ADHD – Attention Deficit Hyperactivity Disorder

Have you experienced challenges with concentration, impulsivity, restlessness, and organization throughout your life? Have you ever wondered whether you might have attention-deficit/hyperactivity disorder (ADHD)? Although ADHD is well known as a condition that affects children, many adults also experience it. ADHD can be harmful to an individual’s social relationships and work and school performance, but effective treatments are available to manage the symptoms of ADHD. Learn about the signs and symptoms of ADHD and when to discuss it with your health care provider.

What is ADHD?

ADHD is a developmental disorder associated with an ongoing pattern of inattention, hyperactivity, and/or impulsivity. The symptoms of ADHD can interfere significantly with an individual’s daily activities and relationships. ADHD begins in childhood and can continue into the teen years and adulthood.

What are the symptoms of ADHD?

People with ADHD experience an ongoing pattern of the following types of symptoms:

• Inattention–having difficulty paying attention
• Hyperactivity–having too much energy or moving and talking too much
• Impulsivity–acting without thinking or having difficulty with self-control

Some people with ADHD mainly have symptoms of inattention. Others mostly have symptoms of hyperactivity-impulsivity. Some people have both types of symptoms.

Signs of inattention may include challenges with:

• Paying close attention to details or making seemingly careless mistakes at work or during other activities
• Sustaining attention for long tasks, such as preparing reports, completing forms, or reviewing lengthy papers
• Listening closely when spoken to directly
• Following instructions and finishing duties in the workplace
• Organizing tasks and activities and managing time
• Engaging in tasks that require sustained attention
• Losing things such as keys, wallets, and phones
• Being easily distracted by unrelated thoughts or stimuli
• Being forgetful in daily activities, such as paying bills, keeping appointments, or returning calls

Signs of hyperactivity and impulsivity may include:

• Experiencing extreme restlessness, difficulty sitting still for extended periods, and/or wearing others out with one’s activity
• Fidgeting with or tapping hands or feet or squirming in seat
• Being unable to engage quietly in leisure activities
• Talking excessively
• Answering questions before they are asked completely
• Having difficulty waiting one’s turn, such as when waiting in line
• Interrupting or intruding on others

Other mental disorders may occur with ADHD, including anxiety, mood, and substance use disorders.

How is ADHD diagnosed in adults?

ADHD is a disorder that begins in childhood and continues into adulthood. Adults who are diagnosed with ADHD experienced several symptoms of ADHD before the age of 12. As adults, they currently experience at least five persistent symptoms of inattention and/or five persistent symptoms of hyperactivity-impulsivity. These symptoms must be present in two or more settings (for example, home, work, or school; with friends or relatives; in other activities) and interfere with, or reduce the quality of, social, school, or work functioning.

Adults who think they may have ADHD should talk to their health care provider. Primary care providers routinely diagnose and treat ADHD and may refer individuals to mental health professionals.

Stress, other mental health conditions, and physical conditions or illnesses can cause similar symptoms to those of ADHD. Therefore, a thorough evaluation by a health care provider or mental health professional is necessary to determine the cause of the symptoms and identify effective treatments. During this evaluation, the health care provider or mental health professional will examine factors including the person’s mood, medical history, and whether they struggle with other issues, such as alcohol or substance misuse.

A thorough evaluation also includes looking at the person’s history of childhood behavior and school experiences. To obtain this information, an individual’s health care provider may ask for permission to talk with partners, family members, close friends, and others who know the individual well. A health care provider or mental health professional may use standardized behavior rating scales or ADHD symptom checklists to determine whether an adult meets the criteria for a diagnosis of ADHD. An individual may complete psychological tests that look at working memory, executive functioning (abilities such as planning and decision-making), visual and spatial (related to space), or reasoning (thinking) skills. Such tests can help identify psychological or cognitive (thinking-related) strengths and challenges and can be used to identify or rule out possible learning disabilities.

How does ADHD affect adults?

Some adults who have ADHD don’t know they have it. These adults may feel it is impossible to get organized, stick to a job, or remember to keep appointments. Daily tasks such as getting up in the morning, preparing to leave the house for work, arriving at work on time, and being productive on the job can be especially challenging for adults with undiagnosed ADHD. These adults may have a history of problems with school, work, and relationships. Adults with ADHD may seem restless and may try to do several things at the same time—most of them unsuccessfully. They sometimes prefer quick fixes rather than taking the steps needed to gain greater rewards.

A person may not be diagnosed with ADHD until adulthood because teachers or family did not recognize the condition at a younger age, they had a mild form of ADHD, or they managed fairly well until they experienced the demands of adulthood, especially at work. Sometimes, young adults with undiagnosed ADHD have academic problems in college because of the intense concentration needed for college courses.

It is never too late to seek a diagnosis and treatment for ADHD and any other mental health condition that may occur with it. Effective treatment can make day-to-day life easier for many adults and their families.

What causes ADHD?

Researchers are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other disorders, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors that might raise the risk of developing ADHD and are studying how brain injuries, nutrition, and social environments might play a role in ADHD.

What are the treatments for ADHD?

Treatment for ADHD includes medication, therapy and other behavioral treatments, or a combination of methods.

Medication

Stimulants are the most common type of medication used to treat ADHD. Research shows these medications can be highly effective. Like all medications, they can have side effects and require an individual’s health care provider to monitor how they may be reacting to the medication. Nonstimulant medications are also available. Health care providers may sometimes prescribe antidepressants to treat adults with ADHD, although the Food and Drug Administration (FDA) has not approved these medications specifically for treating ADHD.

As with all prescriptions, individuals should disclose other medications they take when discussing potential ADHD medications with a health care provider. Medications for common adult health problems, such as diabetes, high blood pressure, anxiety, and depression, may interact with stimulants. In this case, a health care provider can suggest other medication options.

Psychotherapy and Support

Research shows that therapy may not be effective in treating the core symptoms of ADHD. However, adding therapy to an ADHD treatment plan may help individuals better cope with daily challenges. Therapy is especially helpful if ADHD co-occurs with other mental disorders, such as anxiety or depression.

Psychotherapy, including cognitive behavioral therapy, might help an adult with ADHD become more aware of attention and concentration challenges and work on skills to improve organization and use of time in completing daily tasks. For example, they might help individuals break down large tasks into smaller, more manageable steps. Psychotherapy also can help adults with ADHD gain confidence and control impulsive and risky behaviors. Some adults also may find it helpful to get support from a professional life coach or ADHD coach who can help with different skills to improve daily functioning.

Complementary Health Approaches

Some people may explore complementary health approaches, such as natural products, to manage symptoms of ADHD. Unlike specific psychotherapy and medication treatments that are scientifically proven to improve ADHD symptoms and impairments, complementary health approaches for ADHD generally have not been found to improve ADHD symptoms and do not qualify as evidence-supported interventions.

How can I help myself?

Therapy and medication are the most effective treatments for ADHD. In addition to these treatments, other strategies may help manage symptoms:

• Exercise regularly, especially when you’re feeling hyperactive or restless.
• Eat regular, healthy meals.
• Get plenty of sleep. Try to turn off screens at least 1 hour before bedtime and get between 7 and 9 hours of sleep every night.
• Work on time management and organization. Prioritize time-sensitive tasks and write down assignments, messages, appointments, and important thoughts.
• Connect with people and maintain relationships. Schedule activities with friends, particularly supportive people who understand your challenges with ADHD.
• Take medications as directed, and avoid use of alcohol, tobacco, and drugs.

Where can I turn if I feel alone in my diagnosis of ADHD?

Adults with ADHD may gain social support and better coping skills by talking with family, friends, and colleagues about their diagnosis. If the people in your life are aware of your diagnosis, they will better understand your behavior. Psychotherapy for families and couples can help relationship problems and teach everyone involved about ADHD. There are also support groups for adults with ADHD.