Adult ADHD

ADHD in adults is a much more elaborate disorder than ADHD in children. The symptoms in adults are more than simply having trouble paying attention or controlling impulses. The problem lies in an underdeveloped ability to perform tasks and to know when to get them done. In many cases, treatment with medications and behavioral therapy can help improve the symptoms in adults.

What Is Adult ADHD?

Attention deficit hyperactivity disorder (ADHD) is a highly publicized childhood disorder that affects approximately 3 to 5 percent of all children.
 
The number of people with adult ADHD is unknown, and medical experts continue to debate whether children can expect to outgrow the symptoms of ADHD by the time they reach adulthood. Some studies have shown a significant decline in symptoms as a person ages. Others estimate that between 30 and 70 percent of children with ADHD will continue to have symptoms into adulthood.
 
In adults, ADHD is a much more elaborate disorder than in children. It's more than a lack of paying attention and controlling impulses; the problem is developing self-regulation. This self-control affects an adult's ability not just to perform tasks, but to determine when they need to be done. You don't expect four- or five-year-olds to have a sense of time and organization, but adults need goal-directed behavior -- they need help in planning for the future and remembering things that have to get done.
 

Causes of Adult ADHD

The exact cause or causes of adult ADHD are not known. The disorder was once looked upon as a discipline and behavioral problem resulting from bad parenting. Some suggested that the condition was caused by:
 
  • High sugar intake
  • Food additives
  • Excessive TV viewing
  • Family problems.
 
However, none of these explanations are supported by scientific evidence.
 
Most scientists agree that ADHD is a biologically based disorder of the nervous system. Brain imaging research using a technique called magnetic resonance imaging (MRI) has shown that differences exist between the brains of children with and without ADHD, but the exact mechanism of brain function causing the ADHD symptoms is unknown. Scientists caution that MRIs used in studies are research tools and cannot be used to diagnose ADHD in a specific person.
 
Recently published research suggests that ADHD tends to run in families. In these studies, children with ADHD have, on average, at least one close relative with the disorder. Over the years, other theories have suggested that exposure to lead in the environment, premature birth, birth trauma, and brain injury may lead to the development of ADHD.
 
Some studies have shown a possible correlation between the use of cigarettes and alcohol during pregnancy and the risk of giving birth to a child with ADHD. For this and many other health reasons, women who are pregnant should avoid both cigarette and alcohol use.
 

Different Types of Adult ADHD

Everyone has trouble sitting still sometimes, or managing time, or completing a task. However, the behavior of people with adult ADHD goes beyond occasional fidgeting, disorganization, and procrastination. For them, performing tasks can be so difficult that it interferes with their ability to function at work, at home, at school, and socially.
 
A diagnostic manual compiled by the American Psychiatric Association identifies three types of ADHD:
 
  • Inattentive
  • Hyperactive-impulsive
  • Combined.
     
A person with inattentive adult ADHD, previously known as attention deficit disorder (ADD), has trouble focusing on activities, organizing and finishing tasks, and following instructions.
 
Hyperactive and impulsive adults feel restless, are constantly "on the go," and try to perform multiple tasks at once. They are often perceived as not thinking before they act or speak.
 
Individuals with the combined form of adult ADHD show symptoms of both inattention and hyperactivity-impulsivity.
 

A History of Adult ADHD

The first studies on adults who were never diagnosed as children with ADHD but showed symptoms as adults were done in the late 1970s by Drs. Paul Wender, Frederick Reimherr, and David Wood. These symptomatic adults were retrospectively diagnosed with ADHD after the researchers' interviews with their parents.
 

Diagnosing Adult ADHD

The researchers developed clinical criteria for diagnosing ADHD in adults (the Utah Criteria), which combined past history of ADHD with current evidence of ADHD behaviors.
 
Other diagnostic assessments for adult ADHD are now available; among them are the widely used Conners Rating Scale and the Brown Attention Deficit Disorder Scale.
 
Typically, adults with ADHD are unaware that they have this disorder -- they often just feel that it's impossible to get organized, stick to a job, or keep an appointment. The everyday tasks of getting up, getting dressed and ready for the day's work, getting to work on time, and being productive on the job can be major challenges for someone with ADHD.
 

Treatment Options for Adult ADHD

Although there is no cure for adult ADHD, treatment with medications and behavioral therapy can help with the symptoms of this condition.
 

Consequences of Adult ADHD

Whether in a child or an adult, ADHD can have serious consequences. People with this disorder are more likely to suffer from depression and anxiety, low self-esteem, be fired from jobs, and get divorced than adults without ADHD.
 
Teens and adults with ADHD have two to three times more auto accidents and twice the number of severe accidents resulting in vehicle damage and bodily injury as those without. They have:
 
  • Coordination deficits
  • Less skill in maneuvering vehicles in traffic
  • Slower reaction time
  • Inattention.
 
Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD
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