Home   ADHD info  |  News & Events  | Join Adhasa | Shop  | Branches | Articles on ADHD  | Research  | Links |
 

Adult ADD: fact or myth?

Ever been driven to distraction by the motor mouth in the office? The person whose boundless energy and total disorganisation drives you to distraction? Perhaps you are living with an unidentified ADD sufferer. ADD – Attention Deficit Disorder with or without hyperactivity – a condition said to be identified in children only. Well, no longer – the question is where do these childhood sufferers go – into adulthood naturally! And … they become your friends, lovers, co-workers, bosses.

For some the problem has never been identified. Others are identified as those lucky few who find a place where they can put their boundless energy to work, working long and demanding hours with very little sleep. Sadly, some find it difficult to hold down a job, their sense of disorganised chaos, their lack of focus, their lack of drive to complete a task sees them bounce from job to job – great starters but never able to finish.

If this is you or someone you know – possibly unidentified ADD is the cause. Many adults with identified or unidentified ADD look back over their school careers and point to being brilliant on the sports field and dismal in the classroom. They are proud of their single-minded focus on one activity requiring high level of energy and react with embarrassment when talking about results in the classroom. Most have found their lives totally turned up side down at a whim and are unable to know or understand why. Perhaps one needs to first look at and understand what this ADD thing is.

Attention Deficit Disorder is a recognised medical condition in both adults and children. Usually described as the inability to stay focused and to concentrate for any length of time. This can include hyperactive behaviour which contributes to the lack of attention and challenges a person to be constantly on the go, with very little sleep or focused energy. As adults, many look back over a difficult time at school, some have reading problems, many have depression and a string of broken relationships. Some have dabbled in drugs or religion in an effort to control themselves and to find a sense of meaning in their lives, most are highly intelligent and articulate with rapid speech patterns. Others are affected by the total lack of drive and focus and this hypo-activity leads them to be described by others as lazy, slothful, unable to complete a task, unreliable.

In many cases, the adult ADD is usually treated medically for depression and insomnia as ADD is not easily recognised. Of interest is the fact that many of the ADD sufferers report that Ritalin has had a positive effect on their lives and that they feel more positive and in control once medicated. Others fear medication, saying it is a crutch and an excuse but then try to self medicate instead.

What can be done? – a good first port of call is a neurologist who is able to assist in the identification of the condition and prescribe the right medication. Secondly, find a psychologist who understands the condition and can work closely with you and your partner to shore up an often stormy relationship. Thirdly, join the ADD support group – a group dedicated to education and support of both those suffering from the condition and those who survive around them.

Terry Wilke

M.Ed. (Psychology)

Educational Psychologist

 

AN OVERVIEW OF
ADD IN ADULTS

Until the late 1980s it was thought that Attention Deficit Hyperactivity Disorder (ADHD) was outgrown by adolescence, and always by adulthood (Barkley, 1998.  Research has however suggested that up to two out of three children diagnosed with ADHD continue to experience symptoms into adulthood.

It is generally accepted that ADHD often manifests differently in adults, with hyperactivity becoming more internalized and subtle with age.  As we learn more about ADHD in adults, we realize how far-reaching its impact can be academically, vocationally and in social areas.  More and more adults seem to be recognizing ADHD symptoms in themselves. 

Many adults recognise ADHD symptoms in themselves when their own children are diagnosed and it is often these adults who approach the ADHD Support Group in search of help and more information. 

ADHD is not an all-or-nothing condition but can fall at any point along a continuum.  It is important to note that not every person will experience all the different symptoms and that most people experience some of these symptoms at some point in their lives.  Barkley (1989) stresses that in order for an adult to be diagnosed as ADHD, he/she must have suffered as a child, even if not formally diagnosed in childhood.

As yet, there are no diagnostic criteria for adult ADHD which have been validated by trials, as there have been for children.  Nevertheless, two well-known American practitioners in the field of ADHD, E.M. Hallowell and J.J. Ratey (1995) have compiled a set of frequently reported symptoms of adults with ADHD, based on their experience with patients.  A number of themes that emerge from their list of symptoms include:  distractibility, impulsivity, and hyperactivity or restlessness, as well as problems with mood, depression, self-esteem and self-image: 

A CLOSER LOOK AT
THESE SYMPTOMS:

Distractibility:  Adults with ADHD are frequently easily distractible.  They have trouble concentrating and focusing their attention on activities such as reading, having a conversation or listening to the radio.  They also tend to be forgetful.  Conversely, ADHD adults frequently also have the ability to hyper-focus, highlighting the view of Hallowell and Ratey (1995) that this is a syndrome of “attention inconsistency” rather than “attention deficit”.

Impulsivity:  Impulsivity in the form of poor response inhibition or poor self-control can present either verbally or actively.  Verbal impulsivity may include butting into a conversation or verbalizing thought before thinking them through thoroughly.  Active impulsivity may include changing plans at the last minute, spending money excessively or committing oneself without first thinking things through.  Low frustration tolerance and poor organizational skills may also be symptomatic of impulsivity.

Hyperactivity/Restlessness:  Hyperactivity as seen in children, usually does not present in adults.  Instead it often presents in adults as restlessness in the form of pacing, fidgeting, nervousness, poor follow-through, impatience and stress intolerance.  A sense of restlessness may also precipitate adults with ADHD to frequently look for high stimulation or novel experiences.

Moods, depression, self-esteem and self-image:  Many of these symptoms may be due to experiences of frustration and/or failure as a consequence of being distractible, impulsive and/or restless.

Some untreated adults with ADHD are at risk for developing addictive behaviours such as substance abuse, gambling, shopping or eating.  Such behaviours may not only be indicative of impulsivity, but also the sufferer’s way of attempting to ‘soothe’ his/her underlying ADHD symptoms.  On the positive side however, ADHD adults are often creative, entrepreneurial, intuitive and intelligent individuals.  They are also often dynamic.

SUGGESTIONS FOR THE
MANAGEMENT OF ADULT ADHD

Education:  Educating oneself and others abut ADHD is essential for adults coping with ADHD.  Information may be obtained from a variety of sources including talks, tapes, videos, books and websites.  Education about ADHD is empowering both for the sufferer and for those with whom they live.

Structure:  Structure provides one with a reliable system of external controls that is essential to compensate for unreliable internal controls.  These controls may include lists, reminders, notepads, diaries, schedules, weekly planners or alarm watches.  Regularly used items such as keys, stationery or tools should be kept in a set place.  While attempting to perform activities, interruptions should be kept to minimum.  Putting such a system of structure in place will be beneficial in promoting a sense of order and calmness in one’s environment which is in turn confidence building and empowering.

Psychotherapy or coaching:  Psychotherapy includes reframing the disorder as being neurobiological rather than as a disorder of character; and empowering individuals to believe that they can be different and that their lives can be improved.  Coaching may help people identify areas of personal growth and change, as well as develop and step-by-step action plan to achieve those goals, and motivate them in reaching those goals. 

Diet and Supplementation:  A healthy diet free of anti-oxidant preservatives, synthetic additives and colourants, as well as supplements in the form of essential fatty acids (omega 3 and 6), and a good multivitamin and mineral supplement have been found to be particularly helpful for ADHD children as well as for adults with ADHD.

Medication:  The most commonly prescribed medications for ADHD are stimulants (Ritalin).  Tricyclic anti-depressants as well a various other medications are also sometimes prescribed.

Merle Croock

November 2003

 

References

ADHD news (Spring 2002, Spring 2003)

The National Attention Deficit Hyperactivity Disorder Information and Support Service (ADDISS)

Barkely, R.A. (1998).  Attention Deficit Hyperactivity Disorder.  New York: Guilford Press.

Hallowell, E.M. and Ratey, J.J. (1995).  Driven to Distraction.  Touchstone, New York, New York.

WEBSITES

www.addiss.co.uk

www.adders.org

www.addwarehouse.com

www.breggin.com

www.chadd.com

www.rabiner.com