Adult ADHD

ADHD has always been considered a children's disorder, but increasingly in the last 25 years, adults have been diagnosed and medicated for this problem. By definition, this disorder cannot appear suddenly in adults. Rather, if an adult is newly diagnosed with ADHD, the syndrome is viewed as the adult component of a childhood disorder that was never diagnosed. Although symptoms can be caused by other events such as a head injury, hyperthyroidism (high levels of thyroid hormone) or seizure disorders, true ADHD appears during early childhood.

Some individuals with adult AD/HD had more severe symptoms as children that persisted across time. Others (e.g., individuals who are very bright) may have found ways to compensate for their symptoms when they were young, but experience more challenges as they tackle living independently, pursuing a career, raising a family, and other common adult life stages.

ADHD significantly interferes with adults' ability to function in all arenas of their lives; work, home, school, and social interactions. The most common negative outcome of adult ADHD is underachievement. As adults, these individuals are often better able than children to recognize that they are different than others. However some people who have lived with ADHD their entire lives may not realize that these symptoms are indicative of a mental disorder, rather than a problem with motivation, trying hard, or any other negative comments that they may have heard throughout their lives.

Age of Onset

According to DSM diagnostic criteria, ADHD develops in childhood, with at least some symptoms present prior to age 7. Estimates of children whose symptoms continue into adulthood range up to 60%.

Prevalence

Prevalence rates for adults with ADHD are not as clear as they are for children, but estimates suggest that 1 to 5% of American adults have some form of the disorder, including people whose symptoms are significantly reduced, but not fully in remission (i.e., have not disappeared completely). Although more males than females have the disorder in childhood, the numbers seem to even out by adulthood.

Adult ADHD symptoms often look different than children's symptoms; they are more likely to be very distractible and impulsive, rather than blatantly hyperactive. Often, the most prominent characteristic in adults with ADHD is difficulty with executive functioning (the ability to redirect attention, inhibit inappropriate behavior, make decisions, and switch problem-solving strategies). This significant function affects individuals in all aspects of their lives and can impair their ability to structure their lives and to plan even simple daily tasks. Other symptoms observed in adults include disorganization, impulsivity, restlessness, difficulties focusing attention, emotional instability and low stress tolerance, as evidence by the following:

• Disorganization and Difficulty with Task Completion
• Poor organizational skills
• Chronic procrastination or trouble getting started
• Working on many projects simultaneously
• Trouble with follow through on promises or commitments
• Changing plans, enacting new schemes or career plans and the like
• Difficulty structuring time and setting priorities (e.g., chronic lateness)
• Impulsivity-A tendency to say what comes to mind without considering the timing or appropriateness of the remark
• Difficulties with self-control
• Spontaneous, spur-of-the-moment behaviors or comments
• Frequently interrupting others when they are talking
• A tendency toward addictive behaviors
• Hyperactivity-Physical or cognitive restlessness
• Craves excitement, frequently searching for high stimulation
• An intolerance of boredom
• Attention Problems-Easily distracted, trouble focusing attention (e.g., tunes out or drifts away in the middle of a page or a conversation)
• Chronic forgetfulness
• Inaccurate self-observation
• Emotional Instability-An ongoing tendency to worry excessively, that may alternate with disregard for actual dangers
• A sense of insecurity
• Mood swings
• Chronic problems with self-esteem
• Frequent boredom and discontent
• A chronic sense of underachievement, of not meeting one's goals, regardless of actual performance
• Low Stress Tolerance-Impatient, doesn't deal well with frustration
• Easily flustered, tense
• Exaggerates the significance of negative events (i.e. makes "mountains out of molehills")
• Short temper, likely with a history of explosive episodes