Attention deficit hyperactivity disorder (ADHD) is not just something that affects children. About 10 million adults in the US have ADHD. Research indicates that adult ADHD is an under-diagnosed and under-treated condition, meaning that some adults will be living with untreated ADHD and the considerable personal burden that comes with that.
ADHD is a neurodevelopmental disorder that causes inattention, impulsivity and hyperactivity at levels that are inappropriate for the age of the person. It’s not clear exactly what causes ADHD, but it does tend to run in families.
Knowing the signs and symptoms of adult ADHD can help you to identify it in yourself and others.
ADHD types and symptoms
ADHD presents itself in three ways according to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5). The DSM-5 is a handbook that sets out the criteria healthcare professionals use to diagnose ADHD and other mental disorders. The three types of ADHD and their symptoms are listed in the table below.
|Presentations of ADHD||Symptoms|
Often people with predominantly inattentive ADHD:
Often people with predominantly hyperactive-impulsive ADHD:
Adult ADHD symptoms can look a little different to those seen in children
Many adults with ADHD are unaware they have the condition. The disruptive or hyperactive behaviors associated with childhood ADHD may be replaced by more subtle or slightly different symptoms in adults.
Adults with ADHD may:
- Find it impossible to get organized. Daily tasks like getting out of the house and to work on time may be difficult, for example
- Find it hard to stick with a job. An adult with ADHD may also find it’s difficult to be productive and get their work done, which can affect their ability to keep a job
- Find it difficult to remember and keep appointments
- Find it difficult to keep track of things, such as their keys and phone
- Find it difficult to listen to instructions and complete tasks
- Find it difficult to remember details
- Have a tendency to always resort to the ‘quick fix’
- Seem especially restless. In children hyperactivity may be evident in a busy child who runs about and climbs excessively, but in adults hyperactivity can present as restlessness
- Maintain a level of activity that wears other adults out
- Have multiple traffic accidents
- Have a history of problems at home, school and work. There may be a history of chronic underachievement at school and work
- Have a history of failed relationships
- Find they feel overwhelmed and have feelings of guilt, frustration and embarrassment
- Have difficulty controlling or regulating emotional responses (emotional dysregulation)
Can you develop ADHD as an adult?
ADHD is not something that suddenly develops as an adult. Several inattentive or hyperactive-impulsive symptoms must have been present before a person was 12 years of age to be diagnosed with ADHD at any age, according to the DSM-5.
ADHD affects 11 percent of school-age children, but symptoms follow as many as three-quarters of these children through into adulthood. About one-third of children diagnosed with ADHD will still have enough symptoms in their 20s to meet the full diagnostic criteria for ADHD.
ADHD is usually diagnosed in early childhood, but it’s also possible to receive a diagnosis in adolescence or adulthood if it was not picked up earlier. Symptoms may have been more subtle in childhood, but stress and the demands of adult life can mean that those same symptoms become more of an issue.
Females with ADHD often have less of the hyperactivity and disruptive symptoms and more of the inattentive ones, which can be less obvious. Females also tend to be better at developing strategies to mask their symptoms, which also means that ADHD can go undetected for longer.
Symptoms of ADHD can also change over time leading some people to believe they’d outgrown the condition, when in fact their symptoms had just changed.
How is ADHD in adults diagnosed
A range of healthcare professionals can diagnose adult ADHD including clinical psychologists, psychiatrists, neurologists, a family doctor or clinical social worker. As mentioned above, healthcare professionals use the diagnostic criteria set out in the DSM-5 to determine if a person has ADHD.
To be diagnosed with ADHD, adults and adolescents 17 years and older must have had at least five symptoms of a particular ADHD type present for the past 6 months, which is one less symptom than that required for a diagnosis in younger patients.
In addition to having the required number of symptoms, patients must also:
- Have had several symptoms be present before they were 12 years of age
- Have several symptoms be present in two or more settings. For example, having symptoms at home and work, or work and another activity
- Show that the symptoms interfere with or reduce the quality of their functioning at work, school, home and in social settings
- Not have another cause that better explains their symptoms
There is no blood test or scan that detects ADHD. Instead your healthcare provider may take a detailed history of how you function, use symptom checklists, conduct standardized behavior rating scales, and also ask questions of family and other important people in your life.
Your healthcare provider is also likely to conduct a thorough examination and tests to rule out the possibility another health complaint is responsible for the ADHD-type symptoms.
ADHD can exist alongside other conditions such as depression and anxiety - or even masquerade as them - which can make it difficult to recognize. ADHD-type symptoms can also be caused by stress, and lack of sleep and exercise, for example.
Online tests for ADHD are a starting point
Many sites provide online symptom checklists or questionnaires to help self-diagnose ADHD. These tests aren’t standardized or validated and don’t replace the need to see a healthcare professional.
That said, screening tools have been developed to help identify adults who may have ADHD, such as the Adult ADHD Self-Report Scale (ASRS) Version 1.1, which was developed by the World Health Organization (WHO). This can be used as a way to identify adults who may have ADHD, but it is not a diagnostic tool.
Untreated adult ADHD can have serious consequences
Untreated ADHD in adults can have a significant impact and result in serious consequences for those living with the condition.
It can impact all aspects of a person’s life, affecting home life, work and relationships. Untreated ADHD can cause a whole host of problems including job loss, stress and disruption, relationship failures and even lead to depression, mood or conduct disorders, substance abuse and risky behaviors.
Getting a diagnosis and appropriate treatment, which may include prescription medications, behavioral therapy or a combination of the two, is the key to helping overcome the difficulties associated with living with adult ADHD.
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