Adult ADHD
Approximately 10 million adults have attention-deficit/hyperactivity disorder (ADHD). In early adulthood, ADHD may be associated with depression, mood or conduct disorders and substance abuse. Adults with ADHD often cope with difficulties at work and in their personal and family lives related to ADHD symptoms. Many have inconsistent performance at work or in their careers; have difficulties with day-to-day responsibilities; experience relationship problems; and may have chronic feelings of frustration, guilt or blame.
Individuals with ADHD may also have difficulties with maintaining attention, executive function and working memory. Recently, deficits in executive function have emerged as key factors affecting academic and career success. Executive function is the brain’s ability to prioritize and manage thoughts and actions. This ability permits individuals to consider the long-term consequences of their actions and guide their behavior across time more effectively. Individuals who have issues with executive functioning may have difficulties completing tasks or may forget important things.
The DSM-5 lists three presentations of ADHD—Predominantly Inattentive, Hyperactive-Impulsive and Combined. The symptoms for each are adapted and summarized below:
ADHD predominantly inattentive presentation
Fails to give close attention to details or makes careless mistakes
Has difficulty sustaining attention
Does not appear to listen
Struggles to follow through with instructions
Has difficulty with organization
Avoids or dislikes tasks requiring sustained mental effort
Loses things
Is easily distracted
Is forgetful in daily activities
ADHD predominantly hyperactive-impulsive presentation
Fidgets with hands or feet or squirms in chair
Has difficulty remaining seated
Runs about or climbs excessively in children; extreme restlessness in adults
Difficulty engaging in activities quietly
Acts as if driven by a motor; adults will often feel inside as if they are driven by a motor
Talks excessively
Blurts out answers before questions have been completed
Difficulty waiting or taking turns
Interrupts or intrudes upon others
ADHD combined presentation
The individual meets the criteria for both inattention and hyperactive-impulsive ADHD presentations.
These symptoms can change over time, so adults may fit different presentations from when they were children.
Several of the symptoms must have been present prior to age 12. This generally requires corroboration by a parent or some other informant. It is important to note that the presence of significant impairment in at least two major settings of the person’s life is central to the diagnosis of ADHD. Impairment refers to how ADHD interferes with an individual’s life. Examples of impairment include losing a job because of ADHD symptoms, experiencing excessive conflict and distress in a marriage, getting into financial trouble because of impulsive spending, failure to pay bills in a timely manner or being put on academic probation in college due to failing grades. If the individual exhibits a number of ADHD symptoms but they do not cause significant impairment, s/he may not meet the criteria to be diagnosed with ADHD as a clinical disorder.
A diagnosis of ADHD is determined by the clinician based on the number and severity of symptoms, the duration of symptoms and the degree to which these symptoms cause impairment in various areas of life, such as home, school or work; with friends or relatives; or in other activities. It is possible to meet diagnostic criteria for ADHD without any symptoms of hyperactivity and impulsivity. The clinician must further determine if these symptoms are caused by other conditions, or are influenced by co-existing conditions. Child-Testing specializes in diagnosing ADHD and other learning impairments in both children and adults needing accommodations (such as extended time for exams). Call us for a consultation (813) 468-6528.