ADHD in Adults

ROBERT M. NEWELL, PH.D.

FORENSIC AND CLINICAL PSYCHOLOGY

Specializing in Behavioral Healthcare for Children &

Adolescents, Families, Couples, and Adults.

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ADHD IN ADULTS

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Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most frequently occurring disorders in children. In the past, it was commonly thought that many children with ADHD outgrew the disorder by the time they entered adulthood. However, in recent years, our understand of this disorder has increased substantially, and we now know that between 30 to 70% of children diagnosed with ADHD will continue to display symptoms into adulthood.

It is not unusual for adults with ADHD to be unaware that they have this disorder. They may express that they have a great deal of difficulty staying organized, staying on-task, or to keep appointments, but they may not associate these problems with their true cause—ADHD. Everyday tasks of waking up, getting dressed and ready for work, getting to work on time, and being productive on the job can be major challenges for the ADHD adult.

Diagnosing ADHD in an Adult

Obtaining an accurate diagnosis of ADHD can bring an individual a sense of relief. The individual has brought into adulthood many negative perceptions of himself that may have led to low esteem. Now he can begin to understand why he has some of his problems and can begin to face them. This may mean, not only treatment for ADHD but also psychotherapy that can help him cope with the anger he feels about the failure to diagnose the disorder when he was younger. Diagnosing an adult with ADHD is not easy. Many times, when a child is diagnosed with the disorder, a parent will recognize that he or she has many of the same symptoms the child has and, for the first time, will begin to understand some of the traits that have given him or her trouble for years—distractibility, impulsivity, restlessness. Other adults will seek professional help for depression or anxiety and will find out that the root cause of some of their emotional problems is ADHD. They may have a history of school failures or problems at work. Often they have been involved in frequent automobile accidents.

To be diagnosed with ADHD, an adult must have childhood-onset, persistent, and current symptoms. The accuracy of the diagnosis of adult ADHD is of utmost importance and should be made by a clinician with expertise in the area of attention dysfunction. For an accurate diagnosis, a history of the patient's childhood behavior, together with an interview with his life partner, a parent, close friend, or other close associate, will be needed. A physical examination and psychological tests should also be given. Comorbidity with other conditions may exist such as specific learning disabilities, anxiety, or affective disorders.

Treatment of ADHD in an Adult

Medications. As with children, if adults take a medication for ADHD, they often start with a stimulant medication. The stimulant medications affect the regulation of two neurotransmitters, norepinephrine and dopamine. Antidepressants are considered a second choice for treatment of adults with ADHD. In prescribing for an adult, special considerations are made. The adult may need less of the medication for his weight. A medication may have a longer "half-life" in an adult. The adult may take other medications for physical problems such as diabetes or high blood pressure. Often the adult is also taking a medication for anxiety or depression. All of these variables must be taken into account before a medication is prescribed.

Education and psychotherapy. Although medication gives needed support, the individual must succeed on his own. To help in this struggle, both "psychoeducation" and individual psychotherapy can be helpful. A professional coach can help the ADHD adult learn how to organize his life by using "props"—a large calendar posted where it will be seen in the morning, date books, lists, reminder notes, and have a special place for keys, bills, and the paperwork of everyday life. Tasks can be organized into sections, so that completion of each part can give a sense of accomplishment. Above all, ADHD adults should learn as much as they can about their disorder.

Psychotherapy can be a useful adjunct to medication and education. First, just remembering to keep an appointment with the therapist is a step toward keeping to a routine. Therapy can help change a long-standing poor self-image by examining the experiences that produced it. The therapist can encourage the ADHD patient to adjust to changes brought into his life by treatment—the perceived loss of impulsivity and love of risk-taking, the new sensation of thinking before acting. As the patient begins to have small successes in his new ability to bring organization out of the complexities of his or her life, he or she can begin to appreciate the characteristics of ADHD that are positive—boundless energy, warmth, and enthusiasm.

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DR. ROBERT M. NEWELL

Telephone: 509-910-0329

Email: mail@drrobertnewell.com

Website: www.drrobertnewell.com