Every night when I went to sleep, when I was eight, I either banged my legs up and down against the bed or banged my head on the wall, until I fell asleep. Sounds crazy but true, and no one gave it a second thought
In class I could never sit still, I didn’t cause trouble, but I couldn’t pay attention.
Every report card would say the same thing. Grade: C or D-“Bruce has the potential to be a good student if he only applied himself.” ADHD hadn’t been “invented” yet, so more than anything my frustration built and my self-Esteem suffered.
Writing about ADHD is easy for me, I’ve lived with it my whole life. At the same time it is at times very frustrating. I was in Grade School in the late 1960’s and early 1970’s. I finished High School in the Mid 1970’s. About that time, ADHD, ADD began being recognized as a Disorder or as my Doctor put it to me a learning Disability.
Before I elaborate on the facts of ADHD, In my opinion, since a diagnosis of ADHD is in vogue today, it seems everyone has it. They don’t. It’s a easy diagnosis to make, but often incorrect. I was 27 when I was diagnosed with ADHD, only thing in Adulthood the Hyperactivity went away, but the inability to concentrate, focus, complete tasks etc. didn’t.
There are as many as eight million adults with ADHD in the USA alone—about 1 in 25 people. Almost 60 percent of children with ADHD will have the disorder through adulthood. It is important to diagnose ADHD in adults and get correct treatment, as ADHD can affect work, social interactions and personal relationships.
Types of Adult ADHD
There are three main types of adult ADHD. These are the different symptoms for each:
- Makes careless mistakes when working on uninteresting or difficult projects
- Difficulty paying attention at work, or holding down a job for a significant amount of time
- Difficulty concentrating on conversations
- Has trouble finishing projects once started
- Problems with organization
- Avoids or delays starting projects that require a lot of thought
- Loses or can’t find things at home or work
- Disorganized personal items causing excessive clutter in the home, car, etc.
- Distracted by activity or noise
- Problems remembering appointments or obligations; inconveniently changes plans on a regular basis
- Tendency to interrupt in conversation
- Difficulty sitting still or frequent feelings of restlessness
- Tendency to choose highly active, often risky jobs
- Seeks constant activity
- Frequent feelings of boredom
- Self-destructive, risk-seeking behavior including addictions
- Intolerant to frustration, easily irritated
- Impulsive, makes snap decisions and engages in irresponsible behaviors
- Tendency to be short-fused
- Individuals display both inattentive and hyperactive/impulsive
Patients with adult ADHD may also have anxiety, depression or bipolar disorder. This can complicate the diagnosis and treatment of the condition.
Questions to Ask Your Doctor About Attention Deficit Hyperactivity Disorder (ADHD) in Adults
After you receive an adult ADHD diagnosis, you’ll probably have a lot of questions. Review this list of common concerns before your appointment, or print it out to bring with you.
Questions About My Diagnosis
- Other than adult ADHD, are there other possible causes for my symptoms?
- What kinds of tests do I need?
Questions About My Treatment
- What’s the best treatment? How long will I need to continue my treatment?
- What are the alternatives to the approach that you’re suggesting?
- I have these other health conditions. How can I best manage them together?
- Should I see a specialist such as a psychiatrist or psychologist?
- Are there any brochures or other printed material that I can take home with me? What websites do you recommend for more information?
- What are the side effects of the medications you’ve prescribed? Is there a generic alternative?
Questions About My Lifestyle and Family
- What changes should I make in my lifestyle to overcome my condition?
- Should my family and friends be made aware of my condition?
- How will ADHD affect my work?
- Will I pass this condition on to my children?
- How will my condition and its treatment affect my daily routine?
- Are there any specific instructions to deal with daily routine?
Tests and Diagnosis
There is no specific test for ADHD. It is diagnosed mainly through a psychiatric screening, but doctors may run additional tests to rule out other conditions that can cause similar symptoms.
This is performed by observation and asking the patient (and his or her caregiver, if the patient is a child) a series of questions. These are the symptoms that may point to ADHD:
- Attention problems: Has trouble focusing, misses details, doesn’t listen carefully, and is forgetful and easily distracted
- Hyperactivity: Has trouble sitting still, talks excessively, and runs around when it’s not appropriate
- Impulsive behavior: Has trouble waiting for his or her turn, interrupts others when speaking
Some combination of these symptoms is usually seen before the age of seven. In addition to screening for ADHD, doctors will also attempt to rule out other developmental problems, schizophrenia or psychotic disorders.
Tests to Rule out Other Conditions
Aside from psychiatric screening, doctors will do a complete physical examination to look for other problems that may be causing ADHD symptoms. The following tests may also be performed:
- Thyroid function test and vitamin deficiency test: Blood test to rule out thyroid disorder and vitamin deficiencies, which can cause memory loss and concentration problems
- Regular blood test: To measure lead levels in the blood, which can cause permanent behavioral problems
- CT Scan and MRI: Medical imaging tests to rule out any brain lesions causing ADHD-like symptoms
- Psychological tests: To rule out conditions like sleep disorders and memory impairment, which can cause symptoms similar to ADHD. May include IQ tests and psychical observation
- Electric encephalography (EEG): To measure electrical activity of the brain and determine normal brain function
Medications and Treatment
Most adult ADHD treatments include a combination of medication and counseling. Some patients may also try alternative therapies along with or instead of more conventional approaches.
Medications to Treat Adult ADHD
Prescription drugs are the first-line treatment of ADHD. Experts estimate that ADHD drugs, when used properly, are 70-90 percent effective. Choosing the right medication for a patient with ADHD is often about avoiding making other health problems worse.
- Stimulants: They stimulate the part of the brain that maintains focus and keeps impulses in check. Extended-release formulations work for longer periods of time.
- Non-stimulants: These drugs also alter brain chemistry but are considered less effective than stimulants. Atomoxetine is the first non-stimulant drug approved for adult ADHD and may produce fewer side effects than stimulants.
- Antidepressants: These are prescribed to reduce tics and insomnia caused by other ADHD medications. They also helps to reduce aggression associated with ADHD.
- High blood pressure medications: They help to balance neurotransmitters in the brain to control severe symptoms of ADHD for a short period of time. The dosage varies depending upon the severity of the symptoms.
Psychotherapy to Treat Adult ADHD
Therapy may be helpful, not just to the adult ADHD patient, but to his or her family as well. The following types of counseling may be helpful in managing ADHD on a day-to-day basis:
- Cognitive-behavioral therapy: Helps patient to develop organizational skills and map out daily coping strategies
- Family Therapy: Helps family members to cope up with the condition
*Medications and therapy provided by Dr. Louis Bergman, M.D. Professor at UCLA Medical Center