Attention Deficit Hyperactivity Disorder (ADHD) In Adults

Learn About ADHD In Adults

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity).  ADHD affects about 4.1% American adults age 18 years and older in a given year.

To be diagnosed with ADHD, an adult must have ADHD symptoms that began in childhood and continued throughout adulthood.  An evaluation will look at the person's history of childhood behavior and school experiences, and may include interview of spouses or partners, parents, close friends, and other associates.  It is important to consider a wider range of symptoms when assessing adults for ADHD because their symptoms tend to be more varied, and possibly not as clear-cut, as symptoms are in children.  Pertinent questions will include:

How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?

How often do you have difficulty getting things in order when you have to do a task that requires organization?

How often do you have problems remembering appointments or obligations?

When you have a task that requires a lot of thought, how often do you avoid or delay getting started?

How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?

How often do you feel overly active and compelled to do things, like you were driven by a motor?

How often do you make careless mistakes when you have to work on a boring or difficult project?

How often do you have difficulty keeping your attention when you are doing boring or repetitive work?

How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?

How often do you misplace or have difficulty finding things at home or at work?

How often are you distracted by activity or noise around you?

How often do you leave your seat in meetings or other situations in which you are expected to remain seated?

How often do you feel restless or fidgety?

How often do you have difficulty unwinding and relaxing when you have time to yourself?

How often do you find yourself talking too much when you are in social situations?

When you’re in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?

How often do you have difficulty waiting your turn in situations when turn taking is required?

How often do you interrupt others when they are busy?

For some adults, a diagnosis of ADHD can bring a sense of relief. Adults who have had the disorder since childhood, but who have not been diagnosed, may have developed negative feelings about themselves over the years. Receiving a diagnosis allows them to understand the reasons for their problems, and treatment will allow them to deal with their problems more effectively.

Just as for children, the most common type of medication used for treating ADHD in adults is called a stimulant. Although it may seem unusual to treat ADHD with a medication considered a stimulant, it actually has a calming effect on people with ADHD, because the pathways in the brain that respond to the stimulant are inhibitory in function. Many types of stimulant medications are available. A few other ADHD medications are non-stimulants, but these have in common with stimulants an increase in the action of the neurotransmitter norepinephrine.

Stimulant medications come in different forms, such as a pill, capsule, liquid, or skin patch. Some medications also come in short-acting, long-acting, or extended release varieties. In each of these varieties, the active ingredient is the same, but it is released differently in the body. Long-acting or extended release forms allow once-daily dosing.
Under medical supervision, stimulant medications are considered safe. Stimulants do not make people with ADHD feel high.  Although some patients worry that stimulant medications may lead to substance abuse or dependence, there is little evidence of this.

Adult prescriptions for stimulants and other medications require special considerations. For example, adults often require other medications for physical problems, such as diabetes or high blood pressure, or for anxiety and depression. Some of these medications may interact badly with stimulants. An adult with ADHD should discuss potential medication options with the doctor. These and other issues must be taken into account when a medication is prescribed.

A professional counselor or therapist can help an adult with ADHD learn how to organize life with tools such as a large calendar or date book, lists, reminder notes, and by assigning a special place for keys, bills, and paperwork. Large tasks can be broken down into more manageable, smaller steps so that completing each part of the task provides a sense of accomplishment.

Psychotherapy, including cognitive behavioral therapy, also can help change one's poor self-image by examining the experiences that produced it. The therapist encourages the adult with ADHD to adjust to the life changes that come with treatment, such as thinking before acting, or resisting the urge to take unnecessary risks.

Adapted from and expanded upon NIMH
Symptom Checklist from Harvard Medical



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