Attention deficit hyperactivity disorder - adults

Attention deficit hyperactivity disorder (ADHD) is a common behavioural disorder that affects around one in 20 adults, mainly men. Until recently, scientists thought that children outgrew ADHD during adolescence, due to developmental changes in their brain chemistry. But now they believe that seven out of 10 children with ADHD will mature into adults with ADHD.

A person with ADHD has difficulty paying attention, controlling impulsive behaviours and keeping their thoughts on track.

Symptoms of ADHD

A person with ADHD may:

• Have unpredictable mood swings
• Make careless mistakes at work
• Find it hard to sustain attention in work or leisure
• Not seem to listen when spoken to directly
• Not follow instructions or finish tasks
• Find it hard to organise tasks and activities
• Avoid sustained mental effort in work
• Lose things like keys, paperwork and things needed for tasks
• Be easily distracted by other stimuli
• Be forgetful in daily activities
• Fidget with hands or feet, or squirm in their seat
• Find it hard to remain seated
• Constantly run to do things
• Be impatient
• Have trouble doing things quietly
• Talk excessively
• Blurt out things without thinking
• Have trouble waiting their turn in queues and other such situations
• Butt into conversations or other activities.

ADHD and quality of life

ADHD affects a person’s quality of life. They may find it difficult to maintain relationships or keep a job. If their condition was undiagnosed and untreated in childhood, they may have done badly in school. A lifetime of grappling with this behavioural disorder often means the person has low self-esteem.

Some people with ADHD turn to drugs or alcohol to try and cope with their feelings of frustration and failure. People with ADHD are more likely to have personality disorders and other psychological problems, such as anxiety or mood disorders. On the other hand, an adult with properly managed ADHD often shows great imagination and creative flair.

Causes of ADHD

Despite intensive research, we do not know the exact cause of ADHD. Possibly, it is caused by structural and chemical differences in the brain. One theory is that a lack of a particular group of brain chemicals, called monoamines, may play a part. The fact that some people can manage their ADHD with medication suggests that brain chemicals are at least partially involved.

Diagnosis of ADHD

It is important to obtain an accurate diagnosis. Symptoms of ADHD can be similar to symptoms of anxiety, depression or other mental illness. There is no single test to see whether or not a person has ADHD.

A typical investigation might include:

• Ruling out other psychological problems that have similar symptoms to ADHD
• Ruling out alcohol or drug abuse that might be causing the symptoms (although a person with ADHD may also have alcohol or drug problems)
• Rating the person’s current behaviour and lifestyle
• Checking back to see if the person showed ADHD symptoms in childhood
• Interviewing family, friends, spouse (wife or husband) and others about the person’s behaviour
• Electroencephalograph (EEG) tests to check for abnormal brain wave patterns. This remains controversial, although some doctors find it useful in diagnosing ADHD.

Treatment for ADHD

Treatment depends on how severe the person’s disorder is, but can include:

• Education – to help the person understand and better manage their condition
• Lifestyle improvement – such as cutting back or quitting drugs and alcohol, and taking up regular exercise
• Medication – psychostimulant medications are used
• Psychotherapy – to address self-esteem problems or substance abuse
• Therapy – to teach anger management, organisational skills or social skills, depending on the needs of the individual
• Vocational counselling – to increase the person’s chances of success and satisfaction in the workplace
• Family therapy – when one family member has ADHD, the whole family needs support.
• Attention deficit hyperactivity disorder was once thought to affect only children, but symptoms can persist into adulthood.
• We do not know the cause, but problems with brain chemistry might play a part.
• Treatment may include medication, education and counselling.