Your distraction is symptomatic of a disorder

What is best way of beating distractions at work? I have in my drawer a warning letter from my new employer to better concentrate at work.

A few months ago, a child drowned in a swimming pool and there was, as expected, a major crisis. The parent in charge of the children at the time was the father, and he was blamed for his carelessness on the day of the drowning. All agreed he did not do his job of parenting properly.

He developed a severe depressive illness in the context of the bereavement, made worse by the fact that his family blamed him for the death of the child. His wife left him and by the time we saw him, he was drinking heavily and was on the verge of losing his job. After a fight with a waiter at the club, his friends forced him to seek help and he agreed.

Following a period of detoxification from the alcohol, it became evident that we were dealing with a severely depressed man who was on the verge of suicide. He had neglected his personal hygiene. His hair was long and unkempt as was his beard. The smell emitted from the days without soap and water portrayed a doctor in great need of help. He had lost much weight, and his dirty clothes were ill-fitting. His finger nails were long and dirty, and he walked with great difficulties. His voice was low and hesitant and he simply looked awful.

Over the months after the death of the child, his sleep pattern had changed. He easily fell off to sleep when he got to bed, but by 3am, all sleep was gone, and he turned and tossed until morning. He went to work every day tired, angry and hating his job, and cursing the wife and the world who would not understand that it was not his fault. He was soon enveloped by a deep sadness that soon became a sense of hopelessness and he often felt that the world would be a better place without him. He was suicidal.

He had frequent nightmares and as demonstrated by the fight with the waiter, he had developed a “short fuse”.

Ten days into treatment he started to feel better. The sadness was lifting as was the sleep pattern getting better. At last, his dark cloud had a thin ring of silver lining. He was eating better and started watching TV with other patients in the facility.

The nurses noticed that he kept misplacing things. He lost keys to his locker, as well as a number of books he had borrowed. One nurse entered in her notes; “a rather absent minded doctor.” As it turned out, this was to be the key to the entire mystery!

When his mother came to visit, she was seen by one of the psychologists in the team. The mother was surprised that the psychologist was so keen to understand the “absent minded” character of her son!

She explained that both her husband and father in law were also absent minded. The doctor (her son) had been this way all his life. When his school reports were brought in the following day, the diagnosis was clear.

Through primary and secondary school, the comments were consistent; “A bright boy who could do much better if he concentrated in his work.” The next set of comments included; “This boy is too playful and disruptive in class. It is a miracle that he remains above average in his class work.”

His mother was also observed. She was neatly dressed, all her colours matched and when asked about herself she confessed that she was a perfectionist. How else could she live with her husband and her son if she did not set the rules in the house!

The psychologist got it right the first time.

The patient (like his father and grandfather) had clear features of Attention Deficit Hyperactivity Disorder (ADHD). A mother who had features of obsessionality had brought him up under her watch and he had grown up to be a doctor and husband because of the strict rules of the home. A mother obsessed with orderliness can control even the most difficult son and his father.

When he was left in charge of the children that afternoon, his mind had wondered off the task in hand and the child drowned. This led to the depression and contact with us.

Can you relate to our doctor in any way? Many people with ADHD come to us complaining of “being distracted at work.”