Attention-deficit/ hyperactivity disorder (ADHD) is a neurodevelopment disorder. It has an estimated prevalence of four percent in the world population. The most distinctive symptoms of this disorder are being inattentive and/ or hyperactive or impulsive. In this article, you will read about adult ADHD, its symptoms, how it can be diagnosed, treatment options, and coping tips during the pandemic.
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Adult ADHD Diagnosis
By definition, neurodevelopment disorders develop either in infancy or early childhood. These disorders are listed in a manual known as the Diagnostic and Statistical Manual of Mental Disorders (DSM). According to the latest edition of the manual DSM-5 which was released in May 2013, symptoms are to have been seen before the age of 12 years in order for a diagnosis of ADHD to be made. However, in reality, many people with ADHD are not diagnosed until they reach adulthood.
One reason for this is that many times children are tested for ADHD on the recommendation of a teacher. This is often because a child is having problems keeping up with school work or they are exhibiting difficult or odd behavior like being unable to stay seated and quiet in class. Children who perform well in school or whose symptoms like hyperactivity are not very obvious are often missed and go into adulthood diagnosed.
You or a loved one you suspect may have ADHD is never too old to be diagnosed. This is done with an ADHD evaluation that is done by psychiatrists, psychologists, and other mental health professionals. Your general physician can refer you to one. Different psychological assessment measures can be used to diagnose ADHD in adults. They are:
The Behavior Rating Inventory of Executive Functioning-Adult Version (BRIEF-A)
This is a rating scale that is norm-referenced. It is used to collect information about a person’s ability to remain focused, finish tasks, regulate their impulses, and be organized. Other abilities or a lack of them that are characteristic of ADHD are also tested.
The Test of Variables of Attention (TOVA)
The Test of Variables of Attention is computerized. It is standardized and it measures whether one can pay attention and complete a task that is visual and auditory. The scores compare the performance of the person being evaluated against that of a person of the same gender and age who doesn’t have ADHD.
The Barkley Adult ADHD Rating Scale (BAARS)
This test BAARS links a patient’s symptoms to the DSM diagnostic criteria. This is done through observer data and the patient participation through a report that they do themselves following a format given in a form.
The Conners Adult ADHD Rating Scales (CAARS)
This is a norm-referenced rating scale that is used to test for difficulty with remaining attentive, being impulsive, being hyperactive and other symptoms that characterize ADHD. ADHD patients complete a self-report form and another person who is close to them completes an observer form. Along with one of these tests, the mental health professional will also gather information about a patient’s history. This is typically done in a diagnostic interview that gives context to the assessment method that was used.
Adult ADHD Treatment
After a positive diagnosis for adult ADHD has been made, the next step will be for the mental health professional to determine the best course of treatment. Before treatment begins, your health care provider will explain to you what the treatment entails and why they believe it will be the best way to go for you.
This will be your chance to ask any questions and raise any concerns you have, although you will be free to do so at any time as treatment continues. Treatment for ADHD in adults can be with medication, therapy, the building of new skills, and appropriate accommodations. It may also involve the use of more than one treatment approach.
Some of the treatment options used for adult ADHD are given below:
Adult ADHD Medication
Medication options for treating ADHD in adults may be stimulants or non-stimulants. Stimulants can be amphetamine-based or they can be methylphenidate-based. The latter can be in the form of immediate, sustained, or extended release. Vyvanse, Adderall IR, and Adderall XR are some of the most commonly prescribed types of amphetamine-based stimulants.
With methylphenidate-based stimulants, Concerta, Ritalin LA, and Ritalin IR are often prescribed. Examples of non-stimulant medication are Guanfacine and Strattera. Medication for adult ADHD works by regulating impulses and enhancing the ability to remain focused. Some types of medication are taken daily while others are taken when they are needed for the focus to complete specific tasks.
Adult ADHD Therapy
Depending on the findings of your ADHD evaluation tests, your mental health care provider may recommend that you get treatment with therapy or a combination of therapy and medication or other treatment options. Therapy is helpful for processing life stressors. It also helps with building new behavioral skills that are very helpful for dealing with the symptoms of ADHD. Some of the forms of therapy that have been proven effective for treating ADHD are cognitive behavior therapy, mindfulness-based therapy, and brief motivational interviewing.
Adult ADHD Social Support
Apart from medication and therapy, social support goes a long way to helping adults with ADHD to cope with it and successfully undergo treatment. Support from those who are close like a partner, other people in the household, family, and colleagues will make a big difference.
Adult ADHD Impact on Relationships
Even the happiest relationships have challenges from time to time. There are much more challenges if the relationship is with a person who has ADHD. Their ADHD symptoms can make them come across as distracted and forgetful. Keeping in mind that these are symptoms these people will always have, partners may give up on them. Things can become worse when the condition causes anger or inappropriate outbursts. These fits of rage typically pass as quickly as they come but their frequency and intensity can leave partners, children, and other family members traumatized.
The person with ADHD sees the damage and is caught up in a web of a negative self-image, lack of esteem, and shame for their actions. If they have been diagnosed with another condition such as depression or anxiety, it may get worse. This is how everyone can get caught up in a vicious cycle of rage and regret if help is not sought for ADHD. This does not mean that a marriage or a relationship with a person who has ADHD is doomed.
This is if it is recognized that the problem is ADHD and not the person who has it. However, along with this, the person who has it has to be willing to get help for it. Along with this, couples therapy would be helpful. A mental health care professional can help a couple navigate their way through the symptoms by equipping them with the means to communicate honestly and effectively, even in the middle of an argument.
Adult ADHD Impact on Criminality and Safety
Meta-analyses have found that men who were diagnosed with ADHD as children are two to three times more likely to be arrested, convicted, or incarcerated as adults compared to children who don’t have ADHD. Additional research has established that the percentage of prison populations with ADHD could be as high as 50 percent. One reason for this high percentage is the impulsivity that people who have ADHD have.
It compromises their ability to regulate or control their emotions and behavior and the ability to think and plan coherently and sensibly. Another meta-analysis showed there was empirical evidence of a link between the inability to control one’s behavior and criminal behavior. This was found to be of more importance than socioeconomic status when it came to predicting crime. Over the years, as additional research into criminal behavior is done, the theory of self-control has become more and more important.
Adult ADHD Impact on Substance Abuse
The most common symptoms of ADHD which are impulsive behavior and lack of self-control and the similar neurological pathways that are seen when one is craving something have been linked to substance use disorder (SUD) in people with ADHD. A study into ADHD and addiction established that 50 percent of teens with SUD have ADHD. Also, adults who have ADHD, as well as conflict disorder (CD), are more likely to develop SUD.
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Adult ADHD and Comorbid Conditions
Over half of adults with ADHD have at least one comorbid diagnosis. This refers to a person having more than one disorder. For instance, an adult could have ADHD and an anxiety disorder, depression, bipolar disorder, personality disorder or other mental disorder. Many people with ADHD are diagnosed with either a learning disorder or autism spectrum disorder.
Lifestyle Changes and Natural Remedies for Adult ADHD
While ADHD is genetic, it is also, to a degree, environmental. While DNA cannot be altered, changing the environment a person with ADHD lives in can help to alleviate the symptoms of the disorder. This has been established through epigenetics which is the study of how lifestyle choices can influence DNA.
The three factors that need to be changed are sleep, exercise, and diet. ADHD people who tend to be impulsive and hyperactive may have trouble falling asleep or sleeping uninterrupted. Yet sleep is a must-have for the brain and body. It is important for regulating mood and remaining attentive throughout the day.
Getting into a routine can be very helpful. It should involve avoiding blue light on TV and devices an hour before bed and adapting to a nightly routine that is relaxing. It may be taking a warm bath, drinking tea, or reading a book. On the advice of a health care professional, a melatonin supplement may be taken by ADHD patients who need to reset their circadian rhythm.
Exercise is the other lifestyle factor that can help to calm ADHD symptoms. Frequent exercise has been proven to significantly reduce or even reverse feelings and effects of trauma or stress. It also enhances brain growth and efficiency and enhances the ability to learn. In people with ADHD, exercise has been proven to dramatically enhance the ability to focus and the executive functioning of the brain including working memory.
To get the most out of it, it is recommended that exercise is regular and should be moderate to vigorous. It should also be done for at least half an hour and ideally, it should be varied with different routines and maybe outdoor sessions sometimes.
The third important lifestyle factor is nutrition. Eating healthy wholesome foods has been found to be beneficial. Foods rich in omega-3 fatty acids like fish and nuts are particularly healthy. Micronutrients like Vitamin D, iron, and zinc that the brain needs for optimal function are also beneficial. Reducing or eliminating caffeine is also helpful.
Adult ADHD: Next Steps
The first step in dealing with ADHD is recognizing that there is a problem. As stated earlier, it is never too late to be diagnosed regardless of age. The second step should be to get evaluated and the next one will be to start treatment. The most important factor will be what happens here in terms of sticking with the plan which can be adjusted depending on the outcome of the initial treatment methods.
Situations like a pandemic can be particularly difficult on people with ADHD. Their symptoms can get worse because they can’t be out which challenges their tendency to be impulsive. Experts recommend the following 10 strategies to cope, especially in the worst-case scenario of a lockdown:
- Be mentally prepared for the change and you will be less anxious about it.
- If a decision is made to lock down your area, create a routine that works around it rather than getting anxious about it.
- Start or continue your exercise routine. It will give you something to focus on and you can keep doing it at home. You can change it up by working out outdoors sometimes.
- Be logical to counter anxiety or frustration. Remember that what is going on will come to pass and normalcy will resume with it.
- Stay positive about the changes. For instance, if you can now work from home, enjoy the flexibility and not have to deal with colleagues who stress you out.
- Try new things like a new workout routine that you can find online or new recipes. Do the things that you don’t normally have time to do.
- Improve your skillset or academic qualifications. You can do this online on websites like SkillShare, YouTube Master Classes, and online university classes.
- Make plans and stay focused on them. Decide what you would like to be able to do once the pandemic eases? Is it travel? Decide exactly where you want to do, find out how much it will cost, and start saving up towards it. It will give you something to focus on and look forward to.
- Start a hustle like many people did when they lost their jobs because of the pandemic. Some have gone on to make successful businesses out of their hobbies.
- Enhance your environment by taking up DIY projects to change your living space. Making over some rooms or your entire house will give you a fresh start, lift your mood and keep you busy.
Do mark and celebrate your milestones as you get through each day of the pandemic. Buy yourself or your household small gifts for staying strong and positive through it all.
What Is ADHD? Definition, Myths & Truth
Continous research about ADHD has disproved the myths that it is a behavior disorder. It is now known that the fact is that ADHD is a development impairment that compromises the brain’s ability to self-regulate and self-manage. Other myths that research has shattered is that ADHD is a childhood disorder, that is just bad behavior, that people with high IQ can’t have it and that it can be outgrown among other myths. The facts are that it can be treated to alleviate the symptoms in both adults and children.
Children & Family
Children with ADHD can cause strain in a household. It has been established that 40 percent to 70 percent of children with ADHD also have oppositional defiant behavior (ODB). This disorder presents with ongoing defiant or hostile behavior towards authority figures. The problem is therefore seen not only with parents and siblings but also teachers in school.
Looking at it with the boot on the other foot, living in a household with a person with ADHD can be traumatic for a child. This is especially if it is a parent or caregiver who has the disorder. Angry outbursts at unexpected times and places can be very scary for them, especially young children who cannot understand that the behavior is caused by a disorder.
Health & Wellness
Research has busted the myth that a person with ADHD cannot live a happy, healthy life and have happy relationships with family, friends, and a partner. While problems with focusing, being organized, managing emotions and finishing tasks may persist, but these can be alleviated with treatment. The support and understanding of loved ones will go a long way to helping a person with ADHD live a happy, fulfilled life.
The fact is that not everyone will be understanding or ready to deal with a person with ADHD. This includes people in the immediate family including a partner, siblings, and sometimes even parents. They may opt to avoid a person with ADHD rather than offer acceptance, understanding, and help to deal with it.
Hopefully, they will be even one person offering this. It could be a friend and not a family member. If not, a person with ADHD will have to find in themselves the hope and strength to deal with the order with a mental health care professional. That doctor could also be that friend who not only provides professional help but also understanding. At the same time, getting that help could open the way to building happy, healthy relationships.
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Symptoms of ADHD can be different among children and adults so a proper diagnosis from professional mental health experts is necessary. Mango Clinic has a team of professional mental health experts you can consult for proper ADHD diagnosis. Contact us now for proper ADHD treatment or click the banner below to book your appointment.