In Laurie McFetridge's home, there are calendars in every room -- reminders to go to work, pay the bills, call the doctor, take her medication.

"But how do you remember to update all those calendars?" said Ms. McFetridge, 29, who creates floral arrangements and also works as a freelance Web designer.

Help comes from her boyfriend of more than five years. They met at Clarion University and both now live in Oakland, where he is employed by the University of Pittsburgh.

For most of her life, Ms. McFetridge has lived with attention deficit, hyperactivity disorder, or AD/HD. The often-misunderstood condition affects an estimated 5 percent of school-age children in the United States, according to the National Institute of Mental Health. Of those diagnosed with the condition as a child, two-thirds will continue to exhibit its behaviors as an adult.

In the last 20 years, awareness has grown among researchers and medical experts on the profound effects this condition can have on undiagnosed adults -- impacting everything from their personal relationships to their coping skills at work.

"If you have so much impairment over the years, so much difficulty that you develop maladaptive behavior, you might become dispirited, disengaged," said Oscar Bukstein, a psychiatry professor at the University of Pittsburgh's Western Psychiatric Institute and Clinic.

"If you are fired from a number of jobs, you don't bother looking for a job anymore."

About 18 months into their relationship, Ms. McFetridge explained her condition to Andrew, 25, who did not want to be identified by his last name.

"Things he thought were just random and weird made sense when I finally told him," she said.

Experts are finding that medication can help overall but it is also very beneficial for adults with the condition to have a supportive significant other.

"One of the stresses with AD/HD marriage, to do really well, an AD/HD adult needs a coach," said Brenton Mock of Scott, a marriage educator who has been diagnosed with the condition.

"By default, it often falls on the [spouse]. The dynamic in the marriage often means that one partner is under-functioning, and that creates resentment."

Carol Mock, Brenton's wife of 38 years, is well acquainted with the challenges of living with someone with attention deficit issues.

"Our family teases him by calling him space cadet, absent-minded professor," said Mrs. Mock, a retired high school history and English teacher.

"We can tell when he's being Captain Clueless."

The National Institute of Mental Health funded a 2006 survey by Harvard University researchers that estimates 4.4 percent of adults ages 18-44 in the United States experience AD/HD symptoms and some related disability.

That number likely is higher, however, because adult AD/HD is an underreported condition, said Dr. Bukstein, who is involved in WPIC's clinic for adults and children with AD/HD.

Symptoms in adults might include inattentiveness, problems with self-control and sense of responsibility, time management and organization difficulties, restlessness and impulsiveness. Those with AD/HD often are easily distracted, which makes it difficult to focus on what teachers or spouses are saying.

In adults, hyperactivity occurs less frequently. But AD/HD in adults is more likely to be combined with other conditions such as depression and anxiety. This, researchers said, is possibly a result of years of frustration stemming from untreated AD/HD.

Dr. Bukstein's work has shown up to 80 percent of children with attention problems respond to stimulant medications such as Ritalin. In adults, it's closer to 50 percent.

Children's brains are different, he explained, although the medication treatment for patients of all ages is "pretty much the same." The big difference in treatment, he said, lies in the type of cognitive therapy patients receive.

"With children, we focus on behavior management," he said. "In adults, it's problem-solving -- how do you structure your life, how do you organize your life?"

A significant proportion of childhood AD/HD patients learn techniques to compensate as they reach adulthood, Dr. Bukstein said.

"They have figured out how to get someone to pay the bills, who takes care of making the appointments," he said. "If they go into a business, they have someone else keep the books."

Dr. Brian Wymbs, who for more than a year conducted weekly group therapy sessions at Pitt for adult couples coping with AD/HD, said he anticipated his study would attract couples in which one partner has ADD or AD/HD and one does not. He said he was surprised to discover that in several couples who participated, both had the condition.

Ms. McFetridge said she and her boyfriend heard about the study by accident. While throwing away some trash, they saw a flyer: "Do you or your romantic partner often ... zone out during conversations? Say things without thinking? Get angry easily with each other?' "

Dr. Wymbs' sessions at Pitt included exercises in communication, but also covered topics such as self-management skills and improving attention.

"One person talks at a time," Ms. McFetridge said. "It sounds stupid and like such a little thing, but it helps in the long run."

"The bulk of the work is outside of the sessions," said Dr. Wymbs, now a research scientist at Seattle Children's Research Institute's Center for Child Health, Behavior & Development. "We want them to get through issues as a team instead of one person taking charge. I think that focus has been grasped well in the groups so far."

Studies underline the importance of the non-ADD member taking care of his or her own needs, said Gina Pera, author of "Is It You, Me or Adult ADD? Stopping the Roller Coaster When Someone You Love Has Attention Deficit Disorder."

A popular analogy in therapy invokes the flight attendant speech on an airplane, where parents are told to "Put on your own oxygen mask first" before helping others.

Some common personality traits among those with AD/HD, Ms. Pera noted, are intense interest in some subjects to the exclusion of all else, extreme swings in mood and concentration, and a seeming lack of awareness when it comes to mundane tasks such as remembering birthdays or picking up laundry.

One of the initial challenges for adults dealing with the condition is for people to recognize that they have the condition in the first place.

"Sometimes, it's denial, but denial also assumes some degree of awareness," said Michele Novotni, a Philadelphia-area psychologist and coach who has written several definitive books on the subject.

"Some of these people are almost oblivious to their condition."

Many people who are diagnosed with adult ADD or have had AD/HD for years are instead considered to be high-energy, quirky or scatterbrained because most people think the condition affects only children.

Mr. Mock, now 62, had long suspected he had AD/HD. But it was only when he sought help for depression more than 10 years ago at a Veterans Administration hospital that he was diagnosed with AD/HD.

He was a church counselor for 27 years, and has worked as a behavioral therapist and parenting specialist. More recently, he and Mrs. Mock have served as marriage counselors. Now he is obtaining his master's degree in Arts in Marriage and Family Counseling through online classes from Liberty University in Lynchburg, Va.

"Classroom instruction is hard for me. Probably the most difficult environment for anyone with AD/HD is to sit still and pay attention ... but online, you set the pace," Mr. Mock said.

Picking up on social -- particularly nonverbal -- cues also is difficult for many people with adult AD/HD. Mr. Mock also has a hearing impairment, which made some personal interaction even more difficult.

"I got the reputation of being cold and indifferent," he said, but he added that "when I intentionally choose to be, I can hyperfocus."

That's a big problem for many with AD/HD. Ms. Pera's husband was a neurology post-doc when he was diagnosed. "His brain was like a pinball machine," she said.

"But people often assume that if you're not fidgety and wiggly, you must be inattentive."

About 10 years ago, Dr. Novotni, a psychologist, was invited to speak at a conference on AD/HD.

"They didn't think anybody was interested, so they stuck me in a teeny-tiny room," she said. "There was such an overflow of people, standing on chairs, overflow all crowded in the hallway ... . "The [organizers] said, 'Darn, people are interested in this; would you mind moving to a ballroom?' "

Children and Adults with Attention Deficit Disorder originated as a program for children, but it now has more than 200 affiliates nationwide that address adult issues.

"A lot of adults with AD/HD are of late diagnosis," Ms. Pera said. "They were treated, or they weren't treated correctly, earlier in life, so they have a lot of baggage."

A recent CHADD chapter meeting billed as beginning at 7 p.m. in the WPIC auditorium didn't get rolling until about 20 minutes later.

"We have a tendency to start a little late because people arrive a little late," noted Leslie Stone, Pittsburgh chapter coordinator.

Although the meeting addressed dealing with AD/HD in business relationships and in college, many of the practical concerns it covered could apply to personal life as well.

Asking for help from colleagues at work can be difficult for those with AD/HD, who don't want to be viewed as different from everyone else. But it's a lot easier, in the office or at home, if you don't have to go it alone.

"The trick is to find a balance in any relationship," Dr. Novotni said. "If a person is unable to do certain things for themselves, you need someone to jump in.

For Sara, that person may be her boyfriend, Brian.

They attended one of the first Pitt couples therapy sessions last summer while she attended graduate school at Pitt and he worked as a graphic designer. Although Sara said their relationship "was not in furious jeopardy," she and Brian learned important communication skills in those sessions. They now live in Philadelphia.

"I have some sort of attention-something," said Sara, 32, who like many of those interviewed did not want to provide last names for herself or her boyfriend.

"The [sessions] were pretty much what I expected, pretty fun and helpful," she said. "It made it easy to bring things up later, like the fact that I interrupt him when he's talking, but also things like what makes a good relationship."

Resources

• Children and Adults with Attention Deficit/Hyperactivity Disorder Pittsburgh: 412-682-6282, or www.pittsburghadd.org.

• The National Resource Center, operated by CHADD: 1-800-233-4050, or www.help4adhd.org.

• Western Psychiatric Institute and Clinic AD/HD clinical program: 412-246-5268.

• Gina Pera's website: www.adhdrollercoaster.com.

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