
- Brian's Mother is Diagnosed with Inattentive Type...
Shay is a 36-year-old mother of three and a graphic arts designer who describes her childhood as being happy and uneventful. She was a "huge daydreamer" throughout her grade school years, and spent much of her free time drawing and writing poetry.
Shay does recall problems with poor attention and concentration dating back to early childhood, though. She did well in classes she liked, but had to work extremely hard to complete the work in classes that did not hold a strong interest for her. Studying for tests was an exercise in frustration because even after studying for hours, on the day of the test she would forget what she had studied. In general, trying to keep up with schoolwork was an exhausting and frustrating experience for her.
Shay still has difficulties with maintaining concentration on the task at hand. She finds it difficult to read for more than 15 or 20 minutes without her mind wandering, but she very rarely has problems focusing when engaged in her graphic arts work.
The responsibilities involved in raising three young children and managing a household are more demanding and stressful for her than her job duties had been. Her struggles with maintaining a household are raising doubts in her mind about her competence and taking a toll on her self-esteem.
- And His Aunt Might Have AD/HD Too
Shay's sister, Sharon, is five years younger. Although the sisters are close, they grew up with very different interests and different circles of friends. Shay describes Sharon as highly distractible, impulsive, and forgetful. "She's a lot like me, but she's very hyper." Sharon is still trying to decide what career, if any, she wants to pursue. She went to three colleges over the course of six years, but quit in frustration after only earning two years worth of credits.
Sharon was diagnosed with severe depression after dropping out of college and was treated with antidepressant medication. Her medication, along with the work of several different therapists, did not provide significant benefits for her. She went though an inpatient treatment program for substance abuse, at age 24, but had a relapse shortly after.
- Lost Opportunities, New Hopes
When Buck and Barry grew up in the 1940s and 1950's, AD/HD did not even exist as a concept. When Shay and Sharon attended school in the 1970's and 1980's, our understanding of AD/HD was still very limited and focused primarily on hyperactive young boys. The availability of accurate diagnostic protocols and effective treatment methods was still many years away.
At age 63, Buck wonders what might have happened if he and his brother had been diagnosed and treated when they were growing up. Certainly the school failures and many of the behavioral and family problems might have been prevented. He wonders if Barry's short, troubled life might have been happier.
Shay has strong concerns about her sister Sharon and has been discussing issues related to AD/HD with her. How might things have been different if Sharon's suspected AD/HD had been diagnosed and treated five years ago, along with her depression and substance abuse? Could the years of struggling, pain, and treatment failures have been averted? The question makes her angry, but she also realizes that there is still much Sharon can do to help herself. The ball is now in her sister's court.
Shay also asks herself how her life might have been different if she knew 25 years ago what she knows today about AD/HD; but not being one to live in the past, she is now focusing her energies on helping herself in the present.
Adults with AD/HD like Buck, Shay, and Sharon, although sometimes wondering "what if," also have new opportunities and many reasons to count their blessings. Though much remains to be done in furthering our knowledge about AD/HD and improving treatment options, it is almost startling to realize how rapidly advances have been achieved. Brian is the fortunate one in his family - his parents now have options to help him that were not available to past generations.
Peter Jaksa, Ph.D., is a Clinical Psychologist in Chicago, IL. He is the Parenting Editor for ADDitude Magazine and serves on the Scientific Advisors board. Dr. Jaksa is president and Clinical Director of ADD Centers of America, LLC. He serves on the Board of Directors of the Attention Deficit Disorder Association, and is a past president of the organization. Dr. Jaksa may be reached via e-mail at firstname.lastname@example.org .