Most people might think attention-deficit/hyperactivity disorder is a childhood issue, but the truth is that adults also can be diagnosed with ADHD.
The American Psychiatric Association reports that an estimated 8.4% of children and 2.5% of adults have ADHD. The cause of ADHD isn’t known, but there is some evidence that genetic factors play a role — the APA says three out of four children with ADHD also have a relative with the disorder — and other factors, such as premature births, brain injuries and smoking, drinking alcohol or experiencing extreme stress during pregnancy may also contribute to ADHD manifestation.
While there are multiple symptoms that can indicate ADHD in adults, most frequently it’s apparent when “individuals have difficulty paying close attention to details and can make careless mistakes at work or other activities,” Dr. Misty Tu, M.D., medical director and psychiatrist at Seattle Anxiety Specialists, says.
A lack of sustained attention span, seemingly not listening when being directly spoken to, easily losing things or being distracted are all indicators of adult ADHD, Tu says. Beyond that, “some individuals can have issues with fidgeting, talking excessively, interrupting others, waiting their turn, or have trouble quietly enjoying leisurely activities.”
Adult ADHD
According to the APA, many adults aren’t aware they have the disorder. Adults don’t tend to display the same symptoms as children, like hyperactivity, for example, but there is some evidence of a link between childhood and adult ADHD. Tu cites a recent APA report where in a longitudinal study of 500 children diagnosed with ADHD, only 9% didn’t have symptoms as adults.
Dr. Katharine Liang, M.D., Ph.D., consulting psychiatrist at Seattle Anxiety Specialists, says that if you’re diagnosed with ADHD as an adult, you likely also experienced ADHD as a child. Because of this, “it’s important for us to take a good history when we see adult patients. ADHD is thought to arise from certain circuits in the brain not fully developing properly, interfering with the signaling that helps us with day-to-day concentration and focus.”
Liang adds that ADHD can also be related to other mental health issues like anxiety or depression and it’s often “the rule, not the exception.” She adds that evidence suggests adults with ADHD “also have a higher likelihood to use drugs to self-medicate and develop substance use disorders, especially if their ADHD is untreated or undertreated.”
Tu echoes the need for a proper diagnosis and says that providers should try to differentiate between anxiety, depression and ADHD to come up with the right treatment plan. “There are individuals that have a combination, or all three of these issues, at the same time.” Substance abuse can further complicate a diagnosis as it can create symptoms that look like ADHD.
Treatment for ADHD
If you’ve been diagnosed with ADHD, there are generally two different medications prescribed to help alleviate symptoms, Tu says. One of the medications is in the stimulant class — think Ritalin — and the other class are nonstimulants.
One benefit is that many of the medications work quickly, Tu added, and some people may experience immediate effects. This also means that initially you may see your doctor with more frequency to ensure you’re getting the proper dosage. Other medications, usually the nonstimulant medications, can take up to two weeks before a patient feels the effect. And, in some instances, “if you have a very mild form of ADHD you may be able to use behavioral modification and avoid medication.”
“Organizational skills and behavior modification can be taught — even diet and exercise can be beneficial,” Liang says. But she stresses that any treatment plan “should be based on the severity of illness and level of dysfunction.”
Living with ADHD
After getting a diagnosis of ADHD, it’s important to follow a plan directed by your doctor. There are some concrete actions people can take to help them focus, such as maintaining daily to-do lists or incorporating other self-help steps recommended by a psychiatrist.
It’s common to want to know if any disease you have is curable or not — most of us are hard-wired to think in those terms. But Tu cautions that while many medical illnesses can be cured (think of having your appendix removed because of appendicitis), “mental health issues are more comparable to illnesses like diabetes or high blood pressure. When you take your blood pressure medication, your blood pressure becomes normal, but technically you still have high blood pressure.”
Liang concurs and adds that “some people will always need medication. Others with milder disorders might be able to manage and adapt with behavioral modifications.”
Liang and Tu acknowledge there are different options when it comes to treating ADHD that encompass everything from medication and psychiatric help to behavior modification and finding the right coping skills. But the best step to managing ADHD is to get a proper diagnosis and know that there are solutions out there to help you.
Seattle Anxiety Specialists, PLLC is a private psychiatry and psychotherapy practice in downtown Seattle, providing evidence-based treatments and in-depth self-exploration for anxiety and conditions that create anxiety including phobias, depression, GAD, OCD, PTSD, ADHD, OCPD and bipolar.