ADHD

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Attention deficit hyperactivity disorder

Adult attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity and impulsive behavior. Adult ADHD can lead to unstable relationships, poor work or school performance, low self-esteem, and other problems.
Though it’s called adult ADHD, symptoms start in early childhood and continue into adulthood. In some cases, ADHD is not recognized or diagnosed until the person is an adult. Adult ADHD symptoms may not be as clear as ADHD symptoms in children. In adults, hyperactivity may decrease, but struggles with impulsiveness, restlessness and difficulty paying attention may continue.
Treatment for adult ADHD is similar to treatment for childhood ADHD. Adult ADHD treatment includes medications, psychological counseling (psychotherapy) and treatment for any mental health conditions that occur along with ADHD.

Symptoms

Attention deficit hyperactivity disorder, or ADHD, is a medical condition that occurs due to differences in brain development and activity. Also sometimes called attention deficit disorder (ADD), it can be present in both children and adults, but issues tend to arise during childhood, which is the point where an ADHD diagnosis is usually made.
Many adults with ADHD aren’t aware they have it — they just know that everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.
Adult ADHD symptoms may include:

What's typical behavior and what's ADHD?

Almost everyone has some symptoms similar to ADHD at some point in their lives. If your difficulties are recent or occurred only occasionally in the past, you probably don’t have ADHD. ADHD is diagnosed only when symptoms are severe enough to cause ongoing problems in more than one area of your life. These persistent and disruptive symptoms can be traced back to early childhood.
Diagnosis of ADHD in adults can be difficult because certain ADHD symptoms are similar to those caused by other conditions, such as anxiety or mood disorders. And many adults with ADHD also have at least one other mental health condition, such as depression or anxiety.

When to see a doctor

If any of the symptoms listed above continually disrupt your life, talk to your doctor about whether you might have ADHD.
Different types of health care professionals may diagnose and supervise treatment for ADHD. Seek a provider who has training and experience in caring for adults with ADHD.

Causes

While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include:

Risk factors

Risk of ADHD may increase if:

Complications

ADHD can make life difficult for you. ADHD has been linked to:

Coexisting conditions

Although ADHD doesn’t cause other psychological or developmental problems, other disorders often occur along with ADHD and make treatment more challenging. These include:

Diagnosis

Signs and symptoms of ADHD in adults can be hard to spot. However, core symptoms start early in life — before age 12 — and continue into adulthood, creating major problems.
No single test can confirm the diagnosis. Making the diagnosis will likely include:

Physical exam, to help rule out other possible causes for your symptoms

Information gathering, such as asking you questions about any current medical issues, personal and family medical history, and the history of your symptoms

ADHD rating scales or psychological tests to help collect and evaluate information about your symptoms

Other conditions that resemble ADHD

Some medical conditions or treatments may cause signs and symptoms similar to those of ADHD. Examples include:
  • Mental health disorders, such as depression, anxiety, conduct disorders, learning and language deficits, or other psychiatric disorders
  • Medical problems that can affect thinking or behavior, such as a developmental disorder, seizure disorder, thyroid problems, sleep disorders, brain injury or low blood sugar (hypoglycemia)
  • Drugs and medications, such as alcohol or other substance misuse and certain medications

Treatment

Standard treatments for ADHD in adults typically involve medication, education, skills training and psychological counseling. A combination of these is often the most effective treatment. These treatments can help manage many symptoms of ADHD, but they don’t cure it. It may take some time to determine what works best for you.

Medications

Talk with your doctor about the benefits and risks of any medications.
  • Stimulants, such as products that include methylphenidate or amphetamine, are typically the most commonly prescribed medications for ADHD, but other medications may be prescribed. Stimulants appear to boost and balance levels of brain chemicals called neurotransmitters.
  • Other medications used to treat ADHD include the nonstimulant atomoxetine and certain antidepressants such as bupropion. Atomoxetine and antidepressants work slower than stimulants do, but these may be good options if you can’t take stimulants because of health problems or if stimulants cause severe side effects.
The right medication and the right dose vary among individuals, so it may take time to find out what’s right for you. Tell your doctor about any side effects.

Psychological counseling

Counseling for adult ADHD generally includes psychological counseling (psychotherapy), education about the disorder and learning skills to help you be successful.
Psychotherapy may help you:
  • Improve your time management and organizational skills
  • Learn how to reduce your impulsive behavior
  • Develop better problem-solving skills
  • Cope with past academic, work or social failures
  • Improve your self-esteem
  • Learn ways to improve relationships with your family, co-workers and friends
  • Develop strategies for controlling your temper
Common types of psychotherapy for ADHD include:
  • Cognitive behavioral therapy. This structured type of counseling teaches specific skills to manage your behavior and change negative thinking patterns into positive ones. It can help you deal with life challenges, such as school, work or relationship problems, and help address other mental health conditions, such as depression or substance misuse.
  • Marital counseling and family therapy. This type of therapy can help loved ones cope with the stress of living with someone who has ADHD and learn what they can do to help. Such counseling can improve communication and problem-solving skills.

Working on relationships

If you’re like many adults with ADHD, you may be unpredictable and forget appointments, miss deadlines, and make impulsive or irrational decisions. These behaviors can strain the patience of the most forgiving co-worker, friend or partner.
Therapy that focuses on these issues and ways to better monitor your behavior can be very helpful. So can classes to improve communication and develop conflict resolution and problem-solving skills. Couples therapy and classes in which family members learn more about ADHD may significantly improve your relationships.
(Mayoclinic.org, 2024)
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