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CNN Saturday Morning News

Weekend House Call: Adult ADD

Aired July 19, 2003 - 08:28   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Good morning.
Today on Weekend House Call, we're talking about Adult Attention Deficit Disorder. Now, we've all heard of children with ADD, but can adults have it, too? One pharmaceutical company says millions suffer, but some wonder whether they're creating the disorder.

(BEGIN VIDEOTAPE)

COHEN (voice-over): Feeling distracted, disorganized? Trouble waiting your turn in line? Fidgety? Maybe you have attention deficit disorder. Maybe you need to see your doctor. That's the new marketing message from pharmaceutical giant Eli Lilly, which has the only drug approved by the FDA to treat adults with ADD.

UNIDENTIFIED MALE: You may have adult attention deficit disorder.

COHEN: Here's how the Lilly marketing plan works. TV and radio ads direct people to go to a Web site, where there's a quiz with six questions such as, "How often do you feel restless or fidgety?," "How often do you have difficulty waiting your turn?"

If you respond sometimes to these six questions, the Web site tells you that you may have symptoms that are consistent with adult ADD and suggests printing out the quiz and bringing it to your doctor. I took the test and I have symptoms that are consistent with adult ADD. So do my producer, several friends and my daughter's nursery school teacher.

ARTHUR CAPLAN, UNIVERSITY OF PENNSYLVANIA: Trying to hook a potential user of your drug by this kind of a questionnaire technique just strikes me as very ethically suspicious.

COHEN: The drug company says their screening tool is valid and has been tested and verified and is not meant to diagnose people.

DR. CALVIN R. SUMNER, ELI LILLY AND COMPANY: We're very concerned that folks have a disorder that is impairing and limiting their life.

COHEN: But some have ethical questions about Lilly's marketing campaign.

CAPLAN: I'm worried that what you're going to do is generate a disease rather than respond to a problem. COHEN: The concern? There's no blood test for ADD. The diagnosis is up to a physician's judgment. A leading expert on ADD and a consultant to Lilly says in today's hurried world, many people may look like they have ADD when they really don't and drugs could actually harm them.

DR. EDWARD HALLOWELL, PSYCHIATRIST: They're going so fast, they're doing so much, they're so saturated with information overload, the symptoms of ADD can look just like the symptoms of modern life.

COHEN: So how are physicians supposed to distinguish between a case of ADD and a case of modern life? Lilly's educating them.

SUMNER: We have a very large agenda working with doctors and helping them understand their disorder.

COHEN: The target audience? Internists and family physicians who usually have just minutes with each patient.

CAPLAN: The natural reaction of a doctor who's pressed for time is write the prescription. It's not good medicine. It may not even be ethical medicine.

COHEN: Some estimates say eight million American adults suffer from ADD. Eli Lilly says their ads and Web site are meant to reach the person who needs help turning a chaotic life into a productive one.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

COHEN: Now, one of the reasons that ADD is so controversial is that the symptoms occur in most of us from time to time. Here are a few -- having a lot of difficult sustaining attention, making careless mistakes and not paying attention to details. The adult with ADD often doesn't seem to listen or seems tuned out. He or she is severely disorganized and can't keep track of things. They lose things often and they get easily distracted by outside stimuli, such as people talking or things going on outside a window. They forget to do things very frequently, which means they don't get everything done. Physical restlessness is also an ADD trait. People fidget or they can't sit still. They're also physically active or even over active, always on the go. Reacting impulsively without thinking first is a common trait, as well.

Now, all of us can behave this way sometimes. The experts say you might have ADD if you behave this way consistently, so much so that you find it hard to function. If you have questions about ADD, now is the time to call. Our number is 1-800-807-2620. Or send your e-mail to housecall@cnn.com.

We have with us Dr. Edward Hallowell. He joins us from Boston to help us answer our questions. He's a psychiatrist and author of several books on ADD.

Dr. Hallowell, welcome to our show.

And, first of all, we need to ask you, is there a difference between ADD and ADHD? We see both names used and it can get confusing.

DR. EDWARD HALLOWELL, PSYCHIATRIST, HARVARD UNIVERSITY: It can be confusing. They're -- ADHD is the proper name for the condition, Attention Deficit Hyperactivity Disorder. What confuses people is that you can have ADHD without any symptoms of hyperactivity whatsoever. And particularly in adult women, you can find Attention Deficit Hyperactivity Disorder with hypo activity. If anything, they're serene.

COHEN: So with adults I've always seen it written as ADD and that's because with adults that, the H part, the hyperactivity part, is not always so obvious, is that what you're saying?

HALLOWELL: Yes, and that was the original term, Attention Deficit Disorder. And then they renamed it Attention Deficit Hyperactivity Disorder just to confuse us all.

COHEN: OK. Well, we've had many e-mail questions on this subject, so let's get to the first one from David in Massachusetts.

David asks, "How do you tell the symptoms of ADD apart from the effects of every day stress?"

Dr. Hallowell, you talk a lot about ADD being easily confused with plain old modern life.

HALLOWELL: Exactly. We all look like we have ADD if we live in an urban setting, at least some of the time. The crucial distinction is the intensity of these symptoms, their duration, their existence in multiple settings and are they impairing your life? If you're able to cope with it, you say, oh, gee, I just feel stressed, but I'm able to get my job done, that's not ADD. Not at all.

However, if you're saying gosh, darn it, I am under achieving day in, day out, month after month, year after year, then, indeed, this diagnosis and treatment might turn your life around tremendously.

Having this condition, having the real condition can be absolutely crippling and very, very painful. And the good news is with proper diagnosis and treatment, this condition that so many people think is just found in children, actually also found in adults, can change your life dramatically for the better.

COHEN: Dr. Hallowell, we have a call now from Andrea in New York.

Andrea, go ahead with your question.

ANDREA: Hi, Dr. Hallowell.

I was calling, it's a two part question. I wanted to know what kind of doctor, if I think my brother, who's 24 years old, should I take him to? And also what kind of tests would they do to him?

HALLOWELL: That's a real good question. The people who have the most training in treating ADD, interestingly enough, are child psychiatrists. All child psychiatrists also see grownups. So if you can find a child psychiatrist, that's probably the best person to go to.

Second best is anyone who has experience in treating this condition. It might be a pediatrician, an internist, a family physician, a psychologist, an adult psychiatrist. But ask the doctor, do you have extensive experience in diagnosing and treating this condition? It's very important that you find that, because sometimes people with very little experience are handing out medication and that's where you get into trouble.

COHEN: All right, Dr. Hallowell...

HALLOWELL: And, oh, you asked about the tests. The best test for this condition is a really careful history. We don't have a blood test. We don't have, you know, a physical test to prove that you have it or don't have it. So a careful history, a careful evaluation as done by the expert is the best test. And then that may be supplemented with medical tests or psychological tests.

COHEN: And Dr. Hallowell, you made the point with me earlier that if someone actually has, say, manic depression or hyperthyroidism or a host of other diseases and they get ADD drugs, that can actually be a big problem. So that's something to keep in mind, Andrea, with your brother when he goes to get diagnosed.

HALLOWELL: Absolutely. Absolutely.

COHEN: And we also have an e-mail now from Howard in Texas. And he writes, "Adult ADD? Come on. Our entire culture can't sit still. It's hardly a disorder. It's 100 percent marketing B.S. We're the only country in the world to create disorders to assure people they're not abnormal in any way."

Well, Howard obviously has strong feelings about this.

Dr. Hallowell, what do you think?

HALLOWELL: Well, I understand where he's coming from. I mean you can feel like, particularly in today's world, we're all like that, you know, come on, suck it up and, you know, let's stop making excuses.

But remember, it wasn't too long ago that people talked that way about depression. They'd say oh, come on, everyone's sad now and then. You know, be strong. Suck it up. Look on the bright side. Go for the best in life. And they sort of dismissed depression as if it were a cover over for being weak.

Well, we know now depression is a bona fide medical condition that some marvelously wonderful people have -- our greatest president, Abraham Lincoln, for example -- and that it's really wrong and cruel to trivialize that and sort of accuse people who have it of being weak.

Well, the same thing applies to ADD, believe or not. You know, this is a biologically based, genetically transmitted condition characterized by extreme distractibility, extreme trouble with organization, extreme problems with controlling impulses and restlessness. It is not some lame excuse for getting out of taking responsibility. Instead, it's a powerful explanation to help people take responsibility more effectively.

COHEN: Thank you, Dr. Hallowell.

We have to take a quick break now.

When we come back, can you pass ADD on to your children? And who does ADD affect more, men or women?

We'll have those answers. Call us with your questions. Our number is 1-800-807-2620. Or e-mail us at housecall@cnn.com.

Weekend House Call will be right back.

(COMMERCIAL BREAK)

COHEN: Today on Weekend House Call, we're talking about Adult Attention Deficit Disorder. Are you feeling distracted, trouble concentrating? Maybe you have Adult ADD. Find out more about the disorder. Call us with your questions at 1-800-807-2620. Or e-mail us at housecall@cnn.com.

While we get those phone calls lined up, let's check our quiz. Who is more likely to be diagnosed with ADD, men or women? We'll have that answer in 30 seconds.

Stay with us.

(COMMERCIAL BREAK)

COHEN: Checking the daily dose health quiz, we asked you who is more likely to be diagnosed with ADD, men or women? And the answer is men. Men are two to three times more likely to be diagnosed than females. That doesn't mean that ADD is rare in women. It just means that men tend to be more aggressive and active and often are diagnosed more often.

We're talking about Adult Attention Deficit Disorder. Let's get right to some questions.

We have a phone call from Andrew in Toronto.

Andrew, go ahead.

ANDREW: I just wanted to know what is the best and safest drug for ADD? Because I was on Dexedrine for a period of time and I actually didn't like the way it made me felt. So I actually got off of it.

COHEN: Dr. Hallowell?

HALLOWELL: Well, fortunately we have now several medications that can be helpful in treating adults who have Attention Deficit Disorder. You can't say what is THE best and safest drug for everybody. What you can ask is what is the best and safest one for you? And that really is a matter of trial and error. You find a good doctor to work with. Three out of four people with adult ADD can be helped by one or another medication. But you won't know in advance which one.

COHEN: And Dr. Hallowell, you've spoken publicly about how you have ADD and you have chosen not to take drugs. You deal with it without drugs. And so do other people.

Can you talk about how you do that?

HALLOWELL: Yes, I have Attention Deficit Disorder. I also have dyslexia. You know, both of those conditions can really get in your way. I learned how to deal with it when I was in school before we knew about these conditions. You know, back then it was smart and stupid and good and bad and those kinds of unfortunate terms. And I was able to develop strategies that worked for me so that I was able to have a good educational career, go to medical school, you know, become a child psychiatrist.

That is not the way for most people, however, and I'm probably not a good example, because I'm in a distinct minority. The medications don't work for me. All they have, in my case, are side effects. And as I said, there are others like me. However, the majority of folks who have this condition will benefit from one or another medication, should they choose to take them. They don't have to take them. It's not as if you must take medication if you have Attention Deficit Disorder. I think it's worth trying medication to see if it helps you. But it's certainly not essential.

COHEN: OK, Izzy from Texas has written us an e-mail. He writes, or she writes, "My husband has a hard time concentrating and get easily distracted. He can sit and study for hours, but when it's time to take a test, he's lucky if he gets a C. My daughter has been diagnosed with ADHD. Could it be that my husband has ADD? Is it hereditary?"

HALLOWELL: Yes. This is, most of the time, genetically transmitted. And one of the myths about ADD is that you must always be distracted in order to qualify for the diagnosis. Not true. People with Attention Deficit Disorder at times can super focus. They can focus better than anyone. And then in another setting, they drift away and are unable to focus. And that really, it's one of the hallmarks of this condition is the inconsistency. And that's often why the diagnosis gets missed.

As I said earlier, if you get a careful evaluation as an adult, you really can turn your life around. This is not a puffy condition to be taken lightly. It truly does cripple adults. And there are millions of adults out there right now who are severely under achieving, both at work and in their personal lives, because of undiagnosed ADD. So it is really worth it to get a careful evaluation. It could turn your life around dramatically for the better.

COHEN: Now, Jeni from Dallas has also written us an e-mail. She asks, "I have ADD. Is the drug Strattera addictive?"

HALLOWELL: Strattera is the new medication that Lilly has put out and it is not addictive. Indeed, none of the medications we use to treat ADD are addictive. This is another one of the myths about the medication treatment of ADD.

Indeed, far from being addictive, when you get the right medication, if you do get the right medication, that greatly reduces your risk of becoming addicted to the drugs of abuse. So far from being addicting medications, the medications we use to treat ADD reduce the risk of addiction to dangerous drugs.

COHEN: We have another e-mail. Nancy from Texas asks, "Can bipolar symptoms look like Adult ADD?"

HALLOWELL: Another wonderful question, and really points up why it's so important to see a real good professional to get an evolution. Bipolar disorder can look like Attention Deficit Disorder and, indeed, the two may coexist. Some of the real important research on this has been done here in Boston by Janet Wozniak at Massachusetts General Hospital. And what she has found is, indeed, the overlap between Attention Deficit Disorder and bipolar disorder. It's a tricky evaluation to tease out which is which, and that's why, again, very important that you see a real good professional to get an elevation to determine which you have before treatment begins.

COHEN: When we come back, don't ask, don't tell, when should you disclose that you have ADD? Could you be discriminated against? We'll talk about that when we come back.

(COMMERCIAL BREAK)

COHEN: We're talking about Adult ADD. And we have another interesting e-mail question. This one is from Annette in Kentucky. She says, "I was diagnosed with ADD along with my children. When I was open about it at my place of employment, my boss tried to find ways to have me dismissed. I would like to be open and above board about my ADD and dyslexia, but once spurned twice shy. I wonder if anyone else has experienced this."

We have with us Dr. Edward Hallowell from Massachusetts, a psychiatrist and expert on ADD.

Dr. Hallowell, how should she deal with this?

HALLOWELL: Well, unfortunately her case is altogether too common. And it points up one of the big problems in dealing with mental issues in general. There remains a great deal of stigma, which is based in ignorance. Remember, it wasn't that long ago that Thomas Eagleton had to withdraw from a national political race because it came out that he was taking anti-depressant medication. Well, the same thing pertains to ADD. My advice, if you're an adult in the workplace, is not to tell anyone about it. It's a shame that that's my advice, but we're -- until we advance to the point where people can be open about their minds as well as about their bodies, you're better off if you don't tell anyone at work, unless you know for sure they're sophisticated, informed and will understand.

COHEN: Judith in South Carolina is on the telephone with a question.

Judith, go ahead.

JUDITH: Hi. My husband is 65 and I have suspected he has ADD for a long time. Do you ever outgrow it or is there any chance that it could lead to like early dementia or?

HALLOWELL: Well, that question is a very interesting one and the answer is it's a research question and we're not sure of the relationship with dementia. And as for outgrowing it, if you're going to outgrow it, you would have done it back in puberty. So it's not going to happen. The oldest person I treated for ADD was 86 and she said the treatment changed her life. At least she was able to read to hear great grandchildren without getting distracted and play with them without getting bored and having to go do other things.

So it's never too late to get the diagnosis and the treatment.

Mentioning treatment, why don't I just quickly run through what I consider to be adequate treatment? Number one step is diagnosis. Make sure you have an accurate diagnosis and a complete diagnosis. ADD often occurs with other conditions like depression or substance abuse or anxiety disorders or a history of trauma or associated learning disabilities.

Number two, education. Very important that you learn what this condition is and what it isn't. There are a lot of myths out there and a lot of misinformation. So you need to learn about it from your doctor, through books, lectures, talking to other people who have it. Get the right information.

Number three, lifestyle changes. Exercise, for example, wonderful treatment for ADD. Proper amount of sleep, proper nutrition, evidence that omega 3 fatty acids may help. Adding structure to your environment, lists, reminders, alarm clocks. Find the right job. Marry the right person. That's big time structure. Minute structure, a basket next to the front door where you always put your car keys so you don't start your day with a frantic search for your car keys. Part of this is management of modern life in general, but for ADD people it's particularly important.

Step number four, coaching, someone to help you implement structure. In other words, it's hard to do it alone. So work with a coach and sometimes a psychotherapist to have couples therapy and family therapy.

And then finally, step number five, medication. Notice that medication is only one step in a five step comprehensive treatment program. This is very important. Don't think of the treatment of ADD as simply taking medication. But when it's part of a five step program, it can be extremely helpful.

COHEN: Now, if you'd like some more information on ADD, Dr. Hallowell mentioned that there are some places to get good information. So we'd like to show you a Web site that has some good information on Adult ADD. Go to www.add.org. You can also go to our Web site, at cnn.com/health.

And we'll be right back.

(COMMERCIAL BREAK)

COHEN: We have an e-mail from Brian in California we just had to share with you about ADD. He wrote, "Can you explain -- oh, wait, I need to check the meatloaf. Distractions, distractions, distractions."

Dr. Edward Hallowell, thank you for joining us. And thank you for all of that great information on ADD. We really appreciate it. We hope to have you back on CNN soon.

HALLOWELL: Thank you.

COHEN: That's all the time we have for today.

Make sure to watch tomorrow's Weekend House Call when we talk about allergies and some alternatives to those expensive over the counter medications. We'll have an allergist with us for some good options for those suffering from sneezes, sniffles and sticker shock.

That's tomorrow on Weekend House Call.

Thanks for watching.

I'm Elizabeth Cohen.

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Aired July 19, 2003 - 08:28   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Good morning.
Today on Weekend House Call, we're talking about Adult Attention Deficit Disorder. Now, we've all heard of children with ADD, but can adults have it, too? One pharmaceutical company says millions suffer, but some wonder whether they're creating the disorder.

(BEGIN VIDEOTAPE)

COHEN (voice-over): Feeling distracted, disorganized? Trouble waiting your turn in line? Fidgety? Maybe you have attention deficit disorder. Maybe you need to see your doctor. That's the new marketing message from pharmaceutical giant Eli Lilly, which has the only drug approved by the FDA to treat adults with ADD.

UNIDENTIFIED MALE: You may have adult attention deficit disorder.

COHEN: Here's how the Lilly marketing plan works. TV and radio ads direct people to go to a Web site, where there's a quiz with six questions such as, "How often do you feel restless or fidgety?," "How often do you have difficulty waiting your turn?"

If you respond sometimes to these six questions, the Web site tells you that you may have symptoms that are consistent with adult ADD and suggests printing out the quiz and bringing it to your doctor. I took the test and I have symptoms that are consistent with adult ADD. So do my producer, several friends and my daughter's nursery school teacher.

ARTHUR CAPLAN, UNIVERSITY OF PENNSYLVANIA: Trying to hook a potential user of your drug by this kind of a questionnaire technique just strikes me as very ethically suspicious.

COHEN: The drug company says their screening tool is valid and has been tested and verified and is not meant to diagnose people.

DR. CALVIN R. SUMNER, ELI LILLY AND COMPANY: We're very concerned that folks have a disorder that is impairing and limiting their life.

COHEN: But some have ethical questions about Lilly's marketing campaign.

CAPLAN: I'm worried that what you're going to do is generate a disease rather than respond to a problem. COHEN: The concern? There's no blood test for ADD. The diagnosis is up to a physician's judgment. A leading expert on ADD and a consultant to Lilly says in today's hurried world, many people may look like they have ADD when they really don't and drugs could actually harm them.

DR. EDWARD HALLOWELL, PSYCHIATRIST: They're going so fast, they're doing so much, they're so saturated with information overload, the symptoms of ADD can look just like the symptoms of modern life.

COHEN: So how are physicians supposed to distinguish between a case of ADD and a case of modern life? Lilly's educating them.

SUMNER: We have a very large agenda working with doctors and helping them understand their disorder.

COHEN: The target audience? Internists and family physicians who usually have just minutes with each patient.

CAPLAN: The natural reaction of a doctor who's pressed for time is write the prescription. It's not good medicine. It may not even be ethical medicine.

COHEN: Some estimates say eight million American adults suffer from ADD. Eli Lilly says their ads and Web site are meant to reach the person who needs help turning a chaotic life into a productive one.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

COHEN: Now, one of the reasons that ADD is so controversial is that the symptoms occur in most of us from time to time. Here are a few -- having a lot of difficult sustaining attention, making careless mistakes and not paying attention to details. The adult with ADD often doesn't seem to listen or seems tuned out. He or she is severely disorganized and can't keep track of things. They lose things often and they get easily distracted by outside stimuli, such as people talking or things going on outside a window. They forget to do things very frequently, which means they don't get everything done. Physical restlessness is also an ADD trait. People fidget or they can't sit still. They're also physically active or even over active, always on the go. Reacting impulsively without thinking first is a common trait, as well.

Now, all of us can behave this way sometimes. The experts say you might have ADD if you behave this way consistently, so much so that you find it hard to function. If you have questions about ADD, now is the time to call. Our number is 1-800-807-2620. Or send your e-mail to housecall@cnn.com.

We have with us Dr. Edward Hallowell. He joins us from Boston to help us answer our questions. He's a psychiatrist and author of several books on ADD.

Dr. Hallowell, welcome to our show.

And, first of all, we need to ask you, is there a difference between ADD and ADHD? We see both names used and it can get confusing.

DR. EDWARD HALLOWELL, PSYCHIATRIST, HARVARD UNIVERSITY: It can be confusing. They're -- ADHD is the proper name for the condition, Attention Deficit Hyperactivity Disorder. What confuses people is that you can have ADHD without any symptoms of hyperactivity whatsoever. And particularly in adult women, you can find Attention Deficit Hyperactivity Disorder with hypo activity. If anything, they're serene.

COHEN: So with adults I've always seen it written as ADD and that's because with adults that, the H part, the hyperactivity part, is not always so obvious, is that what you're saying?

HALLOWELL: Yes, and that was the original term, Attention Deficit Disorder. And then they renamed it Attention Deficit Hyperactivity Disorder just to confuse us all.

COHEN: OK. Well, we've had many e-mail questions on this subject, so let's get to the first one from David in Massachusetts.

David asks, "How do you tell the symptoms of ADD apart from the effects of every day stress?"

Dr. Hallowell, you talk a lot about ADD being easily confused with plain old modern life.

HALLOWELL: Exactly. We all look like we have ADD if we live in an urban setting, at least some of the time. The crucial distinction is the intensity of these symptoms, their duration, their existence in multiple settings and are they impairing your life? If you're able to cope with it, you say, oh, gee, I just feel stressed, but I'm able to get my job done, that's not ADD. Not at all.

However, if you're saying gosh, darn it, I am under achieving day in, day out, month after month, year after year, then, indeed, this diagnosis and treatment might turn your life around tremendously.

Having this condition, having the real condition can be absolutely crippling and very, very painful. And the good news is with proper diagnosis and treatment, this condition that so many people think is just found in children, actually also found in adults, can change your life dramatically for the better.

COHEN: Dr. Hallowell, we have a call now from Andrea in New York.

Andrea, go ahead with your question.

ANDREA: Hi, Dr. Hallowell.

I was calling, it's a two part question. I wanted to know what kind of doctor, if I think my brother, who's 24 years old, should I take him to? And also what kind of tests would they do to him?

HALLOWELL: That's a real good question. The people who have the most training in treating ADD, interestingly enough, are child psychiatrists. All child psychiatrists also see grownups. So if you can find a child psychiatrist, that's probably the best person to go to.

Second best is anyone who has experience in treating this condition. It might be a pediatrician, an internist, a family physician, a psychologist, an adult psychiatrist. But ask the doctor, do you have extensive experience in diagnosing and treating this condition? It's very important that you find that, because sometimes people with very little experience are handing out medication and that's where you get into trouble.

COHEN: All right, Dr. Hallowell...

HALLOWELL: And, oh, you asked about the tests. The best test for this condition is a really careful history. We don't have a blood test. We don't have, you know, a physical test to prove that you have it or don't have it. So a careful history, a careful evaluation as done by the expert is the best test. And then that may be supplemented with medical tests or psychological tests.

COHEN: And Dr. Hallowell, you made the point with me earlier that if someone actually has, say, manic depression or hyperthyroidism or a host of other diseases and they get ADD drugs, that can actually be a big problem. So that's something to keep in mind, Andrea, with your brother when he goes to get diagnosed.

HALLOWELL: Absolutely. Absolutely.

COHEN: And we also have an e-mail now from Howard in Texas. And he writes, "Adult ADD? Come on. Our entire culture can't sit still. It's hardly a disorder. It's 100 percent marketing B.S. We're the only country in the world to create disorders to assure people they're not abnormal in any way."

Well, Howard obviously has strong feelings about this.

Dr. Hallowell, what do you think?

HALLOWELL: Well, I understand where he's coming from. I mean you can feel like, particularly in today's world, we're all like that, you know, come on, suck it up and, you know, let's stop making excuses.

But remember, it wasn't too long ago that people talked that way about depression. They'd say oh, come on, everyone's sad now and then. You know, be strong. Suck it up. Look on the bright side. Go for the best in life. And they sort of dismissed depression as if it were a cover over for being weak.

Well, we know now depression is a bona fide medical condition that some marvelously wonderful people have -- our greatest president, Abraham Lincoln, for example -- and that it's really wrong and cruel to trivialize that and sort of accuse people who have it of being weak.

Well, the same thing applies to ADD, believe or not. You know, this is a biologically based, genetically transmitted condition characterized by extreme distractibility, extreme trouble with organization, extreme problems with controlling impulses and restlessness. It is not some lame excuse for getting out of taking responsibility. Instead, it's a powerful explanation to help people take responsibility more effectively.

COHEN: Thank you, Dr. Hallowell.

We have to take a quick break now.

When we come back, can you pass ADD on to your children? And who does ADD affect more, men or women?

We'll have those answers. Call us with your questions. Our number is 1-800-807-2620. Or e-mail us at housecall@cnn.com.

Weekend House Call will be right back.

(COMMERCIAL BREAK)

COHEN: Today on Weekend House Call, we're talking about Adult Attention Deficit Disorder. Are you feeling distracted, trouble concentrating? Maybe you have Adult ADD. Find out more about the disorder. Call us with your questions at 1-800-807-2620. Or e-mail us at housecall@cnn.com.

While we get those phone calls lined up, let's check our quiz. Who is more likely to be diagnosed with ADD, men or women? We'll have that answer in 30 seconds.

Stay with us.

(COMMERCIAL BREAK)

COHEN: Checking the daily dose health quiz, we asked you who is more likely to be diagnosed with ADD, men or women? And the answer is men. Men are two to three times more likely to be diagnosed than females. That doesn't mean that ADD is rare in women. It just means that men tend to be more aggressive and active and often are diagnosed more often.

We're talking about Adult Attention Deficit Disorder. Let's get right to some questions.

We have a phone call from Andrew in Toronto.

Andrew, go ahead.

ANDREW: I just wanted to know what is the best and safest drug for ADD? Because I was on Dexedrine for a period of time and I actually didn't like the way it made me felt. So I actually got off of it.

COHEN: Dr. Hallowell?

HALLOWELL: Well, fortunately we have now several medications that can be helpful in treating adults who have Attention Deficit Disorder. You can't say what is THE best and safest drug for everybody. What you can ask is what is the best and safest one for you? And that really is a matter of trial and error. You find a good doctor to work with. Three out of four people with adult ADD can be helped by one or another medication. But you won't know in advance which one.

COHEN: And Dr. Hallowell, you've spoken publicly about how you have ADD and you have chosen not to take drugs. You deal with it without drugs. And so do other people.

Can you talk about how you do that?

HALLOWELL: Yes, I have Attention Deficit Disorder. I also have dyslexia. You know, both of those conditions can really get in your way. I learned how to deal with it when I was in school before we knew about these conditions. You know, back then it was smart and stupid and good and bad and those kinds of unfortunate terms. And I was able to develop strategies that worked for me so that I was able to have a good educational career, go to medical school, you know, become a child psychiatrist.

That is not the way for most people, however, and I'm probably not a good example, because I'm in a distinct minority. The medications don't work for me. All they have, in my case, are side effects. And as I said, there are others like me. However, the majority of folks who have this condition will benefit from one or another medication, should they choose to take them. They don't have to take them. It's not as if you must take medication if you have Attention Deficit Disorder. I think it's worth trying medication to see if it helps you. But it's certainly not essential.

COHEN: OK, Izzy from Texas has written us an e-mail. He writes, or she writes, "My husband has a hard time concentrating and get easily distracted. He can sit and study for hours, but when it's time to take a test, he's lucky if he gets a C. My daughter has been diagnosed with ADHD. Could it be that my husband has ADD? Is it hereditary?"

HALLOWELL: Yes. This is, most of the time, genetically transmitted. And one of the myths about ADD is that you must always be distracted in order to qualify for the diagnosis. Not true. People with Attention Deficit Disorder at times can super focus. They can focus better than anyone. And then in another setting, they drift away and are unable to focus. And that really, it's one of the hallmarks of this condition is the inconsistency. And that's often why the diagnosis gets missed.

As I said earlier, if you get a careful evaluation as an adult, you really can turn your life around. This is not a puffy condition to be taken lightly. It truly does cripple adults. And there are millions of adults out there right now who are severely under achieving, both at work and in their personal lives, because of undiagnosed ADD. So it is really worth it to get a careful evaluation. It could turn your life around dramatically for the better.

COHEN: Now, Jeni from Dallas has also written us an e-mail. She asks, "I have ADD. Is the drug Strattera addictive?"

HALLOWELL: Strattera is the new medication that Lilly has put out and it is not addictive. Indeed, none of the medications we use to treat ADD are addictive. This is another one of the myths about the medication treatment of ADD.

Indeed, far from being addictive, when you get the right medication, if you do get the right medication, that greatly reduces your risk of becoming addicted to the drugs of abuse. So far from being addicting medications, the medications we use to treat ADD reduce the risk of addiction to dangerous drugs.

COHEN: We have another e-mail. Nancy from Texas asks, "Can bipolar symptoms look like Adult ADD?"

HALLOWELL: Another wonderful question, and really points up why it's so important to see a real good professional to get an evolution. Bipolar disorder can look like Attention Deficit Disorder and, indeed, the two may coexist. Some of the real important research on this has been done here in Boston by Janet Wozniak at Massachusetts General Hospital. And what she has found is, indeed, the overlap between Attention Deficit Disorder and bipolar disorder. It's a tricky evaluation to tease out which is which, and that's why, again, very important that you see a real good professional to get an elevation to determine which you have before treatment begins.

COHEN: When we come back, don't ask, don't tell, when should you disclose that you have ADD? Could you be discriminated against? We'll talk about that when we come back.

(COMMERCIAL BREAK)

COHEN: We're talking about Adult ADD. And we have another interesting e-mail question. This one is from Annette in Kentucky. She says, "I was diagnosed with ADD along with my children. When I was open about it at my place of employment, my boss tried to find ways to have me dismissed. I would like to be open and above board about my ADD and dyslexia, but once spurned twice shy. I wonder if anyone else has experienced this."

We have with us Dr. Edward Hallowell from Massachusetts, a psychiatrist and expert on ADD.

Dr. Hallowell, how should she deal with this?

HALLOWELL: Well, unfortunately her case is altogether too common. And it points up one of the big problems in dealing with mental issues in general. There remains a great deal of stigma, which is based in ignorance. Remember, it wasn't that long ago that Thomas Eagleton had to withdraw from a national political race because it came out that he was taking anti-depressant medication. Well, the same thing pertains to ADD. My advice, if you're an adult in the workplace, is not to tell anyone about it. It's a shame that that's my advice, but we're -- until we advance to the point where people can be open about their minds as well as about their bodies, you're better off if you don't tell anyone at work, unless you know for sure they're sophisticated, informed and will understand.

COHEN: Judith in South Carolina is on the telephone with a question.

Judith, go ahead.

JUDITH: Hi. My husband is 65 and I have suspected he has ADD for a long time. Do you ever outgrow it or is there any chance that it could lead to like early dementia or?

HALLOWELL: Well, that question is a very interesting one and the answer is it's a research question and we're not sure of the relationship with dementia. And as for outgrowing it, if you're going to outgrow it, you would have done it back in puberty. So it's not going to happen. The oldest person I treated for ADD was 86 and she said the treatment changed her life. At least she was able to read to hear great grandchildren without getting distracted and play with them without getting bored and having to go do other things.

So it's never too late to get the diagnosis and the treatment.

Mentioning treatment, why don't I just quickly run through what I consider to be adequate treatment? Number one step is diagnosis. Make sure you have an accurate diagnosis and a complete diagnosis. ADD often occurs with other conditions like depression or substance abuse or anxiety disorders or a history of trauma or associated learning disabilities.

Number two, education. Very important that you learn what this condition is and what it isn't. There are a lot of myths out there and a lot of misinformation. So you need to learn about it from your doctor, through books, lectures, talking to other people who have it. Get the right information.

Number three, lifestyle changes. Exercise, for example, wonderful treatment for ADD. Proper amount of sleep, proper nutrition, evidence that omega 3 fatty acids may help. Adding structure to your environment, lists, reminders, alarm clocks. Find the right job. Marry the right person. That's big time structure. Minute structure, a basket next to the front door where you always put your car keys so you don't start your day with a frantic search for your car keys. Part of this is management of modern life in general, but for ADD people it's particularly important.

Step number four, coaching, someone to help you implement structure. In other words, it's hard to do it alone. So work with a coach and sometimes a psychotherapist to have couples therapy and family therapy.

And then finally, step number five, medication. Notice that medication is only one step in a five step comprehensive treatment program. This is very important. Don't think of the treatment of ADD as simply taking medication. But when it's part of a five step program, it can be extremely helpful.

COHEN: Now, if you'd like some more information on ADD, Dr. Hallowell mentioned that there are some places to get good information. So we'd like to show you a Web site that has some good information on Adult ADD. Go to www.add.org. You can also go to our Web site, at cnn.com/health.

And we'll be right back.

(COMMERCIAL BREAK)

COHEN: We have an e-mail from Brian in California we just had to share with you about ADD. He wrote, "Can you explain -- oh, wait, I need to check the meatloaf. Distractions, distractions, distractions."

Dr. Edward Hallowell, thank you for joining us. And thank you for all of that great information on ADD. We really appreciate it. We hope to have you back on CNN soon.

HALLOWELL: Thank you.

COHEN: That's all the time we have for today.

Make sure to watch tomorrow's Weekend House Call when we talk about allergies and some alternatives to those expensive over the counter medications. We'll have an allergist with us for some good options for those suffering from sneezes, sniffles and sticker shock.

That's tomorrow on Weekend House Call.

Thanks for watching.

I'm Elizabeth Cohen.

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