Modern mom’s stress, or ADHD?

(Extraído de Journal Gazette)

Brigid Schulte | Washington Post

WASHINGTON – At a few minutes shy of 3 p.m., Michelle Suppers pulls her minivan into the parking lot at a Catholic school in Virginia, where her son, Anthony, attends first grade.

For most of the mothers already queued up in the pickup line, this is probably not a big deal. But for Suppers, who for as long as she can remember has always been late to just about everything, the effort required to plan her day, watch the clock and make it to the school on time is nothing short of Herculean.

“I lose track of time,” she says, flushing pink with embarrassment.

On the console beside her seat in the van are two library books she needs to return. Both are overdue.

Anthony, 6, dressed in his nicely pressed uniform blue shirt and gray pants on this crisp fall day, smiles at her as he climbs into the car seat behind his 3-year-old brother, Christopher. Anthony chatters nonstop about the art project he did, what he ate for lunch and how he had a “green” day.

A green day means he didn’t interrupt the teacher, pester his classmates, jump up from his seat, fidget, forget to turn in his homework, space out wondering about the clouds out the window or stare at the blank paper on his desk that he is supposed to be filling up with classwork.

Suppers, 30, pulls out of the parking lot and begins to explain that Anthony has attention-deficit hyperactivity disorder, or ADHD …

“Mommy,” Anthony chirps from the back of the van.

… That, though he’s smart, he has a tough time sitting still, getting going on things that bore him, such as homework, and that he is easily distracted or frustrated in school …

“Mommy,” Anthony persists.

… And how, the more she learns about his ADHD, the more she wonders …

“Mommy!”

…. whether she has it herself.

Frazzled at home

Since Suppers quit a job a few months ago that she loved but felt she couldn’t manage along with the house and the kids, she is also bracing herself for what is now her most stressful time of day: managing to keep their two dogs outside and Christopher downstairs in the playroom so the living room will be quiet. That’s where she helps Anthony with the homework that is always a fight to get him to do.

But in the kitchen, the counters and table are awash in scraps of paper, kid artwork, opened and unopened mail, bills and toys. For meals, Suppers sometimes shoves the clutter to one end, and the family eats at the other. Lately, they’ve taken to eating in front of the TV in the living room.

When the homework battle has finally finished, her husband, George, arrives home. He takes over cooking dinner when she gets distracted looking through piles of paper on the counter for a sticky note he left her about a car repair the week before that she forgot about.

He is convinced that she has ADHD. He teases her that she has never made a decision in her life, not even about what to order for dinner.

“There’s just always way too much stuff going on in my head,” she says. “It feels kind of silly trying to make serious conversation about it. Other people have it so much worse. I think if I didn’t have the kids, I’d think, this is the way I am, so whatever. But I worry about passing it on.”

Growing diagnosis

Attention-deficit hyperactivity disorder has variously been called “minimal brain dysfunction,” “hyperkinesis” or a “defect in moral control.”

Its hallmark symptoms are the inability to pay attention, get organized, or start or finish tasks; a penchant for spacing out, forgetting or losing things; and, for some, the inability to sit still, stop talking or be patient and a tendency to act or blurt things out impulsively. They’re traits long thought to affect only children. Particularly boys. Particularly disruptive boys in school.

In the 1990s, studies to determine the causes of ADHD began to find that it ran in families. And, far from disappearing as children grew up, as had been the assumption, the disorder could last a lifetime.

Now, surveys by Harvard Medical School, the National Institute of Mental Health and the World Health Organization report that, conservatively, about 4.4 percent of adults in the United States, or 8 million people between ages 18 and 44, have ADHD, making it the second most common psychological problem in adults after depression.

But with only 15 percent having a diagnosis or seeking treatment, most of them, apparently, don’t know it.

Adults with ADHD have been found to be more likely to lose a job, change a job or not show up for work, costing an estimated $77 billion a year in workplace failure.

They are more likely to get divorced, go broke or be arrested. They have four times as many accidents. They experience more relationship difficulties, sleep problems or substance abuse addictions. They have higher rates of eating disorders, depression and anxiety than the general population, and lower educational attainment and earning potential.

Nearly half of the estimated 5.2 million Americans in 2005 taking prescription ADHD medication – the majority of which are classified as Schedule II controlled substances so powerful that they can be prescribed only in 30-day doses – are adults.

Women, whose average age at diagnosis is 36 to 38, now account for the fastest-growing group taking prescription ADHD medication.

It’s not that women are suddenly coming down with ADHD. It has been there all along and no one noticed, says Patricia Quinn, a physician in Chevy Chase, Md., who was one of the first to work with girls and women with ADHD 30 years ago. As girls, these women were more likely to be spacey, inattentive, easily distracted and disorganized rather than hyperactive – the last of which, for decades, was considered the key to diagnosis.

For years, the disorder was diagnosed in 10 times as many boys as girls. Now it is diagnosed in adult men and women in equal numbers.

Critics of the increasing ADHD diagnoses say the disorder is just the latest medical fad, that it is overdiagnosed and that too much medication is being prescribed too freely based on the results of studies paid for by large pharmaceutical companies looking to expand their market without understanding the long-term consequences to the human brain.

“Look,” Quinn says, “Everyone loses their keys or glasses sometimes, shows up late once in a while or forgets to do the laundry. ADHD is on a spectrum of normal human behavior.

“To have the disorder, we’re talking about people who do this all the time – to the point where it affects all aspects of their lives, their work, their marriages and their children. People don’t realize how devastating ADHD is for women.”

Getting help

Though she’d never really heard of ADHD before, Michelle Suppers first began to suspect she may have it in the summer of 2009.

Anthony was 4. He was a sweet, smart kid, but he couldn’t sit still. He argued constantly. And he was getting into impulsive fights with other kids at two different preschools. On the advice of a concerned teacher, she took him to a behavioral specialist who gave her and George reams of questionnaires to fill out.

As they sat on the couch late one night completing the paperwork, Suppers began to see not just her son but also herself.

Suppers began reading about ADHD, often late into the night, and discovered that once it is diagnosed in a child, studies have found a 40 percent chance that one or both parents also have it.

In December, Suppers finally makes it to a psychologist for an ADHD screening. She sits stiffly on the edge of a chair and talks fast, interrupting herself, digressing and coming back to elaborate on points she’d made earlier, leaping decades forward and backward as her life story spills out.

The psychologist stops Suppers. “There’s a party going on in your head. Everything’s all jumbled up inside, and you don’t know where to begin?” Suppers nods. “And this has been going on since you were a child?” Suppers nods again.

The psychologist sets down her notebook. “You meet all the criteria.” Michelle Suppers is officially diagnosed with ADHD.

The psychologist tells Suppers that now she needs to work on learning life skills to better manage the disorder. She recommends some sessions of cognitive behavioral therapy and coaching. And if Suppers wants to see whether medication can help clear the fog in her brain, the psychologist tells Suppers to go back to her doctor for a prescription.

“You help yourself,” the psychologist says, “you help your son.”

She meant to call the doctor for a prescription. But then came the holidays. Then her father got sick and was in the hospital. Then, in the spring, Anthony’s behavior in school got worse. She had started to walk more for exercise, but that didn’t help much.

She thinks the prescription could change her life. For Suppers, it’s more just a matter of getting around to making the call.