ADHD in adults
Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most widespread mental disorders (American Psychiatric Association, 2022b; Kooij et al., 2010). While, ADHD is more associated with children and development, it also commonly affects adults as well. Symptoms of ADHD may include inattentive behaviours, hyperactivity and impulsivity symptoms, or a combination of these (American Psychiatric Association, 2022a). In adults, the main features of ADHD include trouble paying attention, impulsiveness and restlessness, along with features such as disorganisation and poor time management, problems prioritising, planning and multitasking, low tolerance for frustration, mood swings and emotional outbursts, difficulties completing tasks, and trouble coping with stress (American Psychiatric Association, 2022b).
It is important to note that it is normal to experience all of these symptoms at some point, and if you identify with some of these symptoms it doesn’t necessarily mean you have ADHD. If the symptoms are new to you or an infrequent occurrence or can be attributed to a normal stress response, you most likely don’t have ADHD. However, if these symptoms are a little too familiar – say you experience them with great frequency and have done for most of your life, it is worth finding out more.
In adults, at least five symptoms of either inattention and/or hyperactivity and impulsivity are required for diagnosis (American Psychiatric Association, 2022a).
The inattention symptoms include:
– frequent lack of attention to detail or frequent careless errors,
– difficulty maintaining focus during tasks,
– frequently seems not to listen when spoken to (i.e., ‘zones out’),
– often fails to follow through with or complete tasks,
– struggles with organisation (poor time management, messy, poor multitasking skills),
– avoidant, reluctant or dislikes engaging in tasks that require prolonged mental effort,
– frequently loses items for tasks,
– easily distracted by stimuli or unrelated thoughts,
– frequently forgetful in day-to-day tasks.
Hyperactivity and impulsivity symptoms include:
– frequently squirms in seat or taps and fidgets with hands or feet,
– leaves seat frequently in circumstances when staying seated is expected,
– frequently feeling restless or running about in an inappropriate setting,
– struggles to engage in leisure activities quietly,
– frequently acts as though they are “driven by a motor” or difficult to keep up with,
– frequently talks excessively,
– frequently interrupts conversation or questions to give input, (e.g., cannot wait for their turn in conversation),
– frequently struggles to wait their turn (e.g., during an activity)
– often interrupts or intrudes into others’ activities or conversation and may take over from others or uses items without asking permission.
Additionally, several of these symptoms must have been present before the individual was 12 years old and in two or more settings (e.g., home, work, recreation, etc.). The symptoms must clearly interfere or hinder ones social, academic, or occupational functioning and may not be better fit to another mental disorder (American Psychiatric Association, 2022a).
Diagnosis of ADHD can be especially difficult for adults as many of the symptoms associated with the disorder overlap with symptoms of anxiety and mood disorders, and to make things even more complicated ADHD can present simultaneously with anxiety and mood disorders (Geffen & Forster, 2018).
Despite pop culture attributing ADHD to eating too much sugar or watching too much TV, little is actually known about the causes of ADHD. It does however appear to be a genetic disorder (American Psychiatric Association, 2022b; Kooij et al., 2010). So, if you have a family member with ADHD and the symptoms listed above sound familiar, it may be a good idea to investigate further. There is no need to panic. ADHD is highly manageable, and by implementing various psychological strategies, symptoms will significantly reduce.
There are a number of psychotherapies that have been developed to assist with the management of ADHD (Geffen & Forster, 2018; Kooij et al., 2010; Safren, 2006). Studies have shown that cognitive-behavioural therapy (CBT- a common therapy used by psychologists), is a very effective in managing the symptoms and struggles of ADHD. The strategies often associated with CBT for adult ADHD include:
– psychoeducation about ADHD and how it can influence someone’s life,
– Sharing skills and strategies in organisation, planning, and time management, this may include target prioritisation or integrating useful tools such as calendars or lists, in a way that works best for that individual,
– structured problem-solving techniques,
– minimising distractions or improving attention span,
– combatting negative self-assessment and stress responses,
– development of methods to reduce impulsive or irrational behaviour,
– support quality relationships with important social connections (family, friends, partners, co-workers, etc.)
Management of ADHD might also include couples counselling or family therapy (Kooij et al., 2010). People with ADHD can often experience difficulties in relationships due to challenges such as impulsive decision making or poor time management. Therapy which focuses on the social connections, can help to facilitate communication and awareness around the issues. It can also be incredibly helpful in giving loved one’s techniques to provide support and manage stress.
If you think you may have ADHD, or just think therapy may be beneficial for you, then we can help.
Our wonderful team at PlenishMindHealth have extensive experience in both one-on-one counselling and couples/family therapy and are always eager to provide support you in your life journey.
ADHD in women
Female manifestations of ADHD have been relatively overlooked in both clinical practice and in research, especially in childhood with most studies having a ratio of around one girl to five boys identified with ADHD. Interestingly, this gender difference does not track into adulthood, as more women are identified thus making diagnostic ratios far less skewed (Kooji et al., 2010).
There are a few theories as to why this is the case. The main explanation given for this difference is that girls typically experience more inattentive symptoms, whereas boys are more likely to experience hyperactivity and impulsivity related symptoms (Kooji et al., 2010; Levy et al., 2005). Additionally, males tend to have higher comorbidity rates of oppositional defiant disorder (ODD) and conduct disorder, whereas females have higher rates of separation anxiety disorder. This simply means, females tend to internalise symptoms while males external them (Levy et al., 2005). Thus, diagnosis for ADHD, for girls may be tricky as they have less obvious symptoms and therefore more likely to be overlooked or ignored. The increase in ADHD diagnosis in women during adulthood, may in part be attributable to women’s help seeking behaviours. That is, as adults, women are likely to reach out and consult a therapist which may helped to even out the prevalence of ADHD between men and women (Kooji et al., 2010).
If you or someone you know is exhibiting some of the symptoms listed above, it may be beneficial to get an ADHD assessment from a professional. At PlenishMindHealth, we can help with the management of symptoms and the emotional distress that comes along with it. Regardless of your diagnosis, we can provide support and guidance to ensure that you are able to reach your greatest potential in leading a fulfilling and rewarding life.
References
American Psychiatric Association. (2022a). Neurodevelopmental Disorders. In Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).
American Psychiatric Association. (2022b, June). What is ADHD? https://www.psychiatry.org/patients-families/adhd/what-is-adhd#section_0
Geffen, J., & Forster, K. (2018). Treatment of adult ADHD: a clinical perspective. Therapeutic Advances in Psychopharmacology, 8(1), 25–32. https://doi.org/10.1177/2045125317734977
Kooij, S. J. J., Bejerot, S., Blackwell, A., Caci, H., Casas-Brugué, M., Carpentier, P. J., Edvinsson, D., Fayyad, J., Foeken, K., Fitzgerald, M., Gaillac, V., Ginsberg, Y., Henry, C., Krause, J., Lensing, M. B., Manor, I., Niederhofer, H., Nunes-Filipe, C., Ohlmeier, M. D., … Asherson, P. (2010). European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry, 10(1), 67–67. https://doi.org/10.1186/1471-244X-10-67
Levy, F., Hay, D. A., Bennett, K. S., & McStephen, M. (2005). Gender Differences in ADHD Subtype Comorbidity. Journal of the American Academy of Child and Adolescent Psychiatry, 44(4), 368–376. https://doi.org/10.1097/01.chi.0000153232.64968
Safren, S. A. (2006). Cognitive-behavioral approaches to ADHD treatment in adulthood. Journal of clinical Psychiatry, 67(8), 46-50.
