Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder diagnosed in childhood or adulthood; however, many people with ADHD aren’t diagnosed until later in life, if ever. Key components of the disorder are trouble concentrating, fidgeting, procrastination, and impulsive behavior. While many children and adults experience some variation of these symptoms, those with ADHD usually don’t outgrow them.1
Signs & Symptoms of Adult ADHD
For an adult to be diagnosed with ADHD, there must have been significant symptomatology that began in childhood before the age of twelve. Because of this, it can be difficult to get an ADHD diagnosis as an adult if you’re not able to accurately recall childhood symptomatology.
There are three key presentations of ADHD. Depending on the adult’s ADHD symptoms, their ADHD diagnosis will contain one of the following specifiers:
- Predominantly hyperactive/impulsive presentation
- Predominantly inattentive presentation
- Combined presentation
While the underlying symptoms of ADHD remain the same from childhood into adulthood, the expression of these symptoms tends to change as the individual ages. In other words, inattention, impulsivity, and/or hyperactivity will usually remain present from childhood into adolescence and adulthood. The difference will be in the way that these symptoms manifest, and someone may have learned ways to be “high-functioning” and mask their ADHD symptoms in adulthood.
Hyperactive/Impulsive
For diagnosis of a hyperactive/impulsive presentation in adults, at least five of these symptoms must be present:2
- Fidgets, taps hands or feet, squirms in the seat
- Leaves seat when remaining seated is expected
- Runs about or climbs when not appropriate
- Unable to engage in leisure activity quietly
- Is often “on the go,” acting as if “driven by a motor”
- Talks excessively
- Blurts out an answer before a question has been completed
- Difficulty waiting his/her turn
- Interrupts or intrudes on others
Inattentive
For diagnosis of an inattentive presentation, at least five of these symptoms must be present:2
- Fails to give close attention to details, makes careless mistakes
- Difficulty sustaining attention in tasks
- Does not seem to listen when spoken to directly
- Does not follow through on instructions and fails to finish schoolwork, chores, or work assignments
- Difficulty organizing tasks and activities
- Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
- Loses things necessary for tasks or activities
- Easily distracted by extraneous stimuli
- Forgetful of daily activities
How these inattentive symptoms may look in adults:3
- Procrastinating important work assignments
- Disorganized or messy work and home environments
- Financial risk-taking behaviors
- Poor time management and time blindness
- Problems focusing on tasks, easily sidetracked
- Mood swings
- Irritability or low frustration tolerance
- Inability to complete tasks, often starting but rarely finishing tasks
- Unable to multitask
- Restlessness or fidgeting
These symptoms provide the basis of an ADHD diagnosis. Other factors, such as length/duration and severity of symptoms are also considered. Many people may have some or many of the symptoms without meeting the complete criteria for a diagnosis.
Do Women Experience Adult ADHD Differently Than Men?
While ADHD is more prominent in males than females, females are more likely to present with inattentive vs. hyperactive features. Because hyperactivity is easier to recognize, there may be an under-reporting of female cases.2 Studies also suggest that women with ADHD are more likely to experience depression and anxiety as well as low self-esteem. Plus, they tend to focus less on fixing existing problems and more on compensating for unfinished or forgotten tasks.4
Challenges of Adult ADHD
Challenges of ADHD can occur within the realm of work/school life, social life, and home life. Note that symptoms can change over time, aren’t always present, and vary from setting to setting. Symptoms may also lessen or be less noticeable when the individual is receiving praise, engaged in activities they find interesting, interacting one-on-one, or having consistent external stimuli (phone, tv, video games, etc.).2
Issues At Work/School
Because of issues related to inattention and focus, those with ADHD often struggle with organization, prioritization, procrastination, and task completion. This leads to poor occupational performance, attainment, and attendance, as well as higher rates of unemployment. Those who are unfamiliar with the signs and symptoms of ADHD often misinterpret these individuals as lazy, irresponsible, and uncooperative.2
Impact On Relationships
Because ADHD is associated with reduced behavioral inhibition and other inappropriate social behaviors, social relationships are often more difficult for people with ADHD. They can have difficulty maintaining relationships and are more prone to elevated interpersonal conflicts.
Adult ADHD & Potential Substance Use
Many people with ADHD try to self-medicate, meaning they use drugs (legal or illegal) and/or alcohol in an attempt to alleviate, mask, or numb their symptoms. Young adults with ADHD are more likely to abuse alcohol than those without. Due to decreased inhibition and lack of impulse control, they are also more likely to start abusing alcohol and drugs at an earlier age, although genetics can play a role as well.5
Typically, adults with untreated ADHD are much more susceptible to engaging in substance abuse and other behaviors that would lead to legal issues and incarceration than those who are diagnosed and receive treatment.6
Treatment of Adult ADHD
Treatment for adult ADHD can be divided into two categories: therapy and medication. Problems with attention/focus and impulsivity/hyperactivity can be greatly helped with proper medication usage. However, other aspects like organizational skills and procrastination are generally better managed with psychotherapy and behavior modification training.
Therapy
Common types of therapies used to treat adult ADHD include:
- Behavior therapy: Organizational skills, time management, social skills, and healthy lifestyle changes
- Psychotherapy: Helps with stress and anxiety reduction, processing thoughts and emotions, and developing coping skills
Medication
Common medications used to treat adult ADHD include:7
- Stimulants: Medications that stimulate the central nervous system are the most commonly prescribed treatment for ADHD. They work by increasing dopamine and norepinephrine in the brain.
- Non-stimulants: Some non-stimulant medications also work by increasing norepinephrine in the brain. There are other non-stimulant medications that can treat ADHD, though the reason they work isn’t fully known; however, research suggests that they aid certain chemicals in the brain associated with memory and attention.
Note that you should always discuss your symptoms and medical history with your prescribing doctor to determine whether stimulants or non-stimulants are the best treatment for you.
Common side effects of ADHD medication include:
- Trouble sleeping
- Loss of appetite, stomach upset, weight loss
- Nervousness, irritability
- Headaches
- Dry mouth
More serious side effects include:
- Hallucinations
- Increased blood pressure
- Seizures or allergic reactions
- Suicidal ideations
Your doctor can prescribe ADHD medications, but because stimulant medications are a controlled substance, many general practitioners will refer you to a psychiatrist for diagnosis and medication management. Regular medication management checkups will also be required for prescription refills.
How to Get Help for Adult ADHD
If you think you may have adult ADHD, talk with your doctor about your symptoms. They can either evaluate you themselves or refer you to a specialist. You can also contact a mental health professional, such as a psychologist or licensed counselor. These individuals usually have referrals for psychiatrists if you decide to consider medication along with psychotherapy.
If you suspect you may have some symptoms associated with ADHD but are unsure whether you meet criteria for a diagnosis, therapy can still be beneficial to treat the symptoms. There are also many self-help books available on the topic of ADHD in adults and its associated symptoms (organizations skills training, social skills development, etc.).
Self-Help Strategies For Managing Adult ADHD
To help manage ADHD symptoms, there are a number of simple, everyday practices that focus on organizational and time management skills as well as lifestyle changes.
Six of these helpful strategies include:
- Create a routine that follows a set schedule
- Get organized and maintain organization daily: have designated spots for things like school/work supplies, shoes, clothing, wallet and keys, etc.
- Manage distractions by learning what background noises impede attention and what may help, such as movement or music
- Take breaks when completing long tasks and try to break down long or complicated tasks into shorter, more manageable ones
- Search for and create positive opportunities: identifying ways in which you excel can help create positive experiences
- Maintain a healthy lifestyle: eating nutritious foods and getting regular physical exercise are an important part of overall health and can have a positive impact on ADHD symptoms
Adult ADHD & Co-Occurring Mental Health Concerns
One of the biggest concerns for people with ADHD is the co-occurrence of other mental health disorders. In fact, the majority of those diagnosed with ADHD are also diagnosed with a second or third co-occurring disorder. Only a trained healthcare professional can evaluate and diagnose these disorders.
Common disorders that co-occur with ADHD include:2
- Generalized anxiety disorder
- Social anxiety disorder
- Major depressive disorder
- Intermittent explosive disorder
- Oppositional defiant disorder
- Substance use disorders
- Personality disorders
- Obsessive-compulsive disorder
- Tic disorder
- Autism spectrum disorder
Adult ADHD Tests, Quizzes, & Self-Assessment Tools
There are many tests and diagnostic measures used by doctors and therapists to aid in diagnosing ADHD. Each test is evaluating symptomology based on the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
With modern technology, there are also different online tests readily available to the general public to aid in assessing ADHD in adults. Connected Mind offers a free screening tool that assesses multiple mental health concerns like depression, anxiety, and ADHD. Of course, these tools cannot provide a diagnosis and should only be used as a starting point. Talk with your doctor or a mental health provider if you believe you have ADHD.
Final Thoughts on ADHD in Adults
What you are dealing with may be unique to you, but you are not alone. Talking to a therapist or reaching out to a trusted friend or family member can make a positive difference. Don’t be afraid to seek help. If you want to start your search for a mental health professional, consider using an online directory.
Adult ADHD Infographics
