Adult attention deficit hyperactivity disorder

This article is intended to focus on the condition in adults. See also main article, Attention-deficit hyperactivity disorder.

Adult attention deficit disorder (AADD) is a term commonly used to describe the neurological disorder attention-deficit hyperactivity disorder. The conditions present in adulthood follow the same diagnostic criteria as ADD and ADHD. Although the exact prevalence of each in adults is unknown, epidemiologic studies thus far reveal that the condition, marked by inattentiveness, difficulty getting work done, procrastination, or organization problems, probably exists in about 2-4% of adults.^{[citation needed]} ADHD is a lifelong disorder, but the prevalence in adults is difficult to gauge because individuals differ in their level of affliction, as well as their abilities to compensate for their difficulties. Many only notice symptoms in adulthood and some stop seeking treatment in adulthood. Those who seek treatment, over time, may develop coping skills and other forms of adaptive behavior which make symptoms less noticeable to themselves and others.^{[citation needed]} Those whose symptoms do continue to significantly affect their functioning in adulthood can be labeled as having the adult version of ADHD. Although the disorder may not have been diagnosed in an individual during childhood, adults with the disorder must have had symptoms in childhood.

History

A watershed event in the history of this condition occurred in the 1970s as researchers began to realize that the condition now known as ADHD did not always disappear in adolescence, as was once thought. At about the same time, some of the symptoms were also noted in many parents of the children under treatment. The condition was formally recognized as afflicting adults in 1978.^{[citation needed]}

Controversy

As with childhood ADD or ADHD, the diagnosis for adult ADD or ADHD is controversial and has been questioned by some professionals.

Some, especially after treatment, point out the potentially positive behaviours some people with ADD or ADHD have such as hyperfocus. Others believe ADD or ADHD is a divergent or normal variant of human behaviour and use the term neurodiversity to describe it.^{[citation needed]}

Further, critics suspect ulterior motives of the medical industry, which both authorizes the psychiatric definitions of mental disorders and promotes the use of pharmaceutical drugs for their treatment.^{[citation needed]}

Symptoms

Adults are less likely than children to realize that they might have ADD/ADHD. Children tend to be looked at in school. ADD and ADHD are somewhat difficult to diagnose as symptoms can present in adults, as well as children, in at least 16 different ways.

In the book Driven To Distraction^[1], Edward M. Hallowell described an experience of the "hyperactive" aspect of the ADHD disorder from a patient's perspective:

...It's like being super-charged all the time. You get one idea and you have to act on it, and then, what do you know, but you've got another idea before you've finished up with the first one, and so you go for that one, but of course a third idea intercepts the second, and you just have to follow that one, and pretty soon people are calling you disorganized and impulsive and all sorts of impolite words that miss the point completely. Because you're trying really hard. It's just that you have all these invisible vectors pulling you this way and that, which makes it really hard to stay on task.

Many people express that they "feel" this way in their lives. That does not mean that the person has ADD, ADHD or any combination of the two. It is important to be tested if you chose to seek treatment. It is also important to note that ADD and ADHD are not the same thing. ADD stands for "Attention Deficit Disorder". ADHD stands for "Attention Deficit Hyperactivity Disorder". ADD can be likened a bit more to inattention, without the hyperactivity. The people typically diagnosed with it are not "hyper" at all. They typically tend to "miss" important information, have "papers" everywhere and the inability to "keep things tidy", but many of them are very calm, less "hyper" than their ADHD cousins.^{[citation needed]}

The "combined subtype" of ADHD is characterized by symptoms of inattention, impulsivity, and "hyperactivity". Both with childhood onset, although the condition may not have been diagnosed then. Hyperactivity symptoms tend to be less noticeable in adults. Those who do not exhibit hyperactivity/impulsivity symptoms fall under the "predominantly inattentive" subtype and the rare adult who exhibits only hyperactivity/impulsivity symptoms falls under the "predominantly hyperactive/impulsive" subtype.

ADHD in adults leads to moderate to extreme difficulties in functioning at work, home, or school^[2]. The disorder is usually characterized by inattentiveness, impulsive behavior, and restlessness. In adults the problem can be manifested in an inability to structure their lives and plan simple daily tasks. ADD/ADHD can also lead to loss of relationships, job hopping, or difficulty with people or work. The difficulty is not due to the ADD person's direct behaviour, but usually more due to "the simple things that the ADD person will miss.", especially when an adult of their age or experience should catch or know. Generally, symptoms may manifest themselves differently in adults than in children.^{[citation needed]} Adults with hyperactive-impulsive symptoms feel extremely driven, sometimes restless. To calm themselves down, they tend to stay constantly "on the go" and attempt to do but usually fail to complete "multiple tasks at once". They are often perceived as not thinking before they act or speak. Generally, the biggest problem is developing self-regulation, which is often not necessarily expected of young children. The mechanism for self-regulation is medically not present in someone with ADD or ADHD. This is what is treated medically in the ADD/ADHD person. This lack of self-understanding and what looks like "lack of control" affects an adult's ability not just to do tasks, but to determine when and how they need to be done, as well as how other people perceive them. ^[3]

Symptoms of ADHD can vary widely between individuals and throughout the lifetime of an individual. The most prominent characteristic in ADHD often is difficulty with executive functioning, which is the brain activity that oversees the ability to monitor a person's own behaviour by planning and organizing. Other symptoms include inattention, impulsivity, and restlessness as well as frequently accompanying behavioral, learning, the toll of which tend to cause emotional problems.

Studies have indicated that adults with ADHD are much more likely to "self medicate" with anything that gives them an adrenaline rush (thus the keeping very much on the go). Many of them also try to "self treat" with drugs or alcohol, and tend to have a slightly higher rate of substance abuse problems than adults who do not have ADHD.^{[citation needed]} They are also more likely to suffer from depression and anxiety, be fired from jobs, and get divorced, more often than many non-ADHD adults^{[citation needed]} due to the common lack of understanding.

Diagnosis

The diagnostic criteria for ADHD in adults are identical to those for children. It is important to note that adult diagnosis requires establishing whether the symptoms were also present in childhood, even if not previously recognized. [1] Diagnosis must also exclude other medical or psychiatric causes of symptoms. The diagnostic criteria^[4] require multiple symptoms observed in multiple settings (school, home, work, etc.) within the preceding 6 months.

Assessment of adult patients seeking a possible diagnosis can be better than in children due to the adult's greater ability to provide their own history, input, and insight. The therapeutic process may also see more benefit in behavioral solutions because they can be designed more collaboratively with mature individuals. BUPA says: “Aggressive or disobedient behavior can get worse if ADHD is left untreated, so early diagnosis and management is important”^{[citation needed]}

Treatment

Generally, treatments which have proved effective for children were observed to work equally well or better in adults with similar diagnosis.^{[citation needed]}

References

^ Hallowell, Edward M, and Ratey, John J. Driven To Distraction : Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood
^ http://www.fda.gov/fdac/features/2004/604_adhd.html
^ http://www.fda.gov/fdac/features/2004/604_adhd.html
^ http://www.behavenet.com/capsules/disorders/adhd.htm

External links

National Institute for Mental Health official website
National Mental Health association, AADD webspage
National Attention Deficit Disorder Association
CHADD Support groups, national education devoted to helping and supporting people with ADD and ADHD

[1] Hallowell, Edward M, and Ratey, John J. Driven To Distraction : Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood

[2] ttp://www.fda.gov/fdac/features/2004/604_adhd.html

[3] ttp://www.fda.gov/fdac/features/2004/604_adhd.html

[4] ttp://www.behavenet.com/capsules/disorders/adhd.htm

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