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Adult ADHD (attention-deficit/hyperactivity disorder)
Attention-deficit/hyperactivity disorder (ADHD) has been called attention-deficit disorder (ADD) and hyperactivity. But ADHD is the preferred term because it includes the two main aspects of the condition: inattention and hyperactive-impulsive behavior.
Adult ADHD symptoms may include:
Many adults with ADHD aren't aware they have it — they just know that everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.
All adults with ADHD had ADHD as children, even if it was never diagnosed. Some people with ADHD have fewer symptoms as they age, while others continue to have significant symptoms as adults.
Almost everyone has some symptoms similar to ADHD at some point in their lives. If your difficulties are recent or occurred only occasionally in the past, you probably don't have ADHD. ADHD is diagnosed only when symptoms are severe enough to cause ongoing problems in more than one area of your life. These persistent and disruptive symptoms can be traced back to early childhood.
Diagnosis of ADHD in adults can be difficult because certain ADHD symptoms are similar to those caused by other conditions, such as anxiety or mood disorders. And many adults with ADHD also have at least one other mental health condition, such as depression or anxiety.
If inattention, hyperactivity or impulsive behavior continually disrupts your life, talk to your doctor about whether you might have ADHD. Because signs of ADHD are similar to those of a number of other mental health conditions, you may not have ADHD — but you may have another condition that needs treatment.
While the exact cause of ADHD is not clear, research efforts continue.
Multiple factors have been implicated in the development of ADHD. It can run in families, and studies indicate that genes may play a role. Certain environmental factors also may increase risk, as can problems with the central nervous system at key moments in development.
You're potentially at increased risk of ADHD if:
ADHD has been linked to:
Although ADHD doesn't cause other psychological or developmental conditions, a number of other disorders often occur along with ADHD. These include:
You're likely to start by first talking to your family doctor. Depending on the results of the initial evaluation, your doctor may refer you to a specialist, such as a psychologist or psychiatrist.
What you can do
To get ready for your appointment:
Basic questions to ask your doctor include:
Don't hesitate to ask questions anytime you don't understand something.
Be ready to answer questions your doctor may ask, such as:
Different types of doctors may diagnose and supervise treatment for ADHD. Seek a provider who has training and experience in caring for adults with ADHD. Psychiatrists, psychologists, family doctors and neurologists may diagnose ADHD, but only psychiatrists and psychologists are likely to provide counseling. Psychologists do not prescribe medication.
It can be more challenging to identify ADHD in adults than in children. Signs and symptoms in adults can be hard to spot. No single test can confirm the diagnosis. Your doctor will likely start by doing a physical exam and asking you questions.
Your doctor or mental health provider will consider whether your symptoms may be caused by something other than ADHD. Conditions that can cause symptoms similar to those caused by ADHD include:
A persistent pattern of signs and symptoms as a child is essential for a diagnosis of adult ADHD. You may have a hard time remembering whether your problems date back to childhood. For that reason, your doctor may ask for your old school records and for information from teachers, parents and anyone else who knew you when you were young. Your doctor may also ask to hear from your spouse, a parent, close friend or someone else who knows you well.
To be diagnosed with ADHD, you must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. You must have six or more signs and symptoms from one or both of the two categories below.
Inattention
In addition to having at least six symptoms from these categories, someone with adult ADHD:
Because symptoms of ADHD may differ in adults from those in the DSM criteria — especially those listed for symptoms of hyperactive behavior — other criteria more specific to adults are generally used to help confirm a diagnosis.
Your doctor may give you a questionnaire and expanded list of signs and symptoms to help determine whether you have ADHD. In addition, your doctor will carefully examine the impact of your symptoms on your current life — your performance at work or in school and your relationships with friends and family.
Current treatments typically involve medication, psychological counseling or both. A combination of therapy and medication is often the most effective treatment.
Stimulants (psychostimulants) are the most commonly prescribed medications for ADHD, but other drugs may be prescribed.
The right medication and the right dose vary between individuals, so it may take some time in the beginning to find what's right for you. Talk with your doctor about the benefits and risks of medications. And keep your doctor informed of any side effects you may have when taking your medication.
Counseling for adult ADHD can be beneficial and generally includes psychological counseling (psychotherapy) and education about the disorder. Psychotherapy may help you:
Common types of psychotherapy for ADHD include:
Because ADHD is a complex disorder and each person is unique, it's hard to make recommendations for all adults who have ADHD. But some of these suggestions may help:
If you're like many adults with ADHD, you may be unpredictable and forget appointments, miss deadlines, and make impulsive or irrational decisions. These behaviors can strain the patience of the most forgiving co-worker, friend or partner.
Therapy that focuses on these issues and helps you better monitor your behavior can be very helpful. So can classes to improve communication, conflict resolution and problem-solving skills. Couples therapy and classes in which family members learn more about ADHD may significantly improve your relationships.
There's little research that indicates that alternative medicine treatments can reduce ADHD symptoms. Before using any alternative interventions, talk with your doctor to determine risks and possible benefits. Some alternative treatments that have been tried but are not yet fully proved scientifically include:
While medication can make a big difference with ADHD, taking other steps can help you understand ADHD and learn to manage it. Some resources that may help you include:
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