Get Help Now

The Challenge of Identifying, Addressing ADHD in Adults

As is unfortunately often the case when it comes to the understanding of mental health issues and behavioral disorders, Attention Deficit Hyperactivity Disorder (ADHD) is often thought of in stereotypical terms -- most likely involving fidgety adolescent boys wreaking havoc in middle school classrooms.

But the reality of ADHD is much more complex, and surprising more inclusive. For example, though teen and adolescent boys account for the majority of ADHD diagnoses, they are hardly the only ones who are dealing with this disorder.

According to the U.S. Centers for Disease Control and Prevention, within the 6 to 17 age group, ADHD affects 9.5 percent of boys and 5.9 percent of girls. But gender isn't the only demographic division capable of being bridged by this behavior disorder.

Experts estimate that between six and eight of every 10 young people with ADHD will carry the disorder with them into adulthood -- and sources such as the medical website WebMD report that as many as 5 percent of adults may be affected by ADHD.

In other words, ADHD is much more than just a "kid's condition."

Diagnosing Adult ADHD

Even with recent increases in the awareness of adult ADHD, experts believe that the majority of adult ADHD cases go undiagnosed.

In addition to having to overcome the common misperception that ADHD affects only young people, diagnosing the disorder in adults is also made more difficult by the fact that the criteria established in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are designed for pediatric patients and cannot be directly applied to adults.

Mark Bowes, PhD, addressed these obstacles to effective diagnosis of ADHD in adult patients in an article that appeared in the February 2001 edition of the journal NeuroPsychiatry Reviews.

In an effort to design adult-appropriate diagnostic criteria for ADHD, Bowes reported, a team led by C. Keith Conners, PhD, professor emeritus of psychiatry and behavioral sciences at Duke University Medical Center, established a rating scale that incorporated the following nine symptom domains:

1. Inattention/concentration
2. Hyperactivity/restlessness
3. Impulsivity/self-control
4. Executive function (for example, self-regulation, prioritization of work and awareness of time)
5. Memory
6. Difficulties with self-image
7. Interpersonal problems
8. Learning problems
9. Mood disturbances (including irritability, frustration or overreaction to stressful events)

An Alternative Approach

The Conners team was not the only group working on ways to recognize ADHD in adults, Bowes wrote. An alternative, he noted, was the Brown Attention Deficit Disorder Scale, which was designed by Thomas E. Brown, PhD, assistant clinical professor of psychiatry at Yale University School of Medicine:

Dr. Brown noted that adults who are being evaluated for ADHD present with a variety of complaints -- including concentration problems, disorganization or distraction, and difficulty initiating tasks, working consistently and attending to details -- and many of the deficits involve impairment of executive functioning.

Using interviews with a number of people who had been evaluated and received a diagnosis based on existing criteria, he and his colleagues attempted to identify a core group of symptoms that affect most adults with ADHD and that these individuals describe as particularly troublesome.

Brown's research, Bowes reported, led him to establish five primary indicators of adult ADHD:

1. Problems getting organized, prioritizing and activating tasks
2. Difficulty sustaining focus and attention, especially with reading
3. Trouble sustaining alertness, effort, processing speed and motivation
4. Issues related to affect, such as preventing anger from getting out of control
5. Deficits in working memory and memory retrieval

Dealing with Adult ADHD

As medical professionals continue to refine the manner by which they identify ADHD in adult patients, they are also devising more effective strategies for treating the disorder.

As is the case with any mental health or behavioral disorder, treating ADHD -- or adapting one's life in order to mitigate its effects -- depends upon a number of factors that are specific to each individual. However, some general principles are applicable to most adults who are dealing with ADHD.

The October 2009 issue of the Harvard Health Letter featured the following five areas of importance for adults who suspect that they or someone they care about may be exhibiting symptoms of ADHD:

• Evaluation -- If you think you may have ADHD, make an appointment with a healthcare professional who is capable of making an effective diagnosis. You should also contact any ADHD support groups or advocacy organizations in your area.
• Medication -- Ritalin and Adderall aren't only effective for children. For many adults, the Health Letter noted, medications can lessen the "internal noise and outward chaos," of ADHD, and can increase your sense of self-control.
• Education -- From your local library to physician-supplied materials to reputable online medical websites, you have access to a wealth of information about adult ADHD. Take advantage of your ability to access this information, and take an active role in your diagnosis and treatment.
• Organization -- Desk calendars, personal digital assistants and regular daily routines are all effective ways to help organize your life, which can give you a greater sense of control while lessening your exposure to confusion, frustration and stress.
• Counseling -- While juvenile ADHD is often associated with behavioral problems and academic difficulties, adult ADHD has been identified as an obstacle to healthy relationships (meaning that friendships, marriages and families can be harmed or destroyed by the disorder). Counseling can help all concerned parties identify and address the issues that may be impacted by a parent or partner's ADHD.

Similar to its effect on young people, ADHD can have a pervasive impact on the life of an adult. However, with proper diagnosis and treatment, the disorder can be brought under control and the patient can experience a significantly improved quality of life.