In the work Dr. Amen has done with SPECT imagining of brains, he has found the blood flow to the pre-frontal cortex (home of executive function in the brain) diminishes significantly when those with ADD focus on an activity. This is the opposite of how a neuro-typical brain responds. I saw it in my son's scans.

My child in particular has a type of ADD brain pattern on SPECT scans (Amen calls it ring of fire) that looks identical to a Manic/Depressive brain pattern. The Hyperactivity and impulsivity can be Mania rather than ADHD and lack of focus and lethargy can be depressive symptoms. They were careful to tease out whether DS had any depressive symptoms or ideation. I was told what HowlerKarma was sharing about Bipolar when discussing appropriate treatment at my son's psychiatrist's clinic.

I've read a bit about the "outgrowing it" theories for ADD/ADHD. The most plausible thing to me is the proposition that adults have more freedom to work out their own environments. An adult can choose a job with constant movement or take a walk down the hall or even buy a treadmill desk (have you seen these?). I've heard it suggested that ER doc was the ideal career for someone with ADD.

My husband (ADD) is a phenomenal multi-tasker. He also raises the adrenaline level by managing multiple clients on the side while maintaining a fulltime job. There's always someone needing something. Focusing on ONE job is death to him. He can't stay awake or get it done. In college he had 12hrs of classes and 12hrs of independent study when we started dating. He's never been medicated and he does frequently leave the milk out overnight and is horrendous at home maintenance tasks. If he had a job that didn't allow flex scheduling, he would certainly be fired. But as it is, in the environments he has chosen, he's been a mostly high functioning individual.

My BIL chose a career as a gym teacher and both he and my FIL include time to run each day which allows them to sit and work as needed.

Nutrition is huge as has been stated. Changes there (including therapeutic levels of vitamins and minerals) and with aerobic exercise, including choosing flexible environments make coping with adult ADD more manageable.

So many of you touched on these things I had to chime in with experience with our extended ADD family. It's been fascinating to me to learn about it.