ADULT ADD AND ADHD

Dr. Paul Standal has found that many adults have residual symptoms of Attention Deficit Hyperactivity Disorder (ADHD) that affects 3-5 percent of children in the United States. Two thirds of those with the disorder continue to have residual Attention Deficit symptoms through adulthood. Adults with Attention Deficit Disorder, though intelligent, have increased challenges attaining their potential through education, in their jobs, and socially. They suffer from increased sense of frustration and low self-esteem with concomitant symptoms of depression. They also appear more vulnerable to obsessions and compulsivity and to substance abuse or dependence.

The Core Symptoms of Adult ADD are:

• Is easily distracted
• Difficulty sustaining attention span for most tasks in play, school, or work
• Trouble listening when others are talking
• Difficulty following through on tasks or instructions (procrastination)
• Difficulty keeping an organized area (room, desk, book bag, filing cabinet, locker, etc.)
• Trouble with time, e.g. is frequently late or hurried, tasks take longer than expected, projects or homework are “last-minute” or turned in late.
• A tendency to lose things
• Careless mistakes, poor attention to detail
• Forgetful
• Restless
• Noisy, has a hard time being quiet
• Acts as if “driven by a motor”
• Talks excessively
• Impulsive (doesn’t think through comments or actions before they are said or done)
• Difficulty waiting his or her turns in lines
• Interrupts or intrudes on others (e.g. butts into conversations)

Adults with ADD can often experience additional symptoms of impulsivity that makes their personal and professional life difficult. These symptoms are:

• Worries excessively or senselessly
• Oppositional and argumentative
• A strong tendency to get locked in to negative thoughts, having the same thought over and over
• A tendency toward compulsive behaviors
• A tendency to hold grudges
• Trouble shifting attention from subject to subject
• Difficulties seeing options in situations
• A tendency to hold on to his or her own opinion and not listen to others
• A tendency to get locked into a course of action, whether or not it is good for him or her
• A need to have things done a certain way or becomes very upset
• Is criticized by others for worrying too much

There appears to be a genetic and neurological component to ADD and ADHD.  The brain may be reacting to a relative deficiency of the neurotransmitter dopamine that is generally considered the neurotransmitter involved in inattentive ADD, although, in this case, its imbalance is felt by another area of the brain.

Diagnosis and treatment of ADHD takes a person-centered approach. Counseling and psychotherapy help the individual with ADD to understand and accept the situation and helps to reduce common feelings of depression and low self-worth. Counseling and coaching also helps the individual to maintain a healthy lifestyle with continued focus on structure to help ameliorate symptoms and the consequences of the disorder on oneself and on other relationships, especially those of significant others who deal with it every day with you. Each individual may present the core symptoms differently. Adults who have anxiety, depression, or relationship, occupational or substance abuse issues often show these signs, or, of course, these problems may amplify or be amplified by an underlying ADD condition.

The focus of treatment has several goals:

1. Increased concentration and focus
2. Decreased restlessness or high activity levels
3. Decreased impulsiveness and increasing thoughtfulness
4. Decreased irritability
5. Increased motivation
6. Improved overall functioning at school, at work, at home, in relationships, and within the self

With adults, medications can be a helpful adjunct as part of the treatment. Adderall has been found to be effective with adult ADD/ADHD.

Corollary behavior-based treatments appear to be effective in helping manage individual lives. Some suggestions are:

1. Reduce outside stimulation like watching too much TV
2. Getting regular sleep
3. Creating healthy rituals and habits like putting one’s keys and wallet in one place in the house
4. Making to do lists
5. Doing daily schedule of events
6. Getting support from loved ones without becoming defensive
7. Learning to take time-outs and institute quiet time
8. Remember to breathe when stressed

Ineffective treatment is not innocuous. When treatments fail, individuals and families get discouraged. Aside from the negative personal ramifications to the patient experiencing this discouragement, a failed healing process leads to the ADD remaining untreated. The costs for untreated ADD are high for both the individual and society. Diagnosis and treatment is very important.