This is the story of the day Dr Edward Hallowell was conceived: his severely bipolar father had mistakenly been given leave from a mental hospital. He arrived home and “decided, for no apparent reason that he wanted to murder my mother”. Hallowell’s mum – an alcoholic who was “amazing at handling men, it was her great talent in life” – somehow persuaded her husband to “make love” instead.
Afterwards, her husband went out into the snowy Cape Cod countryside, starkers except for a pair of galoshes, and began shooting crows out of the sky (believing they were Nazis) until neighbours called the police. An ‘utterly barmy’ family This is not even the craziest story Hallowell tells about his family (“crazy” is a word he cheerfully bandies about). The Hallowells were posh, well-connected, charming and for the most part – to use another non-clinical term – utterly barmy.
Nevertheless, he somehow emerged with little worse than a 20-year smoking habit, periodic “low self-esteem” and a self-diagnosed case of ADD (attention deficit disorder), a condition in which he would go on to specialise as a psychiatrist.
He has come to see his difficult childhood as a gift, and perhaps a signpost to his vocation. “It was full of wonderfully interesting, eccentric and some truly crazy people,” he tells . “It turned me into a person who understands and loves differences in people. I cherish crazy people, although I feel for their pain.
” Explaining attention deficit disorders Hallowell is best known for a book, Driven to Distraction, which put attention deficit disorders (ADD and ADHD, which includes hyperactivity) firmly in the public consciousness in the 1990s and went on to sell more than a million copies. But his latest book is a memoir, and its title, ‘Because I Come From a Crazy Family’, is the answer to a question he has been asked countless times during his career. Its subtitle is The Making of a Psychiatrist.
In 1981, Hallowell attended a lecture about ADD, which, he says, “began the most interesting voyage of discovery I have ever taken”. At the time, the condition had begun to be identified in adults and, on researching further, he recognised its traits – the distractability, impulsiveness and restlessness – in himself. “It was so freeing,” he recalls, “so exciting to know there was a name for the way I was.”
Diagnosis is key with ADHD, he still believes, is the key step in helping those with ADHD to thrive. “When I was a kid,” he recalls, “we had two diagnoses: smart and stupid. And one treatment plan: try harder.” That was in the 1950s, and things have certainly changed since. Hallowell’s enthusiasm for recognising and treating cases of ADD has put him, along with a majority of psychiatrists in this field, at odds with those who believe the condition is over-diagnosed and over-medicated.
They say it lines the pockets of Big Pharma while somehow pathologising childhood or excusing poor behaviour. Hundreds of thousands of children in the UK are treated for ADD/ADHD with Ritalin and other prescribed drugs. In the US, it is the second most common long-term diagnosis made in children (the first is asthma). Hallowell says there is some truth in this view: “A rambunctious boy can be slapped with a diagnosis and the next thing you know he’s a mental patient.” ADHD can ruin a person’s life but he believes we should be equally concerned about under-diagnosis. “The prisons are full of people with undiagnosed ADHD,” he says, “as are the lines of the unemployed, the marginalised, the addicted and the depressed. ADHD can ruin a person’s life, or hold them back from ever reaching their full potential. “On the other hand, if it is managed properly, it can be associated with tremendous success. Most entrepreneurs have it.”
In the US, he says, medications are “both over-prescribed and under-prescribed. Some doctors give them out too readily, while other don’t ‘believe in’ ADHD, as if it were a religious principle, and don’t prescribe at all.” Stimulant drugs such as Ritalin are not always the answer, he says. He reckons they help people “70 to 80 per cent of the time”. But “when these meds work, they really work. The improvement in focus can be compared to eyeglasses: ‘At last I can see!’”
Where he and many of his critics would broadly agree is that there might be less recourse to medication if we were to work towards a less rigid and stratified education system that could allow for broader definitions of success. Positive traits ADD, he believes, need not be a disability and carries with it many positive traits, such as creativity, independent thinking, positive energy and “charisma or a special something, a twinkle in the eye”.
Meanwhile, he is emphatic that any treatment plan should always include strategies such as education, lifestyle review, physical exercise, meditation, and “frequent daily doses of positive human connection.” It is this feeling of connection, he believes, that has delivered him a happy and successful adulthood from such unpromising beginnings: an extended family that was rent apart by alcoholism and mental illness, his parents’ divorce, even though he still believes they loved each other deeply, and a stepfather apt to transform, when in his cups, from a charismatic charmer into an abusive, raging monster. And that’s not to mention the ADD that must have taken considerable ambition and ingenuity to overcome.
An Adverse Childhood Experiences score (known in his field as ACE) of eight, “where a score of four pretty much says your chances of a good life are slim”. What made him turn out OK? “The love my cousins gave me. Many, many teachers who took an interest in me. Dogs. My mom and dad. They did their best,” he says with the notable lack of rancour that characterises his childhood reminiscences. “My wonderful, crazy family who sprinkled me with their special eccentric fairy dust all the time.”