Adult ADHD

ADHD in Adults: Your Guide to Symptoms, Diagnosis and Treatment

Adult ADHD causes problems with memory, focus, organization, and time management in nearly 5 percent of American adults. Though ADHD symptoms begin in childhood, many patients remain undiagnosed or misdiagnosed until adulthood, particularly when they present inattentive rather than hyperactive symptoms. Here, learn how a qualified ADHD specialist can assess and treat the condition using rating scales, medication, and natural therapies.

Medically Reviewed by William Dodson, M.D.

ADHD in Adults: Overview

Adult ADHD is a neurological disorder that affects nearly 5 percent of the United States’1 adult population. Adults with ADHD often struggle to regulate attention, impulses, and hyperactivity due to differences in the way their brains developed and function. The most common ADHD symptoms among adults are problems with working memory, focus, organization, and time management; emotional hypersensitivity is also a common byproduct of ADHD.

Attention deficit hyperactivity disorder (ADHD) was previously considered a childhood condition that hyperactive boys outgrew with time and maturity. However, the medical community now accepts that ADHD is often a lifelong condition that lasts through adulthood, and also affects girls and women. Because ADHD research and understanding has improved so markedly in the last few decades, many adults today are recognizing their ADHD symptoms for the first time in their 30s, 40s, 50s, and even older.

Adult ADHD: Symptoms

Symptoms of ADHD begin in childhood, and express themselves differently as a person grows and ages. For example, a hyperactive child might fidget in her seat or jump up and run around the classroom. A hyperactive adult may feel internally restless, dissatisfied, or unable to relax.

ADHD in adults can cause difficulties in daily life at work and at home. With age, ADHD symptoms tend to manifest as failure to pay attention to details, trouble organizing and completing big tasks, forgetting names and dates, talking before thinking or rudely interrupting, or feeling overwhelmed by big emotions or stimulating places. Too often, shame from failing at the day-to-day tasks of adulthood — getting to work on time, keeping a clean house, eating healthy, and managing parenthood — is misdiagnosed as anxiety or a mood disorder. ADHD is missed entirely, particularly in women.

Adult ADHD symptoms include:

  • Inattention
  • Lack of focus or hyperfocus
  • Poor attention to detail
  • Disorganization
  • Difficulty planning or prioritizing
  • Forgetfulness
  • Poor time management
  • Problems completing tasks
  • Impulsivity
  • Extreme emotionality and rejection sensitivity
  • Low frustration tolerance
  • Social failures and relationship problems
  • Executive dysfunction

These adult ADHD symptoms can range on a spectrum from mild to severe, and affect each person slightly differently. For example, difficulty focusing can make an adult with ADHD miss a deadline at work, or run a stop sign while driving. Impulsivity can lead to overspending at the grocery store, or a surprise interjection in a big work meeting.

When undiagnosed and untreated, these adult ADHD symptoms can make everyday tasks more challenging, and raise the risk for serious problems like substance abuse, addiction, or decreased life expectancy.

If you think you might have adult ADHD, take the ADHD symptom test for adults.

Adult ADHD: Causes

What causes ADHD? It’s unknown, but most research suggests three main factors:

  • Genetics or Heredity: Parents of children with ADHD are four times as likely to have ADHD themselves2. Identical twins seem to share and ADHD diagnosis3. However, scientists have not pinpointed a specific gene or genes responsible for attention deficit hyperactivity disorder.
  • Environmental Factors: Studies suggest that exposure to extreme stress, trauma, or certain toxins – like lead4 or bisphenol-A5 –increase the risk or severity of ADHD symptoms.
  • Disruption of Development: Brain injury6 or events that affect the central nervous system during development, like preterm birth7 or alcohol use during pregnancy8, may increase the likelihood of ADHD in an individual.

The factors that do not cause ADHD are well-established. ADHD is not a result of poor parenting, too much sugar, too little exercise, or excessive screen time.

Adult ADHD: Diagnosis

There is no single test for attention deficit hyperactivity disorder.

Doctors diagnose ADHD using symptom criteria from the Diagnostic and Statistical Manual of Mental Disorders9(DSM-V), which lists nine symptoms that suggest Inattentive ADHD and nine that suggest Hyperactive-Impulsive ADHD.

An adult can be diagnosed with either ADHD sub-type — or Combined Type ADHD — if he or she exhibits just five of the nine symptoms in two or more settings – at work and at home, for example – for at least six months.

An adult ADHD symptom assessment often includes the following with a clinician experienced in adult ADHD:

  • A medical exam to rule out other related conditions (see below)
  • A clinical interview to gather information about family medical and symptom history
  • ADHD rating scales completed by the adult and/or loved ones to assess symptoms, strengths, and weaknesses

A complete assessment may take several visits and/or visits with an ADHD specialist.

Symptoms of adult ADHD overlap with many other related, or comorbid, conditions. A good ADHD clinician will also screen for symptoms of these conditions related to ADHD:

  • Generalized anxiety disorder
  • Autism spectrum disorder (ASD)
  • Bipolar disorder
  • Depression
  • Learning disabilities (LD)
  • Obsessive compulsive disorder (OCD)
  • Sensory processing disorder (SPD)

Adult ADHD: Treatment

The best treatment for adult ADHD is a combination of therapy and medication10. The most effective ADHD treatment plans include one or more of the options described below. Adults should expect to work closely with their physicians to adjust medication and dosage, and to find the right ADHD treatment combination to alleviate symptoms.

Adult ADHD Medication

There are two main types of medication used to treat ADHD:

  • Stimulants
  • Non-stimulants

Stimulant Medications for Adult ADHD

Stimulants fall into two major categories: methylphenidates (Ritalin, Concerta, Daytrana, etc.) and amphetamines (Adderall, Vyvanse, Evekeo, etc.). All stimulant medications are different forms of these two types of medication.

Non-stimulant Medications for Adult ADHD

Several types of non-stimulants are used to treat ADHD.

FDA-approved non-stimulant medications, like Strattera or Intuniv, were specifically designed to treat ADHD.

Other non-stimulant medications are used “off-label” to address ADHD symptoms. These include clonidine for ADHD, Wellbutrin for ADHD, and some other antidepressants, blood pressure medications, or wakefulness-promoting medications. Physicians turn to these medications when other ADHD treatment is not effective because they have similar mechanisms of action in the body as some ADHD medications.

Learn more about ADHD medication options here.

ADHD Therapies

Most adults experience symptom reduction with ADHD medication, but many continue to struggle with work, day-to-day responsibilities, or low self-esteem due to a lifetime with attention deficit disorder. ADHD medication can regulate the brain neurologically. Psychotherapy or professional guidance can organize and motivate adults with ADHD to address specific challenges through conditioning. Common therapies for ADHD include:

  • Cognitive behavioral therapy (CBT)
  • Dialectical behavioral therapy (DBT)
  • ADHD coaching
  • Brain training or neurofeedback

These therapies, combined with education about ADHD, can help adults recognize the places where ADD symptoms are causing difficulty in their lives. Then, create a step-by-step plan to change the negative habit or behavior.

Learn more about ADHD therapies here.

Lifestyle Changes and Natural Remedies for ADHD

Environmental factors play a big role in the severity of ADHD symptoms in adults. Adults with ADHD can positively impact their symptoms by modifying lifestyle factors like:

  • Diet: Consume foods that are low in sugar, additives, and carbohydrates, but high in protein and omega-3 fatty acids.
  • Sleep: Adequate rest — 7 to 9 hours of sleep each night — has a positive effect on the ADHD brain and how it functions.
  • Exercise: Studies show that aerobic exercise like martial arts, basketball, and dance all have a positive impact on ADHD brains11. Yoga, mindfulness, and meditation can help keep symptoms in check on a daily basis.
  • Supplements: Vitamins like iron, zinc, and magnesium – often naturally low in people with ADHD – can improve mental and physical health.

A wide variety of alternative therapies exist to help alleviate symptoms of ADHD. Learn more about the natural remedies to treat ADHD here.


Footnotes

1  “Data & Statistics.” Centers for Disease Control and Prevention. Ed. Center for Disease Control. Centers for Disease Control and Prevention, 14 Feb. 2017. Web. 14 Mar. 2017.
2 Hamed, Alaa M., et al. “Why the Diagnosis of Attention Deficit Hyperactivity Disorder Matters.” Frontiers in Psychiatry, 6:168. 26 November 2016. doi: 10.3389/fpsyt.2015.00168
3 Greven, C.U., et al. “A twin study of ADHD symptoms in early adolescence: hyperactivity-impulsivity and inattentiveness show substantial genetic overlap but also genetic specificity.” Journal of Abnormal Child Psychology. February 2011, 39: 2, pp 265-75. doi: 10.1007/s10802-010-9451-9
4 Donzelli, G., et al.”The Association between Lead and Attention-Deficit/Hyperactivity Disorder: A Systematic Review.” International Journal of Environmental Research and Public Health. January 2019, 16:3. doi: 10.3390/ijerph16030382
5 Rochester, J.R., et al. “Prenatal exposure to bisphenol A and hyperactivity in children: a systematic review and meta-analysis.” Environment International. May 2018, 114, pp. 343-356. doi: 10.1016/j.envint.2017.12.028
6Study Finds Traumatic Brain Injuries, Even Mild Ones, Increase Risk of ADHD.” APSARD, November 12, 2018. Web. June 7 2019
7Ask H, Gustavson K, Ystrom E, et al. “Association of Gestational Age at Birth With Symptoms of Attention-Deficit/Hyperactivity Disorder in Children.” JAMA Pediatrics online, 25 June 2018. doi:10.1001/jamapediatrics.2018.1315
8 Eilertsen, E.M., et al. “Maternal alcohol use during pregnancy and offspring attention-deficit hyperactivity disorder (ADHD): a prospective sibling control study.” International Journal of Epidemiology. October 1, 2017, 46:5, pp. 1633-1640. doi: 10.1093/ije/dyx067
Symptoms and Diagnosis of ADHD. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. American Psychiatric Association (2013).https://www.cdc.gov/ncbddd/adhd/diagnosis.html
10American Academy of Pediatrics, Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention‐deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128(5):1007–1022
11 Cornelius, Colleen, et al. “The Effect of Physical Activity on Children With ADHD: A Quantitative Review of the Literature.” Journal of Applied School Psychology, vol. 33, no. 2, 2017, pp. 136–170., doi:10.1080/15377903.2016.1265622.

Updated on June 18, 2019

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