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ADHD in Adults

Attention deficit hyperactivity disorder (ADHD) is a highly publicized childhood disorder that affects approximately 3-5% of all children. What is much less well known is the probability that, of children who have ADHD, many will still have it as adults. Several studies done in recent years estimate that 30-70% of children with ADHD continue to exhibit symptoms in their adult years.

Typically, adults with ADHD are unaware that they have this disorder—they often just feel that it’s impossible to get organized, to stick to a job, to 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 the ADHD adult.

Diagnosing ADHD In An Adult

Diagnosing an adult with ADHD is not easy. Many times, when a child is diagnosed with the disorder, a parent will recognize that he or she has many of the same symptoms the child has and, for the first time, will begin to understand some of the traits that have given him or her trouble for years—distractibility, impulsivity, restlessness. Other adults will seek professional help for depression or anxiety and will find out that the root cause of some of their emotional problems is ADHD. They may have a history of school failures or problems at work. Often they have been involved in frequent automobile accidents.

To be diagnosed with ADHD, an adult must have childhood-onset, persistent, and current symptoms. The accuracy of the diagnosis of adult ADHD is of utmost importance and should be made by a clinician with expertise in the area of attention dysfunction. For an accurate diagnosis, a history of the patient’s childhood behavior, together with an interview with a life partner, a parent, close friend, or other close associate, will be needed. A physical examination and psychological tests should also be given. Additional conditions may exist, including specific learning disabilities, anxiety, or affective disorders.

Treatment Of ADHD In An Adult

As with children, if adults take a medication for ADHD, they often start with a stimulant medication, such as methylphenidate (Concerta®, Metadate®, Ritalin®), or dextroamphetamine (Dexedrine®). The stimulant medications affect the regulation of two neurotransmitters, norepinephrine and dopamine. Newer medications approved for the treatment of ADHD by the FDA, including dexmethylphenidate (Focalin®), atomoxetine (Strattera®), lisdexamfetamine (Vyvnase®) has been tested in controlled studies in both children and adults and has been found to be effective.

Special considerations are made when prescribing ADHD medications for an adult. An adult may need less of the medication for his or her weight. A medication may have a longer half-life in an adult. The adult may take other medications for physical problems such as diabetes or high blood pressure. Often an adult is also taking a medication for anxiety or depression. All of these variables must be taken into account before a medication is prescribed.

Education And Psychotherapy

Although medication gives needed support, the individual must succeed on his own. To help in this struggle, both “psychoeducation” and individual psychotherapy can be helpful. A professional coach can help the ADHD adult learn how to organize his life by using props such as a large calendar posted where it will be seen in the morning, date books, lists, reminder notes, and a special place for keys, bills, and the paperwork of everyday life. Tasks can be organized into sections, so that completion of each part can give a sense of accomplishment. Above all, ADHD adults should learn as much as they can about their disorder.

Psychotherapy can be a useful adjunct to medication and education. First, just remembering to keep an appointment with the therapist is a step toward keeping to a routine. Therapy can help change a long-standing poor self-image by examining the experiences that produced it. The therapist can encourage the ADHD patient to adjust to changes brought into his life by treatment—the perceived loss of impulsivity and love of risk-taking, the new sensation of thinking before acting. As the patient begins to have small successes in his new ability to bring organization out of the complexities of his or her life, he or she can begin to appreciate the characteristics of ADHD that are positive—boundless energy, warmth, and enthusiasm.

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© 2010 Vivacare. Last updated April 4, 2011.

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