Understanding adult ADHD

ADHD (attention deficit hyperactivity disorder) is a well-known disorder, but most people will associate it with children who are unable to focus at school. However, ADHD is much more than this, and it is a disorder that can continue on into adulthood. Dr Lars Davidsson, a leading psychiatrist, explains how ADHD affects adults and how getting a diagnosis can really transform the lives of those living with this condition.

How does ADHD affect adults?

ADHD in adults can express itself in many different ways. People will usually say they have difficulty focusing and concentrating, or they might be spending a lot of time procrastinating and are unable to end projects or work tasks on time. They may easily find themselves doing completely different things, have racing thoughts and are not be able to relax easily. Some adults with ADHD have interests in extreme sports, like bungee jumping, that gives them a rush of adrenaline which makes them feel better temporarily. However, these interests can get people into difficulties, such as car accidents. Interestingly, adults with untreated ADHD have higher incidences of traffic accidents, less job stability and higher rates of divorce.

Adults will often come to see a specialist because something in their lives has gone wrong, for example, they may have had ongoing problems at work where they have been criticised for not meeting deadlines, or they have been unable to hold down a job because of such problems. It is not surprising that experiencing these problems can be tiring, which ultimately encourages people to seek help and to find a solution.

What are the main symptoms of adult ADHD?

The symptoms of adult ADHD can be divided into those of inattentiveness and hyperactivity and impulsivity.

Inattentiveness:

• Easily distracted
• Easily bored
• Poor at decision-making
• Easily stressed
• Unorganised

Hyperactivity and impulsivity:

• Find it difficult to relax
• Make impulsive decisions
• Spend money impulsively
• Fail to complete tasks
• Have poor relationships
• Restlessness

Can ADHD cause anxiety?

There is a link between adult ADHD and other mental health disorders, such as anxiety. Interestingly, many adults who seek an ADHD diagnosis often do so after seeing a psychiatrist about other mental health disorders. Many adults with ADHD also have symptoms of anxiety and mood disorders, but after having ADHD treatment, these symptoms will often resolve. Symptoms such as low self-esteem and feeling useless, which are indicative of mood disorders and anxiety, can proliferate in adults with ADHD because their ADHD is holding them back, both professionally and personally, which leads to the aforementioned feelings.

How is ADHD diagnosed and treated in adults?

In line with NICE guidelines, diagnosing ADHD in adults relies on a validated clinical questionnaire, which is often a computerised test, and a full medical and mental health history assessment. Based on these, if ADHD is diagnosed in adults the following treatments are indicated:

• First line treatments – medication, such as lisdexamfetamine, is recommended for adults whose ADHD is causing them significant impairment.
• Second line treatments – cognitive behavioural therapy (CBT) can help adults with ADHD. CBT can help adults with ADHD to have a better way of thinking about their difficulties and structuring their lives.
• Third line treatments – patients may consider having ADHD coaching to help them to cope better and to manage their ADHD.

To complement the above, many adults with ADHD find practising mindfulness to be very helpful.

Can adults suddenly get ADHD?

ADHD is ultimately a childhood disorder which, over time, gets better. It used to be mainstream thinking that childhood ADHD disappeared after the age of 18 and there was no such thing as adult ADHD. However, this view of ADHD has been discarded and now we see adult ADHD as the continuity of childhood ADHD. Therefore, ADHD is not something that adults can suddenly develop, which is what we currently understand of this condition.

Do you think technology, such as smartphones, play a role in adult ADHD or can make it worse?

Technologies, such as smartphones are, in many ways, making our lives more fragmented and stressful. With smartphones, a lot of us are nearly always available and approachable. On the other hand, smartphones provide tools which can be very helpful in organising our busy lives. For example, phone calendar apps can be a great tool for us to better structure our lives, and the same benefits can be said for adults with ADHD.

The most important thing to take away about adult ADHD is that it is a good thing to seek treatment as treatments are available. Furthermore, these treatments have shown great success with up to 80% of patients with adult ADHD getting better following treatment, which is much better than other mental health conditions.

If you are concerned about your mental health or worry that you might be affected by ADHD, make an appointment with an expert.