Recognizing signs of ADHD in adults

AdobeStock_84459105.jpeg

We all misplace our keys or forget about an important appointment now and then. Some of us have a hard time staying organized or feel like it’s challenging to juggle daily tasks and responsibilities. But, for the 10 million adults who have attention-deficit/hyperactivity disorder (ADHD), what may seem like minor inconveniences to others are instead so persistent and frequent that they interfere with all aspects of everyday life.

ADHD was previously thought to affect only school-age children — young boys in particular — and many doctors assumed it was something they out grew. Now, they recognize that while ADHD starts in childhood, symptoms stick around through adulthood in more than 75 percent of cases. And, missed diagnoses later in life are common, particularly in women. In addition, ADHD in adults can look quite different from ADHD in children.

Although ADHD can be recognized in early childhood, sometimes individuals don’t struggle with symptoms until their schooling becomes more advanced in high school or college or they begin to live independently from their parents.

This may be why diagnoses in adulthood are rising, with a 39 percent increase from 2014 to 2018 in millennial adults. (The Blue Cross and Blue Shield Association’s Health of Millennials report lists hyperactivity as a top-10 adverse health condition affecting adults born between 1981 and 1996.)

What is ADHD?

ADHD is a neurobiological disorder (meaning it occurs in the brain) that affects attention span, mood and emotional regulation, focus, organization, productivity, impulse control, and memory in people of all ages and genders.

Adults with ADHD struggle with paying attention, time management, focusing on a task, a low frustration tolerance, coping with stress, and impulsive behavior. Symptoms can interfere significantly with daily activities — leading to unstable relationships, poor performance at work or school, low self-esteem, and other issues.

Scientists don’t yet know what exactly causes ADHD but believe the condition can develop from a variety of factors including genetics (ADHD is highly hereditary). Environmental factors like lead exposure as a child or problems with the central nervous system during development, may also contribute to the disorder.

According to the Mayo Clinic, the risk of developing ADHD may increase if you have blood relatives with ADHD or another mental health condition, you were born prematurely, or your mother smoked, drank alcohol, or used drugs during pregnancy.

Symptoms of ADHD in adults

There are three different ways ADHD can appear in adults, with varying symptoms for each type:

• Predominantly Inattentive (ADHD-I, formerly known as ADD)
• Hyperactive-Impulsive (ADHD-HI)
• Combined (ADHD-C)

Those diagnosed with Combined ADHD experience both inattentive and hyperactive-impulsive ADHD symptoms.

Predominantly Inattentive ADHD symptoms often look like:

• Struggling with keeping their attention on tasks if they are not stimulating or engaging
• Appearing not to listen to conversation, even when spoken to directly
• Failing to follow through on instructions or follow directions
• Lacking the ability to organize tasks and activities or manage time appropriately
• Becoming easily distracted, particularly by background noise, unrelated thoughts, or other low-priority activities
• Failing to notice important details or making careless mistakes
• Having trouble with both starting and finishing projects, as well as avoiding tasks that require sustained mental effort over a long period of time
• Constantly losing important items like glasses, keys, smartphone, and wallets
• Frequently forgetting about important daily tasks like paying bills, doing household chores, keeping appointments, meeting deadlines at work, or returning calls and emails

Predominantly Hyperactive-Impulsive ADHD symptoms often look like:

• Being unable to sit still or stay seated, especially for long periods of time
• Constantly fidgeting with or tapping hands and feet, or showing signs of extreme restlessness
• Acting as if they’re being driven by a motor and constantly “on the go”
• Talking excessively and frequently interrupting or talking over others in conversations
• Having difficulty with waiting in line or taking turns
• Saying things aloud before thinking them through
• Having trouble with regulating emotions, which can translate to being easily flustered and stressed or having a short temper
• Attempting to do several tasks at once

Diagnosing ADHD in adults

Diagnosing ADHD in adults can be incredibly challenging for a number of reasons. According to the Mayo Clinic, many of the classic ADHD symptoms are similar to those of other mood disorders like anxiety and depression. And, 80 percent of people with ADHD also have another mental health condition that can make it harder to figure out what is actually causing their symptoms.

Finally, many adults who have dealt with undiagnosed ADHD for years have learned to “mask” their symptoms over time in order to appear more acceptable amongst their peers — even when their internal struggles continue. They may not realize others don’t share their struggles or even consider some of their symptoms to be personality traits or quirks.

The criteria for diagnosing an adult with ADHD considers the number of symptoms they’ve been experiencing for at least six months or more. While children younger than age 17 need to show at least six symptoms of either type of ADHD, adults only need to show five. Symptoms must also be inappropriate for an individual’s development level, cause significant daily disruption, and have been present before age 12 to contribute to a diagnosis. Symptoms should also not be explained by any co-occurring mental health conditions like depression or anxiety.

What happens if ADHD goes undiagnosed in adults?

Because there is a lot of misinformation about ADHD in adulthood, many adults go undiagnosed until they begin experiencing significant impairment both personally and professionally. Undiagnosed ADHD can negatively affect nearly every area of someone’s life, leading to physical and mental health problems like substance abuse, anxiety, chronic stress, and low self-esteem; and causing difficulties with work, finances, and relationships.

Treatment options for ADHD in adults

Thankfully, all types of ADHD present in adults are highly manageable once diagnosed. A combination of the following treatment methods is ideal for treating ADHD symptoms in adults:

• Medication. There are both stimulant and non-stimulant medications available to help with ADHD symptoms. A provider may also prescribe an antidepressant or anti-anxiety medication in addition, depending on the situation.
• Therapy or coaching. A mental health professional can meet with you on a regular basis to help manage your stress and emotions, learn new techniques to manage your symptoms, or help you learn better coping skills like organization and time management.
• Lifestyle changes. Developing and sticking to a daily routine, along with getting enough sleep, making time to exercise regularly, eating a healthy, balanced diet and managing stress can have a positive impact.

Seeking an ADHD diagnosis, treatment, and resources

If reading this article hit a little too close to home, you may be wondering how to start the process of getting a formal diagnosis for ADHD. If you already see a therapist or other licensed mental health professional, start there. If not, set up an appointment with your personal doctor to discuss your symptoms and concerns.

Be prepared for the evaluation process to be long and potentially draining — whoever you choose to see for a formal ADHD diagnosis will give you at least one lengthy questionnaire to describe your symptoms, current and past struggles, and other mental health diagnoses to determine whether they’re causing your symptoms.

Many people with ADHD struggle with memory loss, so your provider may have you talk to your parents, friends, spouse, or partner to get their perspective on your struggles and provide a more complete picture. Report cards from early school years, if you still have them, can be especially helpful when going through this process. Oftentimes, teachers may have noted things like late or missing assignments, inability to stop fidgeting, and not working up to potential — which at the time, weren’t considered to be clear signs of ADHD, especially in young girls.

Other resources for adult ADHD where you can learn more about the condition include Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), the Attention Deficit Disorder Association (ADDA), Kaleidoscope Society, and How to ADHD. If you need help finding a personal doctor or licensed mental health professional, log in or register for myWellmark^® to find one in your network.