Adult ADHD (attention-deficit/hyperactivity disorder)
Adult ADHD (attention-deficit/hyperactivity disorder)
Adult attention-deficit/hyperactivity disorder (adult ADHD) is a mental health condition that causes inattention, hyperactivity and impulsive behavior. Adult ADHD symptoms can lead to a number of problems, including unstable relationships, poor work or school performance, and low self-esteem.
ADHD always starts in early childhood, but in some cases it's not diagnosed until later in life. It was once thought that ADHD was limited to childhood. But symptoms can persist into adulthood. For some people, adult ADHD causes significant problems that improve with treatment.
Treatment for adult ADHD is similar to treatment for childhood ADHD, and includes stimulant drugs or other medications, psychological counseling (psychotherapy) and treatment for any mental health conditions that occur along with adult ADHD.
ADHD has been called attention-deficit disorder (ADD) and hyperactivity. But attention-deficit/hyperactivity disorder is the preferred term because it describes both primary aspects of the condition: inattention and hyperactive-impulsive behavior.
Adult ADHD symptoms can include:
Many adults with ADHD aren't aware they have the disorder — they just know that everyday tasks can be a real challenge. Many adults with ADHD find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social engagements. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings, outbursts of anger and troubled relationships. Many adults with ADHD have a history of problems at school and at work.
All adults with ADHD had ADHD as children, even if it was never diagnosed. About 1 in 3 people with ADHD grows out of symptoms; about 1 in 3 continues to have symptoms that are less severe as adults; and about 1 in 3 continues to have significant symptoms as adults.
What's normal, and what's ADHD?
Diagnosis of ADHD in adults can be difficult because certain ADHD symptoms are similar to those caused by other conditions, such as anxiety or mood disorders. To make it even more challenging, half of adults who have ADHD also have at least one other diagnosable mental health condition, such as depression or anxiety.
When to see a doctor
While the exact cause of ADHD remains a mystery, it increasingly appears that structural changes in the brain are linked to the disorder. Here are several factors that may play a role in developing ADHD:
You're at increased risk of ADHD if:
ADHD has been linked to:
Although ADHD doesn't cause other psychological or developmental conditions, a number of other disorders frequently occur along with ADHD. These include:
Preparing for your appointment
You're likely to start by first talking to your family doctor. Depending on the results of the initial evaluation, your doctor may refer you to a specialist, such as a psychologist or psychiatrist.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with the doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For a possible diagnosis of adult ADHD, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
The following chart from the National Institute of Mental Health lists the types of doctors who are qualified to diagnose and supervise treatment for ADHD, although not all may have specific training in the disorder.
Diagnosing ADHD in adults
Ruling out other conditions
Evaluating signs and symptoms that you had ADHD as a child
Diagnostic criteria for ADHD
The DSM assessment was developed primarily for children, but uses the same criteria to diagnose adults. When considering your symptoms, your doctor or mental health provider will consider what symptoms you had as a child, as well as which symptoms you still have as an adult.
For a diagnosis of ADHD, you must have six or more signs and symptoms from one or both of the two categories below:
Hyperactivity and impulsivity
In addition to having at least six symptoms from one of the two categories, someone with adult ADHD:
Other criteria for diagnosing ADHD in adults
A number of questionnaires and expanded lists of signs and symptoms have been developed to check for signs of adult ADHD. Your doctor may have you answer the questions on one of these to help determine whether you have ADHD.
In addition, your doctor will carefully examine the impact of your core symptoms on your current life — your performance at work or in school and your relationships with friends and family.
Treatments and drugs
The best treatment for ADHD is still a matter of debate. Current treatments typically involve medication, psychological counseling or both. A combination of therapy and medication is often the most effective treatment.
These ADHD medications help treat the core signs and symptoms of inattention and hyperactivity — sometimes dramatically. However, effects of the drugs can wear off quickly, especially if you take a short-acting type rather than a long-acting type of stimulant. The right dose varies between individuals, so it may take some time in the beginning to find the dose that's right for you. Stimulants used to treat ADHD include:
Stimulant drugs are available in short-acting and long-acting forms.
Side effects of stimulants can include insomnia, anorexia, nausea, decreased appetite, weight loss, headache, increased blood pressure, faster pulse, abdominal pain and shifting moods. In some people, stimulants may cause involuntary muscle movements of the face or body (tics). Rarely, they cause seizures, high blood pressure (hypertension), delusions (psychosis) or liver problems. For most people, these medications are considered a safe long-term treatment for adult ADHD. If you have certain conditions, including high blood pressure, heart disease, or problems with alcohol or drug use, your doctor may start your treatment with a nonstimulant medication.
Other medications sometimes used to treat ADHD include:
Atomoxetine and antidepressants work more slowly than stimulants and may take several weeks before they take full effect. These medications may be a good option if you can't take stimulants because of health problems, have a history of substance abuse or have a tic disorder or if stimulants cause severe side effects. Bupropion or venlafaxine may be a good choice if you have a mood disorder along with ADHD.
Psychotherapy for adults with ADHD is often focused on helping develop skills to resolve specific issues. It can help you:
Common types of psychotherapy for ADHD include:
Lifestyle and home remedies
Because ADHD is a complex disorder and each person with ADHD is unique, it's hard to make recommendations that are right for every adult. But some of the following suggestions may help:
Therapy that focuses on these issues and helps you better monitor your behavior can be very helpful. So can classes to improve communication skills, conflict resolution and problem solving. Couples therapy and classes in which family members learn more about ADHD may significantly improve your relationships.
While more research is needed, there's some evidence that alternative medicine treatments can reduce ADHD symptoms. Some alternative treatments for ADHD include:
Coping and support
While medication can make a big difference with ADHD, taking other steps can help you understand ADHD and learn to manage it. Some resources that may help you include:
Once you have your ADHD under control, you can take steps to prevent it from getting worse.
Last Updated: 2010-01-28
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