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ADHD as an adult

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 5 minutes read
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Attention Deficit Hyperactivity Disorder (ADHD) is a condition that can affect your ability to focus on a task without getting distracted. It can make you feel restless and compelled to talk or move a lot when you’re expected to sit still. It can make you act on impulse rather than reasoning decisions through or foreseeing consequences. Tasks can be challenging, especially if they require prolonged concentration or you are required to multitask. Losing and forgetting things can be a feature, along with being careless or making mistakes.

While we may all recognize these traits to varying degrees in ourselves, loved ones, or colleagues, ADHD means that these traits are so pronounced that they are having a significant impact on progress in work or studies, on your romantic or working relationships, and on maintaining a harmonious family life.

They can also make you feel quite chaotic within yourself, you can feel on edge or overwhelmed, and it can be difficult to unwind and relax.

Doctor’s advice

How do I know if I have ADHD?

There is no one test that confirms you have ADHD or not. It’s diagnosed through a thorough assessment rather than a blood test or other investigation. Its exact cause is still unclear but it does seem to run in some families, and other factors such as being born prematurely (before the 37th week of pregnancy), smoking or abusing alcohol in pregnancy, and having a low birth weight appear to play a part.

A useful starting point is the Adult ADHD Test on add.org/adhd-test/, where you answer questions that relate to ADHD and are scored according to your answers.

You may have your own suspicions of ADHD, or you may have been encouraged to get assessed by your partner, close family and friends, or your employer. If people have noticed problems, it’s helpful if they can offer specifics. Write these down and take them to your doctor and any further specialist assessment.

Generally, ADHD is felt to be under-diagnosed. Approximately 9% of children aged 2-17 in the US have been diagnosed with ADHD, and almost three-quarters are male. It’s possible that school-age girls are under-diagnosed, as they may be able to mask symptoms better, and the numbers of men and women are equal in adult clinics.

Symptoms of ADHD improve as children transition to adulthood, and they may be less obvious, like the physical hyperactivity of climbing trees or running everywhere becomes a difficulty following meetings or conversations. But some impairments may continue into adulthood.

Internal conflict can arise as society’s expectations of behavior increase, and depression, anxiety, and low self-esteem can often manifest as a result.

What does an assessment involve?

Book an appointment initially with your doctor to discuss your concerns and symptoms. They will then consider the most likely diagnosis, and they may refer you to a specialist, which is likely to be a psychiatrist or psychologist.

At this more detailed assessment, they will ask for specific instances that could suggest ADHD, and they will ask about whether this has held you back in your career or academic studies and any social or relationship problems.

One of the criteria for diagnosing ADHD is that you have had apparent symptoms before the age of 12. You may need to check with parents or siblings or have a look at your old school reports if you can’t remember.

Other criteria are that symptoms of inattention or hyperactivity-impulsivity are evident in two or more settings. You have 5 or more symptoms of each (6 of each are required in children up to 17). These have been present consistently in the previous 6 months. For a diagnosis, these symptoms must have interfered with social, school, or work functioning.

Many signs of ADHD can also feature in other mental health disorders – these affect your behavior, mood, and thinking. Other possibilities are depression, anxiety, obsessive-compulsive disorder, or a personality disorder. While these can certainly co-exist, especially with the challenges of living with ADHD, it requires a detailed assessment to determine if ADHD is the primary condition, which is one of the criteria for diagnosis.

What help is available?

Medication and therapy are available to help with ADHD; providing both together may give the best outcome. The aim is to relieve symptoms, make behaviors easier to manage and live with, and bring calm, which may help improve concentration and reduce impulses.

Cognitive behavioral therapy (CBT), mindfulness techniques, and a psychoeducational group can help adults with ADHD to improve organization, completion of important tasks, reduce anxiety and improve confidence by reducing self-critical thoughts.

Drug therapy usually includes a stimulant medication related to amphetamines, the most common of which is methylphenidate (known best by the brand name Ritalin). Common side effects include poor appetite, weight loss, and – occasionally – psychosis.

Atomoxetine (known by the brand Strattera) is a non-stimulant medication that can be used if this is more suitable.None of the medicines will cure ADHD, but can greatly help with symptoms.

Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD) is a non-profit national organization that provides support and resources for children and adults with ADHD.

ADHD can feel isolating, so you may be able to find like-minded people in public forums or local support groups.

What will a diagnosis bring me?

You may be diagnosed with predominantly inattentive ADHD, predominantly hyperactive-impulsive ADHD, or a combination of both.

It’s worth thinking about how you will react if you pursue a diagnosis of ADHD in adulthood.

Some patients find labels restrictive, and they feel unnecessarily defined by a particular diagnosis, or they feel embarrassed or ashamed of it.

For others, it can be reassuring to be able to account for certain behaviors or working or intimate relationship problems. They like being able to learn more about it and perhaps implement strategies.

Adults may be protected under the Americans with Disabilities Act, and you can expect ‘reasonable' adjustments at work where possible. This might mean regular breaks or breaking tasks into reasonable chunks, so you can still progress in your job.

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Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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