Adult ADHD

ADHD, or attention-deficit/hyperactivity disorder, in adults creates symptoms that can make someone unfocused, forgetful, fidgety, talkative or disorganized. High levels of stress and trauma and exposure to toxic materials and chemicals heighten the severity of symptoms.

The disorder has a strong heritable (or genetic) component, and about 50% of parents who have ADHD pass the disorder along to one of their children. Researchers historically thought of ADHD as a mental disorder that affected children, but the medical community now agrees it’s a lifelong medical condition that affects all ages.

Recent systematic reviews, along with data from the National Institutes of Health, suggest that the prevalence of ADHD in U.S. adults may range from 2% to 5%. ADHD in women is less prevalent than in men. However, diagnosis rates are rising. Researchers believe the disorder is underdiagnosed among adults, partly because symptoms are often overlooked.

Additional adult ADHD symptoms include a lack of attention to detail, poor time management skills and forgetfulness.

Some people may experience emotional dysregulation (or dramatic mood swings) and a low tolerance for frustrating situations. Emotional dysregulation is characterized as reactions that fall outside of acceptable boundaries. Examples include loud outbursts, high-risk behaviors, suicidal thoughts and actions, and extreme anxiety and depression.

Licensed medical providers diagnose ADHD in adults by reviewing their medical history, conducting a routine medical exam and doing clinical interviews with the patient plus loved ones or caregivers. Providers then compare symptoms to the nine listed in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

To reach an ADHD diagnosis for adults, physicians must confirm five specific symptoms associated with the disorder. (They must document six for children.)

The consensus among medical providers is that the best treatment for adult ADHD is a combination of medication and behavioral therapy.

No one drug works for everyone. Some people with adult ADHD do better with stimulant medications, while others respond well to nonstimulants.

Stimulant and Nonstimulant Medications

Stimulants are usually the first ADHD medication options physicians try. Two types exist, and all stimulants fit into one of two classes of drugs: methylphenidates (such as Ritalin, Daytrana and Concerta) and amphetamines (such as Adderall, Vyvanse and Evekeo).

Nonstimulants typically come into play once stimulants have shown they’re not effective. Intuniv (guanfacine) and Strattera (atomoxetine) are two nonstimulant ADHD drugs that are approved by the U.S. Food and Drug Administration.

Some nonstimulant drugs are prescribed as off-label, meaning they were manufactured and marketed to treat another condition but work to control ADHD symptoms. Among them are Wellbutrin (bupropion), clonidine and Provigil (modafinil).

Therapy and Behavioral Treatments

The two behavior therapies (psychotherapies) most used to treat ADHD in adults are cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). Those with ADHD should consider both types of therapy a long-term journey, not a short-term fix.

Clinical trials show CBT helps people recognize and untangle distorted thoughts and emotions to improve self-esteem. In addition, DBT teaches people how to form self-soothing habits to avoid intense emotional situations. Classic DBT involves group and individual sessions.

One myth about managing ADHD as an adult is that tackling the disorder is “just” about ADHD. However, management often means dealing with more than one condition. Of adults with ADHD, 60% to 70% also have at least one comorbidity.

About 1 in 5 people with adult ADHD have a diagnosed mood disorder, and half have a diagnosed anxiety disorder. Roughly 15% struggle with substance abuse.

Specific lifestyle and environmental situations also affect how severe ADHD presents in someone’s life. Develop a meditation and mindfulness practice to regulate symptoms and eat a healthy diet.

Results from the 2020 meta-analysis of adult ADHD show that medical providers often don’t recognize symptoms of ADHD in their adult patients and, as a result, don’t treat them. Researchers suggest doctors and clinicians need better awareness in identifying the various challenges that patients with ADHD and ADD face.

Challenges for Adults with ADHD

The biggest challenge for adults with ADHD is performing competently at work. Symptoms are often magnified at work and in social situations. This can negatively impact one-on-one relationships. Lack of focus or inattention can be a source of irritation to co-workers, family and friends, leading to misunderstandings that can negatively impact work and social relationships.

Fortunately, someone diagnosed with ADHD can request special services or accommodations from their employer or school. Federal law protects against the discrimination of people with disabilities, including ADHD. Understanding your rights and learning about available resources can help you navigate the challenges associated with adult ADHD.