Got the lunches made. Oops, forgot to let the dog out. Need to pick up the dry cleaning. Anyone seen my keys? If these scatterbrained thoughts are a part of your everyday life, you may be one of the estimated 6-15 million adults with ADHD. Learn more about the disorder...
Your inattention and restlessness may not just be your quirky personality. You could have ADHD (attention-deficit/hyperactivity disorder), a behavioral disorder that's mostly associated with unruly children. In fact, about 65% of children with ADHD carry the disorder into adulthood, making it an adult problem too.
Although ADHD adults may have better coping skills than they had as children, it's still a struggle to get through the day. Not only does ADHD interfere with organizing and completing daily tasks, but adults with the disorder are also prone to depression, anxiety, forgetfulness, even an increased risk of divorce and car accidents.
Even simple duties may demand great concentration and effort. In part, that’s because ADHD adults are easily distracted by sound, sight or touch. Whatever the stimulus, they're often knocked off course by even minor distractions.
Symptoms of ADHD
The three main symptoms of ADHD are inattention, hyperactivity and impulsive behavior.
The symptoms of inattention include:
Losing track of thoughts or focus in the middle of tasks
Missing details or making careless mistakes
Inability to complete work assignments
Forgetfulness
Difficulty following instructions
Hyperactivity symptoms in adults are similar to those in children but more subtle:
Constantly shifting in a chair
Tapping your feet or a pencil
Playing or tugging at hair or clothing
Even those aware of their repetitive motions may be unable to stop.
Why Can't They "Grow Up?"
Adults who act impulsively can be even more annoying than kids – and potentially dangerous: They may interrupt constantly or blurt out inappropriate comments. They can’t stand waiting in lines and may try to cut to the front.
They also have trouble anticipating consequences of their actions. In children, it's disruptive, but in adults, it can threaten families, jobs and even safety. A young ADHD adult paired with a car can be a deadly combination.
In the workplace, ADHD can erode performance. Some people with the disorder change jobs often or have trouble holding one. The way they handle tasks shifts from one to the next: One assignment is done well, but the next is late, poorly done or incomplete.
The ADHD adult feels like she breezes through some tasks but can’t get traction on, or stay interested, in others. Co-workers are puzzled by this variability, often attributing it to personal problems or even substance abuse.
Diagnosing ADHD
Unfortunately, scientists don’t know ADHD's cause and laboratory tests can’t confirm a diagnosis. They have found, however, that the disorder runs in families.
If one of your parents has the disorder, there's a 50% chance you have it too. If your child has been diagnosed with ADHD, you have a 25% chance of having the disorder yourself. Unlike childhood ADHD, which affects 3 times as many boys as girls, adult ADHD affects men and women equally.
Doctors diagnose ADHD based on family, developmental and childhood history, current signs and symptoms. Still, it's important to rule out potentially serious and/or treatable neurological disorders that can mimic ADHD symptoms, such as Tourette’s Syndrome, temporal lobe seizures, early stage brain tumor, elevated blood lead levels, hypo- or hyperthyroidism, and hearing or vision impairment..
Most workups for detecting ADHD include a physical exam. Some doctors may also request:
EEG (electroencephalogram, which records the electrical activity of the brain)
CT (computed tomography, or X-ray procedure, that records cross-sectional pictures of parts of the body, in this case the brain)
MRI (magnetic resonance imaging, a diagnostic technique that produces cross-sectional images of any body part, in this instance the brain) to rule out other conditions.
ADHD Treatment
ADHD has no cure. Fortunately, several drug treatments – primarily stimulants – work for both children and adults.
About two-thirds of ADHD adults taking stimulants experience significant improvements. And the drugs take effect fast, a remarkable finding because few medications have such a profound and immediate effect.
Unfortunately, most stimulants wear off quickly, returning adults to their usual problems.
Many ADHD adults turn to coffee. In fact, some can’t do without it; caffeine’s stimulating effect helps them focus and stay on task. In fact, some get so much relief that they become caffeine abusers, drinking excessive amounts each day.
Stimulant medications, also called psychostimulants, include Ritalin® and Ritalin LA®, Methylin®, Metadate®, Concerta®, and Adderall® and Adderall XR®.
Several of these offer long-acting formulations to reduce the need for frequent dosing. Only Adderall XR® is indicated for the treatment of ADHD in children, adolescents and adults.
Non-stimulant medications are also available, including Wellbutrin® and Straterra®. Available since 2003, Straterra® is the first non-stimulant medication approved to control ADHD symptoms in children, adolescents and adults.
Wellbutrin® is sometimes used "off-label" for treatment of combined conditions such as ADHD and depression. The term "off-label" means that doctors prescribe the drug for disorders not officially approved by the Federal Drug Administration (FDA).
Along with medications, a 2010 study also showed that behavioral therapy can help adults with ADHD.
How to Cope with ADHD
Doctors often recommend various coping strategies as an adjunct to drug therapy. These include:
Taking medications as directed. (Don’t double up if you miss a dose.)
Making lists of tasks and keeping them nearby
Taking a deep breath or excusing yourself from situations when you're tempted to act out or interrupt; recognizing and minimizing stimuli that distract you (sounds, sights and physical sensations)
Doing things that calm or comfort you, such as gardening, walking or cooking
Physicians and other mental health professionals now have access to a symptom checklist designed to help establish the diagnosis of adult ADHD.
The Adult Self-Report Scale (ASRS-v1.1) was developed in conjunction with the World Health Organization and Workgroup on Adult ADHD, which includes experts from Harvard Medical School and New York University Medical School.
The checklist included 18 questions and takes about 5 minutes to complete.
Of the 18 questions, six were found to be the most predictive of symptoms consistent with ADHD. Patients are asked to score the frequency of symptoms on a 5-stage scale described in each question, from never to very often.
1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
2. How often do you have difficulty getting things in order when you have to do a task that requires organization?
3. How often do you have problems remembering appointments or obligations
4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
6. How often do you feel overly active and compelled to do things, like you were driven by a motor?
If these symptoms sound familiar to you, ask your doctor about a referral to someone who can administer the ASRS and counsel you about the results and your options, if your score indicates a high likelihood of Adult ADHD.
Check out more ADHD Resources:
National Resource Center on ADHD
National Institute of Mental Health
CHADD
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