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Is It Adult ADHD? A Basic Primer

ADHD is usually considered a childhood disorder, so symptoms in adults are often overlooked, even though an estimated four percent of the adult population meets the criteria.

Not Just For Kids

ADHD used to be considered a pediatric disorder, but it’s now clear that many children never outgrow their symptoms. More than 70 percent of children diagnosed with ADHD continue to have it in adolescence. Up to 50 percent will have it as adults. Hyperactive and/or impulsive symptoms often improve in adolescence, while inattention persists or gets worse.

The Causes of ADHD

ADHD is a neurologically based condition caused by a shortage of the neurotransmitters norepinephrine and dopamine in the brain, and the inability of the brain to transmit these chemicals to the brain's neurons. ADHD is not caused by poor parenting, too much sugar, or laziness.

What ADHD Looks Like in Adults

ADHD adults find it hard to manage clutter, be on time, and complete projects. They may interrupt others, or blurt words out without thinking. Adults with ADHD are more likely to be distracted while driving, reading, and doing other tasks. These behaviors frequently lead to underperformance at the workplace and challenging relationships.

Symptoms to Look For

Symptoms of ADHD are divided into two categories: inattentiveness and hyperactivity/impulsivity. A person may fall into one category or into both, called combined type. To be diagnosed with ADHD, at least five symptoms must be present in each category, must have been present before age 12, and must be chronic. (For more on symptoms, take the Adult ADHD Self-Test.)

ADHD Symptom: Hyperactivity/Impulsivity

Most teens and adults with ADHD learn to control their energy, and may not appear overtly hyperactive. However, they often feel restless, and may not be able to relax in the same ways others do. They may act impulsively when it comes to spending money, entering sexual relationships, or eating and drinking. They may interrupt others, or talk without thinking, which can lead to damaged relationships.

ADHD Symptom: Inattention

Adults with inattentive or combined-type ADHD are prone to making careless mistakes, and have trouble staying organized and following through with projects. They are easily sidetracked, and may be distracted by stimuli that others tune out easily. Even when they are spoken to directly, ADHD adults may be distracted or unable to pay attention.

ADHD Symptom: Hyperfocus

Adults with ADHD are able to pay attention to tasks that interest or excite them, to the point of losing track of time and place. This intense state is called hyperfocus. But ADHD adults may be unable to concentrate on tasks that bore them. When those “boring things” are doing laundry, paying bills, or finishing a project at work, ADHDers can find themselves falling short in life.  

ADHD Symptom: Executive Dysfunction

ADHDers’ executive functions—planning ahead, getting organized, managing time, concentrating on a task, and being motivated—are often impaired. EFs are processed in the prefrontal cortex, which matures around the time of puberty. In most cases, ADHD symptoms overlap with executive-function impairment.

Diagnosing ADHD

There is no single test for ADHD in adults. The physician makes the diagnosis after taking a detailed history of the patient. He may also refer to old report cards with comments from teachers and interview an adult’s parents to determine ADHD. Sometimes neuropsychological tests are given when looking for co-occurring conditions, such as learning disabilities. 

The Genetic Component

While scientists are still looking for the gene (or genes) responsible for ADHD, the condition does appear to run in families. Children with ADHD usually have at least one close relative with ADHD, and studies have shown that one-third of all men who had ADHD in their youth have biological children with ADHD.

Looking for Related Conditions

In some cases, conditions like anxiety, depression, bipolar disorder, or sensory integration disorder (SID) cause symptoms that mimic those of ADHD. About half of people with ADHD have other disorders. It can be difficult to determine which symptoms are caused by what disorder, which makes a careful diagnosis essential.

Mild to Severe Symptoms

ADHD is not like pregnancy, in which a person tests either positive or negative. Instead, it’s more like depression, where symptoms occur along a continuum of severity. In order to obtain a diagnosis, symptoms must be severe enough to interfere with normal functioning at home and at work.

Treatment: ADHD and Medication

Stimulant medications are often prescribed to treat ADHD. The two basic classes—methylphenidate and amphetamine—are sold under several different brand names and are administered as pills, patches, or liquids. No drug can cure ADHD, but the right medication regime can help manage core symptoms. 

How Effective Is Medication?

Studies have shown that stimulant medications alleviate symptoms in 70 to 80 percent of those diagnosed with ADHD. Improvements are generally seen 30 to 90 minutes after a dose is administered. When the dose wears off (anywhere from four to 12 hours), symptoms reappear at their former levels.

Treatment: ADHD Coaching for Adults

Most adults improve with medication, but they may struggle with poor habits or low self-esteem. ADHD coaches can help. They are different from psychiatrists in that their focus is practical and goal-oriented. Coaches have different specialties, and may help clients with everything from improving relationships to starting a new business. Most coaches will offer a free initial interview to make sure the match is a good fit.

ADHD and Relationships

ADHD adults have higher divorce rates than the general public. Often, ADHDers will be swept up by the novelty of a relationship at the beginning, only to lose focus later on. Non-ADHD partners may interpret lack of focus as lack of interest. ADHDers may also have trouble finishing chores, paying bills, or remembering important dates, which can cause relationship problems.

ADHD at Work

There is no perfect career for someone with ADHD, but adults diagnosed with the condition have been successful in many fields. ADHD adults do well when they find careers that interest them, and that play to their strengths. Russell Barkley, Ph.D., suggests that ADHD patients have excelled in sales, acting, the military, and many trade professions. ADHDers’ ability to hyperfocus and to generate creative ideas can be an asset in certain jobs.  

ADHD and Diet

While ADHD is not caused by too much sugar or other dietary factors, a healthy diet can help adults manage symptoms. Omega-3 supplements supply healthy fats that ADDers may be deficient in and can improve focus. Protein steadies blood sugar levels, increasing attention. A diet rich in fiber (whole grains, fruits and vegetables, and legumes) can stabilize energy levels.

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