Adult Attention-Deficit/Hyperactivity Disorder (ADHD)

FDR

 Adult Attention-Deficit/Hyperactivity Disorder (ADHD) is a condition that includes a combination of persistent problems, such as difficulty paying attention, impulsive behavior, and can involve some level of hyperactivity. In adults, hyperactivity may decrease, but struggles with impulsiveness, restlessness and difficulty paying attention may continue. Adult ADHD can lead to unstable relationships, poor work or school performance, low self-esteem, and other problems.

 Symptoms. In adults, the main features of ADHD may include difficulty paying attention, impulsiveness and restlessness.

Many adults with ADHD aren’t aware they have it — 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. Symptoms include:

• Impulsiveness
• 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

Typical behavior versus 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. Further, 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.

Causes. While the exact cause of ADHD is not clear, 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.

Complications. ADHD can make life difficult for you. ADHD has been linked to:

• Poor school or work performance
• Unemployment
• Financial problems
• Trouble with the law
• Alcohol or other substance misuse
• Frequent car accidents or other accidents
• Unstable relationships
• Poor physical and mental health
• Poor self-image
• Suicide attempts

Coexisting conditions. Although ADHD doesn’t cause other psychological or developmental problems, other disorders often occur along with ADHD and make treatment more challenging. These include:

• Depressive disorders
• Anxiety disorders
• Substance use disorders
• Learning disabilities

Treatment. Standard treatments for ADHD in adults typically involve medication, education, skills training and psychotherapy. A combination of these is often the most effective treatment. These treatments can help manage many symptoms of ADHD, but they don’t cure it. It may take some time to determine what works best for you.

Cognitive Behavioral Therapy for adults with ADHD involves structured teaching of specific skills to manage your behavior and challenge/change negative thinking patterns into helpful ones. It can help you deal with life challenges, such as school, work or relationship problems, and help address other mental health conditions, such as depression or substance misuse. Psychotherapy for adult ADHD may help you:

• Improve your time management and organizational skills
• Learn how to reduce your impulsive behavior
• Develop better problem-solving skills
• Cope with past academic, work or social failures
• Improve your self-esteem
• Learn ways to improve relationships with your family, co-workers and friends
• Develop strategies for controlling your temper

Additionally, if you’re like many adults with ADHD, you may be unpredictable and forget appointments, miss deadlines, and make impulsive or irrational decisions. These behaviors can strain the patience of the most forgiving co-worker, friend or partner. CBT can also focus on these issues, helping you to better monitor your behavior, improve communications, and develop conflict resolution and problem-solving skills.

Further, some behavioral interventions that may help include:

• 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 reminders.
• 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.

At Our First Appointment, be ready to answer questions such as:

• When do you first remember having problems focusing, paying attention or sitting still?
• Have your symptoms been continuous or occasional?
• Which symptoms bother you most, and what problems do they seem to cause?
• How severe are your symptoms?
• In what settings have you noticed the symptoms: at home, at work or in other situations?
• What was your childhood like? Did you have social problems or trouble in school?
• How is your current and past academic and work performance?
• What are your sleep hours and patterns?
• What, if anything, appears to worsen your symptoms?
• What, if anything, seems to improve your symptoms?
• What medications do you take?
• Do you consume caffeine?
• Do you drink alcohol or use recreational drugs?

Preparing and anticipating questions will help you make the most of your time with the doctor. 

Reprinted from the Mayo Clinic website (www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878 and www.mayoclinic.org/diseases-conditions/adult-adhd/diagnosis-treatment/drc-20350883) 

Read more at the National Institute of Mental Health (www.nimh.nih.gov) and the Attention Deficit Disorder Association (add.org/signs-of-adhd/) websites. 

If you think you might have ADHD or are experiencing difficulties because of ADHD and/or related complications and co-existing conditions, I would like to help. Please e-mail me at Karen@Psychologist-NH.com.