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Adult Attention Deficit Hyperactivity Disorder
Could it be your problem?
Inattention, overactivity and impulsiveness are all signs of adult attention deficit hyperactivity disorder (ADHD). Symptoms can be so severe that it is difficult to carry out normal daily activities.
How do you know if you have ADHD as an adult?
As you read this article, think about whether it describes some of your behaviours or challenges. No single test can be used to make a diagnosis. However, giving your doctor a good description of your symptoms can really help in diagnosing ADHD and deciding whether treatment is appropriate.
Inattention
Write down real life examples of how you have trouble focusing your attention and being distracted. For instance, you might describe having trouble finishing books or a tendency to leave tasks unfinished. Think of specific examples. You may have trouble following instructions, listening to conversations, are unable to get organized, or are forgetful in your daily routine. Does your partner frequently complain about having to repeat instructions and clean up after you?
Hyperactivity
Distinguish between normal high activity versus abnormal over-activity as a child or adult. Did you fidget with your fingers by playing with rings or coat zippers? Did you doodle with pens and pencils? Do you still tap your feet and have trouble sitting still for any length of time? Are you always on the go?
Impulsivity
Examples of being overly impulsive include talking out of turn and interrupting others. Were you the class clown? Do you still talk so much your partner has to tell you to keep quiet? Do you tend to talk or act before thinking of the consequences? Are you accident-prone? Do you get a lot of speeding tickets or are you in frequent car crashes? Do you have trouble waiting your turn?
Childhood history
You cannot suffer from ADHD as an adult if you did not have the condition as a child. To find out what you were like as a child, get out your old school report cards. They will provide information about your grades and behaviour. Have your parents, brothers and sisters write descriptions of what you were like as a child. Your doctor can then evaluate this objective information. If you had psychological testing as a child, these results and records of visits with other mental health professionals will be important. Some doctors may want to repeat psychological tests or have you complete rating scales.
Does having ADHD symptoms mean you have ADHD?
No. We all occasionally have trouble with inattention and being impulsive. However, those with ADHD have daily symptoms. An improvement in your ability to focus when taking stimulant medications does not mean you have ADHD. Even people without ADHD notice more ability to pay attention while taking stimulants.
Other disorders can mimic ADHD. Some individuals with manic-depressive or bipolar disorders can be hyperactive during periods of elevated moods. People with anxiety disorders may have trouble focusing or concentrating because they are so anxious. Those with a learning disability or a hearing problem can be easily distracted and have trouble following instructions. Poor concentration and ability to pay attention can be caused by other medical conditions, medications (prescribed or over-the-counter), and herbal drugs. Drinking excessive amounts of caffeine (or withdrawing from it) can make some inattentive, agitated and anxious. (Some ADHD individuals self-medicate by drinking large amounts of coffee or caffeinated soft drinks.)
If I am diagnosed with ADHD as an adult, should I be treated?
Not everyone who has adult ADHD needs treatment. Ask yourself what the condition is preventing you from doing. If you are doing all you want to do, why take a drug? People often forget there can be advantages to some ADHD symptoms. If you work in sales or marketing there may be advantages to being talkative. Being creative and having a sense of humour may not help the class clown, but in some jobs these traits can be helpful.
What treatments are available?
Treatment depends on having the right diagnosis. A poorly defined problem may lead to questionable solution. Tell the doctor if you are having marriage or work problems. Your doctor should know how much alcohol and coffee you are drinking, and whether you use herbal agents or over-the-counter drugs. Let your doctor know if you are a worrier, have low self-esteem or lose your temper easily. If you have another family member with ADHD or another psychological disorder, this is also important.
Education
Education is key. You need to understand what is wrong and learn more about it. Ask questions about your condition and the treatment. Discuss symptoms you specifically want to address with your doctor. Find out about local and national support groups.
Counselling
If you think symptoms are impairing you, could they be corrected using behavioural techniques? Can someone help you to be more organized? Will using a pocket PC help organize you? Could counselling help you improve social skills, for instance teaching you how not to talk too much or interrupt? Are there self-esteem or anxiety symptoms that need to be addressed with counselling? ADHD spouses can get burned out from having to repeat instructions and constantly organize their partner. Does your spouse need support and counselling? Could couple counselling help?
Measure your symptoms
Measure the frequency and severity of your symptoms. This gives you a more objective way to measure improvement. You can keep note of how often you are late for meetings. You can track your level of efficiency with paperwork. You can measure how many pages of a book you can read. Are you able to follow instructions more closely and make fewer mistakes at work? Choose three or more specific situations to monitor your response during treatment.
Medication
Medications can help and harm. Before you take any drug, know the name, the dose and your condition that the drug is treating. Learn the most common side effects, the most dangerous side effects, and what long-term problems are associated with your medication. Are there dangerous drug interactions? Ask your pharmacist and other health care professionals for help. Create your treating team. If there is a difference in the information you receive, your doctor can help you sort these out.
The stimulant class of medications, such as dextroamphetamine and methylphenidate, has been used for years to treat ADHD. Newer medications are available. There are both short-acting and long-acting stimulants. Addiction, excessive use, misuse and withdrawal can occur with drugs in this class. Doctors tend to be careful when prescribing them.
Stimulants can help a person to focus so paperwork can be completed in a timely manner. They can help individuals who have not been able to get job promotions because ADHD kept them from studying for exams. Stimulants may help individuals with ADHD who are so scattered they cannot hold jobs or are having problems in their marriage.
Stimulants should not be used to help you to stay up longer. If you do this, you risk addiction, exhaustion, toxicity and withdrawal. Stimulants should be used with caution if you have certain medical conditions. As well, they do not always work. They can even make your condition worse. Doses start low and are raised over time. Remember, these medications do not correct the underlying problem. Like high blood pressure medications, they control symptoms while they are being taken. However, problems return if the medicine is stopped.
The use of non-stimulant medications is becoming more common. Bupropion is an antidepressant that has been effective for some ADHD patients. Bupropion is also sold as Wellbutrin SR™, an antidepressant, and Zyban™, an anti-smoking agent. Do not use both of these drugs at the same time. You could become toxic from double dosing.
Some of the older tricyclic antidepressants can help with adult ADHD. Again, there are both advantages and disadvantages to using this class of medication. You can discuss this with your doctor and pharmacist.
Do you have other psychiatric conditions, such as a depression or an anxiety disorder? If so, your doctor may choose one of the newer selective serotonin reuptake inhibitor (SSRI) type antidepressants instead of a stimulant in the beginning phase of your treatment. No matter which drug you take, re-evaluate it on a regular basis and tell your doctor if you have concerns.
As you can see, there is much to do and consider before saying to your doctor, 'I think I have ADHD.'
FAMILY HEALTH is written with the assistance of |
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FAMILY HEALTH is written with the assistance of |
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