Y.They are easily distracted, cannot sit still, and misplace things. You are sure that it is not depression, bipolarity, or dementia. The fact is, you are slowly wondering if this is ADHD. “But it can’t be, I’m an adult.” Actually it is possible …
… There is increasing evidence that ADHD symptoms can persist into adulthood. In addition, ADHD symptoms appear to first appear in early adulthood.
Came on an interesting article in the Psychiatric Times that I just had to share with you. “Adult Attention-Deficit / Hyperactivity Disorder (aADHD)” was written by Dr. Rajesh R. Tampi, Dr. Deena J. Tampi, MSN, and Dr. Manzoor Elahi written.
The discussion about ADHD is well worth our time as it can look very much like a mood or anxiety disorder. And when it comes to addressing our Misery Index, it’s important to consider all options – especially one that we may not know existed.
Summarizing tons of information in the Psychiatric Times. Let’s see what we can achieve …
What is ADHD in Adults?
As you may know, the Diagnostic and Statistical Manual for Mental Disorders, 5th Edition (DSM-5) recognizes three types of attention deficit / hyperactivity disorder (ADHD) and includes diagnostic criteria for them: combined representation, predominantly hyperactive / impulsive, and mostly inattentive.
ADHD has always been viewed as a disorder in children and adolescents. However, there is growing evidence that ADHD symptoms can persist into adulthood. In addition, ADHD symptoms appear to first appear in early adulthood.
To get an optimal overview of aADHD, I think it is advisable to turn to the DSM-5. What is interesting is that no diagnostic code is assigned to aADHD, but professionals often use DSM-5 ADHD criteria to diagnose it.
Okay, our first step is to examine these criteria …
- Often times, the details are neglected or careless mistakes are made in schoolwork, work, or other activities
- Often has trouble drawing attention to tasks or play activities
- Often times doesn’t seem to be listening when speaking to him directly
- Frequently failing to follow directions or finish schoolwork, term paper, or work at work (e.g., losing focus, being followed from the side).
- Often has problems organizing tasks and activities
- Often avoids, likes, or is reluctant to complete tasks that require long-term mental effort (such as schoolwork or homework).
- Frequently loses items necessary for assignments and activities (e.g. school supplies, pencils, books, tools, wallets, keys, paperwork, glasses, cell phones).
- Often easily distracted
- Often forgetful during daily activities
Hyperactivity / impulsivity
- Often fidgets or taps hands or feet or squirms in the seat
- Frequently leaves the seat in situations where it is expected to remain
- Often runs around or climbs in situations where it is not appropriate (teenagers or adults can limit themselves to feeling restless)
- Often unable to play quietly or take part in recreational activities
- Is often “on the move” and pretends to be “driven by a motor”
- Often speaks excessively
- Often an answer is blown out before a question has been answered
- Often struggles to wait for his turn
- Often interrupts or intrudes into others (e.g. bumping into conversations or games)
To meet the criteria for aADHD, a person must have five or more of the nine symptoms of inattention and / or hyperactivity / impulsivity. These symptoms must have persisted for at least six months.
You should also have experienced several inattentive or hyperactivity / impulsive symptoms by the age of 12. These symptoms should occur in two or more settings, including at home, school, or at work. But let’s not forget that ADHD first appears in adulthood. Finally, there should be a significant impairment of social, academic or professional functioning.
More important information …
- The prevalence of ADHD in childhood is 4-7%. It is believed that symptoms can persist into adulthood in 15-65% of cases. The prevalence rate of aADHD is 2.5%.
- People with ADHD tend to have poor self-esteem and decreased quality of personal and professional relationships. For example, they are twice as likely to be divorced.
- People with ADHD have higher rates of traffic violations, motor vehicle accidents, as well as emergency rooms and hospital admissions.
- About 80% of ADHD cases will have at least one other psychiatric disorder during their lifetime. A significant coexistence exists with mood and anxiety disorders as well as substance use disorders.
- aADHD tends to run in families.
How is ADHD treated in adults?
Ideally, given their significant coexistence with other psychiatric disorders, these disorders should be diagnosed and treated first. In this way, the best treatment for the core symptoms of ADHD can be selected.
Okay, medication is the first intervention in ADHD. Approved for use are stimulants such as amphetamines – amphetamine and salts (Dyanavel, Adderall, Mydayis, Adzenys), dextroamphetamine (Dexedrine, ProCentra, Zenzedi) and lisdexamfetamine (Vyvanse) – and methylphenidate – methylphenidate (Ritalin, Concertaphenidate, etc.) and dexmethylinidate ). The non-stimulating atomoxetine (Strattera) is also approved. Other drugs are prescribed off-label, such as modafinil (Provigil), guanfacine (Intuniv), venlafaxine (Effexor), bupropion (Wellbutrin), and desipramine (Norpramin).
The amphetamines and methylphenidate have been shown to be equally effective in treating aADHD, with about 70% of subjects reporting immediate improvement in core symptoms within an hour of administering the drug. However, it is important to mention that side effects and contraindications must be considered. Stimulants are also cClassified as Schedule II substances because of the potential for abuse – especially in those with a substance disorder.
And then there is therapy. Published studies show that cognitive behavioral therapy (CBT) is the most effective psychological treatment for aADHD. These include the comorbid symptoms of anxiety and depression.
My experience shows that medication alone is a tricky business for any psychological situation. Adding therapy is always a smart choice.
Time to move on
Even if there is still so much to review, we have to move on. But I’ll tell you what – you can read all of the information you want by reading the original article in the Psychiatric Times.
By the way, if you’re looking for a great screening tool, check out the Symptom Checklist for Adult ADHD Self-Reporting (ASRS-v1.1).
So adult attention deficit / hyperactivity disorder (aADHD): many things in common with mood and anxiety disorders. And so we have to be aware of it.
Yes, it’s possible.
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