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Adults with ADHD often don’t realize they have the disorder. If you’ve long struggled to focus on tasks and pay attention at work or home, or if you frequently feel impulsive, make hasty decisions, or often have a hard time organizing work or other activities, you have some of the symptoms of attention-deficit/hyperactivity disorder (ADHD). But whether you might be diagnosed with the disorder and stand to benefit from medications or other treatments is a more complex question.
The good news: You’re already on the journey to figure out if there’s a treatable condition behind your symptoms. Either way, know that ADHD is pretty common in adults, and the good news is several medications and therapies have proven helpful in treating it.
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What is ADHD?
ADHD, in broad terms, is described as “a behavioral condition that makes focusing on everyday requests and routines challenging” (American Psychological Association, n.d.). It is a complex and multifaceted condition that long ago absorbed what we called simply “attention deficit disorder”, or ADD (CHADD, n.d.).
If you have ADHD, you may never determine the cause. Heredity plays a strong role, and smoking or alcohol use during pregnancy could contribute, but no specific cause has been discovered (American Psychiatric Association, n.d.).
Though often thought of as a childhood disorder that kids supposedly grow out of, about 10 million adults, or 4.4% of adults have ADHD (Culpepper, 2010). The disorder typically starts in childhood, and although healthcare professionals can treat the symptoms, there’s no cure. Many who were diagnosed as kids will continue to have ADHD into adulthood. If you have ADHD, you can reduce and manage the symptoms through behavioral changes and medication (Wolraich, 2019).
Some adults with ADHD may never have been diagnosed. A relatively mild childhood case may have gone unrecognized by you and others, but it could still prove challenging and even harmful later on in your adult life (NIMH, n.d.).
What ADHD looks like
Signs of ADHD can change through the years. Adults with the condition may struggle with inattention, impulsivity and disorganization but no longer be as hyperactive as a child with ADHD. Adults with ADHD may struggle to cope with work challenges or family and relationship difficulties (CHADD, 2017). But ADHD can affect all parts of adult life.
For example, if you’ve been in several car accidents or otherwise are prone to dangerous distractions or impulsive decisions, ADHD could be to blame. One study found that the rate of car crashes was 1.45 times higher in those with a childhood history of ADHD compared to adults with no ADHD (Roy, 2020).
If you think you might have ADHD, here are some questions to consider, though you should not consider your answers a diagnosis (NIMH, CHADD):
- Have you often lost jobs or quit them?
- Do you often forget or just miss appointments?
- Did you struggle to pay attention in school as a kid?
- Is it a challenge to simply get up and ready for work in the morning?
- Do you have frequent problems in relationships at home, work, or otherwise?
- Do you have strong, chronic feelings of frustration, guilt, or self-blame?
- Do you have low self-esteem?
If you were diagnosed with ADHD in childhood, you may or may not have developed coping skills that keep the symptoms from causing you problems now. Particularly talented or intelligent individuals can be better at compensating for their ADHD symptoms. Or, it’s also possible you had ADHD as a child but it was not diagnosed, either because you had a mild form or perhaps the symptoms were viewed by teachers, parents, other caregivers, or even medical professionals as being due to some other condition—experts think these could be among the reasons some children seem to outgrow the disorder (CHADD).
You can also look to your family for hints. Because ADHD has a hereditary component, adults with the condition are more likely than other people to have a child with the disorder. Some adults may only learn they have it after their child is diagnosed (Harpin, 2005; American Academy of Family Physicians, n.d. ).
Now let’s drill down to specific symptoms. At any age, ADHD is marked by two distinct but often overlapping aspects. One aspect, inattention, produces several symptoms that distinguish it from the other aspect, hyperactivity-impulsivity.
Several of these behaviors will be present in someone diagnosed with ADHD (NIMH, n.d.):
Primarily inattentive (the ADD variety)
- Struggle to pay close attention to details or makes careless mistakes
- Can’t stay focused on tasks or activities
- Don’t listen well
- Don’t follow through on instructions
- Struggle to organize tasks, causing missed deadlines
- Avoid or dislike tasks that require sustained mental effort
- Often lose things needed for tasks or daily life
- Easily distracted
- Forget daily tasks, activities, or appointments
- Fidget, tap hands or feet, or squirm
- Can’t stay seated
- Are “always on the go” or otherwise relentless
- Can’t engage in leisure activities quietly
- Talk excessively
- Blurt out answers before a question is completed
- Struggle to wait in line
- Interrupt or intrude on others
If you have the hyperactive symptoms of ADHD, you may be extremely restless and wear other people out with your constant activity. Impulsiveness can have serious consequences, causing you to be socially intrusive and interruptive. It can cause you to make weighty decisions, financial or otherwise, without considering the long-term ramifications (NIMH, n.d.).
How ADHD is diagnosed
A family practitioner can, in some cases, diagnose ADHD but may instead refer you to a psychiatrist or psychologist who specializes in the condition. Whoever you start with, take charge and ask about their training and experience with ADHD among adults (CHADD, n.d.).
A diagnosis will be based on the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5). The practitioner will ask a lot of questions, both of you and of loved ones who know you well. The answers to these questions will help them to determine if you have at least five symptoms of inattention and/or hyperactivity-impulsivity, and several of the symptoms must have started before age 12. They’ll also aim to determine if your symptoms interfere with normal functioning in at least two settings, such as home and work (American Psychiatric Association, 2013).
Experts say that if you’re struggling with ADHD or even just some of the symptoms, it’s never too late to seek help. But given the complexities, they advise against trying to diagnose ADHD on your own or with an online survey (American Academy of Family Physicians, n.d.).
Another reason it’s important to seek a professional diagnosis and help: ADHD is often accompanied by one or more other mental conditions, including depression, anxiety, learning disabilities, and substance use disorders. The symptoms of those disorders can be similar to ADHD symptoms, and treatment of ADHD can improve the symptoms of these other disorders (Magnus, 2020).
Gender differences in symptoms and diagnoses
Men with ADHD were often diagnosed as children. Their hyperactivity may have offered a clear sign of the disorder, and boys are more than twice as likely as girls to get the diagnosis. ADHD in girls may more often go unrecognized. Girls tend to struggle with the same attention issues but are less apt to be hyperactive. (American Psychological Association, n.d.).
Some doctors think girls are just as likely to have ADHD, but they may develop it a little older than boys typically do (American Academy of Child & Adolescent Psychiatry, 2013).
Women who had undiagnosed ADHD in childhood may well still have it as adults. But there’s a shortage of research on ADHD in girls and women. Women also tend to be better than men at concealing the symptoms. Rather than lashing out or otherwise appearing impulsive, women with undiagnosed ADHD are apt to quietly suffer anxiety and depression.
However, as awareness of the condition continues to increase in society, women may be more likely to recognize the signs themselves—finances are a mess, daily responsibilities at work or home become overwhelming, paperwork is in disarray—and seek treatment. (CHADD, n.d.)
Treatment and coping skills for ADHD
If you are diagnosed with ADHD, your care provider should suggest a range of possible remedies, including medicine and behavioral therapy (Magnus, 2020).
Several medications have been proven useful for treating ADHD symptoms. The most common, including Adderall and Ritalin and their generic equivalents, are stimulants that have been tested rigorously for effectiveness and safety, but they all have side effects. Stimulants are the mainstay of treatment for ADHD. They are effective in about 70-80% of patients (Magnus, 2020). While these medications will stimulate most people, they have a calming effect on people with ADHD (American Academy of Family Physicians, n.d.).
Whether you have ADHD or not, if you got this far, something is likely getting in the way of your work, family life, or friendships. Figuring out what it is, whether ADHD or another condition that mimics some of its symptoms, could turn the page on a brighter chapter in your life.
- American Academy of Child & Adolescent Psychiatry (2013), ADHD Parents Medication Guide. Retrieved from: https://www.aacap.org/App_Themes/AACAP/Docs/resource_centers/adhd/adhd_parents_medication_guide_201305.pdf
- American Academy of Family Physicians, Attention-Deficit Hyperactivity Disorder (ADHD) https://familydoctor.org/condition/attention-deficit-hyperactivity-disorder-adhd/
- American Psychiatric Association, What is ADHD? . Retrieved from:https://www.psychiatry.org/patients-families/adhd/what-is-adhd
- American Psychiatric Association. Attention-deficit and disruptive behavior disorders. In: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013. Retrieved from: https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), ADHD in adults. Retrieved from: https://chadd.org/for-adults/overview/
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) (2017) ADHD Changes In Adulthood. Retrieved from: https://chadd.org/adhd-weekly/adhd-changes-in-adulthood/
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), ADHD in Women and Girls. Retrieved from: https://chadd.org/for-adults/women-and-girls/
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) (2017) ADHD in Adults. Workplace Issues. Retrieved from: https://chadd.org/for-adults/workplace-issues/
- Culpepper L, Mattingly G. Challenges in identifying and managing attention-deficit/hyperactivity disorder in adults in the primary care setting: a review of the literature. Prim Care Companion J Clin Psychiatry. 2010; Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3067998
- Harpin VA, The effect of ADHD on the life of an individual, their family, and community from preschool to adult lifeArchives of Disease in Childhood 2005. Retrieved from: https://adc.bmj.com/content/90/suppl_1/i2.citation-tools
- Magnus W, Nazir S, Anilkumar AC, et al. Attention Deficit Hyperactivity Disorder. [Updated 2020 Jun 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK441838/
- National Institute of Mental Health (NIMH), Could I Have Attention-Deficit/Hyperactivity Disorder (ADHD)? https://www.nimh.nih.gov/health/publications/could-i-have-adhd/index.shtml
- National Institute of Mental Health (NIMH), Attention-Deficit/Hyperactivity Disorder (ADHD). Retrieved from: https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd.shtml
- Roy A, Garner AA, Epstein JN, Hoza B, Nichols JQ, Molina BSG, Swanson JM, Arnold LE, Hechtman L. Effects of Childhood and Adult Persistent Attention-Deficit/Hyperactivity Disorder on Risk of Motor Vehicle Crashes: Results From the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry (2020). Retrieved from: https://jaacap.org/article/S0890-8567(19)31458-3/fulltext
- UpToDate (2021) Pharmacotherapies for attention deficit hyperactivity disorder in adults. Retrieved from https://www.uptodate.com/contents/pharmacotherapies-for-attention-deficit-hyperactivity-disorder-in-adults
- U.S. Centers for Disease Control and Prevention, Attention-Deficit / Hyperactivity Disorder (ADHD). Retrieved from: https://www.cdc.gov/ncbddd/adhd
- Wolraich ML, Hagan JF Jr, Allan C, Chan E, Davison D, Earls M, Evans SW, Flinn SK, Froehlich T, Frost J, Holbrook JR, Lehmann CU, Lessin HR, Okechukwu K, Pierce KL, Winner JD, Zurhellen W; SUBCOMMITTEE ON CHILDREN AND ADOLESCENTS WITH ATTENTION-DEFICIT/HYPERACTIVE DISORDER. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019 Oct. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/31570648/
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.