Edmonton resident Nikki Houde was 41 when she was formally diagnosed with attention-deficit/hyperactivity disorder (ADHD).
In November 2021, the middle school success coach was working from home during the COVID-19 pandemic, often finding her concentration drifting during video meetings, regularly avoiding tasks and making up distractions to get out of completing her work.
“I was just creating things so I didn’t have to do things that I didn’t want to do,” she said
After speaking with a friend who had been diagnosed with ADHD, Houde decided to seek help and learned that she was one of the thousands of adults who struggle with undiagnosed ADHD.
If left undiagnosed, experts like Dr. Ainslie Gray — a psychiatrist who founded the Springboard Clinic in Toronto and serves as the facility’s medical director — say that adult ADHD can seriously reduce a person’s overall quality of life.
“ADHD can impact every element of an individual’s life and the stereotype that it resolves by adulthood, even if it has been diagnosed in childhood, is not true,” she said, adding that the majority of people diagnosed in childhood and adolescence continue to experience challenges in adulthood.
Houde works as a success coach supporting school and vulnerable youth. (Submitted by Nikki Houde)
When Houde was finally diagnosed, she said she “felt relief because it explained a lot of things about myself that I didn’t have to feel so bad about myself, because there are things beyond my control.”
Houde’s feelings of relief are familiar to Gray.
“Adults often feel tremendous relief because they gain an understanding of what areas of their life have been responsible for their impairment,” Gray told The Dose host Dr. Brian Goldman.
According to Gray, ADHD is a “usually genetic” neurodevelopmental disorder that can range in symptoms, most often associated with hyperactivity, restlessness and inattention.
According to the Centre for ADHD Awareness, Canada (CADDAC), roughly five per cent to seven per cent of children are diagnosed with the condition, while four per cent to six per cent of adults are diagnosed.
While children may have a harder time processing their symptoms, Gray says adults can “learn to mask their symptoms,” making it difficult to determine if patients have ADHD or other mental health concerns.
Dr. Ainslie Gray is a psychiatrist and founder and medical director of the Springboard Clinic in Toronto. (Submitted by Ainslie Gray)
Still, the life impacts of adult ADHD are very real.
“There’s real concrete stats saying there’s compromised socioeconomic status, there’s lower annual incomes, there’s higher divorce rates, there’s less workplace satisfaction and less job security,” she said.
A study published in 2022 concluded that “adults diagnosed with ADHD and their spouses had more unfavourable patterns in their marriages with regard to the level of conflict, marital adjustment, conflict resolution styles and reciprocal evaluations” compared with non-ADHD couples.
ADHD in girls often harder to spot
Gray added that boys are more likely to be diagnosed than girls, but the ratio shifts to roughly 50/50 by adulthood.
“In children and adolescents, the male individual often presents with more overt emotional dysregulation or physical hyperactivity,” she said.
In comparison, girls are more likely to be inattentive rather than hyperactive — which makes it harder to diagnose their symptoms.
Gray speculates that one of the reasons the ADHD diagnosis ratio shifts in adulthood is because women are often more likely than men to seek medical help.
More women are being diagnosed with ADHD. Here’s why.
Girls are three times less likely to be diagnosed with ADHD, according to the Centre for ADHD Awareness, Canada. But it has more to do with society than genetic differences.
Looking back at her experiences, Houde acknowledged that she showed signs of ADHD even during childhood.
She would hyperfixate on things, often finishing books in a single night. She would also have trouble following conversations, either getting distracted or interrupting the other person while waiting for her turn to speak.
Additionally, Houde remembers often being told by her mother that she spoke very quickly — which is one of the many symptoms of hyperactivity associated with ADHD.
Since her overall experiences didn’t line up with those of the boys diagnosed with ADHD in her class, Houde didn’t think she had ADHD.
As she grew older, Houde’s experienced difficulty completing tedious tasks — like paying bills — often procrastinated and completed work at the last minute or not at all.
Coping with symptoms
Nonetheless, she found ways to cope with her symptoms.
“Post-its all over my office with to-do lists, things that I need to get done or reminders,” she said. “I have my calendar on my phone, and then I had a paper calendar, then I had a calendar on the wall to remind me of things.”
Dr. Sara Binder, an adult psychiatrist in Calgary, said adults with undiagnosed ADHD often find workarounds to manage their symptoms, sometimes even choosing professions that are “naturally stimulating and interesting for them.”
Dr. Sara Binder is an adult psychiatrist at the Foothills Medical Centre in Calgary. (Submitted by Sara Binder)
Binder said she often treats professionally successful adults with ADHD who are struggling in other areas of their life due to the undiagnosed condition.
“When you dig a bit deeper and you find out what’s going on in the rest of their life, or how hard they have to work just to stay at that level of functioning compared to their peers, you realize that there is actually significant impairment of functioning.”
According to Binder, part of the challenge with diagnosing adults with ADHD is that patients can sometimes present symptoms associated with other conditions — like anxiety, depression and substance abuse.
“By adulthood, if somebody has not been diagnosed and treated for ADHD, about 85 per cent of them will have at least one other psychiatric comorbidity,” she said.
How to treat ADHD
Gray says the first step in treating ADHD at any age is consulting with an appropriate specialist to receive a diagnosis.
Her clinic typically has patients meet with a psychiatrist, clinical psychologist and a coaching therapist.
“When those three interviews get together, along with questionnaires, it’s pretty clear when someone has ADHD and when they don’t,” she said.
After being diagnosed, Gray says a combination of prescribed medication and coaching or behavioural intervention to “deal with their signs and symptoms of impairment” is often best.
She says stimulants are an effective treatment, adding that long-acting preparations are significantly safer than immediate-release pharmaceuticals.
“Prescribing immediate-release stimulants, in my opinion, should never happen,” she said.
More adults are taking ADHD medication
New data from B.C. shows the rate of adults using ADHD medication has gone up dramatically. It can mean a fresh start for many newly diagnosed adults but physicians warn there can be drawbacks of taking medication.
A better life after diagnosis
For her part, Houde says her life has improved in the two years since her diagnosis, and she no longer struggles with managing her responsibilities.
She pays bills on time, stays in touch with friends and family and has enhanced her overall communication skills.
For those adults who might be worried about being diagnosed with ADHD or worried about the use of medication, Houde says her own journey has helped boost her self-image.
“If you think there’s something going on, there usually is,” she said. “It’s eye-opening and it helps you walk your path that you’re actually supposed to be walking on.”
MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.
There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.
The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.
Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.
Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.
Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.
“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.
Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.
But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.
That includes his own teenage daughter.
“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.
It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.
“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”
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AP data journalist Kasturi Pananjady contributed to this report.
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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
How a sperm and egg fuse together has long been a mystery.
New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.
“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.
The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.
Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.
It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.
Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.
Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.
The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.
The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.
The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.
The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.
The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.
“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.
When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.
“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.
“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.
The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.
Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.
The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.
“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.
They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.
“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”
This report by The Canadian Press was first published Oct. 17, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
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