The symptoms of ADHD include inattention and/or hyperactivity and impulsivity. These are traits that most children display at some point or another. But to establish a diagnosis of ADHD, sometimes referred to as ADD, the symptoms should be inappropriate for the child’s age. ADHD is common in children and teens. Adults also can have ADHD. With ADHD in adults, there may be some variation in symptoms. For instance, an adult may experience restlessness instead of hyperactivity.
Based on the most recent revision, DSM-V, there are three different types of ADHD, including:
- Combined ADHD (the most common type), which involves all of the symptoms
- Inattentive ADHD which is marked by impaired attention and concentration and/or sluggish cognitive tempo
- Hyperactive-Impulsive ADHD, which is marked by hyperactivity without inattentiveness
For a diagnosis of ADHD, some symptoms that cause impairment must be present before age seven. Also, some impairment from the symptoms must be present in more than one setting. For instance, the person may be impaired at home and school or home and work. Also, there must be clear evidence the symptoms interfere with the person’s ability to function at home, in social environments, or in work environments.
Inattention may not become apparent until a child enters the challenging environment of school. In adults, symptoms of inattention may manifest in work or in social situations.
A person with ADHD may have some or all of the following symptoms:
- difficulty paying attention to details and tendency to make careless mistakes in school or other activities; producing work that is often messy and careless
- easily distracted by irrelevant stimuli and frequently interrupting ongoing tasks to attend to trivial noises or events that are usually ignored by others
- inability to sustain attention on tasks or activities
- difficulty finishing schoolwork or paperwork or performing tasks that require concentration
- frequent shifts from one uncompleted activity to another
- disorganized work habits
- forgetfulness in daily activities (for example, missing appointments, forgetting to bring lunch)
- failure to complete tasks such as homework or chores
- frequent shifts in conversation, not listening to others, not keeping one’s mind on conversations, and not following details or rules of activities in social situations
Hyperactivity symptoms may be apparent in very young preschoolers and are nearly always present before the age of seven. Symptoms include:
- fidgeting, squirming when seated
- getting up frequently to walk or run around
- running or climbing excessively when it’s inappropriate (in teens this may appear as restlessness)
- having difficulty playing quietly or engaging in quiet leisure activities
- being always on the go
- often talking excessively
Hyperactivity may vary with age and developmental stage.
ADHD Affects Adults, Too
Attention deficit hyperactivity disorder is not limited to children — 30% to 70% of kids with ADHD continue having symptoms when they grow up. In addition, people who were never diagnosed as kids may develop more obvious symptoms in adulthood, causing trouble on the job or in relationships. Many adults don’t realize they have ADHD, leaving them mystified about why their goals seem to slip out of reach.
Signs of Adult ADHD: Running Late
ADHD in adults follows a slightly different pattern than in children. Adults may be chronically late for work or important events. Adults may realize that their tardiness is undermining their goals, but they just can’t seem to be on time.
Signs of Adult ADHD: Risky Driving
One of the hallmarks of ADHD is difficulty keeping your mind on the task at hand. That spells trouble for teens and adults when they’re behind the wheel of a vehicle. Studies show that people with ADHD are more likely to speed, have accidents, and lose their drivers’ licenses.
Signs of Adult ADHD: Distraction
Adults with ADHD may have trouble prioritizing, starting, and finishing tasks. They tend to be disorganized, restless, and easily distracted. Some people with ADHD have trouble concentrating while reading. The inability to stay focused and follow through on tasks can derail careers, ambitions, and relationships.
Signs of Adult ADHD: Outbursts
Adults with ADHD may have problems with self-control. This can lead to:
- Difficulty controlling anger
- Impulsive behaviors
- Blurting out rude or insulting thoughts
Signs of Adult ADHD: Hyperfocus
Some adults with ADHD can focus intently on things they enjoy or find interesting — the ability to hyperfocus. But they struggle to pay attention to tasks that bore them. The trouble is that many tasks necessary for success in everyday life are dull, from making a grocery list to filing documents at work. People with ADHD tend to put off boring tasks in favor of more enjoyable activities.
Multitasking or ADHD?
It may seem like everyone has ADHD these days, as we respond to text messages, email, calls, and fast-paced work environments. While all of this can be distracting, most people manage to focus on important responsibilities. In people with ADHD, distractions interfere with the completion of vital tasks at home and at work.
ADHD or Something Else?
If you are often restless and have trouble concentrating, don’t jump to the conclusion that you have ADHD. These symptoms are also common in other conditions. Poor concentration is a classic sign of depression. Restlessness or anxiety could indicate an overactive thyroid or anxiety disorder. Your health care provider will investigate whether these conditions could be causing your symptoms instead of — or in addition to — ADHD
What Causes ADHD?
In people with ADHD, brain chemicals called neurotransmitters are less active in areas of the brain that control attention. Researchers don’t know exactly what causes this chemical imbalance, but they think genes may play a role, because ADHD often runs in families. Studies have also linked ADHD to prenatal exposure to cigarettes and alcohol.
Treatment of ADHD helps control the ADHD symptoms, including inattention, hyperactivity, and impulsivity. Consistent ADHD treatment can improve the ability of the person with ADHD to function better in school, at work, and in social situations.
Treatment for ADHD is multifaceted. It consists of ADHD medications or behavioral modification therapy, counseling, education, and both Neurofeedback and Cogmed Working memory training have been found to be efficacious and help for symptoms associated with ADHD. ADHD treatment should be tailored to meet the unique needs of the child or adult who has ADHD as well as the needs of the family.
Which medications are used to treat ADHD?
The primary ADHD medications include stimulants, nonstimulants, and antidepressants.
Stimulants are the most common treatment for ADHD in children and adolescents. They includemethylphenidate — Ritalin, Metadate, Concerta, Daytrana — or amphetamines, including Dexedrine,Dextrostat, and Adderall. A newer drug, Vyvanse, is a type of amphetamine that’s formulated to last longer and to be less conducive to abuse or dependence than other stimulants.
Other FDA-approved drugs for ADHD in children and adolescents include the nonstimulants Stratteraand Intuniv. Strattera works on levels of the brain chemical norepinephrine and is quite effective at treating and controlling ADHD symptoms. Intuniv affects certain receptors in the brain and also improves concentration and impulse control. Both of these drugs pose a much lower risk of abuse or dependence than stimulants.
The antidepressant Wellbutrin has been shown to be beneficial in treating ADHD. Wellbutrin can be an alternate treatment when tolerance or abuse of a stimulant is a problem.
Antidepressants have a positive effect on all three of the major components of ADHD: inattention, impulsivity, and hyperactivity. They are another option for children whose response to stimulant medication has been inadequate. They also are used as an alternative for children who experience unacceptable side effects, such as tics or insomnia, from stimulant medication.
How Effective Are ADHD Drugs for Adults?
There have been far fewer studies of ADHD drugs in adults than in children, but the research to date is promising. Studies have consistently shown adults taking stimulants have fewer ADHD symptoms. The benefits kick in within 30 minutes of the first dose and can last all day in the case of controlled-release medications.
Counseling for ADHD
Most adults with ADHD improve when they start medication, but they may continue to struggle with poor habits and low self-esteem. Counseling for ADHD focuses on getting organized, setting helpful routines, repairing relationships, and improving social skills. There is evidence that cognitive-behavioral therapy is particularly helpful in managing problems of daily life that are associated with ADHD.
Adult ADHD on the Job
Holding down a job can be tough for people with ADHD. They often have trouble breaking down tasks and following directions, staying organized, and making deadlines. They’re also prone to tardiness and careless mistakes. In one national survey, only half of adults with ADHD were employed full time, compared to 72% of adults without the disorder. People with ADHD also tend to earn less than their peers.
Adult ADHD and Marriage
ADHD can sabotage marriage and other relationships. The condition makes it difficult to remember social commitments, birthdays, or anniversaries, finish household chores, and pay bills on time. Adults with ADHD may lose their tempers easily or engage in reckless behavior. This leads to higher rates of separation and divorce.
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