By Edward C. Geehr, M.D., Lifescript Chief Medical Officer
forgot to let the dog out. Need to pick up the dry cleaning. Anyone seen
my keys? If these scatterbrained thoughts are du jour, you could be one
of an estimated 6-15 million ADHD adults. Learn more about the symptoms
Your inattention and restlessness may not just
be your quirky personality. You could have ADHD
(attention-deficit/hyperactivity disorder), a behavioral disorder that's
mostly associated with unruly children. In fact, about 65% of children
with ADHD carry the disorder into adulthood, making it an adult problem
Although ADHD adults may have better coping skills than they
had as children, it's still a struggle to get through the day. Not only
does ADHD interfere with organizing and completing daily tasks, but
adults with the disorder are also prone to depression, anxiety,
forgetfulness, even an increased risk of divorce and car accidents.
simple duties may demand great concentration and effort. In part,
that’s because ADHD adults are easily distracted by sound, sight or
touch. Whatever the stimulus, they're often knocked off course by even
minor distractions.Symptoms of ADHD
The three main symptoms of ADHD are inattention, hyperactivity and impulsive behavior.
The symptoms of inattention include:
- Losing track of thoughts or focus in the middle of tasks
- Missing details or making careless mistakes
- Inability to complete work assignments
- Difficulty following instructions
Hyperactivity symptoms in adults are similar to those in children but more subtle:
- Constantly shifting in a chair
- Tapping your feet or a pencil
- Playing or tugging at hair or clothing
Even those aware of their repetitive motions may be unable to stop.Why Can't They "Grow Up?"
who act impulsively can be even more annoying than kids – and
potentially dangerous: They may interrupt constantly or blurt out
inappropriate comments. They can’t stand waiting in lines and may try to
cut to the front.
They also have trouble anticipating
consequences of their actions. In children, it's disruptive, but in
adults, it can threaten families, jobs and even safety. A young ADHD
adult paired with a car can be a deadly combination.
workplace, ADHD can erode performance. Some people with the disorder
change jobs often or have trouble holding one. The way they handle tasks
shifts from one to the next: One assignment is done well, but the next
is late, poorly done or incomplete.
The ADHD adult feels like
she breezes through some tasks but can’t get traction on, or stay
interested, in others. Co-workers are puzzled by this variability, often
attributing it to personal problems or even substance abuse.Diagnosing the ADHD Adult
scientists don’t know ADHD's cause and laboratory tests can’t confirm a
diagnosis. They have found, however, that the disorder runs in
If one of your parents has the disorder, there's a 50%
chance you have it too. If your child has been diagnosed with ADHD, you
have a 25% chance of having the disorder yourself. Unlike childhood
ADHD, which affects 3 times as many boys as girls, adult ADHD affects
men and women equally.
Doctors diagnose ADHD based on
family, developmental and childhood history, current signs and symptoms.
Still, it's important to rule out potentially serious and/or treatable
neurological disorders that can mimic ADHD symptoms, such as Tourette’s
Syndrome, temporal lobe seizures, early stage brain tumor, elevated
blood lead levels, hypo- or hyperthyroidism, and hearing or vision
Most workups for detecting ADHD include a physical exam. Some doctors may also request:
- EEG (electroencephalogram, which records the electrical activity of the brain)
(computed tomography, or X-ray procedure, that records cross-sectional
pictures of parts of the body, in this case the brain)
(magnetic resonance imaging, a diagnostic technique that produces
cross-sectional images of any body part, in this instance the brain) to
rule out other conditions.
ADHD has no cure. Fortunately, several drug treatments – primarily stimulants – work for both children and adult ADHD patients.
two-thirds of ADHD adults taking stimulants experience significant
improvements. And the drugs take effect fast, a remarkable finding
because few medications have such a profound and immediate effect.
Unfortunately, most stimulants wear off quickly, returning adults to their usual problems.
ADHD adults turn to coffee. In fact, some can’t do without it;
caffeine’s stimulating effect helps them focus and stay on task. In
fact, some get so much relief that they become caffeine abusers,
drinking excessive amounts each day.Stimulant medications, also called
psychostimulants, include Ritalin® and Ritalin LA®, Methylin®,
Metadate®, Concerta®, and Adderall® and Adderall XR®.
these offer long-acting formulations to reduce the need for frequent
dosing. Only Adderall XR® is indicated for the treatment of ADHD in
children, adolescents and adults.
Non-stimulant medications are
also available, including Wellbutrin® and Straterra®. Available since
2003, Straterra® is the first non-stimulant medication approved to
control ADHD symptoms in children, adolescents and adults.
is sometimes used "off-label" for treatment of combined conditions such
as ADHD and depression. The term "off-label" means that doctors
prescribe the drug for disorders not officially approved by the Federal
Drug Administration (FDA).
Along with medications, a 2010 study also showed that behavioral therapy can help adults with ADHD
.How to Cope with Adult ADHD
Doctors often recommend various coping strategies as an adjunct to drug therapy. These include:
- Taking medications as directed. (Don’t double up if you miss a dose.)
- Making lists of tasks and keeping them nearby
a deep breath or excusing yourself from situations when you're tempted
to act out or interrupt; recognizing and minimizing stimuli that
distract you (sounds, sights and physical sensations)
- Doing things that calm or comfort you, such as gardening, walking or cooking
and other mental health professionals now have access to a symptom
checklist designed to help establish the diagnosis of adult ADHD.
Adult Self-Report Scale (ASRS-v1.1) was developed in conjunction with
the World Health Organization and Workgroup on Adult ADHD, which
includes experts from Harvard Medical School and New York University
The checklist included 18 questions and takes about 5 minutes to complete.
the 18 questions, six were found to be the most predictive of symptoms
consistent with ADHD. Patients are asked to score the frequency of
symptoms on a 5-stage scale described in each question, from never to
1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
2. How often do you have difficulty getting things in order when you have to do a task that requires organization?
3. How often do you have problems remembering appointments or obligations
4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
6. How often do you feel overly active and compelled to do things, like you were driven by a motor?
these symptoms sound familiar to you, ask your doctor about a referral
to someone who can administer the ASRS and counsel you about the results
and your options, if your score indicates a high likelihood of adult
Check out more ADHD Resources:
National Resource Center on ADHD National Institute of Mental HealthCHADDTest Your Social Skills IQ
is the key to social skills, but when it breaks down, social ineptitude
takes on a life of its own. Test how savvy your social skills are with
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