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ADHD in Adults

ADHD is known to be a childhood disorder that affects 3-5 percent of all children. It is less known that many of the children with ADHD will continue to have the condition after they are fully grown. Recent studies estimate a percentage between 35 and 70 of the children who suffered from the attention deficit hyperactivity disorder will continue to show symptoms after they become adults.

Doctors Paul Wender, Frederick Reimherr, and David Wood were the first to show studies on adults with the symptoms of ADHD who were never diagnosed with this condition in their childhood, in the late 1970's. The specialists developed clinical criteria for diagnosing the ADHD in adults, what was known as the Utah Criteria. Nowadays, more diagnostic assessments are available: Conners Rating Scale, The Brown Attention Deficit Disorder Scale, etc.

Adults are usually not aware of their disorder. the impossibility of sticking to a job, of keeping an appointment, of getting organized, is just a strange feeling; getting up, getting dressed and getting to work on time can be a real challenge for adults with ADHD.

Diagnosing Adults with ADHD Condition

Diagnosing adults with ADHD condition is not an easy task. When a child is diagnosed with ADHD, a parent may also recognize some of the child's symptoms and begin to understand, for the first time, few of the traits that gave him or her trouble for years: distractibility, impulsivity, restlessness. The disorder's symptoms also commonly confused with depression or anxiety and after professional help is sought in this matter, they will discover that the root cause of some of their emotional problems is ADHD. They may have a history of school failures or problems at work or have been frequently involved in car accidents.

For obtaining a correct ADHD diagnosis, which is very important and should be made by a clinician with expertise in the area of attention dysfunction, an adult's symptoms must persist since childhood. A history of the patient's behavior in childhood, together with an interview with his life partner, a parent, close friend, or other close associate, is required. Physical and psychological tests should also be taken. Comorbidity with other conditions may exist such as anxiety, affective disorders or specific learning disabilities. The correct diagnosing of ADHD can bring a sense of relief. The adult may have created many negative ideas of himself that led to low esteem ever since childhood but it is just now that he begins to understand the causes for some of his problems and can begin to face them. This can provide both treatment for ADHD and psychotherapy that can help him to succeed in dealing with the anger he feels about the failure to diagnose the disorder in childhood.

The Treatment for Adults with ADHD

Medications. As in the case of children, the medication for ADHD in adults often starts with a stimulant medication. The stimulant medications affect the regulation of two neurotransmitters, norepinephrine and dopamine. The newest medication approved for ADHD by the FDA, has been tested in controlled studies in both children and adults and has been found to be effective is Atomoxetine (Strattera).

As a second choice for treatment of adults with ADHD antidepressants are taken into consideration. The tricyclics, older antidepressants, are sometimes used because they, like the stimulants, affect norepinephrine and dopamine. A newer antidepressant, is also used for its effect on norepinephrine Venlafaxine (Effexor). Bupropion (Wellbutrin), an antidepressant with an indirect effect on the neurotransmitter dopamine, has been useful in clinical trials for treating both children and adults suffering from the ADHD condition. It has also been proved to reduce the necessity of smoking.

Special considerations are made in prescribing for an adult due to difference of effects. In an adult, less of the medication may be needed for his weight, a medication may have a longer "half-life". Some adults may take other medications for physical problems, diabetes or high blood pressure. A medication for anxiety or depression is also taken by adults often, so, before prescribing to an adult, many variables must be taken into consideration.

Psychotherapy and Education. Although medication gives support, the individual must succeed on his own. Individual psychotherapy and "psychoeducation" can be helpful in this battle. Professional help for the ADHD adult can teach him to organize his life by using "props", a large calendar placed where it can be seen in the morning, lists, reminder notes, date books, a special place for keys, bills, and the paperwork of daily life. Organizing tasks into sections, so that completion of each part can give a sense of achievement. And first of all, learning as much as they can about the disorder that affects them.

Medication and education are very well completed by psychotherapy. Remembering small things for the beginning, as keeping an appointment with the therapist will turn to a routine. The low esteem feeling can be overcome by studying the experiences that led to it through therapy. The changes brought by treatment: the loss of impulsivity and love of risk-taking, the process of thinking before acting will be encouraged by the therapist.

Step by step, small successes will appear into the patient's life by the changes that took place showing improvement and so an opportunity of enjoying some of the ADHD's characteristics as warmth, enthusiasm, energy.