Familial Threads: The Tapestry of Generational ADHD and its Impact on Families

Imagine gathered around the family table, swapping stories that span generations. You notice recurring themes among the narratives – a restless spirit here, a wandering mind there, or perhaps impulsive decision-making throughout. These traits, tendencies, patterns, or dynamics, often cherished as colorful “family quirks”, might be the threads of ADHD woven into the intricacies, complexity, diversity, and beauty of your family’s history. ADHD rarely impacts just one person in a family. Instead, it blankets familial connections, reshaping relationships and sometimes challenging bonds.

The Genetic Blueprint of ADHD

Since the 2000s, research suggests that genetics plays a significant part in the heritability of ADHD. Heritability refers to the extent to which genetic factors contribute to ADHD symptoms in individuals, families, and a population. Studies have shown that ADHD does tend to occur in families, meaning that if one person in a biological family has been diagnosed with ADHD, there is a very high likelihood that other family members have ADHD.

How much more likely? According to a study by Larsson et al. (2014), the heritability estimate for ADHD ranges from 70% to 90%.

To appreciate ADHD’s 70-90% heritability rate, consider the studies of adult height (Wood et al., 2014) that have a 60-80% heritable influence, which means that how tall we are as adults is similar and predictable based on how tall our biological parents were. Similar types of studies (Sullivan et al., 2000) suggest that familial depression is around 40-50% heritable. The genetic risk of coronary heart disease is about 40-60% (Nikpay et al., 2015), and the heritability of myopia (shortsightedness) is between 60-80% (Nalls et al.,2014). As the science of genetics evolves, it becomes more evident that inheriting ADHD is similar to predicting adult height in children based on their biological parents’ height and the likelihood that corrective lenses will be needed for another family member diagnosed with shortsightedness.

Unraveling the Symptoms

Although the chance of inheriting ADHD is substantial, the experience of ADHD can vary significantly between individuals, even among close family members. The primary symptoms of ADHD, inattention, hyperactivity, and impulsivity, only touch the surface and describe a small number of how individuals experience ADHD. Persons with ADHD can experience mental hyperactivity and not physical hyperactivity. The impulsivity of ADHD can range from blurting our thoughts to spontaneous spending. Inattention can be experienced as wandering thoughts accompanied by frenzied activity or, with some, a sense of being stuck in a daydream, unable to bring their attention back to the present moment.

ADHD symptoms also manifest differently across ages and genders. Studies as early as 1997 (Gaub and Carlson, 1997), including a study by Barkley and Fischer (2010) in the “Journal of Clinical Psychiatry, suggest that this subtype accounts for approximately 25% to 50% of all ADHD cases with women often experiencing more inattentiveness and internalized symptoms compared to the physical hyperactivity commonly observed in men. This subtlety in symptoms for women can lead to a lifetime of struggles with self-esteem, anxiety, and depression. For men, their symptoms are often externalized physically and emotionally with impulsivity, hyperactivity, risk-taking, and aggression (Biederman, J., et al., 2008) with lifetime challenges academically, occupationally (Kuriyan, A. B., et al.,2013), depression, anxiety and substance abuse (Chronis-Tuscano, A., et al.,2010).

Variability Across Generations

The generational gift of ADHD can impact each family member uniquely and also reshape the fabric of families as a whole. Now that the individual expressions of ADHD symptoms are being appreciated, we are beginning to recognize the inattention, hyperactivity, and impulsivity of ADHD, rippling through generations and influencing family dynamics in profound ways. For example, consider a parent who went undiagnosed as a child. Their struggle with ADHD symptoms around focus, organization, and impulsivity may, in turn, hinder their ability to provide the structure and consistency they want for their children. Without awareness of the complex experience of ADHD, it seamlessly becomes a cyclical dynamic with the potential to strain the following generation, leaving a legacy of guilt, inadequacy, shame, and hopelessness.

Multiple factors contribute to the variability of the ADHD experience across generations, including diagnostic criteria and awareness. In past generations, ADHD was perceived as a disorder affecting only hyperactive young boys, leading to an unfortunate and significant underdiagnosis of those with more inattentive ADHD and adults who had not been previously identified. Grandparents raised during this time of limited perspective may find themselves struggling to comprehend ADHD-related behaviors in their grandchildren, questioning disciplinary or personality factors that often serve to perpetuate ADHD as a stigma to avoid rather than an explanation of a neurodevelopmental disorder that needs to be talked about. Conflicting generational experiences divide family relationships, creating chaos rather than community at all stages of family life, from child-bearing to end-of-life care.

Generations to Understanding and Change

Approximately 7.5 generations have passed since the symptoms we now associate with ADHD were first identified in the medical literature by Alexander Crichton, a Scottish physician, who described a condition he called “mental restlessness” in his book “An Inquiry into the Nature and Origin of Mental Derangement” published in 1798. It wasn’t until the late 1970s and early 1980s that it was considered that the symptoms of ADHD might continue into adulthood, and inattention was a more common challenge for some with ADHD than previously thought.

Eight generations allow decades for family patterns, values, beliefs, and behaviors to emerge, solidify, and be absorbed into family identities. Beliefs or myths about ADHD that contribute to the continued stigma and misunderstanding of the condition within families, including:

  1. ADHD is the result of an individual’s moral deficiency.
  2. ADHD is caused by bad parenting.
  3. ADHD is a result of sugar consumption.
  4. ADHD is a phase that children will outgrow.
  5. ADHD only affects boys.
  6. ADHD is not a real disorder.
  7. Medication is the only treatment for ADHD.

With no malintent, these myths and misconceptions have distorted the fabric of individual and familial understanding of ADHD. Despite evolving scientific advancement, it may take several more generations for ADHD to be understood and explained as a complex neurobiological condition that doesn’t discriminate based on age, gender, ethnicity, religion, sexual or gender identity, or geographical location. Families around the globe have been struggling for generations under the stigma of AHD. Top of FormBottom of Form

The Path Forward: Strategies and Support

As advances in science provide answers, families can now adopt a new understanding of ADHD as a complex neurobiological condition, paving the way for new insight into ADHD symptoms and coping behaviors in family members, empathy for family members undiagnosed in the past, and even fostering new generations of families with ADHD that thrive in an environment where individuals with ADHD feel understood and valued.

Mending the impact of ADHD across generations requires resilience and support. If individuals and families notice patterns of generational ADHD within their family, there are proactive ways they can address and even diminish its impact, including:

  • Seek a Professional Evaluation: If you suspect that you or a family member may have ADHD, seek a thorough evaluation from a healthcare provider specializing in ADHD. Early identification can open doors to support and management strategies.
  • Educate Yourself and Your Family: Knowledge is power. Learn as much as you can about ADHD, especially how it presents in women and girls. Seek to be your own advocate by understanding ADHD symptoms, treatment options, management strategies, and genetic predisposition from qualified healthcare professionals.
  • Fostering Support: Encouraging open communication within the family is essential, allowing members to express their feelings and concerns without judgment.
  • Seeking Support: Mental health professionals, support groups, community resources, and coaches specializing in ADHD can provide invaluable assistance in managing ADHD-related challenges individually and within families.

ADHD’s impact on generations of families converges on the complexity of genetics, environment, and societal attitudes. Although the symptoms of ADHD were once thought to be the result of a ‘defect of moral character,’ a new understanding can turn the challenges of generational ADHD into opportunities for growth and space for a more compassionate and proactive approach to supporting individuals of all ages affected by ADHD, strengthening family bonds, and enriching the tapestry of all our lives and communities.

What is your experience? How has ADHD been expressed in your family?