Max Been (pictured below) remembers the day he learned he had ADHD. “I was about 8 years old and sitting in the back seat of the car," he says. "We were driving past the firehouse in the center of town, and my mom asked, ‘If there were a pill that would help you focus better, would you be interested?’”
At the time, Max was struggling in school. “I was having trouble getting my work done,” he recalls. “I would also get in trouble in class for doing impulsive things — for being crazy.” But Max, who is now 17, didn’t see himself as having a problem. “I wasn’t that self-aware,” he admits.
Still, he was curious. Max tried the pill — Ritalin — and the change, according to his mother, Ali Farquhar, was dramatic. “There was an immediate improvement,” she says. "His teachers noticed a difference, too. And Max himself felt different, “like I could slow myself down.”
ADHD: A Pervasive Disorder
But being diagnosed and treated was just the beginning of Max's journey of dealing with
ADHD — attention deficit hyperactivity disorder — which has been diagnosed in about 9.5 percent of children aged 5 to 17. In simple terms, ADHD interferes with a person’s ability to focus and maintain self-control, but the disorder can be much more complicated. “It should really be called
executive function disorder,” says Russell A. Barkley, PhD, a clinical psychologist who has been studying ADHD for 30 years. The disorder can affect a person’s ability to organize, solve problems, and self-regulate. “It seems to pervade every aspect of life,” Dr. Barkley says, “particularly academics and work.”
Though Max became aware that he had ADHD when he was in grade school, his parents suspected that his problems started much earlier. “When he was in preschool I would get calls from his teacher asking if he had gotten enough sleep,” says Farquhar. “If he didn’t want to do something, he would just lie down on the floor.” Later, his behavior became more impulsive and disruptive. “As
schoolbecame more demanding, it became more difficult for Max to cope,” Farquhar says. “He would sit in front of his homework for an hour and write two words.”
By the time Max was in second grade, his teachers and parents agreed that he should be evaluated by a neuropsychologist. The results were unequivocal: Max had the most common form of the disorder, called combined-type ADHD, in which a person has symptoms of both inattention and hyperactivity/impulsivity. Max seemed to have a severe case of the disorder.
At first, Farquhar and her husband resisted the idea of putting Max on medication. “I thought, ‘Oh, this is the American malady everyone throws drugs at,’” she recalls. But as Farquhar watched her son “go downhill psychologically,” she decided to give meds a try. “Boy, was I humbled,” she says. Medication has helped Max immensely; he has tried various pills over the years and now takes Ritalin LA, an extended-release pill.
Growing Up With ADHD
While Max takes Ritalin every day, “it’s not a miracle cure,” he says. ADHD is chronic disorder. Doctors now know, though, that the right
medications and a good educational setting can make a huge difference in helping a child learn to cope with and address his or her symptoms.
Max, who lives in Weston, Mass., is a typical teenager in many ways. He plays video games, reads a lot, and likes to riff on his guitar and drums. He loves sports and has a playful manner and quick wit. He’s tall and handsome, with an athletic build.
But many of the tasks that become second nature to teens are extremely challenging for Max, particularly when it comes to school. “If something doesn’t interest me, it’s a titanic struggle for me to focus on it,” he says. “The act of doing it is so unwelcome.” Last year, for example, Max had a research paper that he kept putting off. He finally began to work on it two days before it was due. “Ultimately I didn’t get it done,” he says.
People with ADHD may appear lazy to others, but “it’s in fact 5 to 10 times harder for them to do things they don’t like than it is for people without the disorder,” says Barkley. This may be because their frontal lobes, the areas of the brain that control reasoning, motivation, and discipline, are impaired, making tasks more difficult to complete.
Even under medication, Max has a hard time keeping quiet in class. “Sometimes I talk and talk and the notion of taking a break doesn’t even occur to me,” he says. “I’ll be in class and my teacher will say, ‘Max, Max!’ and I’ll realize, ‘Wow, I’ve been talking this entire time.’”
His talkativeness can be exasperating outside of school, too. Max’s sister Anna, 19, says “It’s like you’re with a person who wants to share his opinion on everything. He’s constantly talking and he thinks he’s the authority on everything. Max is well-intentioned, but he can be irritating.” Max observes: “People who know me are used to me, but those who don’t may be put off by the way I act.” For instance, Max might tell someone he or she is being “stupid,” or interrupt the person with his own opinions.
“The story of my life is act and regret,” Max once told his mother.
An Up-Close Look at Life With ADHD
Max’s impulsivity and talkativeness can be a strain on his family, particularly in the evening when his medication is wearing off. “When’s he’s off
Ritalin, Max is more reactive, provocative, even a little mean,” Farquhar says. “He’s not able to reflect on the impact of what he says.” Family dinners with his parents, Anna and his younger brother, Alec, 14, can be chaotic. “When I was 12 or 13, I began to hold back if there were arguments at the table,” says Anna. “I just knew it wouldn’t help to get involved. Max likes to have the last word.”
“I’m very immature,” Max acknowledges. He loves fart jokes and potty humor, things many of his peers have long outgrown. And he’s as physically restless as a 7-year-old. “He’s always running around,” Anna says with exasperation. “We’ll be walking around a city and he will climb on all the statues.”
His
immaturity has a plus side, though: He’s great with kids. This summer, Max worked as a counselor and lifeguard at the day camp he had attended for 10 years. Anna was a counselor there, too. “The kids really liked him,” Anna says. And a neighbor, Peg Golden, often asks Max to watch her autistic daughter, Carly, also 17. “Carly adores Max,” says Golden. “Her behavior doesn’t faze him at all.”
Max attends a school for students with learning problems, the Corwin-Russell School, which is a 45-minute drive from his family’s home. “It’s a very alternative school. Everyone has their little quirks,” Max says. “It’s better for me to be in an environment like that — I don’t have to try to fit in.” Its Web site says the school is for “bright students with learning issues exacerbated by a variety of neurological, emotional, and social difficulties.…We serve best the very intelligent student who should be able to thrive in school, but does not.”
Now that Max is a junior, he’s thinking about college. He loves physics and science and would like to go to MIT. “I know I’d need to step up my game dramatically,” he says. Max has a remarkably strong memory and, when a subject interests him, he can stay absorbed in it for hours. “Max’s IQ is well above average,” Farquhar points out, but his work habits are not at college level yet.
Peg Golden also remarks on Max’s intelligence. “It’s obvious how bright he is,” she says. “Max has always been very verbal and communicative. He’s a real personable kid with great manners. I love him.”
Though Max is open about having ADHD, he can make light of the disorder and the obstacles he may face in the future. The psychologist Russell Barkley explains that Max’s attitude is characteristic of people with ADHD. “They tend to underreport the severity of their problems,” he says. “They don’t appreciate the areas in which they are less competent. This may be a form of ego protection, but it may also be because their self-awareness is quite restricted.”
Max feels as though he has made great strides. “It just takes willpower,” he says. At least some of that assessment may be right. Anna has noticed a difference in Max recently. “He seems to be more confident and less hyper,” she says. “He’s a really smart kid. I’m sure he will go to college, but perhaps not right away.”
While people generally do not outgrow ADHD, some of the symptoms, such as hyperactivity, may lessen over time. The frontal lobes don’t fully mature in people until their late twenties, Dr. Barkley points out. Once people hit 30, they begin to have a more realistic opinion of themselves.
Max is lucky: He was diagnosed early and his parents were proactive about trying medications and finding him a supportive school environment. Once he matures a bit more, Max’s innate intelligence and curiosity will most likely propel him toward a fulfilling future.
