Adult Attention Deficit Hyperactivity Disorder (ADHD)

Adult ADHD (attention-deficit/hyperactivity disorder)

Definition

Adult attention-deficit/hyperactivity disorder (ADHD) is a mental health condition exhibited by difficulty maintaining attention, as well as hyperactivity and impulsive behavior. Adult ADHD symptoms can lead to a number of problems, including unstable relationships, poor work or school performance, and low self-esteem.

ADHD always starts in early childhood, but in some cases it's not diagnosed until later in life. It was once thought that ADHD was limited to childhood. But symptoms frequently persist into adulthood. For some people, adult ADHD causes significant problems that improve with treatment.

Treatment for adult ADHD is similar to treatment for childhood ADHD, and includes stimulant drugs or other medications, psychological counseling (psychotherapy), and treatment for any mental health conditions that occur along with adult ADHD.

Symptoms

Attention-deficit/hyperactivity disorder (ADHD) has been called attention-deficit disorder (ADD) and hyperactivity. But ADHD is the preferred term because it includes the two main aspects of the condition: inattention and hyperactive-impulsive behavior.

Adult ADHD symptoms may include:

Trouble focusing or concentrating

Restlessness

Impulsivity

Difficulty completing tasks

Disorganization

Low frustration tolerance

Frequent mood swings

Hot temper

Trouble coping with stress

Unstable relationships

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.

All adults with ADHD had ADHD as children, even if it was never diagnosed. Some people with ADHD have fewer symptoms as they age, while others continue to have significant symptoms as adults.

What's normal and what's 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.

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.

When to see a doctor

If inattention, hyperactivity or impulsive behavior continually disrupts your life, talk to your doctor about whether you might have ADHD. Because signs of ADHD are similar to those of a number of other mental health conditions, you may not have ADHD — but you may have another condition that needs treatment.


Causes

While the exact cause of ADHD is not clear, research efforts continue.

Multiple factors have been implicated in the development of ADHD. It can run in families, and studies indicate that genes may play a role. Certain environmental factors also may increase risk, as can problems with the central nervous system at key moments in development.


Risk factors

You're potentially at increased risk of ADHD if:

You have blood relatives (such as a parent or sibling) with ADHD or another mental health disorder

Your mother smoked, drank alcohol or used drugs during pregnancy

Your mother was exposed to environmental poisons — such as polychlorinated biphenyls (PCBs) — during pregnancy

As a child, you were exposed to environmental toxins — such as lead, found mainly in paint and pipes in older buildings

You were born prematurely


Complications

ADHD has been linked to:

Poor school performance

Trouble with the law

Problems at work

Alcohol or drug abuse

Frequent car accidents or other accidents

Unstable relationships

Financial stress

Poor physical and mental health

Although ADHD doesn't cause other psychological or developmental conditions, a number of other disorders often occur along with ADHD. These include:

Mood disorders. Many adults with ADHD also have depression, bipolar disorder or another mood disorder. While mood problems aren't necessarily due directly to ADHD, a repeated pattern of failures and frustrations due to ADHD can worsen depression.

Anxiety disorders. Anxiety disorders occur fairly often in adults with ADHD. Anxiety disorder may cause overwhelming worry, nervousness and other symptoms. Anxiety can be made worse by the challenges and setbacks caused by ADHD.

Personality disorders. Adults with ADHD are at increased risk of personality disorders, such as borderline personality disorder or antisocial personality disorder.

Learning disabilities. Adults with ADHD may score lower on academic testing than would be expected for their age, intelligence and education.



Treatment

Treatment for adult attention-deficit/hyperactivity disorder (ADHD) typically involves medication, psychological counseling or both.

Stimulants (psychostimulants) are the most commonly prescribed medications for ADHD, but other drugs may be prescribed.

Stimulants appear to boost and balance levels of brain chemicals called neurotransmitters. Examples include methylphenidate (Concerta, Metadate, Ritalin, others), dextroamphetamine (Dexedrine), dextroamphetamine-amphetamine (Adderall) and lisdexamfetamine (Vyvanse). These ADHD medications help treat the signs and symptoms of inattention and hyperactivity.

Other medications used to treat ADHD include atomoxetine (Strattera) and antidepressants such as bupropion (Wellbutrin). Atomoxetine and antidepressants work slower than stimulants do and it may take several weeks before they take full effect. These may be good options if you can't take stimulants because of health problems or if stimulants cause severe side effects.

The right medication and the best dose vary among individuals, so it may take some time to find what works for you. Talk with your doctor about the benefits and risks of medications. And keep your doctor informed of any side effects you have.

Counseling for adult ADHD can be beneficial and generally includes psychological counseling (psychotherapy) and education about the disorder. Psychotherapy 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 and social failures

Improve your self-esteem

Learn ways to improve relationships with your family, co-workers and friends

Often, medication combined with psychological counseling works best.