“Suddenly, a Lifetime of Struggles Made Sense”

ADHD was once considered a pediatric disorder, but it’s now clear that many children never outgrow their symptoms. In fact, up to 80 percent of children diagnosed with ADHD have symptoms throughout adolescence. And up to 75 percent will have it as adults. Hyperactive and/or impulsive symptoms often improve in adolescence, while inattention persists or gets worse as you age.

ADHD is a neurologically based condition caused by a shortage of the neurotransmitters norepinephrine and dopamine in the brain, and the inability of the brain to transmit these chemicals to the brain's neurons. ADHD is not caused by poor parenting or too much sugar, and it is not synonymous with laziness. Most adults with ADHD, in fact, work incredibly hard to devise coping systems to compensate for symptoms.

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Adults with ADHD find it hard to manage clutter, be on time, and complete projects. They may interrupt others, or blurt out words without thinking. They are often distracted while driving, reading, and doing other tasks — all of which leads to trouble at work and home. Exhibiting one or more of the behaviors above does not mean you have ADHD. For a full overview of symptoms, read on. 

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Doctors diagnose ADHD using detailed criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders. The DSM-V defines ADHD and stipulates that all cases are diagnosed as ADHD, with one of three quantifying types: Primarily Inattentive, Primarily Hyperactive-Impulsive, or Combined.

• Primarily Inattentive type: People with inattentive ADHD make careless mistakes because they have difficulty sustaining attention, following detailed instructions, and organizing tasks and activities. They are forgetful, easily distracted by external stimuli, and often lose things. This is more common in adults and girls.
• Primarily Hyperactive-Impulsive type: People with hyperactive ADHD often fidget, squirm, and struggle to stay seated. They appear to act as if “driven by a motor” and often talk and/or run around excessively. They interrupt others, blurt out answers, and struggle with self-control. This is more common in children and men.
• Combined type: People with combined-type ADHD demonstrate six or more symptoms of inattention, and six or more symptoms of hyperactivity and impulsivity.

To be diagnosed with ADHD, at least five of the symptoms that follow must be present, be chronic, and be noticeable before age 12.

Most teens and adults with ADHD learn to control their energy, and may not appear overtly hyperactive. On the inside, however, they feel jumpy and restless, even when they have nothing to do. If you have inattentive ADHD, your mind feels like it is whirring along at 90 miles per hour, skipping from topic to topic. People might call you a chatty Cathy or struggle to follow your logic. The hyperactivity of the condition expresses itself verbally and mentally more often than it does physically.

You start gathering dirty clothes, and then the phone rings. Your spouse reminds you it's trash pick-up day and that inspires you to go buy new recycling bins. Two hours later, the laundry is still untouched. Adults with inattentive or combined-type ADHD have trouble staying on task and finishing projects. It's not that you don't want to follow through, you just notice stimuli that others tune out easily, and even when spoken to directly, you have trouble focusing on the conversation.

You act impulsively, whether it's splurging on those way-too-expensive shoes, going out when you should be studying, or eating too much. Since you can't wait for people to finish their sentences, you often interrupt, no matter how many times you resolve not to. Acting without thinking is a common trouble for adults with ADHD, which can lead to regret, financial problems, and social trouble after sticking your foot in your mouth too many times.

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You rarely leave the house with everything you need on the first try. Where did I put the keys? Is the oven off? Can you call my phone? You spend a big portion of every day looking for things you've misplaced, or retracing your steps to see if you've actually done something. The inattention of adult ADHD can come out as spaciness that leaves others frustrated with your behavior — and you feeling like you let everyone down.

Why is it that when you're playing a video game, hours go by in a flash, but when you sit down to pay the bills, you can't seem to concentrate even for a second? Adults with ADHD are able to pay attention to tasks that interest them — sometimes so intensely they lose track of time and place. It's called hyperfocus, and it doesn't often kick in for “boring things” like finishing a tedious project at work. You can feel inadequate or like you're falling short at life because you just.can't.get.it.done.

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Your to-do list is never-ending, but you never seem to cross any important tasks off. You know when you need to pick the kids up at school, but somehow you're always late. Executive functions — planning ahead, getting organized, managing time, concentrating on a task, and being motivated — are often impaired in adults with ADHD, leaving you feeling scattered and disorganized.

Adults with ADHD have higher divorce rates. Often, we get swept up by the novelty and intensity of a new relationship, only to lose focus later. Non-ADHD partners may interpret lack of focus as lack of interest. We also have trouble proactively finishing chores, paying bills, and remembering important dates, which can cause relationship problems.

You struggle to fall asleep at night, or wake up during the night. You describe yourself as a night owl — in part because your bullet-train brain keeps racing with thoughts and worries long after it's supposed to shut off. You stay up too late and then have trouble getting out of bed in the morning. Many of the same regions of the brain regulate both attention and sleep, so a brain that has trouble paying attention will often have trouble going to sleep.

There is no perfect career for someone with ADHD. Adults diagnosed with ADHD succeed in many different fields, but they all tend to hate monotonous jobs that require a great attention to detail and long periods of sustained focus with little stimulation. Russell Barkley, Ph.D., suggests careers in sales, acting, the military, and many trade professions. Your ability to hyperfocus and to generate creative ideas can be an asset in these and other jobs.

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While scientists are still looking for the gene (or genes) responsible for ADHD, the condition does appear to run in families. Children with ADHD usually have at least one close relative with ADHD, and studies have shown that one third of all men who had ADHD in their youth have biological children with ADHD. Often, parents will go for an evaluation after recognizing their child's symptoms in themselves.

There is no single test for ADHD in adults. Your physician will make a diagnosis after taking a detailed medical history, and interviewing people in your life like parents, and former teachers. Sometimes neuropsychological tests are given when looking for co-occurring conditions, such as learning disabilities. Conditions like mood disorders, OCD, ODD, autism, and sensory processing disorder (SPD), can cause symptoms that mimic those of ADHD. Research now suggests that more than half of all individuals who have ADHD also suffer from at least one co-existing condition, which makes symptom detection and diagnosis difficult.

ADHD is not like diabetes, where a person tests either positive or negative. Instead, it’s more like a mood disorder, where symptoms occur along a continuum of severity. In order to obtain a diagnosis, symptoms must be severe enough to interfere with normal functioning at home and at work.

Stimulant medications are often prescribed to treat ADHD. The two basic classes — methylphenidate and amphetamine — are sold under several different brand names and are administered as pills, patches, or liquids. No drug can cure ADHD, but the right medication regime can help manage core symptoms. Studies have shown that stimulant medications alleviate symptoms in approximately 80 percent of those diagnosed with ADHD. Improvements are generally seen 30 to 90 minutes after a dose is administered.

Most adults improve with medication, but many continue to struggle with poor habits or low self-esteem. ADHD coaches can help. They are different from psychiatrists in that their focus is practical and goal-oriented. An ADHD Coach is like a life coach, but they have additional knowledge specific to ADHD. Most coaches will offer a free initial interview to make sure the match is a good fit.

While ADHD is not caused by too much sugar or other nutritional factors, eating healthy meals can help to keep symptoms under control. Omega-3 supplements supply healthy fats that can improve focus. Protein steadies blood sugar levels, increasing attention. Foods rich in fiber (whole grains, fruits and vegetables, and legumes) can stabilize energy levels.

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