When ADHD runs in the family

Even as a small child, Kilian was very restless," says Daniela Chirici. «I constantly had to chase after him in the playground. There was always trouble with other children in the apartment block where we lived. And some parents thought we didn't have a handle on parenting,» says the mother of Kilian, who is now 18.

The trained nurse realised early on that her son was different from other children: as a baby, he cried a lot and reacted sensitively to stimuli. On Kilian's fifth birthday, she contacted an advice centre run by the ADHD organisation elpos and had the abnormalities investigated by a specialist doctor. The diagnosis was ADHD.

It was only much later, when Kilian was already 11 years old, that his mother learnt that Kilian's father also had ADHD. «There was a phase in which he worked a lot and was very stressed,» reports Chirici. «At some point he said: the concentration problems, the restlessness, it all seems familiar to me.» Kilian's father also had himself examined and was diagnosed with ADHD. «It was only then that I realised a few things,» says Chirici. «The fact that the two of them are similar in many ways meant that some situations escalated. When Kilian had a tantrum, his father would often get angry and loud too.»

ADHD in adults is often not recognised for a long time because the symptoms are usually less obvious.

It is not at all uncommon for a child and one or even both parents to have ADHD. «This is not surprising because genetic factors play an important role in ADHD,» explains Isolde Schaffter-Wieland. She is an ADHD coach and board member of the Swiss ADHD Association.

«However, affected parents often only realise at first that «something is wrong», that they are «not getting their parenting or their whole life together». Many don't realise for a long time that they themselves have ADHD.» This was the case for a mother who came to her for counselling: «She was completely overwhelmed with her child, who was later diagnosed with ADHD, and was barely coping with everyday life,» says Schaffter-Wieland. «She was only recognised as having ADHD when her son was 25 years old. Until then, she struggled through life to the point of burnout.»

The fact that ADHD is often not recognised for a long time is due to the fact that the symptoms can vary greatly from person to person. They are often less obvious in adults. Women in particular often manage relatively well in education and work until the birth of their children and have developed strategies to deal with their «peculiarities». «But when they have a child, they are suddenly controlled by others and can no longer structure their day as before,» says Schaffter-Wieland. «This puts them under pressure, which in turn intensifies existing ADHD symptoms.» Many parents initially assume that the problems are solely related to the child - and try in vain to get them under control themselves.

Symptoms of child and parents reinforce each other

However, the constellation of «child and parents with ADHD» can lead to a variety of problems. «The symptoms of the child and parents often reinforce each other,» says Johannes Streif, Deputy Chairman of ADHS Deutschland e. V. «For example, the child may cry over little things and the mother may quickly lose her nerve. Or that the father, who manages well at work, is overwhelmed by the chaos and noise when he gets home.»

It is also typical for parents with ADHD to be inconsistent in their parenting behaviour, overreact and tend to argue. «They are also less aware of their feelings and less able to regulate their behaviour,» says Streif. «They may try to be less impulsive, but don't even realise when their emotions go from green to red in a stressful situation.»

Children with ADHD also need a lot of structure, a clear daily routine and clear rules. «Parents with ADHD sometimes have a chaotic lifestyle themselves and find it difficult to give their children structure,» says Schaffter-Wieland. «On the other hand, there are also parents who have previously organised their lives and want to convey this to their child. They often reach their limits when the child cannot simply adopt the rules or strategies.» In addition, many ADHD sufferers have high expectations of themselves - and quickly become frustrated if they feel that they are not doing everything «well enough».

The diagnosis is often a relief

Children with ADHD are often recognised as early as infancy. The diagnosis is then often made in the first years of school. «Teachers now know more about ADHD and therefore advise parents to get an assessment more often,» says Schaffter-Wieland. «For some parents, the ADHD diagnosis leads them to reflect more on their own behaviour - and sooner or later realise that they are very similar to their child.» Others would realise from information on the internet or tips from their partner that they themselves could be affected. «Basically, it makes sense for parents whose child has ADHD and who have problems coping with everyday life to undergo ADHD screening themselves,» emphasises the expert. This is also recommended by the European Network Adult ADHD - but in practice, this has not yet been consistently implemented.

Knowing the diagnosis is a great relief for many families. Take the Gasser family, for example: both their eldest son Yorick, now 15, and their youngest son Len, 10, were diagnosed with ADHD - attention deficit disorder without hyperactivity - in second grade. «Both tend to be dreamers and find it difficult to concentrate on things that don't interest them,» reports mum Manuela. Their father Matthias also had a check-up - and found out at around the same time as Yorick that he had ADHD. «Knowing that his father has the same thing was very relieving for Yorick,» says Manuela Gasser. «And Len's reaction when he was told the diagnosis was «Oh, that's why some things are so difficult for me at school».»

Treatment is individualised

It is important that the diagnosis is followed by appropriate support. «The first step is psychoeducation, in which parents are informed about the symptoms of ADHD, how to deal with them and the various treatment options,» says Schaffter-Wieland. «Further support can vary greatly from person to person - depending on which ADHD symptoms are in the foreground and how severe the associated problems are.»

For some, a low-threshold offer is sufficient, such as participation in a self-help group for ADHD, counselling or parent coaching. For more pronounced problems, psychotherapy or occupational therapy for the child may be useful - or multimodal therapy, in which such measures are combined with an ADHD medication.

Children with ADHD need clear rules. And parents who lovingly but firmly demand compliance with these rules.

Parent coaching teaches parents, for example, that it is important to behave in a consistent and benevolent manner and to avoid pressure and stress. «They learn how to structure their time better, how to deal with rule violations or how to get their child out of a heated phase,» explains Schaffter-Wieland. It is often helpful if the counsellor accompanies the parents for a while in their everyday lives and supports them in very specific situations. In psychotherapy or occupational therapy, the child in particular, but also the parents, learn strategies on how to better deal with ADHD symptoms.

But ultimately, every family has to find its own way. When Daniela Chirici found out about the ADHD diagnosis, the family moved to a farm where Kilian could better fulfil his urge to move around. Chirici dealt intensively with the topic of ADHD, attended a parents' group and later trained as a parent counsellor herself. Kilian has been regularly attending behavioural therapy since he was eight years old, which has helped him a lot so far. There, Kilian has learnt to calm himself down in angry situations.

It was also very important for the family to have a daily structure and clear rules - for example, when Kilian had to do his homework and how long he was allowed to watch TV. Nevertheless, the school years were difficult for everyone because Kilian found it hard to concentrate on one thing for any length of time. «But at the moment he has the goal of successfully completing his carpentry apprenticeship. That really motivates him to study,» says his mum.

Kilian's father also began therapy after being diagnosed with ADHD. The situation at home became increasingly difficult for him, leading to a separation six years ago. However, he has since made some changes and the relationship between him and Kilian has improved significantly.

Managing a colourful family

ADHD has also turned many things upside down for the Gasser family. After her sons were diagnosed, mum Manuela decided to give up her job and manage her family virtually «full-time». It also turned out that father Matthias is affected by Asperger's autism in addition to ADHD - as is their middle son Orell, aged 13.

«I read a lot of books about ADHD, did courses on the subject and adapted a lot of things in our family life,» says the former paediatric nurse. «Parent coaching also helped us a lot - and couple coaching, which I did with my husband during a difficult phase in our relationship.»

For all three children, it is helpful to have a familiar daily structure, to make clear arrangements and to plan things well in advance - because the unexpected is difficult for them. Her husband, who works as a computer scientist in a hospital, found the hustle and bustle of family life very stressful for a long time. «He now has his own room during the week and is only at home at the weekend,» says Manuela Gasser. «As a result, family life is much better.»

Medication: yes or no?

Medication with stimulants, which many children with ADHD receive, has also helped both families. However, it is not an easy decision for many parents. «They usually look for gentler help first and hesitate for a long time before deciding in favour of medication,» reports Schaffter-Wieland. «But many who try it say that it has made everyday life much easier. Those affected can concentrate better and make better use of their abilities at school, school or university. And both children and adults say that they are more focussed and less impulsive with the medication and can structure their everyday lives better.»

«I was very sceptical at first,» admits Daniela Chirici. «Then my husband suggested I try Ritalin for four weeks first. Kilian was six and a half years old at the time. It really helped a lot: our everyday family life became much calmer and more organised. And the medication also helped Kilian to engage more quickly with the behavioural therapy and learn new strategies better.»

Parents' commitment pays off

Yorick and Len were also both given Ritalin at the age of nine. «That was a great relief for all of us,» reports their mother. «Yorick's school and social skills improved significantly, for example, and it was much easier for him to fit into a group.» He has now found his own rhythm and hasn't taken Ritalin for three years - and it's working well.

Of course, it takes a lot of time and energy to raise a child with ADHD, says Daniela Chirici. «But from my point of view, suitable treatment and the commitment of the parents go a long way. I would also like to convey this to others: that a child with ADHD can become something.»