'A Problem in the Brain'

Robert Tudisco, 40, didn't realize he had attention-deficit/hyperactivity disorder when he was working as a criminal prosecutor in New York City. His job provided him with "plenty of excitement, lots of courtroom action," and he relied on adrenaline to keep him focused. But when Tudisco left the D.A.'s office for private practice, he found it impossible to manage his time and stay on top of the paper flow. After floundering for a few years, he went to a psychiatrist who diagnosed him with ADHD and prescribed a stimulant. On days when he's in court, Tudisco doesn't take it. But on days when he has to organize case files, the medication keeps him on track.

ADHD isn't just for kids anymore these days adults are being diagnosed with it in record numbers. New data released from Medco Health Solutions, a pharmacy benefits manager, indicates that about 1.5 million adults between the ages of 20 and 64 are currently taking medication to treat attention problems, up from 758,000 in 2000--and most of them were diagnosed well into adulthood. While there are still more kids taking ADHD medication--about 3.5 million--Dr. David Goodman, director of the Adult Attention Deficit Disorder Center in Baltimore, expects the number of adults taking the drugs to continue to rise. "Many adults who for years have been called lazy, crazy or stupid," says Goodman, "are realizing the problem may be in their brain."

ADHD in children is characterized by hyperactivity, inattentiveness or both, and is usually detected when kids struggle with peers or in school. Diagnosing ADHD in adults can be trickier. Often adult sufferers procrastinate, are chronically disorganized and are unable to effectively manage their time. But not every-one who blows a deadline or misplaces the car keys is afflicted. According to the American Psychiatric Association, the symptoms have to be severe enough to disrupt both work and family life. There's no such thing as "adult onset" ADHD, either. Before doctors prescribe ADHD drugs to adults--whether amphetamines or drugs like Ritalin, Concerta and Strattera--patients must be able to describe symptoms that date back to childhood. Drug companies have profited from the growing public awareness of the disorder: in 2004, ADHD drug sales topped $3.1 billion, up from $759 million in 2000.

But some experts worry that people are using ADHD drugs to treat the natural forgetfulness that comes with aging and the stresses of modern life. Dr. David Pomeroy, an ADHD specialist from Bellevue, Wash., estimates that 10 percent of people who seek treatment are healthy but want stimulants to improve their performance at work. "Anyone who takes them is going to feel more focused," says Pomeroy, who says he prescribes only to patients who meet the strict ADHD criteria. Arthur Caplan, director of biomedical ethics at the University of Pennsylvania medical school, warns that we may be overmedicating ourselves. As doctors begin prescribing medication for people whose attention or productivity is low, but still within the range of normal, he says, "we begin to change the definition of what normal focus and productivity really looks like."

For many people, though, the drugs have been a godsend. Linda Cohodes, 53, an obesity counselor from Chicago, knew about ADHD from her son, Chris, who was diagnosed in grade school. When she returned to the work force last year, though, she felt overwhelmed and underproductive. Although she talked fast and was always on the move, she felt as if she just couldn't keep up with her workload. After four months of struggle, her psychiatrist diagnosed her--along with her husband and daughter--with ADHD. The medication, she says, is helping her stay focused enough to develop new strategies at work. She says she's learning to keep her job--and her life--in order.

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