Up to four percent of adult Americans have attention-deficit/hyperactivity disorder (ADHD), which is a mental health disorder that causes impulsivity and attention issues. However, the condition is thought to be severely undiagnosed.
The signs and symptoms of ADHD in adults are often overlooked entirely or misdiagnosed for another mental health condition. Left undiagnosed and untreated, ADHD in adults can cause an array of emotional, professional, social and behavioral problems.
ADHD doesn't spontaneously emerge later in life. According to Deborah Grossman, PsyD, a licensed clinical psychologist at Bryn Mawr Family Practice, part of Main Line Health, the ADHD symptoms were there all along but were never identified in people's childhoods. "The person has just gone through their life having never been identified as somebody with ADHD," Dr. Grossman says.
Typically, it's not until people start recognizing the symptoms and reach out to a mental health professional for a clinical evaluation that they get diagnosed with ADHD as an adult.
"ADHD can be diagnosed at any age. Though many adults get diagnosed in their 20s and 30s, some don't get diagnosed until they're in their 40s, 50s, 60s and beyond," says Dr. Grossman.
Here are the common signs of ADHD in adults
The signs of ADHD in adults vary from person to person. Some people will find it challenging to follow directions or remember information. Others may experience forgetfulness or struggle with concentration and organizational tasks. Many adults with ADHD have issues with time management skills, which can impact their ability to finish their work or show up on time to their commitments. Impulsivity is another sign of ADHD, which may cause people to interrupt others or stop listening to a conversation.
ADHD often goes hand in hand with mental health conditions like anxiety and depression. "There can be chronic boredom in folks with ADHD, along with difficulty controlling anger, low frustration tolerance, self-esteem issues and mood swings," says Dr. Grossman.
While adult men and women with ADHD experience similar symptoms, the presentation can differ. Women's ADHD symptoms tend to be more internal: they may overthink or develop intrusive thoughts, negative self-talk or insomnia. Men's ADHD symptoms, on the other hand, tend to be more external: they may appear hyperactive, aggressive or fidgety.
"Women tend to have more of those internal symptoms, whereas men often have more external symptoms," says Dr. Grossman.
How ADHD symptoms in adults impact quality of life
Untreated ADHD in adults can make life a lot more difficult. Research shows that, in general, people with ADHD experience less life satisfaction and enjoyment compared to people who don't have ADHD.
The symptoms, like forgetfulness and procrastination, can cause adults with ADHD to struggle at work or in school. ADHD is associated with lower performance at work, reduced occupational status, job instability and more frequent absences.
Having ADHD can also cause self-esteem issues, and the lack of confidence can cause setbacks in the workplace or in relationships. The risk-taking behaviors associated with ADHD in adults can lead to substance abuse, gambling, financial issues and unsafe sexual practices.
How ADHD in adults is diagnosed and treated
The diagnostic process for adults with ADHD involves undergoing a neuro-psychological evaluation by a mental health professional. The evaluation includes a detailed clinical interview in which patients open up about their ADHD signs and symptoms, including when they first began, how they developed and how they've impacted their lives.
The mental health provider will then conduct various tests to evaluate the patient's executive functioning skills, like working memory, time management, impulse control and organization. Those test results help the provider determine if the patient has ADHD.
Providers can then tailor a custom treatment plan for each patient. Medications, like amphetamine and methylphenidate, can alleviate symptoms of ADHD and boost functioning.
"There are many effective non-pharmaceutical options, too, which can be particularly helpful for those with co-morbid conditions like anxiety or depression," says Dr. Grossman.
Cognitive behavioral therapy (CBT), for example, can teach patients how to better manage their symptoms in their daily life. Research shows that CBT can help people change their behavioral patterns to improve their self-esteem, productivity and happiness.
Just because you weren't diagnosed with ADHD as a child doesn't mean you don't have the condition. Even if you've developed effective strategies to compensate for your attention difficulties, getting an official diagnosis can help you develop better coping skills and regain control of your health, and ultimately, your life.
If you have questions about the signs and symptoms of ADHD in adults, or if you are interested in being evaluated, look up a mental health provider in your area or ask your primary care provider for a recommendation.
Learn more about Deborah Grossman, PsyD
Learn more about behavioral health care at Mine Line Health
Learn about outpatient psychotherapy with Main Line HealthCare Behavioral Health Services
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