You can’t seem to finish anything at work, even as your colleagues breeze through their projects and assignments. You are constantly losing your cellphone, wallet, keys and other important items, and you often feel restless, especially during long meetings.
Sound familiar? If so, you are not alone.
Those are some of the symptoms of adult attention deficit hyperactivity disorder (ADHD), which affects about 10 million adults, according to the national nonprofit group Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). While ADHD is often thought of as a children’s disorder, it can and does affect adults. If you suspect you have adult ADHD, symptoms may have been present when you were a child, but perhaps they were mild and were missed by teachers or family members. This is why many adults with ADHD don’t know they have it, notes the American Psychiatric Association (APA). In addition, more than 75 percent of children with ADHD will still have symptoms as adults, CHADD points out.
Exactly what causes ADHD is not fully understood, but genetics may play a role. In addition, certain environmental factors, namely exposure to lead, may increase risk of developing ADHD. If your mother smoked, drank alcohol, used drugs or was under extreme stress while she was pregnant, you may also be more likely to be diagnosed with ADHD, CHADD says. Babies who were born prematurely are also at heightened risk for ADHD, according to the group. Younger moms who gave birth between the ages of 16 and 25 are more likely to have kids with ADHD, according to a study published in August 2019 in Scientific Reports, a Nature Publishing Group journal. The risk of having a child with ADHD was particularly high among women who gave birth when they were younger than 20, the study showed.
Left undiagnosed and untreated, ADHD in adults has been linked to depression, mood disorders, substance abuse and problems at work or home. What’s more, CHADD explains that adults with ADHD are more at risk of engaging in risky behaviors. Adults with ADHD were shown to be more likely to be in a serious car crash, according to a study published in March 2014 in JAMA Psychiatry.
These consequences can be largely prevented with proper ADHD treatment, and the first step is to get an ADHD diagnosis, according to CHADD.
Adult ADHD diagnosis
There is no definitive blood test that says “you have ADHD.” Instead, adult ADHD is a diagnosis based on your symptoms, how long you have had these symptoms and how these symptoms affect your everyday life. Your doctor or therapist may want to speak with your partner, close family members or colleagues to get a better picture of what is going on at home and work, CHADD notes. Many other conditions may mimic the symptoms of ADHD, including depression, anxiety and thyroid diseases, according to the National Institute of Mental Health. For these reasons, your doctor may order psychological testing for ADHD to rule out these conditions. More than two-thirds of people with ADHD may also have at least one other co-existing condition, according to CHADD.
Tests that evaluate your memory, executive functioning (which includes planning and decision-making) and your visual and spatial skills can also help establish a correct diagnosis of ADHD and any other conditions, CHADD says.
You may be asked to review an ADHD symptom checklist, such as the Adult ADHD Self-Report Scale (ASRS-v1.1), to give your doctor a better idea of what is going on. This expert-approved screening tool includes six questions that are ranked on a scale of 0 to 4:
- How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
- How often do you have difficulty getting things in order when you have to do a task that requires organization?
- How often do you have problems remembering appointments or obligations?
- When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
- How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
- How often do you feel overly active and compelled to do things, like you were driven by a motor?
Your answer choices are "never," "rarely," "sometimes," "often" and "very often." If you have four checks in the sometimes, often or very often categories, you may have ADHD and should talk to a doctor, the World Health Organization says.
A word of caution about tests on the internet: There are many out there, but most are not standardized or validated and should not be used to diagnose you or someone else with ADHD, CHADD says. The user should beware when it comes to adult ADHD testing online and other ADHD self-tests.
Adult ADHD diagnosis
The guidelines for diagnosing ADHD were developed by the American Psychiatric Association and appear in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
There are three main types of ADHD in adults:
1. ADHD predominantly inattentive type
An adult with this type of ADHD must have five or more of the following symptoms:
- Difficulty paying attention to details
- Habitual careless mistakes
- Problems with sustaining attention, especially during lectures or drawn-out meetings
- Poor follow-through
- Organizational challenges
- Avoidance of tasks requiring sustained attention
- Misplacing important items
- Easily distractible
- Forgetful when it comes to paying bills, keeping appointments or returning calls
These symptoms must occur for at least six months and disrupt home or work life for an ADHD inattentive type diagnosis to be made.
2. ADHD predominantly hyperactive-impulsive type
An adult with this type must have five or more of the following symptoms:
- Inability to remain seated
- Extreme restlessness
- Difficulty engaging in activities quietly
- Feeling like they are driven by a motor or are revved up
- Talks constantly
- Shouts out answers before a question has been asked
- Impatient when waiting or taking turns
- Interrupts others often
As with ADHD inattentive type, these symptoms must also occur for at least six months and disrupt home or work life to establish a diagnosis of ADHD predominantly hyperactive-impulsive type.
3. Combination type
An adult with this type of ADHD must have symptoms for both inattention and hyperactive-impulsive types of ADHD, the Centers for Disease Control and Prevention (CDC) explains.
It’s also important that these symptoms occur in two or more settings, such as at home and work or home and social interactions. Adult ADHD symptoms must also be present since age 12, the APA says.
In addition, adult ADHD is also classified as mild, moderate or severe. If you are diagnosed with severe ADHD, it means that more than five symptoms are present or multiple symptoms are severe or your symptoms dramatically affect life at home, school, work and/or social settings.
Final words on adult ADHD
For any adult with ADHD, it's important to remember that treatment can help change your life. ADHD in adults responds well to behavioral therapy, medication or a combination of both, CHADD says. Stimulants and non-stimulants are the two main types of medication used to treat ADHD. Treatment goals for adult ADHD include improving function at work, at home and in relationships. CHADD notes that many adults with ADHD may benefit from a coach who helps them learn to perform activities of daily life in a more organized way.
If you suspect that you or another adult in your life has ADHD, a proper diagnosis and treatment can make a world of difference for everyone involved.
- CHADD, Adult Overview https://chadd.org/for-adults/overview/
- APA, What is ADHD https://www.psychiatry.org/patients-families/adhd/what-is-adhd.
- CHADD, ADHD Day Planners https://chadd.org/wp-content/uploads/2018/05/Time-Management-ADHD-Day-Planners.pdf
- Nature’s Scientific Reports, The genetic relationship between female reproductive traits and six psychiatric disorders https://www.nature.com/articles/s41598-019-48403-x
- JAMA Psychiatry, Serious transport accidents in adults with ADHD, and the effect of medication: A population-based study https://www.ncbi.nlm.nih.gov/pubmed/24477798
- CHADD, Diagnosing ADHD https://chadd.org/about-adhd/diagnosing-adhd/
- NIMH, Could I Have ADHD? https://www.nimh.nih.gov/health/publications/could-i-have-adhd/index.shtml
- CHADD, Coexisting Conditions https://chadd.org/about-adhd/coexisting-conditions/
- Harvard University, Adult ADHD Self-Report Scale (ASRS-v1.1) https://www.hcp.med.harvard.edu/ncs/ftpdir/adhd/6Q_ASRS_English.pdf
- CDC, ADHD Diagnosis https://www.cdc.gov/ncbddd/adhd/diagnosis.html
- CHADD, Adult Treatment https://chadd.org/for-adults/treatment/