Over the years here have been many news articles and television news shows that have reported that too many children were being diagnosed as having ADHD and that they were excessively being prescribed medication. The facts are that 3-7% of children have these disorders and they do need the help of medication and therapy to deal with the symptoms. In addition, we know that these disorders are neurobiological in nature and that they tend to run in families. Therefore, either siblings or parents of ADHD children may have the disorder. What is more significant is that we know approximately 60% of these children will continue to have symptoms into adulthood. Therefore, approximately 4% of adults may have these disorders.
ADHD is a more complex disorder than most people think. The individual with ADHD can not be just characterized as one who cannot sit still or who is "climbing the walls". In fact, we now see ADHD as taking several forms. There are those individuals with the disorder who cannot focus and are disruptive to others. There are some individuals who appear in control, but they are actually internally distracted. Some individuals with ADHD become over focused and get stuck on small details that are not that significant to the task at hand. Then there are individuals who have combinations of ADHD, depression, Oppositional Defiant Disorder, or even Bipolar Disorder. In light of the variability of primary and secondary symptoms, proper diagnosis, specific medications, and therapeutic approaches have to be individualized.
The diagnosis of ADHD in children can be somewhat easier than in adults. Children are required to listen to adults, pay attention in school, and while in school they are actually monitored by many adults. There are frequent measures that can help rule out whether the child's problems are due to ADHD or another issue. In children, learning disabilities, anxiety, or Oppositional Defiant Disorder can make the child appear to have ADHD. Proper diagnosis is important and a good pediatric neurologist or child psychiatrist who specializes in ADHD would be the best route to perform this assessment.
So what are the symptoms in adults? Constant fidgetiness and restlessness can be a sign of ADHD; however, as we age the hyperactivity component of the disorder tends to fade, generally leaving the disorganization piece. Therefore, if they were not properly identified as children, they may slip through the cracks and their ADHD would not be identified. .Other signs that may lead one to suspect ADHD in adults would be concentration difficulties, persistent procrastination, organizational problems, failure to complete tasks, poor time management, poor impulse control, sleep problems, poor management of money, interpersonal relationship problems, anxiety, and depression. These symptoms can be quite diffuse and may be expressions of other disorders, so they may go unrecognized or denied. In adults, the problems may lead to repeated employment failures, tumultuous relationships and poor parental skills. The individual with ADHD may be perceived as a failure or a difficult person to live with but not be recognized as having a disorder. Due to complications of ADHD, adults also may have significant secondary problems with alcohol, drugs, or legal problems.
If ADHD is suspected, what should you do? Given the possible devastation ADHD can have on an adult's functioning and well being, it would be wise if it is suspected to be assessed for the disorder. The testing for ADHD is not that intrusive or complicated. The assessment is based upon the data obtained from a good review of information regarding the individual, their family (parents, siblings), and their early academic experiences. Self-rating forms and Objective Personality Tests are used to gauge the impact of present symptoms on the individual's life. An additional test requiring the individual to work on a computer for approximately 14 minutes provides information on impulse controls, attention, and concentration. Lastly, a conference with a psychiatrist who works with ADHD adults would be necessary to asses the proper medications and dosages.
If an individual has had undiagnosed ADHD for years, they have probably developed low self-esteem and negative coping behaviors. Medication can help with the symptoms of the disorder, but therapy would be needed to improve the self-esteem of the individual, improve their interpersonal skills, and help eliminate nonproductive coping skills. For some executives and professionals who can afford frequent one to one services, there is a specialty line of coaches who work individually on assisting these people with enhancing life skills or teaching new organizational skills.
Although we know that ADHD does not go away, we do know with the proper diagnosis and treatment, the disorder can be controlled and the negative effects can be limited.