Scatterbrain: do you feel like an engine revving in neutral—putting out lots of energy, but not getting anywhere? ADHD could be sabotaging your career and relationships

ONE YEAR, I DECIDED TO TEACH YOGA, home-school my son, join a singing group, and remodel the kitchen. These (and other) projects came up just after I'd finished my degree in interior design and certificate in ayurvedic medicine, published a journal, and redesigned my garden. Somehow I managed to get it all done, which is impressive considering my commitment could usually be measured in days or weeks, not months or years.

When taking stock of my 43 years, I see this same pattern repeated again and again: boundless enthusiasm for idea after idea, tempered by a restlessness that keeps me always moving on to the next thing. What a behavioral neurologist would see is Attention Deficit/Hyperactivity Disorder.

In spite of ample intelligence and enthusiasm, someone with ADHD experiences daily life as a constant struggle. Boredom, procrastination, disorganization, and a tendency to say yes to too many projects can be dizzyingly stressful, while emotional intensity, impulsivity, and a tendency to interrupt make for chaotic relationships. But by accepting the diagnosis of ADHD, I've begun to understand the complexities of the condition and the effectiveness of traditional as well as alternative treatments.

nonlinear in a linear world

ORIGINALLY KNOWN AS "minimal brain dysfunction," then "attention deficient disorder," the condition has had one misleading moniker after another. Those of us with ADHD don't suffer from a deficit of attention--if anything, we have a surfeit of it. We're vulnerable to distraction because we perceive too much at once; we're unable to filter out extraneous stimuli and focus on what is most important.

The cause may be a lack of blood flow and electrical stimulation to the frontal cortex--the area of the brain involved in prioritizing, focusing, and choosing words thoughtfully rather than blurting them out. Scans of people with ADHD usually show reduced activity in this decision-making area of the brain, notes Daniel Amen, M.D., assistant clinical professor of psychiatry and human behavior at the University of California, Irvine, and author of Making a Good Brain Great.

Some researchers suggest that "executive functioning disorder" is a better description. "ADHD people think in a tangential, nonlinear, circular way," says Hal Elliott, M.D., director of adult psychiatry inpatient services at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. "One thing reminds them of something else, which reminds them of something else. People with ADHD tend to be writers, musicians, visionaries, inventors, and people who rock the boat at work--they come up with better ways to do things. There's nothing wrong with being a nonlinear person except that it can make you miserable in this linear world we live in."

About 4 percent of American adults suffer from the condition, and they lose between 12 and 56 workdays annually to their symptoms, according to a national screening survey conducted by Harvard Medical School. A history of childhood ADHD--whether or not it was ever diagnosed--is a criterion, and there is evidence that ADHD runs in families. (A study of ADHD genetics is now under way at the UCLA Neuropsychiatric Institute.) "ADHD isn't something that pops up when you're 45, going through a divorce," says Amen. "You see there was evidence of it all along."

Adults with past or current symptoms of ADHD are also at a higher risk for other problems. A 2005 study in The American Journal of Psychiatry found that 59 percent of ADHD patients suffered from major depression at some point, compared with 40 percent of the non-ADHD group; the respective ratio for anxiety disorder was 21 percent versus 8 percent.

trials and treatments

"SINCE WE STILL know so little about ADHD, treatment is very trial and error," says Hailing Zhang, M.D., a psychiatrist who treats many adults with ADHD. "But the gold standard is stimulant medication." Controlled studies show that drugs like methylphenidates (Ritalin, Concerta) and mixed amphetamines (Adderall) increase mental concentration by making the neurotransmitters dopamine and norepinephrine more available to the brain. Drugs related to antidepressants (Wellbutrin, Strattera) can be successful in treating ADHD, too.

But some of these drugs may cause side effects like insomnia, stomach pain, loss of appetite, irritability, anxiety, or heart problems. Canadian authorities banned the use of Adderall for several months in 2005 due to possible sudden deaths, heart-related fatalities, and strokes in children and adults. And while the FDA considers Strattera an "effective drug" with "low risk," the agency is warning doctors to monitor children and adolescents taking it for suicidal thoughts.

There are alternatives that show promise. Naturopath and acupuncturist Trina Seligman, N.D., L.Ac., a guest lecturer at Bastyr University in Seattle, recommends a "foundation" of a broad-spectrum, free-form amino acid supplement taken daily to balance a patient's brain chemistry. To target specific symptoms, Seligman uses specific aminos. She often prescribes twice-daily single doses of dopamine precursor DL-Phenylalanine or norepinephine precursor L-Tyrosine to improve concentration and diminish restlessness; serotonin precursor L-Tryptophan to alleviate depression; or GABA or L-Theanine to reduce anxiety and irritability.