» Adult ADD
In the past, Attention Deficit Disorder was believed to be a condition that affected children and some adolescents. Although it was known that children with AD/HD were more likely to have difficulties in adulthood, clinicians usually diagnosed and treated these as other conditions. During the past two decades, we have recognized attention deficit disorder in older adolescents and adults.
A limited number of studies have followed children diagnosed with ADD on to adulthood, but the results imply that the vast majority of children with ADD outgrow the diagnosis by early adulthood, and have led some to speculate that the adverse impact of ADD becomes increasingly benign with advancing age. However some have argued that this is a result of both flaws in the studies and flaws in our understanding of the manifestation of ADD in adults.
Although the manifestations of ADHD may change over time, current diagnostic criteria are the same for adults as they are for children. Thus, the same symptoms are used to diagnose children and adults and the same number of symptoms is required. This could artificially reduce the likelihood that an individual would be diagnosed with ADHD in adulthood for two reasons. First, if the manifestations of ADHD change over time, then the symptoms used to define the disorder in childhood may not include features that are more characteristic for adults.
Second, if ADHD symptoms as currently defined decline with age — as they are known to do — then it becomes increasingly unlikely for individuals to display the required number of symptoms as they become older. Scientists are now looking at new ways to assess adults who are struggling with ADD.
Attention Deficit Disorder is first diagnosed in childhood and is not a disorder developed as an adult. ADD was not commonly recognized decades ago and many adults who exhibited symptoms of ADD have spent their lives undiagnosed. As children, these adults might have been accused of being lazy, a day dreamer, or a scatterbrain.
Adults with ADD are often perceived by others as chaotic and disorganized, with a tendency to require high stimulation in order to diminish distractibility and function effectively. As their coping mechanisms become overwhelmed, some individuals may turn to smoking, alcohol, or illicit drugs. Even as an adult, ADD is sometimes difficult to diagnose because there are things the adult with ADD can focus on (a product of decades of being forced to learn coping skills). It is quite common today for an adult to seek out psychotherapy for other reasons only to discover that part of their problem and an explanation for their problem is that they have ADD.
Adults with ADD often realize that they have Attention Deficit Disorder when their own child is diagnosed (especially since there is a hereditary component to ADD). Looking through the list of symptoms, the parent often sees similarities in their own present or past behavior. Individuals with ADD essentially have problems with self-regulation and self-motivation, predominantly due to problems with distractibility, procrastination, organization, and prioritization. The learning potential and overall intelligence of an adult with ADD, however, are no different from the potential and intelligence of adults who do not have the disorder. It is estimated that up to 70% of children with ADD will continue to have significant ADD-related symptoms persisting into adulthood, resulting in a significant impact on education, employment, and interpersonal relationships.
The challenges of Attention Deficit are often the same, whether in a child or an adult. The ADD adult might have trouble with staying on task, staying organized and procrastinating, just as the Attention Deficit Disorder child does. The Attention Deficit Disorder adult might have trouble maintaining relationships and controlling their mood, just like an ADD or ADD child. The main difference between the ADD adult and the ADD child is that the adult with Attention Deficit typically has more sophisticated coping mechanisms.
Whereas teachers and caregivers responsible for children are often attuned to the symptoms of ADD, employers and others who interact with adults are far less likely to regard such behaviors as a symptom. In part, this is because symptoms do change with maturity; adults who have ADD are unlikely to spend much time climbing on the furniture. Research shows that they are far more likely than average to have automobile accidents, however, and less likely to complete their education. Their significantly lower rates of professional employment are not explained by the frequent presence of coexisting psychiatric problems. For the better part, the Attention Deficit Disorder ADD symptom test outlined for children is about the same for the adult, with the word “work” substituted for “school.” You can also look at the Attention Deficit Disorder test for children and ask yourself if, as a child, you had such symptoms or currently have such Attention Deficit Disorder symptoms.
Some frequent traits exhibited by adults with ADD are:
- An internal sense of anxiety or excessive worry
- Impulsive spending habits
- Frequently misplace the car keys, your purse or wallet or other day-to-day items
- Lack of attention to detail
- Family history of ADD, learning problems, mood disorders or substance abuse problems
- Trouble following the proper channels or chain of commands
- Impulsive job changes or inconsistent work performance
- Trouble maintaining an organized work and/or home environment
- Chronically late or always in a hurry
- Frequently overwhelmed by tasks of daily living
- Poor financial management and frequent late bills
- Trouble sustaining friendships or intimate relationships
- A need to seek high stimulation activities
- Tendency toward exaggerated outbursts or an argumentative attitude
- Addictive personality toward food, alcohol, drugs, work and/or gambling
- “Thin-skinned” – having quick or exaggerated responses to real or imagined slights
Many adults with ADD are aware that “something is wrong,” but are unable to find effective solutions for their symptoms. Getting a formal diagnosis of ADD by a trained professional and understanding the disorder as it applies to them, frequently offer adults with ADD the insight about their own behaviors that they need in order to make changes. Successful treatment of ADD is usually based on a combination of medication, behavior therapy, cognitive therapy, and skills training.
The diagnosis of Attention Deficit Disorder in adults can be a complex process. Because ADD is a condition that has its onset in childhood it is important for an adult seeking a diagnosis of ADD to examine their behavior from an early age. Since not everyone has an accurate recall of his or her early life, often it is useful to get information from relatives, spouse or old school records.
As the child moves from adolescence to adulthood, the predominant symptoms of ADD tend to shift from external, visible ones (such as physical hyperactivity) to internal symptoms. There seems to be a decrease in observable symptoms of ADD with age. Although a given adult may not meet the full DSM-IV criteria for full ADD any longer, he or she may still experience significant impairment in certain aspects of life. Depending on the professional or domestic situation, the adult may need to deal with more complex, abstract issues. A given individual’s perception of his or her degree of impairment may vary.
If they were diagnosed at all, many adults were diagnosed incorrectly, even when they were children. Sometimes this was because their main symptoms were inattention and impulsivity rather than physical hyperactivity. In other cases, the individual used his or her high intelligence or great determination to mask the ADD symptoms. Often this compensation occurred at great emotional cost. It is common for high-functioning individuals with ADD to harbor feelings of poor self-worth. They may see themselves as failures and feel that they constantly let others down. Over the years, the individual adapts to the situation. These adaptations, positive or negative, become part of one’s personality, layered over the ADD symptoms.
Adults with ADD are often bored with tedious, repetitive tasks. They may also trouble with planning and organization. Procrastination is common. Impulsivity may lead to frequent job changes, troubled romantic relationships, financial problems and a tendency to interrupt others. College students may have trouble staying focused on paperwork or lectures and keeping track of long term assignments. The ADD adult often becomes frustrated or angry rapidly, but may cool off equally quickly. He or she is then left wondering why everyone else is still upset at the blow up. Because of difficulties following through on commitments, the individual is often called selfish and immature.
There is no magic cure for ADD, but many adults learn to manage it successfully using medication, behavioral therapy, and the development of organizational and coping skills. Adults, more so than children are more likely to benefit from medication alternatives such as seeing an ADD coach or practicing meditation. The most important starting point is an accurate diagnosis of the ADD and any associated medical and psychiatric conditions. Following the diagnosis, the individual should educate himself about the condition. Self-knowledge is necessary in order to learn coping and develop mastery. Adults often respond to the same medications used to treat ADD children. However, one may need to consider the adult’s size, and associated medical conditions and his or her other medications. New medications are expanding our ability to treat ADD with fewer side effects.
Treatment often involves teaching the adult to structure his or her life, while allowing for some spontaneity. Time management and planning are important skills. Daily planners and task lists are beneficial. Often the individual can enlist the help of family or coworkers to help him stay organized. It is important that the adult with ADD chose a vocation that suits his or her interests and personality style. It is often best to avoid jobs that emphasize weaknesses such as repetitive tasks, and find jobs that focus on one’s energy, and ability to shift from task to task. Individuals who experience physical restlessness should try to schedule regular exercise or work breaks. College students who need accommodations need to inform their school early, before problems arise. Examples of accommodations include untimed tests, the use of tape recorders in lectures or the right to take attests in a less distracting setting. Schools often require psychological testing to support special accommodations.
Ways to manage ADD as an adult
- ADD Coaching (adult ADD coaching focuses on practical day to day ways to manage adult ADD more effectively at work and at home.)
- ADD Medication
- Cognitive Behavioral Therapy
- ADD Support
- Adequate diet and frequent exercise
- Meditation or other relaxation and focusing practices
- Tutors or Professional Business and Personal Help
There has been increasing awareness that adults and children with ADD are at increased risk for other psychiatric disorders. Adults have lived longer than children, and thus have had more time to develop other associated psychiatric disorders. Often one must treat the other conditions before treating the ADD.
The ADHD Center, Inc. is located in the North Dallas Bank Tower on the corner of Preston Road and LBJ Freeway.
There is ample free parking.
ADHD Center, Inc.
12900 Preston Road – Suite 1200
Dallas, Texas 75230
Phone: (972) 480-0000
Fax: (972) 960-6097