Attention Deficit Hyperactive Disorder (ADHD in Adults)

Attention deficit hyperactivity disorder (ADHD), a condition that is typically associated with children, can also affect adults.

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What is ADHD in Adults? 

Attention deficit hyperactivity disorder (ADHD) causes people to feel restless and have trouble maintaining attention. ADHD is a mental health condition, and those who suffer from it exhibit inattention, hyperactivity and impulsive behaviour. Having ADHD makes it hard to keep a calm mind and body, or to think before acting. 

These problems can make everyday life difficult, and can interfere with school, work and relationships. It can cause poor job or academic performance, problems in relationships with family, friends and colleagues, and low self-esteem. Adults with ADHD may find it difficult to focus and prioritise, leading to missed deadlines or forgotten meetings or social plans. The inability to control impulses can range from impatience when waiting in a queue or driving in traffic, to mood swings and outbursts of anger. 

No studies have been done in Singapore, but research overseas shows that ADHD occurs in some five percent of children. About half of children with ADHD continue to meet criteria for ADHD as they age. All adults with ADHD would have had ADHD as children, even if it was never diagnosed. Some people will have fewer symptoms as they age, while others continue to have significant symptoms as adults.

Adult ADHD Signs and Symptoms

Symptoms of attention deficit hyperactivity disorder fall under three main categories:

Inattention

Does not pay close attention to details, or makes careless mistakes
Has difficulty concentrating on tasks and activities
May not seem to be listening when spoken to directly; appears to be distracted or daydreaming
Often does not follow through on instructions and fails to finish work or chores, or may start tasks but quickly loses focus and is easily sidetracked
Has difficulty organising tasks and activities, is messy, disorganised, or has poor time management
Avoids tasks requiring sustained mental effort
Often loses things, or is forgetful in daily life
Easily distracted by unimportant stimuli

Hyperactivity

Fidgety or constantly tapping hands and feet
Unable to remain seated even when it is necessary, or is uncomfortable being still for an extended time
Often feels restless, or moves about in situations where it is inappropriate
Unable to work or engage in leisure activities quietly
Often talks excessively

Impulsiveness

Blurts out an answer before a question has been completed
Has difficulty waiting his or her turn
Often interrupts conversations or activities, or takes over what others are doing without permission

These symptoms occur across all settings — at home, at work, and in other social environments — and would have been present before the age of 12.

Early identification and treatment of the condition in childhood aim to reduce negative consequences in later years. Symptoms of inattention tend to be more persistent than hyperactive-impulsive symptoms, and are therefore more likely to last in adulthood. 

An adult’s maturity can also make living with ADHD easier, as adults are more likely to be aware of their symptoms. In addition, they have more freedom over their choices and can choose careers  in which they can better manage their condition. 
 

Seeking Help

A person who has had trouble focusing, paying attention, or sitting still from a young age may regard such behaviour as normal. It is often a friend, co-worker or spouse who first notices the symptoms of ADHD in an adult who was not diagnosed in childhood.

If you think that you or a loved one may have ADHD, talk to your family doctor or a mental health professional who may suggest a referral to a psychiatrist for a formal evaluation. The psychiatrist will look closely for the above-mentioned symptoms, as well as make sure that the symptoms are not caused by other conditions that can look like ADHD.

The psychiatrist may ask to speak to a caregiver who looked after the person as a child, or request to look at old school reports to gain an understanding of whether these symptoms were also noticeable during the person’s childhood.

Treatment for Adult ADHD

While ADHD cannot be cured, medication for adult ADHD or psychological therapy can help lessen the symptoms.

Doctors typically use stimulant medicines, such as methylphenidate, to treat the symptoms of ADHD. These help with focus, concentration and impulsiveness. However, medications that are used to treat depression and other conditions can also be used to help with ADHD symptoms.

For many adults, combining medication with psychological therapy is the most effective treatment. Cognitive behavioural therapy (CBT) is a recognised method that helps to reduce the behaviours and habits that may have developed as a part of ADHD, and improves coping and problem-solving skills. 

Lifestyle Changes and Coping Strategies 

Working with health professionals to find the right treatment for ADHD is critical to living well with the condition. However, there are also non-medical strategies that can help. 

Get Active 

Exercise is excellent for the body and the mind, and in adults with ADHD, it is a healthy way to burn off excess energy before they sit down to focus on work. Make sure to schedule exercise into your day or week.

Eat Well and Sleep Well

A balanced diet rich in colourful fruits, vegetables, whole grains, lean proteins and healthy oils is essential for maintaining physical and mental wellness. At night, a regular bedtime routine can help you relax and get a good night’s sleep. Some ADHD medicines can reduce appetite and make it harder to fall asleep. If these side effects are prominent, ask your doctor about other treatment options.

Develop a Routine and Stick to It

Many people do well when tasks and demands are consistent and predictable. Maintain a regular schedule and organise essential items (such as keys, wallets, glasses and bags) so that they are left in the same convenient location ready for the next day.

Supporting a Loved One with Adult ADHD 

Adult ADHD is a condition that is often misunderstood and can be damaging, especially in close relationships. The first step to turning things around is to try to see things from the perspective of the ADHD sufferer. The best way to do this is to simply ask any questions you may have and then listen. Find time to talk to your loved one when both of you are calm, and allow him or her to describe how he or she feels without interruption. 

Further Tips to Help You Organise Your Life

Make to-do lists — smartphone apps and checklists are a satisfying way of ensuring tasks get completed
Create a schedule — keep it handy in a smartphone, tablet, computer or diary
Simplify — break up large projects into smaller tasks, each with its own deadline
Have a routine — consistency helps keep the week’s tasks predictable and easier to manage
Reduce distractions 
Write down distracting thoughts to keep them at bay
Have a clutter-free workspace
Avoid distracting background noises
When at work, put away or turn off potential distracters such as smartphones, games, internet access, and emails
Reward yourself often — feeling appreciated for completing a task or a job well done is a great motivator
Remember what is important to you — keeping the larger goal in mind can help with staying motivated and focused
Build in accountability to others — a calendar is a great way to remember a meeting; asking a colleague to fetch you on the way to the conference room will make it more likely that you will attend; being part of team where others count on you might provide motivation for tasks or projects

This article was first published in Caring Magazine, March/April 2016. 


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