Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder meaning that growth and development of the brain and central nervous system (CNS) differ from that of the general population. ADHD affects the way you think, processes emotions, and respond to your environment.
ADHD is often diagnosed during childhood, with the symptoms such as distractibility, hyperactivity and inattentiveness typically becoming more evident in the school setting.
There are three different sub-types of ADHD, so the approach to treatment varies depending on the diagnosis a person is given as well as a range of other factors such as medical history and age.
Whatever stage of life a person is diagnosed with ADHD, there are a range of treatment options can help them manage symptoms effectively and live a fulfilling, successful life.
What is Attention Deficit Hyperactivity Disorder?
ADHD is a mental disorder, defined in the diagnostic and statistical manual 5 (DSM-5) as a persistent pattern of inattention and (or) hyperactivity or impulsivity that interferes with functioning or development.
Despite significant research into ADHD advancing our understanding of how the disorder affects different people, and the three subtypes that exist, many people still associate ADHD with hyperactive, loud children. In fact, not everyone with ADHD experiences such clear hyperactivity, and can in fact appear lazy or unmotivated to teachers or parents to misunderstand the behaviours of inattentive-type ADHD.
In recent years there’s been increasing recognition for the difference in symptoms presented by people with ADHD based on their sex. Research suggests that women are more likely to experience ADHD symptoms ‘in their head’ with males more likely to experience embodied symptoms – which are often the most obvious, pointing to the disparity in rates of diagnosis, with a male to female ratio of approximately 4:1. Although there has been a shift in popular discourse to better understand the complexity of ADHD symptoms and the expression of the disorder, a lot remains unknown.
Types of Attention Deficit Hyperactivity Disorder (ADHD)
There are three different sub-types of attention deficit hyperactivity disorder, each has it’s own set of symptoms and characteristic behaviours:
- Predominantly inattentive type – ADHD symptoms for inattentive type are generally the least obvious. People with inattentive type ADHD experience difficulty focusing, completing and organising tasks, following instructions and may be seen to make careless mistakes or regularly forget things.
- Predominantly hyperactive-impulsive – People hyperactive-impulsive type display symptoms that most people typically associate with ADHD. People with this type will often fidget and talk a lot, they may struggle to sit still, and instead remain moving or pacing, seeming restless and hyperactive. Impulsivity is also a significant aspect of this type, individuals may interrupt others, grab things from them, fidget, talk at inappropriate times and struggle to control their impulses.
- Combined type – This is the most common type of ADHD. Individuals diagnosed with this type display a combination of both inattentive and hyperactive-impulsive behaviours.
Adults With ADHD
It was previously thought that attention deficit hyperactivity disorder was a condition that only affected people in childhood. however recent evidence suggests that approximately 66% of people given an ADHD diagnosis in childhood report at least one ADHD symptom that causes clinically significant interference with functioning during adulthood.
ADHD Symptoms in Adults
Adult ADHD symptoms include difficulty with time management, memory, organization, emotional regulation. The symptoms of ADHD in childhood and in adulthood are similar, however the intensity of certain symptoms — especially hyperactivity — is decreases over time for many people. Adult ADHD symptoms include:
- Poor attention to detail
- Frequently losing items such as keys
- Difficulty getting started and completing tasks
- Making frequent mistakes or missing details at work or study
- Difficulty focusing and regulating attention
- Poor time management and organizational skills
- Frequent interrupting and excessive talking
- Emotional dysregulation
- Low tolerance for frustration
Treating ADHD in Adults
Whether diagnosed in childhood, adolescence or adulthood, attention deficit hyperactivity disorder is a treatable and manageable disorder. There are a range of modalities for treating ADHD and managing ADHD symptoms to assist you in living a more fulfilling, rewarding life.
The first step in treating attention deficit hyperactivity disorder is to diagnose a person with the disorder and determine which sub type they have. An ADHD diagnosis must be given by an appropriately qualified healthcare professional in order for certain treatment options to be considered. At this stage, it is common to be screened for other psychiatric disorders, as it is common for adults with ADHD to have comorbidities. Mental disorders such as depression, bipolar disorder mood disorders, personality disorders or substance misuse can disrupt ADHD treatment so must also be addressed.
In order to fully comprehend and asses how the symptoms affect your life and in order to give a diagnosis for ADHD, doctor will ask you several questions about your ability to carry out every day tasks such as paying bills, work meeting or shopping.
The doctor will screen for both inattentive type and impulsivity/ hyperactivity type ADHD using the diagnostic and statistical manual (DSM). A diagnosis for requires at least five symptoms to have been present for at least 6 months for adults;
Diagnostic Criteria for Inattentive:
- You often don’t give close enough attention to detail or make careless mistakes in at work, or in other activities
- You often struggle to hold attention on tasks or recreational activities
- You often seem as if you are not listening when spoken to directly
- You often don’t follow through on instructions and fail to complete errands, work, chores, or other duties
- You often struggle organizing tasks and activities
- You are often reluctant to engage in tasks that require mental effort over an extended period of time
- You often loose important items such as tools, bags, purses or wallets, keys, paperwork, phone, books, files and tickets
- You are regularly easily distracted
- You are regularly forgetful in day to day activities
Diagnostic Criteria for Hyperactivity and Impulsivity:
- You often fidget, tap with your hands and feet, or move about when sitting
- You often get up and leave your seat in situations when remaining seated is expected
- You often move around in situations where it is not appropriate or feel restless
- You often struggle to take part in recreational or leisure activities quietly
- You are often “on the go”, engaging in different tasks and activities
- You often talk in a way that is seen as excessive
- You often blurt out answers or responses before a question or statement has been made
- You often experience difficulty waiting your turn
- You often interrupt or intrudes on others, in conversations or other situations
Methods of Treating ADHD in Adults
Whether diagnosed in childhood or in adulthood, there are a range of approached to treat attention deficit hyperactivity disorder. ADHD medication can help the central nervous system regulate itself and alleviate some ADHD symptoms, while cognitive behavioural therapy can help adults with ADHD to create coping mechanisms and alter patterns of behaviour. The best treatment can often include a combination of different approaches.
ADHD Medication Treatment
While some people may display few or no ADHD symptoms, others can experience a variety of symptoms including impaired time management and impulsive behaviour that have a profound impact on their quality of life. Certain medications can be prescribed to adults with ADHD to help them manage ADHD symptoms and help them carry out tasks they often struggle with in everyday life.
The main kinds of ADHD medications are stimulants and nonstimulants.
Central Nervous System Stimulants
Central nervous system (CNS) stimulants are the most widely prescribed form of ADHD medication. Stimulant medication works by increasing dopamine and norepinephrine, two chemicals in the brain responsible for attention, action, reward, learning, and memory processes to name only a few.
For adults with ADHD, central nervous system stimulants produce a calming effect, resulting in reduced hyperactivity and improved attention span. As a result, concentration and focus are generally improved. This calming effect may seem paradoxical for stimulant medication, but is though to be linked to the lack of dopamine in the brains of adults with ADHD.
Common CNS stimulants used to treat ADHD include:
- Amphetamine-based stimulants such as Adderall, Dexedrine, DextroStat)
- Methylphenidate (Concerta, Daytrana, Metadate, Ritalin)
- Dextromethamphetamine (Desoxyn)
- Dexmethylphenidate (Focalin)
Non Stimulant Medications
Another form of attention deficit hyperactivity disorder medication is nonstimulant medications, these are most often considered when stimulants have not shown success in alleviating the core symptoms of ADHD, or in the case that stimulant ADHD medication causes difficult side effects.
Researchers are still working to reveal the full picture of why certain nonstimulant ADHD treatments work, but there is evidence to suggest they assist certain chemicals in the area of the brain involved with attention and memory.
Nonstimulant ADHD treatment medications include:
- Atomoxetine (Strattera)
- Guanfacine (Intuniv)
- Antidepressants like nortriptyline (Pamelor)
- Clonidine (Kapvay)
Therapy for Adults with ADHD
Attention deficit hyperactivity disorder treatment often works best when medication treatment is combined with talking therapy such as behavior therapy, family therapy and cognitive behavioral therapy. While medication for attention deficit hyperactivity disorder can often improve attention and concentration, people often still struggle with disorganisation, time management, forgetfulness, and procrastination— with are often the main issues that cause problems for most adults with ADHD. Cognitive behavioral therapy is thought to be one if the most effective methods for addressing these problems.
Cognitive Behavioral Therapy (CBT)
CBT is a talking therapy that can help you deal with the problems you are facing by shifting the way that you think and behave. For individuals with ADHD this generally takes two directions; the first being to address any negative patterns of thought that may have developed as a result of underachieving, failing to complete projects or generally being misunderstood and undervalued throughout your life. It is common for adults with attention deficit hyperactivity disorder to have developed a negative view of themselves and a low sense of self worth, and part of adult ADHD treatment involves addressing this. Secondly, cognitive behavioral therapy can help adults with ADHD to address the practical challenges of ADHD, and develop strategies to cope with the challenges of completing tasks that require long-term focus, concentration time management.
Marriage and Family Therapy
Marriage and family therapy provides an environment to address the issues that ADHD can cause or exacerbate in your relationships and family life. This may include conflicts or pain caused by a partners unmet needs – often linked to inattentive type, money problems (as a result of disorganisation or impulsivity), forgotten commitments or arrangements, not completing tasks, chores or responsibilities in the home, and making impulsive decisions. Family or couple therapy can help you and the people you care about share and explore these issues. Much like cognitive behavioral therapy, support from a therapist can help you to find constructive ways of dealing with these issues in the moment and create coping mechanisms and strategies to minimise the conflicts going forward.
The nature of attention deficit hyperactivity disorder means that it is common for people to develop other mental health conditions or even substance misuse problems as a result of being misunderstood or undervalued and struggling to control impulsive behaviors such a substance use. Impulsive behaviors can become dependencies and addictions are require specific theraputic treatment.
Relaxation techniques and mindfulness meditation training can be great forms of self-care and coping strategies for adults with attention deficit hyperactivity disorder.
At Addcounsel, we have a variety of treatment methods available. We understand how much attention deficit hyperactivity disorder can interfere will your life, including your career, relationships and mental heath. Our clinic takes a ‘whole person’ approach to treatment, focusing on the symptoms, triggers, and causes of your ADHD. A mental health professional will work with you to create a personalised treatment plan that considers other mental disorders you may have including anxiety disorders as well as the core symptoms of your ADHD. We treat adults with ADHD by designing a plan to help you manage and cope with your condition, so it doesn’t need to affect your day-to-day life.