ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder) have been highly publicized conditions in the last 10 years. Most of the talk and research about ADHD has been directed towards the childhood version without considerable discussion about adult ADHD. This is problematic, however, as many children carry ADHD characteristics into adulthood, where they have to contend with very different life pressures and responsibilities.
There are so many positive aspects to ADHD, but these are often overlooked by mainstream society. Creativity is obvious in many ADHD affected adults, and having a satisfying outlet for this creativity is very important. This may be anything from being a high-performing executive to playing an instrument to extreme sports. In fact, people with ADHD are often very quick minded and intelligent. They can become very successful when they find something they are passionate about and are often able to invest a lot more energy than most people in being high performing and high achieving in activities they put focus and energy into.
Symptoms
The symptoms of adult ADHD change according to the different lifestyles and preferences that come with being an adult with commensurate responsibilities.1 Relationships, employment and everyday tasks can all be affected in a number of ways, both positively and negatively. The three major symptoms of ADHD (as related to adulthood) are impulsivity, hyperactivity, and distractibility:
Impulsivity means the ADHD adult may have a difficult time controlling their immediate reactions. Some ways in which this could present difficulties include addictions such as substance abuse, shopping, gambling, and other behaviors as well as saying the first thing that comes to the person’s mind without filtering how what they are going to say might be perceived by others.
Hyperactivity is probably one of the most well-known symptoms of ADHD. This is typically seen in symptoms of restlessness, fidgeting, or the person having a hard time sitting still. But hyperactivity can also be an asset in that many adults with ADD are capable of fitting a lot more into a day than the average person because of their constant desire to be productive and constantly going and doing until they virtually pass out from exhaustion at the end of the day.
Distractibility also affects many aspects of adult life. Individuals may have problems in keeping the mind focused on a specific task, such as having challenges concentrating on a conversation or being easily bored with a task. Adults with ADD can be very spontaneous such as jumping from one thing to another. While this trait can be endearing it can also be frustrating in relationships with significant others and colleagues. Another way we have seen distractibility manifest is individual having multiple projects or computer applications open simultaneously and, while multi-tasking, being able to get all the work products completed. Although this unconventional approach to getting work competed may be misunderstood by others the end result of high productivity is often not.
Treatment
In the past, the first treatment offered to adults with ADHD has been stimulant medications.2 Although studies show that approximately two thirds of adults with ADHD who are given these medications show significant improvement in ADHD symptoms there are some difficulties in using stimulants to treat ADHD in adults. Stimulants are controlled substances and it is not uncommon for adults with ADHD to have or to have had problems with substance abuse. Short acting stimulants may wear off quickly and since adult patients administer the medication themselves, and usually have problems with forgetfulness, keeping track of medication can be problematic if dosing several times during the day is necessary. Also since medications have worn off by the end of the day adults may experience difficulties in the evening when they need to complete day-to-day activities such as paying bills, helping children with homework, or to do housework.
There are other treatment approaches for Adult ADHD outside of medication that we have found to be very worthwhile and effective as either ancillary to, or instead of, medication regimens:3 4
• Individual cognitive and behavioral therapy to enhance self-esteem.
• Family education and therapy: family support is necessary to help the adult with ADHD function in new ways and build his or her self-esteem
• Relaxation training and stress management to reduce anxiety and stress: Since adults with ADD are often high performing/high charging individuals it can be very difficult for them to relax and unwind. It is not uncommon to see adults with ADD placing unrealistic expectations upon themselves and those whom they love as they may be accustomed to being high performing and accomplishing much in any given day.
• Job coaching or mentoring to support better working relationships and improve on-the-job performance.
• Assessment to determine co-morbidities that need addressing: Because ADHD is often 7PDassociated with other conditions (such as learning disabilities, anxiety and mood disorders, obsessive compulsive disorder and possibly chemical dependency concerns), in-depth assessment is necessary to developing an approach that will be most beneficial for the adult with ADD.
Adults with ADHD can also benefit from some basic organizational concepts and behavior management strategies to help manage the condition:
• Organize yourself. Train yourself to become more organized. This may include lists of daily tasks, using a daily planner, leave reminder notes or utilize phone alarms for appointments or daily activities.
• Minimize distractions. Find ways to reduce the distractions throughout the day. Move yourself to a quiet space if noise has a tendency to distract or use earplugs.
• Control behaviors you might regret. If you have a tendency to do things you later regret, such as shopping excessively, interrupting or saying the first thing that comes to mind manage the impulse putting a “space between action and reaction.” Some people count to 10 slowly while breathing instead of acting out. Often the impulse will pass quickly.
• Find constructive outlets for excess energy. People with ADHD sometimes seem to have more nervous energy than others, and this hyperactivity needs to have an outlet of some sort. A hobby or other pastime can be helpful.
Although most people don’t outgrow ADHD, they do learn to adapt. If the difficulties associated with ADHD are managed appropriately throughout their lives, adults with ADHD can learn to develop personal strengths and become productive and successful.
1 Valdizán, JR; Izaguerri-Gracia, AC (2009). “Attention deficit hyperactivity disorder in adults”. Revista de neurologia 48 Suppl 2: S95–9
2 Spencer,T., Biederman,J., Wilens,T.(2004) Stimulant treatment of adult attention-deficit/hyperactivity disorder
27: 2, 361-72.
3 Weiss, M.; Safren, S. A.; Solanto, M. V.; Hechtman, L.; Rostain, A. L.; Ramsay, J. R.; Murray, C. (2007). Research Forum on Psychological Treatment of Adults With ADHD. Journal of Attention Disorders 11 (6): 642–51.
4 Kolar,D., Keller,A., Golfino poulos,M., Cumyn,L., Syer,C., Hechtman,L. (2008). “Treatment of adults with attention-deficit/hyperactivity disorder”. Neuropsychiatr Dis Treat 4 (1): 107–121
