Attention Deficit/Hyperactivity Disorder in Adults
Restless. Messy. Easily distracted. These are just some of the words used to describe people with attention deficit/hyperactivity disorder (ADHD).
According to the National Institute of Mental Health, approximately 4 to 9 percent of the U.S. population has ADHD. Experts estimate that one-half to two-thirds of children with the disorder will continue to have symptoms and behaviors of ADHD as adults. Some adults who have ADHD may not have been diagnosed as children because their symptoms were not recognized. The symptoms often become more apparent when they begin to take on the demands of adult responsibilities and develop adult relationships.
ADHD can have a significant social impact on a person's life, affecting relationships in the family and on the job.
What is ADHD?
ADHD has been classified into three broad categories, depending on whether the majority of symptoms are hyperactive or inattention, or a combination of both. People with symptoms of both hyperactivity and inattention have "combined type ADHD"; those whose symptoms are mainly attention deficit have "predominantly inattentive type ADD." Those whose symptoms are mainly hyperactivity have "predominantly hyperactive-impulsive type ADHD." Symptoms of hyperactivity tend to decrease as a person ages and are less common in adults.
Brain differences
ADHD is caused by differences in the parts of the brain that control thoughts, emotions, and actions. These differences are probably inherited. They lead people with ADHD to act inappropriately and be inattentive, impulsive, and disorganized. According to the attention deficit association, people with ADHD have problems with these functions:
Stopping and thinking before acting or responding
Analyzing or anticipating needs and problems, and coming up with effective solutions
Short-term working memory; problems receiving, storing, and accessing information in short term memory
Becoming and staying organized
Focusing and starting on a task
Maintaining attention and working until a task has been completed
Controlling emotions, motivation, and activity level; jumping to conclusions, not being able to wait
In most people, the ability to perform all these functions slowly develops as they grow and mature from childhood to adulthood. The demands of adulthood require a person to be able to do all of these complex functions. In some people who have undiagnosed ADHD as a child, problems caused by ADHD may not become apparent until they are teens or adults and they begin to try to handle more complex functions and demands.
Symptoms
The attention deficit association says that symptoms of ADHD can range from mild to severe. Symptoms that may be noticed by friends, family, and coworkers include problems with learning, self-control, addiction, independent functioning, social interaction, health maintenance, and organizing the tasks of daily life.
ADHD can cause problems like these:
Being unable to keep a job or not keeping jobs long
Not achieving educational goals otherwise within their ability
Having marital difficulties
Having accidents, traffic violations, or arrests
Frequent episodes of anger or rage
Symptoms of ADHD also can be symptoms of other health, emotional, learning, cognitive, and language problems. Experts estimate that over 50 percent of people with ADHD have other psychiatric conditions, such as anxiety, depression, and eating disorders. Your health care provider can determine if symptoms are from a developmental, vision, hearing, psychiatric, or medical problem. If your health care provider makes a diagnosis of ADHD, he or she may refer you to a specialist who has training and experience treating ADHD.
ADHD is a lifelong condition. It is often less bothersome for adults than it is for children, but it is not something that goes away. When a problem is so severe that it continues to interfere with your personal life or career, you should seek help.
Under federal law, ADHD is considered a disability. If you have ADHD, your employer must make appropriate and reasonable accommodations to help you work more efficiently and productively.
Treating ADHD
ADHD can’t be cured, but the symptoms of ADHD may be eased with certain kinds of medication and behavioral therapy or counseling. Medication works on the chemical balance in the brain to relieve symptoms so that you can concentrate on behavioral or cognitive therapy.
You may be prescribed a stimulant or nonstimulant medication, although stimulant medications are probably the more effective treatment. Stimulant medications are generally safe, but can have side effects such as insomnia, nervousness, and decreased appetite. If you take a stimulant medication, you should have your blood pressure and heart rate checked periodically.
Nonstimulant medications include norepinephrine reuptake inhibitors, antidepressants, and drugs for high blood pressure.
Only two drugs have been approved to treat adults with ADHD: the stimulant dextroamphetamine/amphetamine (Adderall XR) and the nonstimulant atomoxetine (Strattera). Multiple studies have been conducted to evaluate other medications—those used for children with ADHD. These other medications include the stimulants methylphenidate (Ritalin) and dextroamphetamine (Dexedrine). Ask your health care provider for the latest information.
Behavioral or cognitive therapy can help you to change certain behaviors, deal with the emotional effects, and learn to improve time management and organizational skills.
Your health care provider should evaluate your medication and other treatment methods on a regular basis. Because ADHD treatment is tailored to each person, your treatment may change as your life changes.
You can restructure your daily routine to help you to cope with your behavior. Making your day highly structured and your schedule consistent can help.
What to do
If you think you may have ADHD, talk to your health care provider or a medical professional who has experience in diagnosing and treating adults with the condition. Be prepared to provide as much early history to that professional as possible, including parent and school records.
For more information about ADHD in adults or to find an organization's local chapter, visit the Attention Deficit Disorder Association or the Children and Adults with Attention Deficit/Hyperactivity Disorder's website.