“When ADHD Is All in the Family”
The upside of knowing that ADHD is highly heritable.
If you or your child has ADHD, then someone else in the family has a good chance of having it, too. We learned this like a slap in the face, just about a year ago, in a counseling session for one of our two recently diagnosed-with-ADHD sons. Our therapist gingerly suggested my husband might have the condition as well. We were briefly taken aback—until we thought about it. “Once she said it, it seemed obvious,” said my husband. “Yes, I had it, too.”
It explained a lot, giving new insights and effective treatment options for my husband’s and our sons’ symptoms. When a father is diagnosed with ADHD, it is easy to feel guilty about “giving” the disorder to his kids. Instead, we felt positive about the diagnosis.
“I don’t feel responsibility in terms of heredity,” says my husband. “I had no control over it.” If anything, knowing ADHD is inherited takes away the worry that bad parenting or something else is to blame for the ADHD. Ultimately, the diagnosis was a relief.
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“ADHD makes for a chaotic household, that’s for sure,” he admits, but we now strive to embrace it and work with these challenges instead of against them. It also helps to know that, in coping with the compounding effects of multiple ADHD family members, we are in good company.
Studies show that if you have ADHD, your children have about a 35% chance of acquiring it; if a child has it, there is a 50% likelihood that one of his or her parents does as well. The remaining cases are caused by genetic mutations, prenatal problems, such as infection, hypertension, drinking while with child, or premature birth—or, after birth, head trauma, stroke, excessive lead exposure, or other neurological events.
Researchers have identified 25-45 (25 conservatively, but likely many more) different genes related to this complex disorder, says Russell Barkley, Ph.D., clinical professor of psychiatry at Virginia Treatment Center for Children and Virginia Commonwealth University Medical Center and author of Taking Charge of ADHD (and many other ADHD tomes).
“The more of these genes you have, the higher the risk of getting ADHD and the increased odds that the condition will be more severe,” explains Dr. Barkley. Interestingly, ADHD genes function more like physical traits than cognitive or emotional ones, in terms of heritability. For example, height is passed on through a 95% genetic contribution; 55% for intelligence; and 35-40% for depression and personality traits. “The golden average for ADHD heredity across studies is 75%,” says Dr. Barkley, often showing up closer to 90%. Studies with twins raised in separate households make clear that home environment doesn’t cause it. This is quite different from many other mental health disorders, such as anxiety, mood disorders, and conduct disorder, in which there is a greater interplay of genetic propensity and social factors.
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Social environment—in other words, parenting and the particulars of your background and living situation—is not the initial cause but plays a key role in accessing treatment resources, comorbidity (developing another disorder alongside ADHD), and coping with symptoms. These are the factors we can control and that have the greatest impact on alleviating symptoms and setting up kids (and adults) with ADHD for success. However, when the parent also has ADHD, achieving optimal results gets tricky.
Sharing the diagnosis has benefits and drawbacks, says Joel T. Nigg, Ph.D., professor of psychiatry and behavioral science at Oregon Health & Science University in Portland, Oregon, and author of the forthcoming book Getting Ahead of ADHD.
“When parents also have ADHD, it affects their parenting skills,” says Dr. Nigg. “On the positive side, it may increase empathy for the child and parent, and can help the adult understand a child’s behavior a bit better. At the same time, this can be a negative, feeding a cycle where the child overreacts, which causes the parent to overreact, too. This makes it harder for the child to self-regulate emotions.” The more the adult can keep calm and model self regulation, the better the chance the child will learn those skills as well.
“Remember, many kids and parents survive dual ADHD diagnoses,” says Dr. Nigg. “Do your best to get support for yourself and your child, and don’t beat yourself up when missteps happen. They happen to all of us, just a little more often with ADHD parents.”
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In our household, when calm and order start to fall away (with five kids, two of which have ADHD, this happens often), we try to take our kids’ lead—and really listen. Seeing eye-to-eye invariably helps—even if that means flopping on the floor along with them mid-freakout—as does replacing anger with levity. Every time we laugh instead of silently fume or yell, we are rewarded with more cooperative, connected kids. Plus, studies would undoubtedly prove, it’s harder to overreact (for parents and kids) when you’re giggling.