ADHD and Lacking Empathy: Was I Raising a Narcissist?

ADHD narcissist

What do the words ADHD, low empathy, and narcissist have in common? Potentially, more than many people realize. This knowledge should be more widely understood, including in the mental health field, because it could hold the key to a happier life.

In this post, I’ll explain briefly before introducing an important first-person essay. At the end, you’ll find a link to my podcast of this post — and more links to my blog posts on empathy and ADHD.

A “Poor Prognosis” — In the Wrong Hands

These days, the Internet brims with lurid stories about narcissists.

Yes, it’s important that we understand what we’re up against when confronted with narcissistic behavior. But the psychologists in particular who are sensationalizing this topic might be doing more harm than good. They betray ignorance on the many potential factors that can underlie narcissism, some of which might be treatable mental-health conditions. Many also claim that the behaviors are intentional, volitional, displays of power over others. But that is not always true.

For example, many children with ADHD suffer cognitive impairments far beyond the classroom. Some of these impairments distort any reasonable person’s idea of a “happy childhood.”  I refer to impairments that, in fact, also threaten to negatively shape the course of their entire lives, especially their relationships. These include deficits in empathy, reciprocity, reflection, and remorse.

When we consider the negative chatter around “drugging children” for ADHD, what gets lost? Compassion—for these children and their families. Not to mention: a basic understanding of brain functions.

When your child is a psychopath article The Atlantic

It’s Open Season On Narcissists—including Kids

What’s more, in the wrong mental health professional’s hands, a child lacking empathy and acting with a sense of entitlement can invite a dire diagnosis: narcissistic personality disorder—or even psychopath.

For example, this article at The Atlantic’s website takes an extremely hidebound and punishing look at the phenomenon:  When Your Child Is a Psychopath. 

These diagnoses stick.  That’s because the mental health profession consider them “poor prognoses.” In other words, there is little hope for change. The behaviors are  viewed as part of personality, immutable.

But wait. If that child also has ADHD, there is a good chance that the first-line medication for ADHD, the neurostimulants, can enhance empathy—along with all the other “higher-order” brain functions.  This is not hard to understand. But it is not common knowledge. Far from it.  In fact, you probably read it for the first time in my first book, Is It You, Me, or Adult A.D.D.? 

To be clear: ADHD treatment can often help the narcissistic child have more reliable access to their innate brain functions, including empathy, conscience, and more.

Of course, narcissistic parents might also have ADHD or any of a  number of frontal-lobe issues. Imagine what that is like for their children, especially if the child also has ADHD.

But I suspect it feels even worse when therapists or pop culture tells those adult children that their adult problems stem from their parents’ narcissistic actions, motivated by control and power. Maybe they did. Maybe they didn’t.  That’s just one of the dangers of holding onto old psychological theories. Let’s face it, it’s name-calling.

ADHD, Empathy, and Raising a Narcissist

In fact, my friend Taylor J. was one of those children. Maybe you’ve read her essays in the You, Me, and ADHD Virtual Discussion. Here, she shifts from talking about her own and her husband’s ADHD diagnoses. Now she shares this story of her eldest child’s recent ADHD diagnosis and treatment.

This was big. Taylor had despaired that her daughter would grow up to resemble her own parents: narcissistic and lacking empathy. Generally speaking, empathy deficits form the foundation for narcissism.

Taylor and her husband tried to teach empathy to the girl, but the lessons never took hold. Or, so they thought.

P.S. You Read About ADHD & Empathy Here First

Please note: An earlier version of this post appeared  Jan 27, 2016.  This points to my being among the very first to write on ADHD and empathy. Probably the first.

It’s only in the last couple of years, that many have followed suit. That includes those who publicly lambasted my 2008 book (Is It You, Me, or Adult A.D.D.?) for “saying mean things about ADHD”. They claimed I wrote: “People with ADHD have no empathy.”  What I wrote was this: “ADHD can sometimes create empathy impairments.”

Moreover, I went on to say that medication treatment can often give the person with ADHD more reliable access to their innate empathy.

Why the latter-day conversion? Maybe they saw the high Google search rankings for this post, now that everyone can analyze any websites’ analytics. If that’s what creates enlightenment on this complex topic, so be it.

—Gina Pera

cause and effect

By Taylor J.

The Number One most profound thing I’ve learned about ADHD is this: It can create trouble connecting “cause” with “effect.” And that can create a world of trouble.

For example, a student will not see his poor study habits as the reason for his poor grades. Instead, he’ll blame a “mean” teacher. A wife will not see that her cutting, sarcastic words caused her husband to withdraw emotionally. Instead, she’ll call him “cold.” A young man will not see that his reckless driving and speeding caused a car accident. Instead, he’ll blame barely there weather conditions.

It doesn’t take a genius to see that continually failing to connect actions with consequences will wreak havoc on a person’s life. Worse, it can kill the potential for relationships.

I saw this play out starkly in my 10-year-old daughter. Let’s call her  The Firecracker.

is your parent a narcissist? Does your parent have ADHD?

I Vowed To Be Unlike My Narcissistic Parents

First, let me give you some background.

My parents are horribly mentally ill, and they refuse treatment. Instead, they blamed everyone else for their troubles—and drowned their sorrows in alcohol, drugs, and pity parties. Even when I was in the hospital—sick or with a new baby—my parents could only talk about themselves. I found their utter lack of empathy horrifying.

When married and starting a family of my own, I vowed to be different. Yet, in raising my first-born child, the oldest of four girls, I watched helplessly as every lesson about empathy I tried to impart seemed to bounce cleanly off her soul.

What do I mean by that? Well, for one thing, she would exploit others. She would set up games where everyone had to treat her like a queen visiting from another planet—or convince friends to “share” their favorite toys and clothes. Forever.

I even caught her in an elaborate kindergarten “protection racket” at one point: taking her sister’s money to keep monsters away. (She’d already made 6 dollars!)

She would take—but never give. Her friends would give her presents, invitations, or compliments. Yet she never saw any need to return the favor.

In fact, she would complain if a compliment missed a detail, or if the gift didn’t fit just right. She would even go to a friend’s house and critique their clothes or décor for them! “You really shouldn’t have that dollhouse—it’s for babies. You should get a Barbie dollhouse.” Seriously? Where did you learn this?

I was asking the wrong question. As I came to learn much later, hers wasn’t learned behavior. It was innate.

No “Cause and Effect”—Only “Mean Parents”

My husband and I explained, repeatedly, that her words hurt other people. We’d ask,  “How would you feel if Ginny came to your house and said your dollhouse was for babies?”

The confused-looking Firecracker would reply, “But my dollhouse is not for babies, so she would never say that!” We would punish her for saying cruel words—and she never understood why she was being punished. We were just “mean parents.” The type she might be complaining in the future to a therapist—who won’t have the full picture.

There was more. She would explode over the tiniest frustration. Itchy seams on her socks. Bedcovers not being straight. Her oatmeal being the slightest bit “too watery.” Her low frustration tolerance would set her off on an explosive tantrum—and others were always to blame.

I remember when she was only one year old, screaming at the shape-sorter because she couldn’t make the block go in the way she wanted it to.

Sporadic Bursts of Caring—and Low Frustration Tolerance

We did see sporadic bursts of caring from her. We could just never predict when they would happen.

Her first words upon meeting her sister: “I’m going to watch out for her, and make sure she doesn’t run out into the street without me!” At age 3, she started punching a preschool classmate who came up and shook her baby sister’s car seat carrier (while I was talking to a teacher). She was afraid he would hurt the baby’s “soft spot.”

When I was violently ill with another pregnancy, she proclaimed to her sister, “Don’t worry. When Mom throws up, I’ll make you a sandwich.”

Words, however,  rarely met actions.

The Firecracker screamed at her sister for adjusting her stuffed-animal display. My second daughter would dissolve into tears, and ask, “Why doesn’t she love me?” The Firecracker’s response?  Her sister’s sobs were disturbing her reading time.

Without the larger context, you might take this as typical sibling rivalry. But it was much more troubling.

I had started to wonder if I was raising a narcissist.

ADHD empathy narcissism

Shocking: My Child Has ADHD — Isn’t a Narcissist

My husband and I both have ADHD. We both take medication. I know full well the dramatic changes in cognition and behavior the medication provides.

But when The Firecracker was finally diagnosed with ADHD this past July and began medication treatment, even I was not prepared for the change that followed.

I gave her the first dose of Ritalin. Two hours later, as we were returning from the grocery store, she said, “Mom, you can’t carry all that. Let me help you!” She grabbed two grocery bags and the diaper bag. “You need to ask for help when you need it, mom!”

Then, when the baby started crying: “Oh, honey, come here and let me hug you! Don’t worry, mom, I’ve got her—I know you’re making lunch.”

When I had to change plans that she’d been looking forward to: “Aw, that stinks, but I know you didn’t try to make it hard for me. We can go tomorrow.”

To be clear: My daughter had not become some creepy “good child” automaton.  She was still herself.  But a better emotionally regulated version of herself. A more content version of herself.

This much was obvious: She was as relieved as we were with the changes.

hyperactive child empathy
Our Firecracker, constantly in motion. With her little sister

“It’s Going to Be Okay”

Five hours later, the medication had worn off. The Firecracker came to me, tears streaming down her face, screaming, “Mom! This is awful!!! The baby won’t stop crying! [The baby had cried for one minute.] Is this what it felt like all the time when I wasn’t on medication?”

I took her by the shoulders, looked her in the eye, lowered my voice, and said, “Don’t worry. It’s going to be okay. Yes, this is what it was like all the time. Take your next dose, then sit here and watch something on TV while I set a timer. When the timer goes off, your next dose will have kicked in.” I wiped her tears and turned on something funny.

Half an hour went by. When she felt better, she looked up at me, and said, “Mom, maybe you should get me a puzzle book to work on when I’m angry. Then I can calm down without yelling at anyone.”

I watched the rest of the night as she spoke lovingly to her sisters and forgave them when they committed the grave sin of touching her stuff.

ADHD child narcissist

Relief At Connections Made

As she was reading her favorite book before bed, she looked up and said, “Mom, now I understand why Eragon sighed so deeply when he saw his brother: He was afraid his brother would become a rider, too!” Even the stories were becoming more clear.

Remember, this is just the first day of ADHD treatment.

I asked my husband to tuck the girls into bed that night. Then I turned on the shower and broke down into sobs as the water washed over my face. With immense gratitude and relief, I finally realized that my daughter had ADHD but was not a narcissist. She actually did take in the lessons about compassion and empathy that we were teaching her. She simply couldn’t access them when she needed to.

My daughter had been suffering from a treatable brain condition, not an incurable evil that was lurking behind her smile.

Maybe my parents can be helped to change their narcissistic behaviors, too. I can only hope that they’ll reach a point where they’re willing to try treatment.

So, the next time you hear someone gasp at the thought of putting a child on medication for ADHD, please remember my Firecracker. Please know that it is beyond the control of many people with ADHD, including children, to make certain cause-effect connections. Whatever empathy they have can get lost in impulses and distractibility.

Please know that, since beginning to take stimulant medication, my girl is happier and healthier than she has ever been. (More about that in a future post from Gina.)

ADHD empathy


The Firecracker’s Comic: Overcoming a Struggle

I’ll close with this amazing comic that The Firecracker drew for school. I had nothing to do with this. My daughter loves graphic novels, including authors such as Raina Telegmar, and has created dozens of comics in that style.

Recently, her class read a story called The Dot, about overcoming a difficult struggle. In response, they were to write about a struggle that they overcame. This is my girl’s story.

The Research: ADHD and Narcissistic Traits

Again, this phenomenon is more common than the mental-health profession realizes. That is, the association among ADHD, lacking empathy, and narcissistic behavior.  You can listen to the podcast of this post.

This other post (ADHD and Empathy: A Study, Book Excerpt, and Empathy Defined) tackles the topic from several angles:

1. Defining empathy (it’s not what most people think).

2. Excerpting a passage on empathy and relationships from Is It You, Me, or Adult A.D.D.?

3. Sharing details from yet another study pointing to a connection between dopamine and cognitive empathy.

A sneak preview of the study:  It confirms my observation first observed 20 years ago: Stimulant medication often enhances empathy in people with ADHD.

But wait. This happens not because the medication “creates empathy.” Rather, as the study in the linked post above suggests, the medication enhances dopamine transmission. That, in turn, allows some people with  ADHD to focus on and access this “higher-order” brain function. In fact, they have always possessed empathy. But haven’t been able to reliably access it—or act upon it.

Empathy sounds simple. But it’s really a complex phenomenon. In fact, some people with ADHD have trouble reining in their empathy; medication often helps them, too. As with many ADHD-related challenges, it’s all about the self-regulation.

For another angle on this topic:  Empathy and Mirror Neurons: Or, Monkey See, Monkey Yawn

Gina Pera's online course

How about you? Have you noticed a difference in your child’s

expressions of empathy or mood-regulation post-treatment for ADHD?

I welcome your perspectives.

—Gina Pera


92 thoughts on “ADHD and Lacking Empathy: Was I Raising a Narcissist?”

  1. Lindsay Smith

    OMG, I can’t begin to describe the absolute relief I felt reading this article!! I’ve NEVER heard anyone else describe the absolute disconnect in cause and effect when it comes to my daughter’s role in situations, yet there’s no problem recognizing the same issues in others. I have felt like I’m crazy for never having been sure if it was manipulation or truly didn’t get it! I knew no child has ever been that consistent her entire life if it was a lie, but I also know she’s incredibly smart!! How do you fix something you don’t understand?? So I just couldn’t figure out am I up against a narcissist or what and how in the world I could have raised a kid like that?? But I finally took a huge sigh of relief realizing it’s all still ADHD!! I have it too, mine just never presented like that so it’s been an absolute desperate hunt for education so I can better help her when no one thought girls could have when I was a kid let alone being thought of anything but the “bad ” kids having it!! Im just so glad that we live in Era that info is available and with it real power is held!!! It’s taken a Lotta fights with doctors just to be taken seriously for getting my daughter diagnosed, but it’s been game changing ever since!!

    1. Hi Lindsay,

      I’m happy to know this post had meaning for you. Thanks for your comment.

      This is a topic that few others have been willing to write about honestly. That means many people continue to suffer.

      Adding your experience here will definitely help to validate others.

      This is quite a serious topic. I just heard from a mother the other day. Her 40-year-old daughter is still blaming her for everything that is unhappy in her life.

      A therapist has convinced that daughter that she doesn’t have ADHD, she has trauma induced by her mother’s behavior as she was growing up.

      “Therapy” consisted of laying accusation after accusation at her mother’s feet, with her mother being unwilling to say a word. She could speak only to apologize.

      The mother was heartbroken of course, but even more than that, the therapist is not helping this 40-year-old woman come to grips with ADHD. She was diagnosed as a child, and her father, too. But she’s been convinced it was never ADHD, it was her mother’s abusive and narcissistic behavior.

      Bad therapy can have so many life-long negative consequences. Unfortunately, the trend now is blaming every adult unhappiness on trauma. It’s so easy, it involves no thought at all. Just accusations. Horrible stuff.

      I’m glad you and your daughter are on the right track. Also, that you understand there is nothing cookie-cutter about ADHD. It’s a complex syndrome that affects individuals, not clones.


  2. Desperate Mom

    Dear Gina,
    I know I am a bit late to the comments section regarding this article, but I am a desperate Mom scouring the internet in hope of finding any answers that may help my son. This article has given me a glimmer of hope. I relate so much, so I thought that I’d give it a try.
    After learning more about my own ADHD Inattentive Diagnosis, I instantly knew that my son had it too. The one and only thing that I couldn’t decipher is that he unfortunately exhibits all of the classic signs of having NPD, and I am the complete opposite overly sensitive type. I have spent years trying to get him to seek an ADHD diagnosis in order to help him in other areas of his life, but it wasn’t until recently that he has agreed. His first very small stimulant dose he called me within an hour and told me as much as he hated to admit it to me, that I was right all those years. He could feel the haze lifting and was beginning to think clearly. After a few days of this thought he also became overwhelmed with all these new feelings of empathy, sympathy, and guilt, that he hadn’t felt before. I was a bit in shock because I wasn’t expecting this bonus of help with his NPD traits too. As a Mom I am sure that you can imagine the hope that it gave me for him. I quickly realized though that all those years of feelings coming at him all at once was just too much for him yo process. He was unable to regulate his emotions and started to express feelings of being suicidal. So I asked him to take a break from the medication for a day until we could get ahold of his Dr. From there we tried starting him on the lowest dose. But unfortunately his outcome was the same. So now he’s been prescribed a non stimulant ADHD medication. However he’s not sure now that he even wants to try it. He is like night and day, without the stimulant. You can just feel his tension, and see his lack of sympathy, empathy and guilt come back. I guess my question is.. Have you seen any cases that non stimulant medications actually help these NSP traits too? I’m desperately seeking help for him, but I don’t know which way to go or where to turn.

    A Desperate Mom

    1. Dear Desperate Mom,

      I absolutely understand and appreciate your situation.

      This might sound extreme, but I’ve been at this for decades and have seen it persist. That is, the way that ADHD is “treated” borders on criminal.

      You cannot give a person medications that can have such a profound impact without preparing the person, without education, without support. It just beggars belief.

      Now, there could be other things going on — beyond the medication “turning on” qualities never seen or felt. It could be creating emotional dysregulation.

      It could be that the dose is too high — or increased too quickly.

      I can’t see why the MD would switch to a non-stimulant when your son showed a clear response to the stimulant.

      The best we can know is that about 1/3 of people with ADHD respond well to Strattera/atomoxetine, the only first-line medication for ADHD that is a non-stimulant. It doesn’t have a track record of fully treating the range of symptoms. But it often does help with mood, sleep, and, to some degree, focus. More importantly, at a lower dose (25-40 mg) it tends to work well with a methylphenidate stimulant, to help provide a “soft landing” when the medication wears off.

      I think it’s really important for you to try to discern what happened…..was it “too much too soon”? Or did the medication create depression? Which stimulant was it? It might be that a different stimulant will cause a positive reaction without the negative.

      It could well be that he just doesn’t know what to do with these new perceptions. In which case therapy with a knowledgeable professional might help. Or he could journal about them. Or engage in an online discussion, using a pseudonym, to see how others might have felt this and how they dealt with it.

      You and he might find my online training useful. The hard truth is, it is extremely difficult to find competent therapy and prescribing. I’ve worked hard to fill that void. Because it makes all the difference. You two could share the enrollment.

      Solving Your Adult ADHD Puzzle.

      take care

  3. Uh oh, you happened upon a raw nerve, so this is going to be long.

    I know you have the best of intentions here. There’s a lot of truth in this post, and I definitely think if a child is showing these behaviors, the first step should be ADHD assessment.

    But I am also deeply concerned that you are doing exactly the opposite of what you set out to do. You don’t want children to be erased behind an erroneous label. But you are erasing other children and making it harder for their families to help them and adding to their sense of isolation.

    I lived over 40 years with untreated ADHD. Although only my father and I have official diagnoses, I am confident that both my parents and both my siblings also have ADHD. I say this to show that I have significant experience with how ADHD feels and how it can look in different people.

    My ex-husband was apparently also diagnosed with ADHD when he was a child. As far as I know he doesn’t have any other official diagnoses, but in my opinion, he matches the diagnostic criteria for Narcissistic Personality Disorder (NPD). I didn’t stay with him long enough to feel like I really understand his internal processes. But I’ve been raising our daughter for 17 years.

    While it took me a lot to get to this point, I say confidently that she inherited many narcissistic traits from her father. Before I go into that further, I want to say that she was diagnosed with ADHD 3 years ago, has tried several stimulant medications, is now taking a non-stimulant medication, and has received countless ADHD supports and trainings. While she has grown and changed over the years, and some things have improved, I wouldn’t say the ADHD treatment has done much to help.

    My experience suggests to me that disorders like NPD and Antisocial Personality Disorder (ASPD) are much like ADHD in the following way. We know that symptoms of ADHD can be caused by trauma, but usually we’re talking about people who have a normal variation in the way their brains and nervous systems work and interact with the world. It can cause problems if it’s not accommodated, but it’s not an “illness”, so it can’t be cured. I believe NPD and ASPD work the same way.

    The NPD entry in the DSM is even worse than the ADHD one, in my opinion. It too is nothing more than a bundle of symptoms with no hint at possible underlying causes or suggestion for adequate supports. But the research into it is the worst. NPD can’t be diagnosed in anybody under 18, so there’s very little research into children who seem to be displaying narcissistic traits. And once a person with these traits is 18, they’re incredibly unlikely to get this diagnosis, because that would require them to seek treatment and be transparent with the medical professional. But they don’t seek treatment, because they attribute causes externally — they wouldn’t think that they have any problems that need treatment. Even if they did speak to a professional, it’s very common for people with NPD to lie or leave out context that doesn’t support their world views. So most of the research about NPD (and this is true with ASPD, where psychopathy falls), is done on institutionalized people who have no choice. That means it’s incredibly skewed, and feeds the misconception that only criminals and crazy people have NPD and ASPD. And since most people who end up institutionalized have some sort of trauma, it also feeds the misconception that these are illnesses — that people only end up with NPD or ASPD because something bad happened to them.

    So there are almost no resources and very little information out there for parents like me. I can speak about other parents, because I’m part of a parent’s group for parents of kids who display criminality, violence, or both. We are either invisible or stigmatized, and we’re on our own as far as figuring out how to help our children.

    That means I can’t necessarily share specific studies or direct you to specific websites to support my experiences. But this is my understanding of my daughter. There’s a lot of ADHD in there — the EF challenges, the low dopamine, the emotional dysregulation. But there’s something else, too. She has an incredible ability to “edit” reality to only see certain parts of it. We all do this, like with confirmation bias, but she does this to an extraordinary degree.

    She is an externalizer. She self-regulates externally, not internally. That means in order to change how she feels, she’ll try to change her environment (food, buying things, appearance, entertainment, etc.) rather than working internally. This strategy is only ever partly successful, so she always needs more. If good things happen to her, they’re externally caused. That means if she wants something, instead of trying to make it happen, she tries to make somebody make it happen for her. If bad things happen to her, they’re externally caused. That makes it hard to grow from mistakes, because she doesn’t see her role in them. It also makes her feel like a victim in an unfair world, which makes her much more comfortable with lashing out at or cheating the world — it hurt her first. It makes it almost impossible to trust anybody. As far as empathy goes, she’s got it. But she’s often unable to connect to it, because she feels so miserable. Her self-regulation only helps her feel better temporarily (and often makes her feel worse in the long run, like when she eats junk food), and she’s living in a world that does bad things to her for no reason.

    I wish there were screening protocols, because she’s shown signs of this since she was a baby, but I only recognize them in retrospect. We need way more research into how to support kids like mine (and kids who have traits related to psychopathy), but at the very least, I wish somebody had recognized her signs and done the following for me:

    Made me go get assessed for ADHD. You cannot effectively raise a child like this with poorly managed ADHD, because they don’t self-regulate well. You need to do an extraordinary amount of co-regulation. You need to be able to regulate your own emotions and reactions. And you must be able to stay consistent and aware. So ADHD management is crucial. And then I wish somebody had given me the following guidelines.
    Don’t expect your kid to feel sorry, guilty, ashamed, worried about hurting others, or realize that they’re shooting themselves in the foot.
    Choose your battles carefully. But once you lay down a rule, stick to it. No second chances. No wiggle room. Make sure you’re making rules that you can actually stay on top of and consequences that you can actually enforce.
    Lying will probably be an issue. Make your decisions based only on evidence.
    6. When you’re considering rewards or changing the rules, watch for a pattern of change over time. Don’t change the rules just because your kid does the right thing once or twice.

    Families like mine need help. We need people to acknowledge that kids can be born this way — it’s not a matter of trauma or “bad parenting”. It won’t be fixed by dietary changes. It won’t be fixed by ADHD treatment. Our kids aren’t bad or criminals, but they’re much more likely to harm others, especially since we don’t know the best way to accommodate their needs.

    1. Hi Gabrielle,

      Thanks for your comment. I appreciate the difficult path you have been walking — and often, without knowledgeable help from professionals.

      I’m not understanding your point, though:

      But I am also deeply concerned that you are doing exactly the opposite of what you set out to do. You don’t want children to be erased behind an erroneous label. But you are erasing other children and making it harder for their families to help them and adding to their sense of isolation.

      How am I “erasing” other children exactly? In this writer’s case — again, she is a late-diagnosis adult with a late-diagnosis husband. If anything, they went too long not understanding what was behind their daughter’s behaviors. They blamed their inability to “teach empathy.”

      The “mislabeling” was calling the child narcissistic.

      Human empathy is complex, with many aspects to it. Also, there is no “normal” amount of empathy. I haven’t seen studies but I imagine, as with many other human traits, it follows a bell curve. Most mental-health professionals, I’ve found, have little clue about the brain’s role in empathy. They over-sell “trauma” as the cause of everything — and parenting, as you say.

      You say that your daughter inherited “narcissistic traits” from her father, diagnosed with ADHD. There’s a clue that her reported narcissistic behavior might be connected to ADHD neurobiology.

      You might want to read another of my posts on ADHD and empathy:

      You write: She has an incredible ability to “edit” reality to only see certain parts of it. She is an externalizer.

      Again, this confuses me because this can be very much part of ADHD.

      You might want to read my three chapters on “denial” — its physiological and psychological components — in my first book:

      I couldn’t possibly say that “something else isn’t going on” with your daughter. Perhaps hard-wired low empathy. Perhaps being on the ASD spectrum.

      But I can say that even when recognized, ADHD is often treated with so little understanding of the complexity that most people, including children, never get the education and treatment they deserve.

      Not everything can be “fixed by ADHD treatment.” But much more can be addressed when medication is wisely chosen and consistently taken — and, of course, skills are taught.


    2. @Gina I see what Gabrielle means, in that I’d be cautious about “putting all problems behind ADHD”, I’d worry about doing the same error than psychoanalysys did by explaining every psy-issue by bad parenting (with very bad consequences for autists for instance), or even now the error that I think enthusiasts of “hypersensitivity/SPS” are doing by using such a broad and blurry description, probably leading people into dead end on their own “psychological path”.

      With my (humble) understanding of all of this, for now my idea of all this would be :
      -a base layer with natured peculiarities like ToM, executive fonctions, natured alexithymia, and maybe also the egoistic trait of the firecracker and also a paranoid trait, cuz’ both of these are very peculiar

      -a second layer with innate disorders caused by what’s on the base layer, so here we have ADHD, autism, dys-disorders, and probably others as well, like schizophrenia, paranoia

      -a third layer with acquired issues, like acquired alexithymia, bad parenting

      -a fourth layer with aquired disorders (BPD, NPD, anxiety etc)

      But where even the acquired disorders of the fourth layer may be (at least partly) caused by unseen difficulties of the base layer.
      A question that remains (to me) is where the egoistic trait should be placed, if it’s standalone, or part of ADHD, it could even be both. Same for paranoid, maybe it’s linked to something else, maybe not. Maybe it’s an extreme trait of cautiousness that might have been great for a hunter-gatherer living in a unified tribe, but not so much for an individual in an individuallistic modern society (but I’m digressing into pseudosience there 😉 ).

      On the other end, I’ve read your book, particularly the 3 chapters about denial and it’s indeed very eye-opening to understand why someone apparently sound can turn into such a childish moron (lets admit it) in no time, and I must say it’s the only time I’ve seen it explained this way (and with the difference between psychological and physiological denial).
      And much more serious than born-again hypersensitives intuition…

      In France (where psychoanalysys is still very prominent), an expression has nonetheless popped out relatively recently I think called “verrou dopaminergique”, which I could translate by “dopaminergical lock” and which I think helps to understand the denial.
      It describes how, in a “balanced brain”, choices and actions are decided based on an even balance between pleasure/gratification and consequences/rules/responsabilities, or to kind of sum up : drive and reason.
      And how in an ADHD brain this balance is tilting more or less strongly towards immediate gratification, and how this “dopaminergical lock” kicks in to make the behaviour totally different from what you’d expect.
      It’s like the train of thoughts is thrusted by this lock, crashing at neurological speed without a care through all warning signs and barriers on the road.

      If you’ve read the comic Tintin in Tibet, you can picture his dog, Snowy, when he faces dilemma between delivering a letter to save Tintin or eating a big bone.
      A devil Snowy and angel Snowy are arguing in his head, the devil one taking over, with the angel eventually bringing Snowy back to reason.
      We can make the hypothesis that Snowy is a bit ADHD :p

      According to the youtube channel “how to ADHD” there may also be a now/later perception of time in ADHD, again leading to very wrong assumptions (for instance the ADHD brain forgot to move what was said 5 minutes earlier from working memory to long term memory, so the assumption is lacking this element, and totally erroneous).

      Anyway, in the case of Gabrielle daughter, I would indeed look for some ASD traits as well.
      They’re often described as “little professor”, and when it’s intertwined with ADHD it seems it may make those people quite “self-entitled”, and so maybe the ADHD medication didn’t work much on the asperger traits.
      I’d say I have two relatives who fit this description of both ADHD and ASD (though it’s difficult to be sure), and the denial to their awkward behaviour, the way they are oblivious to the weirdness of their lives, is mind-boggling, as if they are living in their very own space-time, it’s mind blindness.

    3. Hi Will,

      Thank you for such thoughtful comments!

      1. verrou dopaminergique. – I’m surprised to see any term in French related to dopamine or neurotransmitters, for that matter.

      Acknowledgement of ADHD is rare in France. I hear that the common practice is to prescribe anxiolytics — for everything. Maybe you’d be interested in this post in response to the French Children Don’t Have ADHD hype:

      2. I love the Tintin story! My Francophone husband must have 40 Tintin books. When he wants to relax, he curls up on the sofa with one of those. I’ll tell him about the story.

      3. Yes, ASD traits can often cloud clarity. But also: Many therapists and other mental health workers fail to see ADHD-related challenges with social anxiety, making eye contact, hyperfocus on subjects of interest, etc. with ASD.

      It leads many people astray. Especially here on the West Coast of the U.S.. (Some parents even re-locate to California because the benefits for children with ADHD are so generous….and skewing of diagnoses.)

      My scientist-husband was definitely the “little professor” type. I’m sure he would have been confined to the “ASD Lite” category (Asperger’s, as it was called then). But I clearly saw ADHD. Maximizing ADHD treatment has largely eliminated those said ASD-challenges.

      Will this happen for everyone? No. ASD is real, and I’m a big fan of Simon Baron-Cohen’s work. But too often, treatment just doesn’t address ADHD well enough, and folks leave it at that (ASD).

      4. Thanks for noticing the originality of my chapters on denial. I was the first to explain the phenomenon in this kind of detail. Unbelievable to me at the time and still. Because it is SO OBVIOUS.

      5. Yes, the now/later phenomenon is well known with ADHD. In 2010, I ran this excerpt from Russell Barkley’s book, on “Time Blindness”, to educate the public. On this blog I wrote pro bono for CHADD .


    4. @Gina Haha, yes we’re slowly doing better here in France. Not so long ago there was an “autism plan” for a better awareness and school inclusion of autistic kids (well I can’t say if the results are there, but there’s the intention) and we even have autists on TV or series sometimes, though quite often a bit “cliché”, and it’s getting slowly better for ADHD as well as Ritalin is now reimbursed for adults as well.
      On the negative, I’ve read that most psy-universities are still psychoanalysis oriented, or at least psychodynamic, but it’s getting better.
      I would guess that Internet helps a lot as the resources available in Canada are often available in both english and french.

      @Gabrielle, to be a bit more specific about what I think could be related to ASD, in his guide about Asperger’s Syndrome, Tony Attwood describes how someone unaware of his ASD may cope with it through 4 strategies :
      -reactive depression (self-explanatory)
      -evasion into imagination
      and the fourth one, which may be the worst one :
      -denial and arrogance

      A kid going this way, while feeling “different”, won’t acknowledge it and will externalize the cause of his struggles, so it’s never his fault, it’s everyone else’s.
      Attwood describes how the kid/teen may then intoxicates himself thinking this way, thinking that his views/intelligence are always right and have to be respected as such.
      Parents don’t know how to deal with it, often the kid may be good in school anyway so they may give up overtime.
      He becomes self-entitled and won’t ever agree that he is wrong, even if he knows deep within that he struggles and feels different.
      It may even lead to a secondary diagnosis of NPD.

      On his website, Attwood says 40 to 70% of autistic children and adolescents have a comorbid diagnosis of ADHD so that’s pretty high (but the contrary is not true as ADHD is much more prevalent than autism).

      And I must say, this strategy sounds so close to denial in ADHD that I wonder if it could be related or not (though I have no clinical experience to say if it’s indeed similar or not so that feel may be totally wrong).

      Well, the way Attwood describes it makes it sound like it’s an acquired strategy (as it looks like an adaptation to deal with struggles created by issues with theory of mind I guess).
      But maybe there’s an innate part to it ?

      And I wonder to which extent this may be caused by alexithymia, I mean : How can someone “not connected” and “not aware” of his own emotions analyze and modify them ?

      It would be interesting to have Tony Attwood meet Russel Barkley and discuss about this.

      But as said before, it’s difficult to grasp all the ways ADHD can “manifest” itself (and make the difference with ASD when there’s both).

    5. Hi Will,

      Sorry for the delay in approving your comment — and thank you for it.

      re: Attwood. I read his books about 15 years ago, when I was first trying to figure out these distinctions…ASD vs. ADHD. At that time, he had very little to say about ADHD. So, that was disappointing.

      But that’s how it is with all the other “specialties” — little comprehension of the comorbid aspect. ADHD experts, on the other hand, are entirely acknowledging of the high comorbidity rate and how it can complicate ADHD diagnosis and treatment. In other words, ADHD experts aren’t stuck in “silos” and territorial.

      The figure I’ve seen quoted on ASD-ADHD is about 50% — and, as you say, not so high in the other direction. That is, when ADHD is primary.

      My perspective, developed over MANY years of meeting real-live people grappling with these dual-diagnoses, is this:


      At least here in the U.S., and especially the West Coast, I see a harmful clinical bias toward ASD and against ADHD. (It probably doesn’t help that California in particular offers generous benefits to school-age children with ASD, but not ADHD. Families actually move here for that.)

      This bias is true for adults and children. And it happens because clinicians fail to understand ADHD in all its complexity.That is, the sometimes rigid cognition — black/white, all/nothing. Also: difficulty maintaining focus in a conversation because the other person’s eyeglasses are too distracting, so avoiding eye contact. “Hyper-focusing.” etc.

      “Theory of mind,” a concept developed by Uta Frith, mentor to Attwood, Simon Baron-Cohen, and others, is applicable to ADHD in some ways, too. Due to deficits in higher-order brain functions such as empathy, perspective-taking, etc.. The important difference: Medications for ADHD typically improve these functions. Not so with ASD. Unless the ASD co-exists with ADHD, which case ADHD should be treated. Say people who know more about this than I do.

      It takes a lot of intelligence and study to suss out the details in the vast gray area. Not a lot of that going around. 🙂


  4. But I feel like I have the opposite. I cry at The Voice which we know is rigged. Sometimes I just cry over missing people etc. Had such trouble growing up with my family saying I was just way too oversensitive about everything

    1. Hi Kat,

      Maybe you missed this at the end?

      Empathy sounds simple. But it’s really a complex phenomenon. In fact, some people with ADHD have trouble reining in their empathy; medication often helps them, too. As with many ADHD-related challenges, it’s all about the self-regulation.

      Also, I refer to THIS post, which goes into more details on Adult ADHD and empathy:


  5. Reading this article about empathy and narcissistic traits might just be another major breakthrough for me. At 65-years-old, I’m determined to find out the true causes of the many mistakes, impulsive behavior, etc. I’ve made in my lifetime. Before I go on, I am in no way and never will use these causes to excuse me from all my major blunders in my life. Yes, I’ve hurt many people, sadly, my own family. I’d love to talk with the 38-year-old Goddaughter of the woman who just wrote to you. How I wish all the recent research on ADD was available when I was 38. I didn’t even find out I had the wiring of an ADD brain until I was in my mid-40’s. At 38, she has many years ahead of her to limit or even stop making more mistakes that she’ll just regret when she’s 65.

    1. Dear Linda,

      I hope the Godmother is reading. She’s doing all she can, but the “mental healthcare system” isn’t always so well-equipped to provide the necessary care.

      1994 – the year the Adult ADHD diagnosis was made official. It’s taken years for many to receive the memo— or know what to do about it.

      It’s admirable that you don’t want to make ADHD the scapegoat. Still, you didn’t know. No one around you knew. We go based on appearances unless we get better information.

      take care,

    1. Hi Eimear,

      Thanks for visiting.

      SPD = Sensory Processing Disorder

      Here’s an excerpt from an article on the topic from CHADD (linked below). It touches upon the common problem of “silos” — that is, one specialty has one name for a phenomenon, and another specialty has another name for it! Perhaps the cause, too.

      Max Wiznitzer, MD, is a pediatric neurologist and co-chair of CHADD’s Professional Advisory Board. He says that sensory processing disorder, in his professional opinion, is not a diagnosis but instead a description of behaviors. While some of the techniques used in sensory integration therapy can help co-occurring conditions, such as anxiety, he says sensory integration therapy does not help with ADHD symptoms.

      “While people have made these claims about sensory processing disorder, the science there is limited,” Dr. Wiznitzer says. “Here are my concerns: The clinical features of this so-called disorder are non-specific and include parts of different disorders. The explanation of the biological base for the disorder is very limited. The research conclusions are not always supported by the data. And improvements that occur in the population frequently occur without medical intervention.”

      The data on the effectiveness of therapy for sensory processing disorder is also limited, he says. The American Academy of Pediatrics recommends pediatricians educate interested parents on how to determine if a suggested therapy for SPD is effective for their child.

      “The family, pediatrician, and other clinicians should work together to prioritize treatment on the basis of the effects the sensory problems have on a child’s ability to perform daily functions of childhood,” the academy writes.

      “There’s very limited data on the impact of the therapy that is supposed to manage (sensory processing disorder),” Dr. Wiznitzer says. “Therefore you have to monitor the treatments you decide on, to determine if they are working (in the time estimated to be needed for improvement).”

      Dr. Wiznitzer says he is concerned parents may accept the suggestion of sensory processing disorder and not go further to look for answers to a child’s struggles with his environment. Several disorders and conditions share symptoms with the description of sensory processing disorder and should also be investigated, he says.

      Sensory Processing Disorder & ADHD: What To Know


  6. These traits are also very common when a kid is dealing with both ADHD and ASD. In some countries, the ASD profile of high anxiety leading to the need for high control and attempted social manipulation as one aspect of control is recognized as “Pathological Demand Avoidance” or PDA. I prefer to call it Pervasive Desire for Autonomy”. Lots of useful info here:
    Learning about PDA transformed how I approached my kid and things are MUCH better now.

    1. Hi there,

      Thanks for the info.

      I read just a bit about “PDA”. One source says:

      Pathological demand avoidance (PDA) is a profile that describes those whose main characteristic is to avoid everyday demands and expectations to an extreme extent.

      To me this sounds like ADHD “can ‘t looks like won’t”. Maybe some oppositional defiance thrown in. Yes, “Pervasive Desire for Autonomy” sounds more accurate! But it’s also possible the “avoidance” is due to inability. That can be camouflaged by anger at even being asked to do something they know they can’t do.

      The field of ASD tends to overlook ADHD contributors to behaviors. It’s estimated that about half of people with primary diagnosis of ASD also have ADHD. Moreover, it’s thought that ADHD treatment helps these people to better manage their ADHD symptoms.

      Thanks for your comment.

  7. So timely! Just went through another “hurricane” with my 38 years old goddaughter who has lived with me over 13 years.

    She is seeing a psychiatrist who works with adult ADHD and is on medication, but the storms have only increased. As I put it, damned if I do and damned if I don’t.

    At 85, she expects me to jump through her hoops so she will “feel” okay.

    I’ve known her since she was five years old and she was considered the “wild child.” She has a bio in Carol Kranowitz’ book, “Out of Sync Child Grows up.” What happens when the adolescent doesn’t “grow up” which is now what I am dealing with?! I’ve helped her find an OT who works with adult SPD and helped her find her find the only Psychiatrist in our area who works with adults. I have weathered a number of storms with her but this one is a category 5! Pat Rice

    1. Hi Pat,

      That sounds rough indeed. What a loving, extremely patient person you must be.

      I know it sounds awful that I would suggest you “do more” but you and she might be living with the consequences of potential sub-part medication treatment. It might be that you could help to improve things. You Me ADD (my first book) explains the basic medication treatment protocol (which a tiny minority of prescribers seem to follow).

      Also, SPD is typically a “symptom” of ADHD, not a separate disorder. The OT might not know (or believe) this.

      It’s so hard to find proper therapy for Adult ADHD. That’s one reason I created my course:

      Solving Your Adult ADHD Puzzle

      take care of yourself, Pat!

  8. Nowadays this condition is getting very well known across online platforms. i personally know close friends and family members who are having narcissistic traits and after reading many articles about this condition in people i trully understood that this is a real treat when interacting with these type of people. Even if members of familly are having narcissistic traits, we have to learn how to cope with them and their condition. thank you for writting this article.

  9. Thought I’d make a post : This article is BIG, and I thought so already when I stumbled upon it around 2 years ago.
    I was in a dire need of understanding “the human mind” after bumping into the wrong person, searching for answers beyond the different innate and acquired personality disorder diagnosis (as ADHD and ASD looked to similar to not have ties) I had narrowed it down mostly to theory of mind issues, executive functions issues, and alexithymia (that’s big as well), and this article was kind of the icing on the cake.

    I probably have a moderate condition of ADD/hypersensitive/giftedness, which give me a “rhizomatic thinking” so I have to be careful not to generalize too much (so as not to replicate with cognitive approach the mistakes that psychoanalysis has done in the past), but I really wonder if a good chunk of BPD, NPD and other acquired PD don’t stem in fact from undiagnosed innate atypical condition (issues with ToM, EF, alexithymia, empathy) more than from bad parenting/abuse (even though it surely doesn’t help of course).
    The egoistic trait displayed in “the firecracker” behavior could be the difference leading to a NPD rather than BPD.

    Imagine if she had grown up without being diagnosed and treated, what would’ve she turn into ?
    As a kid reaches teenage years he/she has to figure out his/her own way of how the “social world” works, and the emancipation process could carve the manipulative behavior as the most effective way to go through life.
    Then the most visible symptoms of hyperactivity/impulsivity may have toned down as a young adult (or be controlled in public), but the manipulative behavior would remain, and unleash at home).

    And when you think that the former POTUS may have an undiagnosed ADHD and was raised with a harsh education, you start to think that along with global warming, cognitive/emotional issues may be the biggest problem on our hands.

    This post is of public interest 🙂

    1. Hi Will,

      Thanks for your comment. I absolutely agree: This post should be required reading for everyone in the mental health profession. 🙂

      You wrote: The egoistic trait displayed in “the firecracker” behavior could be the difference leading to a NPD rather than BPD.

      Yes, that’s what I tried to explain in this post, especially these paragraphs:

      What’s more, in the wrong mental health professional’s hands, a child lacking empathy and having sense of entitlement can invite a dire diagnosis: narcissistic personality disorder—or even psychopath.  (When Your Child Is a Psychopath, an extremely hidebound and punishing look at the phenomenon.). These diagnoses stick.  That’s because the mental health profession consider them “poor prognoses.”

      But wait. If that child also has ADHD, there is a good chance that the first-line medication for ADHD, the neurostimulants, can enhance empathy—along with all the other “higher-order” brain functions.  This is not hard to understand. But it is not common knowledge. Far from it.  In fact, you’re probably hearing it for the first time on my ADHD Roller Coaster blog.

      To be clear: ADHD treatment can often help the narcissistic child have more reliable access to these brain functions.

      In case you hadn’t noticed, it’s “open season” on narcissists. Name-calling is permitted, from celebrity psychologists to the average therapist. And the best advice is: Run. Inquiry into cause? Of little interest. Perhaps because too few in the mental health profession have scientific training — or, in the case of psychiatrists, didn’t take to it very well.

      As for your many potential diagnoses, the confusion often comes from drawing “labels” from different disciplines. For example, “theory of mind” explains certain ASD traits (and the way that ADHD symptoms might appear but not have the same cause as with ASD), but it’s not a diagnoses. Alexithymia describes the behavior, not the cause. Personality disorders, same. Executive Functioning is a theoretical model, also not a diagnoses. EF can be impaired by many of the prefrontal lobe conditions.

      It could be the “big picture” i s….. ADHD. 🙂

      As for the “fake news” POTUS, most certainly he would have qualified in childhood for an ADHD diagnosis. At least, from the accounts I’ve read. There might have been more, though, such as conduct disorder — and there’s some evidence that this has a genetic basis in association with ADHD (that is, a subset). His father certainly showed little in the way of conscience or morality but showed greed abundantly.

      I found it unfortunate that the sister-psychologist called it a “learning disability” and recounted the father’s behavior, the. mother’s absence, etc.. as turning out the result we see today. More hidebound psychoanalytic narrative, imho. But hey, it made her name and lots of cash. I would not have wanted him to be the “AHDD poster boy”. ADHD has enough problems with stigma.

      As for the “harsh education,” as a young boy, he was pelting rocks at the toddler in the play pen next store. The military school seemed more external solution (if a poor one) than cause. Bullies always respect power. He loved his generals, didn’t he, until they didn’t do what he said.

      Elevating our collective human ability to access higher-order brain functions (e.g. cooperation, conscience, reflection, etc..) and think more deliberately, with consequences in mind, is a large part of why I do this work.

      Thanks so much,

  10. I am so thankful for this blog. I am starting to realize that maybe, just maybe, my low level of empathy isn’t because I am horrible person, but because I have a condition.

    I am 45 years old and went to school in 80’s and early 90’s, and back then unless you were hyper, ADHD wasn’t diagnosed. I was the forgotten about child who couldn’t focus, had no motivation, and got poor grades. Also to top it all off, I was frequently bullied, teased, and abused, both at home and at school. I also didn’t have a lot of friends. Even before my dad died when I was 13, my parents had no regard for my mental wellbeing, and that didn’t change. I was left to fail, and left to be bullied. Even without having ADHD-PI that would make it hard for anyone to learn empathy.

    I sought help for ADHD a couple of years ago after the realizing I might have it. Concerta did nothing but my GP was reluctant to try other things. He referred me to a psychiatrist who confirmed the diagnosis but he wasn’t very knowledgeable about ADHD. I begged for a Strattera prescription after I read it could help. I have been on it for about 3 weeks now and will up the dose soon. I will be seeing (at my request) a psychiatrist who specializes in ADHD who has agreed to find the right medication and dosage for me. Maybe I will try Vyvanse or Adderall in addition to the Strattera, if the 80mg doesn’t work for me. I am hoping that once I get the right meds and dose, that it helps with my lack empathy.

    I rarely ever raise my voice or get mad at anyone. I also do not wish anyone pain or unhappiness. However, I am very un-self-aware other people’s pain, even if I am the cause. People to me are only like background characters in this game of life, I am trying to fight my way through. I am glad I am not alone. thank you for this blog and your website.

    1. Dear Mark,

      I am so grateful for your comment, letting me know my work has meaning for you.

      You make a profound point. Even for a child who doesn’t have challenges with “higher-order brain processes”, rarely (if ever) receiving empathic caring provides no foundation for seeing how empathy works in practice.

      Many people confuse ADHD-related symptoms that mean not noticing facial expressions, not remembering what one did in the past that would bring such a big reaction now seemingly “out of nowhere,” etc. with poor empathy. It’s complicated!

      It’s hard to form strong attachments or have empathy for others when it’s hard to focus, organize yourself, watch out for the next invisible banana peel that will trip you up, and “fight your way through” the day.

      A couple of points:

      1. It’s all down to genes, as to which stimulant class will work best for an individual. So, if you gave MPH (methylphenidate) in the form of Concerta a good try without positive effect, that’s useful data.

      2. Did you try brand, though, and not one of the slew of inferior generics?

      3. Strattera doesn’t work as well as the stimulants for most people, research shows. But it does work well for about 1/4 of people with ADHD (as I recall, last I researched this).

      4. It’s a very different mechanism of action targeting different molecules.

      5. Many people with ADHD do well on a lower dose of Strattera (25 mg to 40 mg) and a stimulant.

      6. Strattera can have more urinary/prostate/sexual side effects. So, if that should happen, know that it’s probably the Strattera. You could try a much-lower dose or, at that point, move to Vyvanse.

      I’m not an MD. I just help people who have been ravaged by reckless MDs…by conveying the evidence-based knowledge.

      I wish you all the best. Stay tuned for the “soft launch” of my online training. I think you will find it very useful.


    2. Thanks for the reply Gina. It was definitely was brand name Concerta I tried, and tried many doses from 18-27-36. I am trying strattera to see if I’m one of the ones it works for, and because it’s also easier to get a Doc to prescribe that than an amphetamine. The new doc I will be seeing has no issues with it though. I know about the side effects with strattera and don’t care. Living with adhd-pi is pure agony and will gladly take the sides if it helps with it.

      This was all just initially for the adhd. Now that I know that it could help with empathy as well, I am even more optimistic. Thanks again.

  11. Wow, this is deep. I’ve just left a man because he gave off pretty bad NPD vibes. My mum I suspect is covert NPD. My youngest has adhd and I have always struggled with him showing empathy when one of his siblings got hurt by him. He has only just started on ritalin and I have noticed a big difference in his executive functioning but not yet his emotion regulation…I will keep an eye on him now.

    1. Dear Anna,

      Yes, I am for deep. Because that’s where the critical information is. The kind that can enormously effect the trajectory of a life.

      There are a lot of factors that determine how a person, especially a child, responds to medication. It might be that Ritalin is not the best choice for him, or that he needs better sleep or diet.

      But also, the example you mention is a complex one. Showing empathy when he’s hurt one of his siblings.

      It’s possible that he did not mean to hurt the sibling so he feels that since the intention wasn’t there, he’s not responsible for the aftermath?

      Poorly managed ADHD means that symptoms can get the better of a person.

      make sense?


    2. Wow, I never realized other kids went thru the same thing growing up. Thank you for this.

      I’m 16 and I remember being very bossy most of the time when playing with other kids. I’ve also never had any inclination to help others out with chores, or buy gifts for even my parents on their birthdays ‍♀️ (I started doing chores by “surprising” my mom @ 12yo by doing the dishes one time, and since then she’s expected me to keep it up).

      Then when confronted about it, I wouldn’t feel bad at all. I’d just pretend like I did.

      I’m currently waiting to see a psychiatrist because my family doctor thinks I have inattentive ADHD (formerly known as ADD) and even though I relate to so many things ADHD, I still doubt.

      My parents are convinced it’s just bad habits.. I don’t blame them because many people dismiss mental health issues and expect you to fix everything on your own.

      I took an empathy test and got 9 out of 80. Scary. Anyway, hoping by this time next year I’ll figure out what this is. Thanks again for your article! 🙂

    3. Dear Issy,

      Thanks for reading — and writing.

      How clever you must be, to not only find this post but to be so reflective about the contents as it might apply to you.

      I suspect that “being bossy” is a way for some children with unrecognized ADHD to “stay engaged” in whatever play that’s happening. Much harder to follow someone else’s directions and rules.

      It’s interesting that neither you nor your parents are prone to seeing that you might have it. But your family doctor does….

      If you do have ADHD, that is a very important thing to know how. It could affect the entire trajectory of your life.

      If I were you, I would not be passive about the evaluation. And it doesn’t sound like you are.

      I encourage you to write down snippets such as this….how the ADHD diagnosis might resonate for you.

      If you provide your writings to the professional, I recommend concise bullet points. More likely to be read!

      Good luck and know there is a TON of great information on my blog — the first and oldest on adult ADHD. 2008


  12. Wow – I would love to connect with you to talk about this more.

    I have been diagnosed with ADHD at the age of 29 and being treated. Safe to say, my life has changed. This entire article and firecracker resignate with me strongly. Thank you for sharing

  13. Such an interesting article – I’m glad to hear that Firecracker is doing so well.

    I believe that my parent in their 60s suffers from undiagnosed ADHD (the parent themselves believes so, as do others in the immediate family).

    I grew up with so much fear and anxiety around their erratic, angry outbursts. They are incredibly defensive about even the smallest things. They were either disinterested, or mean and critical. I wonder if ADHD is largely to blame, or if there may be other issues at play as well.

    I don’t know if they would be willing to see anyone or try medication, but is there any hope of change at this later stage in life?

    1. Hi Sam,

      It’s hard to fathom how many people have gone to therapy after growing up with such parents as you describe.

      It’s entirely possible that ADHD plus a lifetime of poor coping responses can credited with the behaviors.

      There is no “cookie cutter” anything about ADHD. Definitely, with impaired higher-order brain functions, some very hurtful, emotionally dysregulated, and narcissistic behaviors are possible.

      Yes, it depends on your parents’ attitude, but definitely: People in their 60s and older have found benefit from treatment.

      The trick will be finding a physician to treat ADHD in the 65+ set, especially if there is a physical condition (hypertension, etc.). Stimulant medications are not necessarily contraindicated for those conditions but many physicians will feel uncomfortable, given poor knowledge of ADHD treatment.

      I hope this helps.

  14. Great article. I was like your daughter growing up and really damaged my family relationships. I had rapid mood swings, a nasty temper, and it was hard to genuinely connect with people (and engage in the give and take the defines all relationships).

    Junior year of college I was diagnosed with ADHD (inattentive) and went on adderall. After my first dose kicked in I immediately felt “warmer” towards people. It was easier to empathize with them, my mood swings stopped, and I actually wanted/could help people out. If I saw my mom needed help (even drying the dishes) I wouldn’t help because it would be painfully boring.

    Soon as I went on adderall I found I could do things I don’t “enjoy” (basically anything that would involve helping someone else) without feeling painfully bored. It also helped me listen to other people and remain engaged.

    1. Hi Jake,

      Thanks for sharing your experience.

      As I read it (as I have read many others like it), I thought, “This is why so many people remain skeptical (including mental-health professionals); it just sounds ‘too easy’ and changing behavior should be haaarrrrddd and takes years of therapy and “processing.”

      good for you.

  15. Hi,

    I came across your website whilst trying to calm down from another very angry outburst from my 22 year old son.
    He overdosed about a fortnight ago, and on the back of that the Dr said he thought he has adhd, depression and anxiety. He prescribed antidepressants and asked my son to come back in 2 weeks.
    He has taken the meds for the 2 weeks but due to covid19 and all the uncertainty he did not return for his appt or the next 2 weeks meds.
    Life really is a rollercoaster, his moods are either loud, angry or stoned. He has no concept of consequence or responsibilities.
    I was so hopeful when he had seen the Dr, but I also knew that the biggest part would be to see if he kept the 2nd appt,, he doesn’t finish anything.
    I’m struggling between having had enough and wanting to see him better.
    I don’t think I can take anymore of his angry outburst and always being the one to blame, when he was at school it was the teachers who were at fault, through his teens it was his dad, there’s always somebody else at fault and I’m just so tired of it all, I just feel so tired of it all like there is no end in sight.

    1. Dear Fran,

      I feel great sympathy for parents in your situation. I hear from them quite often — and several have attended my local group over the years.

      It’s very hard to get on top of ADHD treatment once bad habits and patterns have taken hold, over years. Finding competent medical care is one problem. But their wanting independent is another.

      Then there is the mental healthcare professionals who fail to see the importance of third-party feedback, who don’t want the “controlling” parents to have any say.

      I wonder why the doctor would prescribe antidepressants if the doctor thought the primary condition (based on the listing) is ADHD.

      You are trapped now. Maybe best to, in your mind at least, call a truce. Don’t try to make him be more responsible now. That’s a losing battle.

      If you haven’t already, I encourage you to read my first book. It’s really important that someone (the patient or loved one) be educated and able to help guide treatment.

      While it’s no answer in itself, the chapters on “denial” might help you to understand the scape-goating.

      I wish you some peace and healing.


    2. Fran,
      My daughter is much like your son. She had severe ADHD and ODD at an early age. She went on Ritalin in kindergarten because she was too disruptive for school. At 14 she was bigger than me and began to refuse her meds due to kids teasing her. She had to take it 4 times a day. She became very combative and even physically abusive towards me.
      I have tried repeatedly to have a relationship to no avail. She is 35 and EVERYTHING is still MY fault.
      I live in California and she is in Washington state, thank god!
      I have my own mental health issues. I have anxiety, PTSD, depression and at 58 finally getting my own treatment for ADHD.
      My guilt that I wasnt a “good enough” mom is just bull. My therapist does not want me talking to her because to add to her problems, she is self medicating with alcohol and it just makes it worse. She is in denial that she has any responsibility in any of this. Highly verbally abusive towards most everyone, violent outbursts, she can be quite frightening. I cannot help her. She thinks she is fine. I can only address my own mental health at this point. God bless you and your situation. It’s very difficult.

    3. Dear Penny,

      I can only imagine how difficult it’s been for you.

      “Denial” is real — and it can be devastating. That’s why I included three chapters about it in my first book. It’s critically important and so little understood, especially by the mental-health profession.

      Take care of yourself,

  16. I should leave an update, lol!
    After The Firecracker had stabilized on her current medication, our pediatrician was happy to take over prescribing duties for only the $15 copay. 🙂

  17. My 13 year old son is doing so well on methylphenidate and wellbutrin ! My problem is the Dr doesn’t want him on methylphenidate during the summer (or weekends). Dr doesn’t want his growth to be stunted. My son’s “selfish, wild” behavior is so disturbing to all of us when he isn’t taking that. It’s hard to remember his bad behavior isn’t because I’m raising an “awful” kid. What do you suggest?

    1. Hi Lori,

      Sigh. The nutty things that physicians say.

      Can you find a more competent physician? I am serious.

      1. IS your son’s growth stunted? Is there any evidence of that?
      2. Is his appetite suppressed?

      If so, that is an indicator of poor prescribing. Meds can be adjusted or replaced to eliminate that side effect.

      If the prescriber is also failing to treat co-existing conditions such as anxiety, depression, etc. (which can be exacerbated by the stimulants and thus can affect appetite), that’s a problem.

      You are your son’s mother. He is counting on you to protect him from incompetence. Whether he realizes that or not! 🙂

      Be strong! Demand better! Find better!


    2. Hi Lori!
      This is outdated information that, unless your son is showing SIGNS OF APPETITE SUPRESSION AND STUNTED GROWTH, should truly not be an issue. 🙁

      Doctors who don’t specialize in mental health have *fear* drilled into their brains about stimulants and abuse. In the last ten years, I’ve never had a single doctor or pharmacist focus on the benefits before the supposed risks.

      So, yes, as Gina said, GET A DIFFERENT DOCTOR. Get a psychiatrist or psychiatric NP, and be prepared to show him or her, “My son has shown ZERO growth retardation, and eats like a horse. He’s under an immense amount of distress without the meds. I want him covered on weekends and summers.” Get one that you have to **pay out of pocket** if you must.

      I do. 🙁 Tomorrow, I get to go pay $500 to a psychiatrist for The Firecracker, because the wait would be almost a year to get her into a practitioner on our insurance plan. It’s worth every penny. She’s worth every penny.

      I’m so glad you found us. 😀

    3. Thanks, Taylor.

      You have to pay $500!!!???

      I’d appeal that. In the strongest possible terms. GRRR


  18. I had a child so much like yours, and medication was a godsend. When she was young, some people would tell me she just needed to be disciplined, not medicated, and then would accuse me of bad parenting. Only I had two older ones who weren’t ADHD, so I understood this one was different. So I began social training by using the TV to freeze expressions on faces, and then we would talk about what she saw. When she was angry, I had floor puzzles, a puzzle book, and washable markers for a wall so she could scribble out her frustrations. She also has a co-morbid condition, NF1, along with some learning disabilities, but the research on the brains of kids with NF1 showed they could develop new pathways to learning over a long period of time. It was hard, as I was by then a single parent with a child who looked and acted younger, and who blamed everything that happened on outside events. So I started teaching that every choice had a consequence, and she needed to think about the consequence and whether or not she was willing to accept the consequences of her choices. She is 25 now, has finished 2 years of college, has a great job with benefits, and no longer takes medication. Instead, she comes to me every time something upsets her, which is every day, and we talk through possible solutions. She is highly empathetic, literally giving away what she owns. She gives money to good causes, like providing wells and cows to remote villages in Africa, and she can be counted on to be the first to help me as I am aging. She is a godsend. She is still energetic, impulsive, passionate. But all those lessons from so long ago? They worked. It wasn’t a quick or easy process, but it was worth the time and effort. I applaud all the families who have ADHD members for your love and compassion, and I will be the first one to back you when you turn to meds for help. If your child is in public school, I would recommend They helped me so much in the beginning, and were part of what helped my child graduate high school with the Regent’s core requirement. I didn’t try to raise her by myself, and would encourage all of you that there are resources out there for you, too. Thank you again for an incredible article. It was a blessing to read.

    1. Hi Lily,

      Thanks so much for taking the time to write this thoughtful comment. I know that it will help others.

      And yes, is an excellent source.

      How fortunate your daughter was to have you as her mother — and for you to have such an empathic and energetic daughter.

      If I may be so bold, perhaps you want to think about encouraging your daughter to try medication again. There are many good options. If the reason she stopped the medication is side effects, the plethora of options and our level of knowledge these days mean that she might have a better experience now.

      It might not be the best long-term strategy for her to rely on you to “talk her through” daily upsets. What will she do when you’re not around?

      My best to you both.


  19. Hi Gina-Every night I sit in my basement by myself and read, read, read…everything I can about adhd. For my forever fiance and my 7 year old daughter.

    My fiance was diagnosed as a child but discontinued meds as an adult saying they made him like a zombie. I knew this going in but was not educated on the diagnosis and only knew of it as “something kids grow out of.” Boy is that the furthest thing from the truth.

    Since the first couple of years of our relationship was mostly great, until I’m sorry to say we bought a house and had our first child, I didn’t realize the affects it would have on our relationship. Not until the last two years after the pregnancy and birth of our son.

    I noticed the same behaviors in our daughter that he displayed and knowing what a loving and giving mom I have been and also have tried a million different parenting methods, did I start to realize it could be adhd. Sorry for the long post, I’m kind of venting as your story has brought me to tears.

    I have tried to talk to my fiance about mess. He refuses, he gets angry with me whenever I bring it up. He agrees with me however that our daughter has it and we should get her diagnosed to start treatment. I have been battling in my head the idea of med’s for her not because I am against it but because I am afraid of the effect since she hasn’t hit puberty yet, do you have any insight for me on this?

    Also I am afraid because I don’t want it to change all the greatness about what I believe is her adhd. I don’t want her to be a zombie and then I think she has trouble at school but it’s behavioral not so much academically…yet. I guess I’m afraid not to and I’m afraid to…if that makes any sense.

    And then there’s my fiance whom I love dearly but I want to run….far far away and yet I want to stay and help him but I don’t think I have the energy for both especially since he refuses help. And don’t even get me started on my fear of our youngest having it too. It’s all too much for me to handle at this point.

    I joke and say I take meds (xanax) so nobody else has too but it’s really not funny anymore. I don’t no where to start. Because a unit in parenting is important but so is the well being of our daughter. I made an appointment with a psychologist for her to be tested because I want someone experienced.

    But then what. How do I help him or do I uproot her in the midst of all of this.

    Again I am sorry for this long post. I just need advice from someone who understands and nobody I talk to does. Thank you for your time. I hope to be sitting in my shower one day soon from relief instead of hopelessness.

    1. Hi Ang,

      Of course you need someone to talk with who understand your situation. I know…it’s hard to find such people.

      I invited you to join my online private group. It’s free.

      Here is the information:

      As far as your priorities and what to do next….I strongly encourage you to learn more about ADHD and it’s treatment strategies, including medication. Help your child with treatment before deciding anything else. Especially if your fiancee is providing financial support. One thing at a time. Put your child’s diagnosis and potential treatment as top priority.

      Please don’t worry about your child’s “personality” going away. You say that she has behavioral problems, and those will present greater and greater problems to her (and you) as time goes on. Please don’t delay. The time to help her onto a better track is NOW.

      But please learn about the medications first, so you can be a smart advocate for her. My book goes into the important details.

      And there is an overview of information parents should have here:

      And some general info on medication here:

      One more bit of advice….please consider something other than Xanax. Your physician should NOT have prescribed that for ongoing anxiety. There are better medications toward that purpose, with less “rebound.” So, I’d try to find another MD entirely if that was the best he/she could do for you.

      It’s no joke…you’re right. You should not be taking medication when it’s other family members’ poorly managed ADHD that is driving up your anxiety.

      Good luck!


  20. L. Ollenberger

    [quote]Thank you, everyone, for your kind responses. ONE THING I NEED TO MENTION: since ADHD is a disorder of *regulation*, the OPPOSITE problem can also show up: people who are so dang empathetic that they’ll give you the shirt off their back, and go naked in the snow, because they love you. [/quote]

    I was reading this conversation and the moment I read this, something his home for me. I have blamed myself, for this weakness of over-empathy most of my life. “What a sap” I’d think, or “You’re inviting people to take advantage” and never quite able to see things clearly, so many thoughts, which is better to not help, to not care, or to put me first. I assure you that it becomes what I thought was a moral conundrum.

    But reading these few lines above (thank you Taylor J) I had this moment of relief as if a watershed of understanding for myself had opened and I caught myself saying, “It really isn’t all my fault.”

    Lack of regulation is what I’ve been up against.

  21. I’m not saying that it isn’t a real condition – I’m sorry that I gave that impression. And yes I realize it is anecdotal (except that the people in question are not anonymous to me). As for that – you are anonymous to me as well, but your daughter’s story is quite remarkable and I think it’s wonderful that she was so self aware as to be able to tell the medication helped. That is amazing and pretty much indisputable.

    What concerns me are the ones that fall through the cracks either with misdiagnoses or wrong diagnoses or poor followup on treatment. I’ve taken antidepressants even though I hated to have to do it, but it helped me get a little bit of motivation going to deal with the underlying problem which was chronic pain that was going undiagnosed (they were telling me the pain was caused by my depression and not the other way around, but they did not know me before).

    Also, I am pretty sure I would have been diagnosed as ADHD or something except that I was able to concentrate obsessively on things I liked. I do remember my mom telling me that when the doctor prescribed multivitamins for me as a toddler, she gave them to me and I made her want to climb the walls. 🙂 So she stopped and I calmed down.

    I have allergic reactions to things so that likely paid a role too.

    I am wondering – if you had ever read the story of the lady who found that her daughter reacted to wheat/gluten with this sort of ADHD neurological reaction instead of a GI pain reaction like most do? That was also quite astonishing.

    Again please accept my apology for sounding like I was trying to dismiss your story. I was not, not at all. My clumsy writing is all I can chalk it up to.

    1. “misdiagnoses or wrong diagnoses” sorry that should be “going undiagnosed or mis diagnosed”

    2. HI Paula,

      Thank you for the clarification. No apology necessary, but thank you. I am sorry I misunderstood. Your comment was so typical of the “ADHD deniers” online, and I took it as such.

      From all that you write about yourself, I would strongly encourage you to consider an evaluation for ADHD and stimulant medication treatment.

      Most people with ADHD can focus on something they like to do. It’s regulating their focus that is the problem, shifting focus to things they need to do but might not want to do.

      Interesting reaction to the vitamins. It seems that there is a higher incidence of gluten sensitivity among people with ADHD. (I’ve also had friends with ADHD who found that stimulant medication calmed their hay-fever, so who knows, it might help with the gluten issue, too.)

      There might be people with gluten intolerance only who manifest ADHD-like symptoms when exposed to gluten, but that’s not the same as having ADHD.

      I also know many women with ADHD whose chronic-pain issues improve on a stimulant medication. For the most part, this might stem from an issue with sleep, which ADHD can create havoc with.

      Please keep learning. There are lots of great articles on my blog.

      By the way, my name is Gina, I am the author of a popular book on ADHD and I write most pieces on this blog. But the piece you’re commenting on (“Raising a Narcissist”) was written by my friend, who has ADHD.


  22. I do know that it is over diagnosed in some cases. I had a friend whose teachers claimed her daughter was ADD/ADHD. My friend was surprised because she didn’t act that way at home. My friend took her to the doc, doc gave a prescription, prescription never got filled. The teachers asked what the results of the visit were, and the mother replied “yes the doctor diagnosed her and gave her a prescription.” The teachers IMMEDIATELY began commending the mom and the girl on the dramatic change in her behavior even though she had taken nothing.

    1. Hi Paula,

      Medical conditions of all types of commonly misdiagnosed; that’s no secret. It seems, last I heard, the rate was about 25 percent. For ALL medical conditions.

      As for your anecdote, sorry, but I put no stock in anonymous stories. That one in particular is quite commonly repeated throughout the Internet.

      There could be many things going on with that child—ADHD, child abuse at home, disorganization and chaos at home, poor diet, poor sleep, etc.

      The fact is, many teachers mention the possibility of ADHD because they see the child is having problems. They do this out of concern.

      Sure, I suppose some bad teachers might have a “thing” against active children and lack classroom-management skills. But overall, that has not been my experience in teachers who suggest that parents might want to screen for ADHD.

      It’s a big country; anything can happen.

      Overall, however, many children who have ADHD are missing the diagnosis, and thus a better path in life.

      Only 10-15 percent of adults with ADHD are diagnosed. Most wish their ADHD had been recognized, and understood, as children.


  23. Gina:
    Just finished having dinner with my husband and ADHD son, age 36, who still spends inordinate amounts of time at his parents’ house (us) because he and his girlfriend don’t get along – and according to him, it’s all her fault. We tried medication when he was a child – he had idiosyncratic reactions/side effects (some were horrible – so he doesn’t trust meds now). Long story short, now he’s almost middle age, has a history of repeated failure in jobs, relationships, life. The blame game is alive and well but I can see it’s a defense mechanism, as when he’s less stressed, he’s more congenial and much easier to live with. I wish I could convince him to work consistently with a doc to find the right meds – but it’s a Catch 22 – he doesn’t have health insurance because he doesn’t have a job because he has problems with his untreated ADHD – and of course, because nothing is his fault and there’s nothing wrong with him (according to him), he won’t go. The cause/effect problem you mentioned really hit the nail on the head. I can only hope someday he will be willing to try medication again. Any advice, comments, would be much appreciated! Due to his living here, I am the one on medication – Xanax!! 😉

    1. Hi Carol,

      I wish I wasn’t so familiar with the situation you describe, and I’m definitely sorry you find yourself in it.

      So many pediatric medication attempts go wrong, because too few MDs know how to skillfully prescribe. Including teasing out comorbid conditions.

      I’d say it’s worth an investment on your part, if you can afford it, to get him care. Paying out of pocket might not be as expensive as you think. And it surely beats him being poorly functioning.

      I would encourage you to read the medication chapters in my first book,

      Patients and their loved ones must be educated. If you’re not educated, you won’t even be able to assess if the MD is competent to treat ADHD. And if you are, you can better work as a team.

      Good luck!

  24. So sad. You give knowledge and empathy, but so sad. It is a different kind of sadness than psychiatric
    disorders. Whew. Out of control all the time and doing such obnoxious things they have no control or insight over. You do have a mission, but it is a sad one. Sandra

    1. Sandra, thank you so much. Yes, it’s a sad mission, but when it comes to our kids, or our spouse, what are the other options? Divorce or abandonment. 🙁 I’m so thankful that Gina’s book is out there, because it kept our family together, and gave us real answers that actually worked, and changed lives. <3 And I love every comment you make on here, by the way. 😀 It just brightens my day.

    2. Thanks, Taylor. Sandra’s my big sister, and a big source of encouragement throughout my life. <3

  25. KidletWhoCooks

    Typing this on my phone, as my laptop needs repairs. I can’t say all I would if I were typing with 10 fingers instead of one.

    So many things in this story resonate with me and my own experience with ADHD. It’s both horrifying and validating to read this example of how ADHD can make anyone – even a child – behave so monstrously.

    I’m glad for Taylor and her daughter that they found the solution before more of their lives were hijacked. Life before diagnosis/meds sounds appallingly difficult – for both of them.

    I would say “Imagine what it would be like being married to an ADULT whose late-diagnosis ADHD was causing a similar problem expressing empathy – in addition to all the other behaviors that insidiously emerge, year by year, making your life so hellish that you – the non-ADHD spouse – are on disability, with no support system as a result.”

    I would say “imagine,” but I don’t have to. Because I’m living it.

    aka Kidlet_who_Cooks

    1. Hi Jeannine,

      Yes, I know. The challenges around empathy can be the deal-breaker. It’s one thing to understand forgetfulness, etc. But with a lack of empathy….a soul-killer.


    2. Hi Jeannine, I totally understand what you’re living with. I have the same situation. I did not understand the lack of empathy within my husband until my 12 year old daughter was telling me about psychopathic behaviour and er frustrations with her father. It really opened my eyes and so I started reading about this more and the relationship with ADHD and narcissism. His diagnosis wasn’t until adulthood when I was in his life for a few years even though he had numerous childhood difficulties and behaviour issues. He never learnt to cope with his condition or to understand it properly and so it has made his adulthood super challenging and our relationship is always taxed in different ways due to this.

  26. I can totally relate to the mentally ill parents who don’t seek out treatment out of old-fashioned ways. My dad has a pretty clear-cut case of ADHD, with angry flashes to go along. Needless to say the two of us had our scuffles. Like you though, Gina, I took it as a lesson to do better for the next generation.

  27. I’ve written a blog post on this subject, where I look at the dangers of NOT treating childhood ADHD, as seen from a comorbidity angle, and the increased risk of adulthood adversities. You can find it at my blog Gina, and it is called “How To Create The Psychopaths Of The Future”. It is based on Dr. Susan Young and Dr. Barkley’s research in comorbidity and risk of incarceration.

    1. Hi Peter.

      Thanks for letting me know. I left a couple of comments.

      Important info.

      I will be interested in the design of the study made with the $250K grant. No doubt it will be sloppy.


  28. When our son was 5 (he is now 11) he started medication. Before that time, anytime we went on vacation, he would throw tantrums upon tantrums in the car. Our first vacation after he started medicine we were on our way home, almost there, we realized he did not have one tantrum the whole week.
    Since then we have had the ups and downs of trying to get the right medicine for him, but he is a wonderful work in progress.

    1. Hi Sherry,

      Poor kid! Poor parents!

      I’m glad things are going better for all.

      Thanks for your comment.

      Happy travels,

  29. The new school year was beginning and now my son was in Middle School. I kept thinking “how can we not help him when there is something that will help him!?” We went to the doctor and he finally prescriibed Adderal; I was in tears thinking someone is finally going to help us.. The change was miraculous. I thought I was dreaming because everything up until then had been a struggle,an argument, misunderstanding and frustration. I could not allow him to start a new school where he could have a fresh start and not be the “out of control ” child. The daily phone calls stopped from the school telling me of my sons transgressions each day. His grades began improving. Thank you to all who have struggled through to help me believe I wasn’t a bad Mom for putting my son on some much needed medication.

    1. Dear Mary,

      I’m very happy to read this.

      Good for you, brave and smart mom!!


  30. I have lived this, as a stepmom, and as a milder version of this as a young girl. The ADD brain can get very catatonic, even while exploding! I would jump on the furniture when it was too cold and snowy to play outside, and when I was punished, would blame my furniture wrecking on the weather. Stuck in a blame tape loop. And I would take on the punishment so hard that I would threaten to kill myself since my parents “hated me so much.” I saw this as a step mom, with my unmedicated ADHD son, (Bio mom refused to do meds.) He was so hard to do rewards and consequences with, because he would either see no cause and effect, or he would get stuck in a tape loop of blame, to himself. No turnaround. Finally self-medicating with marijuana scared his mom into trying meds. And such a change.
    So refreshing to read the instant results of medication, after reading so many pseudo-science articles lately about how we are over-drugging our children and making them compliant for our own comfort, or inventing ADD because we want to create kids who fit in the box of school, when really they are creative and gifted Einsteins who don’t fit in a box.

    1. Hi Kendra,

      Well, in a sense, it was the weather’s fault! 🙂

      And yes…how on earth do you do “rewards and consequences” with an impulsive child who cannot remember or see cause and effect. I’ve never understood that. And it’s especially concerning given the CDC ADHD department’s rigid stance on “behavior therapy first.”

      Glad to hear your stepson finally got the help he deserved.

      Thanks for your comment!


  31. Beautifully written! And the story is so moving that I will refrain from making any wisecracks about the “gift” of ADHD. Oh. One thing. My parents tended towards narcissism. They could be woken out of it, but not always.

    1. Your wisecracks are always welcome here, Chef Jeff.

      Thanks for your comment,

  32. Thank you, everyone, for your kind responses. ONE THING I NEED TO MENTION: since ADHD is a disorder of *regulation*, the OPPOSITE problem can also show up: people who are so dang empathetic that they’ll give you the shirt off their back, and go naked in the snow, because they love you. 🙁 An example of this *may* be Fanny Crosby, the blind hymn writer who gave away all of her money, lived in poverty, and separated from her musician husband over “creative differences.” I’m not a psychiatrist, and I can’t diagnose her, but I see the hyper-empathetic all the time in my ADHD friends, and even among our own family.

    1. HI Taylor — Thanks for mentioning that opposite extreme.

      This was touched upon in this previous post on ADHD and empathy especially in the comments—including this one:

      What a huge light bulb moment. I created a nickname for the behavior that goes with it, a long time ago. Save the world syndrome. I have been obsessed with justice and fairness my entire 45 years of life. Have been ADHD aware for 20 plus years but is never ceases to amaze me how much new there is to learn to go along with it. This information is very helpful for myself and my 11 year old mini me

      Even when a person has abundant empathy (and as I wrote about in that post, there are different types of empathy), there is the question of regulating it. You can have empathy for starving children on the other side of the world, and do what you can to help. But should it mean neglecting your own children?


  33. Taylor’s done it again. So good that the two of you hooked up. She digs deep and puts her emotions on the line with everything she writes. Loved her Book Club reviews of your work.
    Thank you, Joan Jager of ADD

    1. Hi Joan,

      Thanks for your comment.

      Yes, it was certainly fortuitous for both of us when Taylor found my book and then wrote a lovely thank-you e-mail to me. We’ve been friends ever since.

      And, as a longtime editor, I know writing talent when I see it. 😉


    2. Joan, and Gina, thank you so much. <3 Gina's book kept me married, so I have no qualms about being vulnerable and open with how much treatment has helped our family. <3

  34. I see both of my oldest kids in this. The girl who before medication, who used to scream at her brothers constantly, but who is now refusing to take a therapeutic dose of meds, and thus is frustrating to deal with again. I’m afraid to leave her along with her brothers because she she makes them do her chores.

    Then there’s our son, who is flunking out of 8th grade and attributes it all to “mean teachers.”

    Bloody hell.

  35. Kelly Roberts

    Oh man! This brought me to tears–both from Firecracker’s awareness of how bad it had been once she realized how good it could be, and Taylor’s moment in the shower…the release, the relief, that can only come from a good cry.

    What an amazing transformation for this entire family.

    1. Hi Kelly,

      Stunning, isn’t it?

      I’m so grateful to Taylor for sharing this story.


  36. Gina,
    I thank God for His help finding your ADHD Roller Coaster blog.
    I’m a senior and only recently was diagnosed with ADHD. I have Anxiety, Depression, & OCD, as long as I can remember. All my many years!
    Reading your blog, following the links provided, all are a huge help for me. I’m now aware I am not alone in this disorder. I am in treatment, CBT & medication. I have tried many different meds, hoping to find the ONE that is helpful.
    I just wanted you to know that this senior lady finds hope in all your words.
    God Bless, Jane

    1. Dear Jane,

      Thank you so much for taking the time to write those kind words.

      I’m so happy that my blog is a comfort and help to you. That’s what it’s all about.

      Sometimes it takes a combination of medications, to treat ADHD and the co-existing conditions (depression, anxiety, etc.)

      Best of luck on your treatment journey. Keep reading, and digging through the archives. There’s lots here!


    2. Dear Jane (again),

      I have to tell you…..I’ve met many “senior citizens” newly diagnosed with ADHD. One 85-year-old came to our group.

      I salute you for having the courage and intelligence to pursue the ADHD line of inquiry.


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