ADHD in Adults: Symptoms, Signs, and Treatment

ADHD used to be commonly associated with children, nowadays, as more research is carried out and our education on the condition grows, ADHD is recognised as a lifelong condition that persists well into adulthood. Attention Deficit Hyperactivity Disorder in adults is characterised by persistent patterns of inattention, hyperactivity, and/ or impulsivity and if not diagnosed and treated early enough, can impact relationships, work performance, and overall well-being.

Some individuals receive a diagnosis in childhood, others don’t obtain an ADHD assessment and diagnosis until well into adulthood, and some remain undiagnosed and struggling with feeling “different” for many years. It is believed that ADHD is significantly underdiagnosed in adults.

How ADHD presents in children and adults can be vastly different. If you think you may have ADHD as an adult but are confused about your symptoms or possible other causes of why you feel different, this guide aims to help you understand that. Below we will look at the signs and symptoms of ADHD in adults, the challenges you could face if you have ADHD, treatment options, and how to live a life that helps you excel and be your true, authentic self. 

How Does ADHD Present in Adults?

Symptoms of ADHD closely resemble those of childhood ADHD; however, the intensity of the symptoms can decrease, specifically hyperactivity. The Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5) states that “Adult ADHD types are predominantly inattentive, predominantly hyperactive, and/ or impulsive, or combined.”  The main symptoms of ADHD in adults relate to inattention and impulsivity, although some adults still struggle with hyperactivity.

Inattention.

This includes poor attention to detail at work and procrastination or difficulty getting started on a new project. Being forgetful about important meetings or dates and appointments for the family, finding it hard to focus and regulate attention, and having poor time management and organisational skills.

Impulsivity.

Feeling restless, unable to regulate emotions and a low frustration tolerance to work colleagues and children. Talking excessively through work meetings, interrupting conversations frequently, not appearing to be listening to important information and fidgeting.

Hyperactivity is mainly associated with childhood ADHD with many children growing out of heightened hyperactivity when they reach adulthood. However, in a lot of cases, hyperactivity is still present, the intensity dies down when the individual gets older or the hyperactive energy morphs into hyperfocus, exercise and other strong interests.

Symptoms of Adult ADHD.

Adults with ADHD may find that they struggle with:

• Organisation - such as keeping track of personal belongings, organising themselves and others for important appointments and meetings, scattered thoughts and prioritising.

• Lack of Focus – including being easily distracted, overlooking details, keeping track of conversations, and not finishing tasks.

• Hyperfocus – becoming so engrossed in something that awareness of anything else is lost, including people, time, and surroundings.

• Forgetfulness – continuously forgetting where you’ve put something, forgetting important birthdays and dates, or appointments.

• Time Management –showing up late for important events, procrastinating on important tasks, and ignoring projects considered not interesting.

• Relationship Issues – getting easily bored, inattentiveness, and interrupting conversations make it hard to form friendships and maintain work acquaintances, and romantic partnerships. Someone with ADHD may come across as uncaring, irresponsible, and insensitive.

• Restlessness – a constant need to do something and be on the go, not feeling able to switch off which leads to difficulties sitting still, a need to move around frequently by tapping their hands or feet or shifting in their seat.

• Emotional Struggles – frustration and anxiety are common with ADHD, feeling bored and needing to seek out excitement. The mind can also replay worrisome events on repeat.

• Personal Negativity – those with ADHD end up being hypercritical of themselves through continuous self-assessment of why they are different from others.

• Impulsivity – can include rushing through tasks and making mistakes, interrupting conversations, acting without thought of consequences, and being socially inappropriate.

• Lack of Motivation – this can function alongside needing to do everything all at once. Procrastination and organisational difficulties can make it hard to find motivation for a task that takes a long time.

• Physical Health – disorganisation, emotional issues, impulsivity, and lack of motivation can make it hard to maintain physical health.

• Fatigue – hyperactivity, sleep problems, ADHD medication side effects, and a constant effort to focus can lead to fatigue of the mind and body. 

What is the Cause of Adult ADHD?

It’s not entirely clear what the cause of ADHD is, it does, however, have strong links to genetics. ADHD is a heritable condition, with approximately half of parents with ADHD having children with the condition also. Brain injury, trauma, or events that affect the central nervous system such as a pre-term birth and alcohol use during pregnancy, are also thought to be linked to the onset of ADHD. Lastly, environmental factors such as extreme stress, trauma, and certain toxins like lead or bisphenol-A, can impact the severity of ADHD symptoms.

Challenges Adults with ADHD Face.

ADHD can impact every aspect of daily life, which for adults include the workplace, social situations, relationships with friends, children, and partners, and their relationship with themselves. If not diagnosed and left untreated, ADHD can lead to very low self-esteem, anxiety and depression. 

Navigating Relationships.

An ADHD adult’s challenges with attention, active listening, having a low frustration threshold, and an inability to complete tasks or remember important dates can lead to difficulties in making and maintaining relationships, including friends, family, romantic, and other social connections. 

Higher Education and the Workplace.

Poor time management, procrastination, concentration and forgetfulness make it difficult for an adult with ADHD to excel in the workplace and when studying in higher education. Leaving ADHD undiagnosed and untreated can make studying, obtaining and maintaining a job incredibly difficult.

Increased Likelihood of Comorbid Conditions.

ADHD very rarely exists on its own, other conditions such as anxiety disorder, social phobia, PTSD, substance use disorder, depression and other mood disorders are commonly linked. Around 60% to 70% of adults with ADHD have a comorbid disorder.

Difficulties with Safety and Taking Direction.

Rule-breaking, ODD (Oppositional Defiance Disorder), criminality, and other legal and safety issues have been linked to ADHD. One study into ADHD and its effects on safety and criminality found that children who showed ADHD symptoms were more likely to engage in criminal activities as young adults compared to neurotypical individuals.

Issues with Substance Abuse.

ADHD adults are twice as likely to be diagnosed with substance use disorder (SUD) compared to those without the condition. This includes the misuse of alcohol and drugs as a way to self-medicate and manage ADHD symptoms. 

Adult ADHD Assessment and Diagnosis.

An adult ADHD assessment will comprise comparing symptoms against the DSM-5’s nine symptoms that suggest predominantly inattentive ADHD and nine symptoms that suggest predominantly hyperactive/ impulsive ADHD. An adult must display five of the nine symptoms in two or more settings such as work and at home for at least six months. 

An experienced clinician will complete a medical exam to rule out any other related conditions and conduct a clinical interview to gather information about family and symptom history, especially during childhood. They will then use the ADHD rating scales completed by adults or those known to them to assess their symptoms, strengths, and weaknesses.

Treatments for Adult ADHD.

The treatment that has been found to work best for adults with ADHD is a combination of medication and therapy. Working closely with a medical professional to get the right dosage of medication and to find the right therapist or counsellor can alleviate symptoms and help adults with ADHD excel and lead lives that make them happy.

Stimulant and Non-Stimulant Medication.

These are the two main types of ADHD medication. Stimulant medication is the most common type of prescription medication for ADHD and works by increasing the levels of dopamine and norepinephrine in the brain. By increasing the levels of these neurotransmitters, the ability to pay attention, think, and stay motivated also increases. Stimulant medications fall into two categories:

• Methylphenidates which include Ritalin, Concerta, and Daytrana.

• Amphetamines which include Adderall, Vyanse, and Evekeo. 

Non-stimulant medications increase the levels of norepinephrine in your brain and help to improve attention, focus, and impulsivity. There are several types of non-stimulant medications used to treat ADHD and they are usually classed “second-line” treatments. They include:

• FDA-approved non-stimulant medications such as Strattera or Intuniv.

• Other non-stimulant medications used off-label to address symptoms of ADHD like Clonidine, Wellbutrin, or wakefulness-promoting medications. These are used when clinicians find other forms of ADHD medications are not effective as they show similar mechanisms of action in the body as ADHD medications.

Therapy and Counselling.

Even if symptoms have reduced whilst taking ADHD medication, it can still be difficult to maintain the daily routine of work life, home life, and children. It can also still be difficult to control self-esteem and emotion levels but seeking out CBT (Cognitive Behavioural Therapy), DBT (Dialectical Behavioural Therapy), and ADHD or life coaching can help to condition your brain and create positive patterns of behaviour.

Lifestyle Changes.

Modifying lifestyle behaviours can help alongside medication and therapy and include:

• Balancing your diet to ensure you’re eating healthily but not restricting yourself too much, alongside taking supplements like iron, zinc, and magnesium which are naturally low in people with ADHD. Melatonin can also help with sleep difficulties.

• Getting adequate sleep each night, between seven and nine hours, can have a positive effect on the functioning of the ADHD brain and can help with symptom management.

• Getting enough exercise throughout your day and practicing mindfulness and meditation can help to regulate symptoms and reduce them.

Living with ADHD as an Adult.

Living with ADHD as an adult can be incredibly tough, especially if not diagnosed or treated correctly. It is a lifelong process but with the right support network, strategies, and medication in place, everyone with ADHD has the chance to lead fulfilling and productive lives in that they excel in and are their authentic selves along the way. Building self-awareness coping mechanisms, and seeking professional help can help to improve daily functioning and overall well-being.

Adult ADHD Assessment at a Private ADHD Clinic in Manchester.

Seeking professional help starts with Beyond Clinics, a private ADHD clinic in Manchester with a team of professionals who all have ADHD, therefore have been in your shoes and understand what you’re going through.

Our ADHD assessment for adults is comprehensive, personalised, and thorough and works to help us understand you, your life experiences, and how your ADHD symptoms may have affected your life so far. We know just how important getting the right help is, which is why we prioritise rapid access to ADHD assessment, diagnosis, and if necessary, treatment so that you can start to excel in your life as soon as possible.

If you want to contact us and speak to one of our medical professionals for a confidential chat, don’t hesitate to get in touch today.