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By all estimations, George Washington Adams, the eldest son of John Quincy Adams, lead a troubled life. Although gifted and considered very intelligent, he was also known to be deeply moody, was given to alcoholism and could suffer from bouts of paranoia. Also, much to the shock of his family, he became a womanizer which lead to one child being born out of wedlock (although the child died in its infancy), shortly after his own suicide.

However, during his short life, Adams practiced law, served a term in the Massachusetts House of Representatives, and was noted as a gifted author with a particular interest in poetry.

So: What if Adams had managed to keep his inner demons in check. Perhaps we can butterfly away the conception of his only child, as it seems probable that the social pressures and shame that came with it were a contributing factor to his death. He probably suffered from depression (a disease that appears with some regularity in several generations of the Adams family), and I suspect that he would never be able to kick his alcohol habit completely. However, people have suffered from both and still lead longer, very productive lives.

Furthermore, Adams had always been fascinated by poetry and the Romantic Poets then in vogue in Europe. Lets say that he has a nasty brush with his own darker side and decides to pour his passion into the writing of poetry. From what evidence we have, he was has gifted with letters (Another trait shared by many members of the family; JQA wrote poetry on the side, was a gifted writer and translator along with his political career, and two of George's nephews would go on to be accomplished writers as well, albeit of history) and, coupled with his name, I could see him becoming successful.

America, at this point, was about to see the debut of a number of poets and writers that would put the nation on the literary map (Poe, Longfellow, and Hawthorn to name but a few), but Adams was a few years older and could be well positioned to lead the way for this generation. Furthermore, American poets never seemed to develop the notorious life styles that marked their brethren on the continent. Adams, with his troubled past, his belonging to to passed as an aristocratic family in the United States, and his life style could well fit into the mold of an American Lord Byron.

What impact might this have on the United States?

(on a side note: this might well help stave off the death of George's younger brother John, who's descent into alcoholism has been blamed on the suicide of his older brother. However, alcoholism claimed the lives of several Adams men, and it seems likely George was predisposed towards it, in any case)
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