ADHD

Understanding ADHD in Adults

Adult ADHD

In the past, ADHD (attention-deficit/hyperactivity disorder) was considered a condition that children had and then "grew out of" before they reached adulthood.  However, we now know that ADHD is a condition that spans a lifetime, from childhood to old age. 

Typically, ADHD symptoms change through a person’s life, at least in terms of what others can observe. For example, a young child’s hyperactivity is visible to someone else because the child is physically very active.

In comparison, an adult might appear to be relatively relaxed and still. This is because adults develop coping strategies in order to fit with social expectations. The hyperactivity is still present, but it has become mostly internal.

Because attention-deficit/hyperactivity disorder is a neurological condition that affects a person’s ability to focus, pay attention, and manage behavior (including impulsiveness), ADHD can create problems in every area of adult life, including relationships, work, health, and finances.

People are often surprised and relieved to realize that some of their behaviors, which they thought were due to being "lazy" or "stupid," are actually related to ADHD–a realization that, for some, comes far after childhood.

There are different types of ADHD, which can affect both children and adults. What ADHD looks like depends on the type you (or someone you love) is managing.

10 Signs of Inattentive ADHD in Adults

You Get Distracted: Your mind might wander off when you are in a work meeting or listening to instructions.  Sometimes you daydream to relieve boredom, and sometimes you get distracted even when you are trying really hard to pay attention.

You Have Problems Paying Attention to Details: This can give the impression that you are careless, or that you do not try hard.

You Are Disorganized: You might find it hard to keep your physical environment tidy. Perhaps you arrive at a dentist appointment on the wrong day, or you have a "messy" look to your appearance.

You Have Time Management Issues: Time can travel differently when you have ADHD. This means you are often late for appointments, hand in work assignments at the last minute, and pull all-nighters to meet deadlines.

Your Memory Is Poor: It is a standing joke among your friends that you never remember their birthday. You always have an uneasy feeling that you have forgotten something, but you are not sure what it is.  When you leave your house, you usually have to go back at least once for an item you forgot.

You Struggle to Complete Tasks: You are fairly good at starting a task, but keeping the motivation and momentum to see it all the way through to the end is challenging.

You Do Not Appear to Be Listening: People accuse you of not listening to them when they are talking to you.

You might find it hard to look directly at them when they are talking, and this gives the impression you are not interested in what they are saying.

You Avoid Tasks: You procrastinate sitting down to work on a task that requires mental effort, especially if it does not have a deadline looming.

You Lose Concentration When Driving: You have had many minor collisions and tickets for not stopping at stop signs because you became distracted.

You Find Mundane Task Difficult: You find basic living tasks, such as grocery shopping, laundry, or unpacking a suitcase, very challenging. This can make you feel bad about yourself, because everyone ‘should’ be able to do these things.

10 Signs of Hyperactive-Impulsive ADHD in Adults

You Always Seem to Be on the Go: You have a full schedule and lots of physical energy. People often think you are much younger than your biological age because of how much energy you have.

You Have a Hard Time Sitting: When you were a child, you probably jumped up many times when you were supposed to be sitting still.

As an adult, you learned to sit, but you still find ways to move by bouncing your foot or tapping your fingers or fiddling with a pen.

You Interrupt When Others Are Speaking: Because your mind works quickly, you finish other people’s sentences or answer a question before it has been asked completely. Other times you interrupt and speak because you are worried you will forget what you wanted to say if you do not say it immediately.

You're Talkative: You are known among your family and friends to be very hyper talkative. You might also speak loudly and enjoy debating.

You Find Waiting Hard: Waiting is challenging for you. Whether you are waiting for a friend to arrive, at a traffic light, or in a line at the store, you feel very restless, impatient, and bored.

You Drive Very Fast: You enjoy speeding–and often get pulled over for it.

You Do Not like Slowness: You get impatient with ‘slow’ people. You also speed through tasks, even important ones, just to get them over with. 

You Feel Internal Restlessness: You feel unsettled when you are required to be physically still (for example, at a restaurant or in a meeting).

This can feel like agony at times.

You Make Decisions Quickly: Sometimes this is good; other times it leaves you with regret.

You Say Things Impulsively: You often offend people because you say things without thinking them through. You say ‘sorry’ a lot. Maybe you've quit a job without giving it a second thought.

How Is Adult ADHD Diagnosed?

Getting diagnosed with ADHD is not as simple as having a blood test or filling out an online questionnaire. A detailed evaluation is required. This is done by a health professional who has experience with ADHD in adults. This person’s job during the evaluation is to decide if you meet the criteria for ADHD as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM)–the official diagnostic guide used in the United States.

The testing is done using questionnaires, rating scales, intellectual screenings, and interviews, and by measuring sustained attention and distractibility. ADHD symptoms can look similar to other conditions like depression, bipolar disorder, learning disabilities, and sleep problems. Therefore, an important part of the evaluation process is to determine if you have ADHD, a different condition, or ADHD and a co-existing condition together. 

The latest edition of the DSM (5th edition), published in 2013, takes into account how symptoms of ADHD look in adults. This is very helpful, as it was felt that adult ADHD was overlooked in previous DSMs.

ADHD and Adult Women

Women are more likely to have inattentive ADHD, which historically has meant that their ADHD symptoms were overlooked in childhood. Teachers and parents were aware that hyperactivity was a symptom of ADHD, but less was known about inattentive ADHD. If a child was daydreaming or disorganized, that was thought to be the child’s character rather than ADHD. Because of this, many women (and some men) are diagnosed with ADHD later in life.

Women can also have hyperactive-impulsive ADHD, though this is less common. Growing up, a girl might be described as a tomboy because of her physical energy, even when ADHD was the cause.

How Is Adult ADHD Treated?

Medication is the most common way of treating ADHD. However, it is not the only way. There is a saying: “Pills don’t teach skills.” This means that learning ADHD-friendly ways to do daily tasks is also helpful. Many treatment plans include a combination of approaches, as each method increases the other’s effectiveness. For example, taking medication can make it easier to implement new behaviors. 

Medication

There are two groups of medications that your doctor might prescribe:  stimulants and non-stimulants

Sometimes people are wary of taking a stimulant; these medications get a lot of negative attention in the press. However, they are the most studied ADHD medications. Stimulants reduce hyperactivity and impulsivity, and increase attention. It is important to work closely with your doctor to find the right dosage for you and to report any side effects you experience.

A non-stimulant medication might be prescribed instead of a stimulant medication if you have a history of addictions or have too many side effects when taking stimulant medication. Sometimes a combination of stimulant and non-stimulant medications is prescribed.

Counseling 

There are many types of counseling approaches. Cognitive behavioral therapy (CBT) has been found to be effective for treating ADHD. With this type of therapy, you learn new ways to behave in the world. Low self-esteem and shame are common feelings for adults who have ADHD, and CBT is a helpful way to address these issues.

Additional Ways to Help Your ADHD

There are many other ways you can minimize the negative effects of ADHD on your life. For example, you might be eligible to get workplace accommodations. You could include exercise in your life and practice stress reduction techniques. Making lifestyle shifts, so that you focus on personal strengths, is also helpful.

Sources:

Antshel, KM, Hargrave TM, Simonescu M, Kaul P, Hendricks K, Faraone SV. 2011. Advances in Understanding and Treating ADHD. BMC Medicine 9 (1): 72.

Jensen, P. 2009. Methylphenidate and Psychosocial Treatments Either Alone or in Combination Reduce ADHD Symptoms. Evidence-Based Mental Health 12 (1): 18.

Kessler, R. C., L. Adler, R. Barkley, J. Biederman, C. K. Conners, O. Demler et al 2006. The Revalence and Correlates of Adult ADHD in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry 163(4): 716-723.

Kessler, R. C., L. Adler, R. Barkley, J. Biederman, C. K. Conners, L.L Greenhill, and T. Spencer. 2011. The Prevalence and Correlates of Adult ADHD. In ADHD in Adults; Characterization, Diagnosis, and Treatment, edited by J.K. Buitelaar, C.C Kan, and P. Asherson. Cambridge, U.K: Cambridge University Press.

Treuer, T., S.S. Gau, L. Mendez, W. Montgomery, J.A. Monk,M. Altin et al 2013. A Systematic Review of Combination Therapy with Stimulants and Atomoxetine for Attention-Deficit/Hyperactivity Disorder, including Patient Characteristics, Treatment Strategies, Effectiveness, and Tolerability. Journal of Child and Adolescent Psychopharmacology 23:179-193.

More from Verywell in Adult ADHD

Learn more about ADHD