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Could I Have Attention-Deficit/Hyperactivity Disorder (ADHD)?

Do you feel that you have struggled throughout your life with poor concentration, inattention, impulsivity, or getting organized? Have you wondered whether you might have attention deficit/ hyperactivity disorder (ADHD)? Our society has become more aware of ADHD as a condition that affects adults as well as children, and there are many adults who struggle with this disorder. At the same time, other life stressors or mental health conditions can cause similar symptoms. Consider getting an evaluation from a psychiatrist or psychologist who has experience in diagnosing ADHD. Getting an evaluation can help you find the right answer to your struggles and identify the treatment you need to feel better.

What is ADHD?

ADHD is defined as a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

  • Inattention means a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; these problems are not due to defiance or lack of comprehension.
  • Hyperactivity means a person moves about excessively when it is not appropriate, and/or excessively fidgets, taps, or talks. In adults, it may appear as extreme restlessness or wearing others out with their activity.
  • Impulsivity means hasty actions that occur in the moment without a person thinking first; or a desire for immediate rewards or inability to delay gratification. Impulsive actions may have high potential for harm. An impulsive person may be socially intrusive and interrupt others excessively or make important decisions without considering the long-term consequences.

ADHD begins in childhood and is considered a developmental disorder, but a person may not receive a diagnosis until adolescence or adulthood.

To receive a diagnosis of ADHD as an adult:

  • Several symptoms must have been present before the age of 12.
  • A person must have at least five symptoms of either inattention and/or hyperactivity-impulsivity.
  • The symptoms must be present in two or more settings, such as at home and at work.
  • There must be evidence that the symptoms interfere with the person's functioning in these settings.

Several other mental health conditions commonly occur with ADHD, including conduct disorder, learning disorders, anxiety disorders, and depression.

How does ADHD affect adults?

Some children with ADHD continue to have the condition as adults.

Many adults who have ADHD don’t know it. These adults may feel that it is impossible to get organized, stick to a job, or remember to keep appointments. Daily tasks such as getting up in the morning, preparing to leave the house for work, arriving at work on time, and being productive on the job can be especially challenging for adults with undiagnosed ADHD. These adults may have a history of academic problems, problems at work, or difficult or failed relationships. Many have had multiple traffic accidents. Like teens, adults with ADHD may seem restless and may try to do several things at once, most of them unsuccessfully. They also tend to prefer "quick fixes," rather than taking the steps needed to achieve greater rewards.

A person may not be diagnosed with ADHD until adulthood because the condition was not recognized by teachers or family at a younger age, the person has a mild form of ADHD, or he or she managed fairly without the demands of adulthood. However, it is common for young adults with undiagnosed ADHD to encounter academic problems in college because of the intense concentration required by higher education.

Untreated ADHD in an adult can lead to significant problems with education, social and family situations and relationships, employment, self-esteem, and emotional health. It is never too late to recognize, diagnose, and treat ADHD and any other mental health condition that can commonly occur with it. Effective treatment can improve the lives of many adults and their families.

What are the symptoms of ADHD?

A person with inattention often:

  • Fails to give close attention to details or makes careless mistakes at work or during other activities
  • Has difficulty sustaining attention in tasks, such as during lectures or lengthy reading
  • Does not seem to listen when spoken to directly
  • Does not follow through on instructions and fails to finish chores or duties in the workplace
  • Has difficulty organizing tasks and activities—for example, is messy and has poor time management
  • Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
  • Loses things necessary for tasks or activities, such as keys, wallets, and mobile phones
  • Is easily distracted by unrelated thoughts or stimuli
  • Is forgetful in daily activities, such as paying bills, keeping appointments, or returning calls

A person with hyperactivity-impulsivity often:

  • Fidgets with or taps hands or feet or squirms in seat
  • Leaves seat in situations when remaining seated is expected
  • Feels restless or is unable to be still for extended periods of time
  • Is unable to engage in leisure activities quietly
  • Talks excessively
  • Blurts out an answer before a question has been completed
  • Has difficulty waiting his or her turn, such as when waiting in line
  • Interrupts or intrudes on others

Some people with ADHD primarily have symptoms of inattention, while others have primarily symptoms of hyperactivity-impulsivity. Some people have symptoms in both categories.

Problems with concentration and staying organized can be common for many busy adults; however, an adult who is impaired both at work and at home, or in social situations, is more likely to have ADHD.

What causes ADHD?

Scientists are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors and are studying how brain injuries, nutrition, and the social environment might contribute to ADHD.

How is ADHD in adults diagnosed?

Adults who suspect they have ADHD should see a licensed mental health professional or doctor, such as a psychologist or psychiatrist who has experience diagnosing ADHD, for an evaluation.

Stress, other mental health conditions, and physical conditions or illnesses can cause similar symptoms to those of ADHD. Some of these include:

  • Stress at work or home
  • Lack of sleep
  • Sleep apnea, a health condition in which a person has one or more pauses in breathing or shallow breaths while sleeping, causing poor sleep quality and daytime sleepiness
  • Lack of exercise
  • Lack of proper nutrition
  • Anxiety
  • Depression
  • Problems with the thyroid gland, a gland in the neck that makes the thyroid hormone, which controls the body's metabolism

Therefore, a thorough evaluation will help the doctor find out what is causing the symptoms and recommend effective treatment.

There is no one test that can diagnose ADHD. Mental health professionals use certain rating scales to determine if an adult meets the diagnostic criteria for ADHD.

A thorough evaluation also includes looking at the person’s history of childhood behavior and school experiences. To obtain this information, the doctor may interview spouses or partners, parents, close friends, and other associates.

The person may also undergo a physical exam and various psychological tests that evaluate working memory, executive functioning (abilities like planning and decision-making), and visual and spatial skills or reasoning. The evaluation will also look at the person’s mood and whether he or she struggles with other issues, such as anxiety, depression, or substance abuse. A person’s medical history is also important, as previous health problems, trauma, or injury can also be the cause of symptoms.

What are the treatments for ADHD in adults?

Adults with ADHD can be treated with behavioral interventions, medication, or a combination of the two.

Medications

Stimulants such as methylphenidate and amphetamines are the most common type of medication used for treating ADHD. In addition, a few nonstimulant medications are also available. Although not approved by the U.S. Food and Drug Administration (FDA) specifically for the treatment of ADHD, antidepressants are sometimes used to treat adults with ADHD. An adult who is offered a prescription for a stimulant for ADHD should tell his or her doctor about all other medications that he or she takes. Medications for common adult health problems, such as diabetes, high blood pressure, anxiety, and depression may interact badly with stimulants. In this case, a doctor can offer other medication options.

For general information about stimulants and other medications used for treating mental disorders, see the NIMH Mental Health Medications webpage (http://www. nimh.nih.gov/health/topics/mental-health-medications/ index.shtml). The FDA website (http://www.fda.gov) has the latest information on medication approvals, warnings, and patient information guides.

Psychotherapy

Psychotherapy, including cognitive behavioral therapy, can help an adult with ADHD to become more aware of the deficit in attention and concentration and can provide the skills for improving organization and efficiency in daily tasks. It can also address feelings of low self-esteem and help adults with ADHD gain confidence, as well as control impulsive and risky behaviors. A professional counselor or therapist can also help an adult with ADHD learn how to organize his or her life and break large tasks down into smaller, more manageable steps.

Where can I turn if I feel alone in my diagnosis of ADHD?

In addition to the benefits of psychotherapy, adults with ADHD can gain social support and better coping skills by talking with family, friends, and colleagues about their diagnosis. If the people in their lives are aware of their diagnosis, they will better understand their behavior. Psychotherapy for families and couples can help any relationship problems and teach everyone involved about ADHD. There are also support groups just for adults with ADHD.

Some adults also find it helpful to obtain support from a professional life coach or ADHD coach who can help with a variety of skills to improve daily functioning.

For More Information

National Institute of Mental Health (NIMH)
http://www.nimh.nih.gov

Centers for Disease Control and Prevention (CDC)
http://www.cdc.gov/ncbddd/adhd/

National Institute of Mental Health
Office of Science Policy, Planning, and Communications
Science Writing, Press, and Dissemination Branch
6001 Executive Boulevard
Room 6200, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or 1-866-615-NIMH (6464) toll-free
TTY: 301-443-8431 or 1-866-415-8051 toll-free
Fax: 301-443-4279
Email: nimhinfo@nih.gov
Website: http://www.nimh.nih.gov
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
National Institute of Mental Health
NIH Publication No. QF 16-3572