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Diagnosis and Coping with Adult ADHD

written by: Emma Lloyd • edited by: Paul Arnold • updated: 7/12/2011

ADHD affects adults and children somewhat differently, because an adult with the disorder has often spent his or her life adapting to and coping with the symptoms. For adults, ADHD can lead to poor relationships with friends and family, and difficulty coping at work, but treatment is available.

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    There are no firm theories as to what causes ADHD in either children or adults, but the answer is thought to be related to the way in which the neurotransmitters dopamine and norepinephrine operate in the brain. In people with ADHD, the molecules that transport these neurotransmitters are overactive, and therefore nerve cell synapses don’t receive the correct levels of dopamine and norepinephrine to operate normally.

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    Adult ADHD Symptoms and Behaviors

    Adults with ADHD tend to display specific patterns of symptoms that differ depending on whether they have the inattentive or the hyperactive version of the disorder. In general, inattentive-type behaviors are more common, but men are more likely to have hyperactive-type behaviors.

    For people with the inattentive version, the following symptoms are common.

    • Poor time management skills, which might include losing track of time and procrastination.
    • Poor memory for details and organizational aspects of a given task.
    • Difficulty with starting or completing an assigned task.
    • Difficulty multitasking, or shifting focus to a new task.
    • Adults with inattentive ADHD are therefore likely to try and avoid jobs that require them to focus their attention for long periods of time.

    Someone with the hyperactive version of the disorder is likely to display some or all of these symptoms and behaviors.

    • Is impatient and easily bored, and does not tolerate frustration well.
    • Is impulsive and likely to make and quickly act on snap decisions.
    • Easily becomes irritated or angry.
    • Requires near-constant activity and cannot easily tolerate sedentary work or tasks.
    • Chooses jobs that require constant activity, and often works long hours.

    Other common symptoms of ADHD in adults include frequently losing small items such as keys, wallets, or purses, and social behavior such as interrupting people who are speaking, or impulsively saying things that are inappropriate.

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    Diagnosis

    With vastly improved tools for diagnosing ADHD in children, it is much less common these days that a child reaches adulthood undiagnosed, but it can still occur. Diagnosis of adult ADHD is a somewhat controversial issue; there is no objective medical diagnostic test for the disorder. Instead, diagnosis hinges on the patient’s medical history, as well as an evaluation of current symptoms.

    Medical history typically includes evidence from family members as well as the patient, of aspects such as childhood behavior, academic performance, and social activity. In addition the patient will undergo a neuropsychiatric evaluation that screens for evidence of other psychiatric or medical conditions that might be masking or influencing signs of ADHD.

    For a diagnosis of adult ADHD to be made, the individual must have a clear and consistent pattern of symptoms that stem from childhood. Diagnosis also requires that these symptoms interfere in some way in multiple areas of life, such as family and relationships, school, and work.

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    Medication for Adult ADHD

    Medication is the most common, and generally most effective, treatment for ADHD in both adults and children; however medication does tend to be more effective in children than in adults.

    Most medications for ADHD are stimulants, which work by providing additional supplies of neurotransmitters for the brain’s synapses to operate with. To reduce the abuse potential of these medications they are generally prescribed as long-acting doses.

    Aside from the abuse potential, these stimulants can potentially increase the risk of conditions such as high blood pressure and heart attack in susceptible people. Due to this risk, it’s important that someone who is taking these medications stays in regular contact with their doctor, and use the medications exactly as prescribed.

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    Therapy

    Therapy can be a particularly effective additional mode of treatment for adults with ADHD. For an adult, ADHD therapy might include talk therapy or cognitive-behavioral therapy, or both. Talk therapy centers on helping the adult with ADHD cope with work and family issues that arise, and with any conflicts that might stem from childhood. Cognitive-behavioral therapy can help people with this disorder to work on changing behaviors and beliefs that cause practical problems such as disorganization and poor time management, and psychological issues such as low self-esteem and poor self-image.

    Joining a support group can be extremely beneficial, particularly because it provides a means of social interaction in a safe environment. Attending a support group can reduce feelings of isolation and allow adults with ADHD to share coping strategies and tips for overcoming the problems that disorder causes.

    For family members, therapy can help with understanding ADHD in adults, and make living with the person easier to cope with in times of stress. Marriage counseling or family therapy can also be of use for dealing with the conflicts that arise in the relationships of adults with ADHD, such as impulsive decision-making and neglect of family responsibilities.

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    References

    H. Russel Searight, Ph.D., John M. Burke, Pharm. D., and Fred Rottnek, M.D. Adult ADHD: Evaluation and Treatment in Family Medicine. From <http://www.aafp.org/afp/20001101/2077.html>. Accessed 9 July 2011.

    Melinda Smith & Jocelyn Block. Adult ADD/ADHD: Signs, Symptoms, Effects, and Treatment. From <http://www.helpguide.org/mental/adhd_add_adult_symptoms.htm>. Accessed 9 July 2011.

    The Mayo Clinic. Adult ADHD (attention-deficit/hyperactivity disorder). From <http://www.mayoclinic.com/health/adult-adhd/DS01161>. Accessed 9 July 2011.