Disease: Adult attention-deficit/hyperactivity disorder (ADHD)
Adult attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity and impulsive behavior. Adult ADHD can lead to unstable relationships, poor work or school performance, low self-esteem, and other problems.
Though it's called adult ADHD, symptoms start in early childhood and continue into adulthood. In some cases, ADHD is not recognized or diagnosed until the person is an adult. Adult ADHD symptoms may not be as clear as ADHD symptoms in children. In adults, hyperactivity may decrease, but struggles with impulsiveness, restlessness and difficulty paying attention may continue.
Treatment for adult ADHD is similar to treatment for childhood ADHD, though some ADHD medications approved for children are not approved for adult use. Adult ADHD treatment includes medications, psychological counseling (psychotherapy) and treatment for any mental health conditions that occur along with ADHD.
Some people with ADHD have fewer symptoms as they age, but some adults continue to have major symptoms that interfere with daily functioning. In adults, the main features of ADHD may include difficulty paying attention, impulsiveness and restlessness. Symptoms can range from mild to severe.
Many adults with ADHD aren't aware they have it â they just know that everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.
Adult ADHD symptoms may include:
- Disorganization and problems prioritizing
- Poor time management skills
- Problems focusing on a task
- Trouble multitasking
- Excessive activity or restlessness
- Poor planning
- Low frustration tolerance
- Frequent mood swings
- Problems following through and completing tasks
- Hot temper
- Trouble coping with stress
What's normal and what's ADHD?
Almost everyone has some symptoms similar to ADHD at some point in their lives. If your difficulties are recent or occurred only occasionally in the past, you probably don't have ADHD. ADHD is diagnosed only when symptoms are severe enough to cause ongoing problems in more than one area of your life. These persistent and disruptive symptoms can be traced back to early childhood.
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. And many adults with ADHD also have at least one other mental health condition, such as depression or anxiety.
When to see a doctor
If any of the symptoms listed above continually disrupt your life, talk to your doctor about whether you might have ADHD.
Different types of health care professionals may diagnose and supervise treatment for ADHD. Seek a provider who has training and experience in caring for adults with ADHD.
While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include:
- Genetics. ADHD can run in families, and studies indicate that genes may play a role.
- Environment. Certain environmental factors also may increase risk, such as lead exposure as a child.
- Problems during development. Problems with the central nervous system at key moments in development may play a role.
Signs and symptoms of ADHD in adults can be hard to spot. However, core symptoms start early in life â before age 12 â and continue into adulthood, creating major problems.
No single test can confirm the diagnosis. Making the diagnosis will likely include:
- Physical exam, to help rule out other possible causes for your symptoms
- Information gathering, such as asking you questions about any current medical issues, personal and family medical history, and the history of your symptoms
- ADHD rating scales or psychological tests to help collect and evaluate information about your symptoms
Other conditions that resemble ADHD
Some medical conditions or treatments may cause signs and symptoms similar to those of ADHD. Examples include:
- Mental health disorders, including mood disorders such as depression or anxiety, conduct disorders, learning and language deficits, or other psychiatric disorders
- Medical problems that can affect thinking or behavior, such as a developmental disorder, seizure disorder, thyroid problems, sleep disorders, lead poisoning, brain injury or low blood sugar (hypoglycemia)
- Drugs and medications, such as alcohol or other substance abuse and certain medications
ADHD can make life difficult for you. ADHD has been linked to:
- Poor school or work performance
- Trouble with the law
- Alcohol or other substance abuse
- Frequent car accidents or other accidents
- Unstable relationships
- Poor physical and mental health
- Poor self-image
- Suicide attempts
Although ADHD doesn't cause other psychological or developmental problems, other disorders often occur along with ADHD and make treatment more challenging. These include:
- Mood disorders. Many adults with ADHD also have depression, bipolar disorder or another mood disorder. While mood problems aren't necessarily due directly to ADHD, a repeated pattern of failures and frustrations due to ADHD can worsen depression.
- Anxiety disorders. Anxiety disorders occur fairly often in adults with ADHD. Anxiety disorders may cause overwhelming worry, nervousness and other symptoms. Anxiety can be made worse by the challenges and setbacks caused by ADHD.
- Other psychiatric disorders. Adults with ADHD are at increased risk of other psychiatric disorders, such as personality disorders, intermittent explosive disorder and substance abuse.
- Learning disabilities. Adults with ADHD may score lower on academic testing than would be expected for their age, intelligence and education. Learning disabilities can include problems with understanding and communicating.
There's little research to indicate that alternative medicine treatments can reduce ADHD symptoms. However, one recent study indicates that mindfulness meditation may help improve mood and attention in adults who have ADHD, as well as those who don't have ADHD.
Before using alternative interventions for ADHD, talk with your doctor about risks and possible benefits.
Lifestyle and home remedies
Because ADHD is a complex disorder and each person is unique, it's hard to make recommendations for all adults who have ADHD. But some of these suggestions may help:
- Make a list of tasks to accomplish each day. Prioritize the items. Make sure you're not trying to do too much.
- Break down tasks into smaller, more manageable steps. Consider using checklists.
- Use sticky pads to write notes to yourself. Put them on the fridge, on the bathroom mirror, in the car or in other places where you'll see the reminder.
- Keep an appointment book or electronic calendar to track appointments and deadlines.
- Carry a notebook or electronic device with you so that you can note ideas or things you'll need to remember.
- Take time to set up systems to file and organize information, both on your electronic devices and for paper documents. Get in the habit of using these systems consistently.
- Follow a routine that's consistent from day to day and keep items, such as your keys and your wallet, in the same place.
- Ask for help from family members or other loved ones.
Coping and support
While treatment 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 are listed below. Ask your health care team for more advice on resources.
- Support groups. Support groups allow you to meet other people with ADHD so that you can share experiences, information and coping strategies. These groups are available in person in many communities and also online.
- Social support. Involve your spouse, close relatives and friends in your ADHD treatment. You may feel reluctant to let people know you have ADHD, but letting others know what's going on can help them understand you better and improve your relationships.
- Co-workers, supervisors and teachers. ADHD can make work and school a challenge. You may feel embarrassed telling your boss or professor that you have ADHD, but most likely they'll be willing to make small accommodations to help you succeed. Ask for what you need to improve your performance, such as more in-depth explanations or more time on certain tasks.
Risk of ADHD may increase if:
- You have blood relatives, such as a parent or sibling, with ADHD or another mental health disorder
- Your mother smoked, drank alcohol or used drugs during pregnancy
- As a child, you were exposed to environmental toxins â such as lead, found mainly in paint and pipes in older buildings
- You were born prematurely
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