Signs of Adult ADHD

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millions of adults are living with

attention deficit hyperactivity disorder

without education and treatment ADHD can

lead to chronic fatigue anxiety

disorganization and issues at work and

at home

as a triple board-certified

neuropsychologist dr. Judy Howe as a

go-to expert in this field so in this

series she shares that expertise and

breaks down how to reach the right

diagnosis find sensible treatment

options and realistically achieve goals

at work and at home when living with

ADHD welcome back to med circle dr. Judy

always wonderful to see you so great

we're talking about ADHD but

specifically in adults let's first

define what ADHD is so attention deficit

hyperactivity disorder is a condition

where the individual might have a lot of

attention symptoms where they have

difficulty focusing or they might also

at the same time have hyperactivity and

impulsive

it's a developmental disorder means that

some symptoms have to be present in

childhood although for a lot of people

they're able to sort of manage until

they get older and the task demands of

everyday life become greater now how is

this different from a dee dee so a dee

dee was an older term where they talked

about it in earlier versions of the DSM

and a DD didn't contain the

hyperactive-impulsive news features

but through a lot of research they found

that actually they were correlated that

it's actually one part of the same

syndrome although still there are people

who have ADHD but inattentive type

meaning that they don't really have the

hyperactivity or impulsiveness symptoms

then we have the individuals who are

just hyperactive-impulsive not

inattentive there's relatively fewer

people that are like that and then we

have a good number where they have the

combined symptoms of both the

inattention and the impulsivity and

hyperactivity now what are some common

misconceptions when it comes to adults

who either believe they have ADHD or

have received the diagnosis I feel like

everybody thinks that they have ADHD and

I think everybody is on the spectrum at

some point at some time but if you just

have inattentiveness occasionally but it

doesn't

actually impair your functioning and

you're not that distressed about it then

you're not really going to qualify for

that diagnosis of ADHD adulthood ADHD is

relatively at 50% of the prevalence rate

as childhood ADHD so national studies

have shown that ADHD in childhood is

about 5% of the population in adulthood

it's two and a half so roughly 50% of

people recover from ADHD by the time

they hit the age of 18 and then 50% go

on to continue to suffer symptoms in

their adulthood and I think a big

misconception is that it looks the same

for some reason because it doesn't in

adulthood ADHD the hyperactive and

impulsive features look very different

as a child the child's running around

the classroom getting out of their seats

really being very rule not abiding you

know which causes some negative

attention and that's usually when the

teachers are going to fight them and

talk to the parents and it's all hood

they may still have that restlessness

but as adults we're a bit more

controlled in terms of our behavior so

we're not going to be running around

when we know we're not supposed to but

you might just feel really fidgety and

so sometimes you see individuals like

tapping very nervously on the desk or on

the table and that may be a

manifestation of an adulthood form of

combined ADHD now we'll get into the

diagnostic process and the criteria in

the DSM for ADHD but as you alluded to

earlier a lot of people think that they

have ADHD because they can't sit down

and read a book for more than an hour or

they can't really focus when they're

having a conversation when is it ADHD

and when is it you're just not

interested in whatever is going on

exactly and I think that that is even

more confusing because of the fact that

right now our culture promotes a lot of

inattentiveness there's so many things

going to grab at our attention there's

been a lot of research that shows that

the more often that you're on social

media the more you actually do start to

show some signs I've been attentive this

doesn't mean that social media causes

ADHD okay but you are going to be more

inattentive just the other day I was

watching the news and not only are the

newscasters talking there's a little

ticker on the bottom that's rolling with

more facts

there's pop-ups in the corner and then a

couple of people that I was watching the

news with were

also looking at the app for CNN at the

same time that we were watching CNN and

so yeah there's a lot of things pulling

at our attention anyway so everybody

experience it from time to time but when

you actually have the clinical features

of ADHD it's very different and in an

adult there's a lot of emotional

dysregulation going on to have a harder

time tolerating frustration they may

have a lot less patience it may be a lot

harder for them to plan ahead and to

organize themselves so they feel very

disorganized and jumbled in their head

all the time and again this is not just

periodically you've got a busy day or a

week this is something that's persistent

that keeps coming up that actually does

cut into your quality of life and

possibly even impairs relationships and

in fact one of the biggest complaints of

adulthood ADHD is difficulty in their

relationships whether it's with friends

or romantic partners because if as you

might imagine if you're not really

attending to your partner you're

constantly asking for repetition and

your partner it gets very impatient with

you saying you never listen to me

you're ever focusing on me and so it can

cause a lot of difficulties in terms of

their relationships what are you finding

as common co-occurring disorders with

ADHD the most common co-occurring

disorder with ADHD is depression so

that's been something that's pretty

well-established and in the literature

that happens to people who have

childhood ADHD as well as adulthood ADHD

as a result of people underperforming in

school because they're diagnosed with

ADHD they start to develop anxiety as

well so that's another common

co-occurring issue and the anxiety is

almost secondary to the ADHD oftentimes

because their ADHD makes them feel

incompetent and so then they start to

have performance anxiety zand feelings

of inadequacy that then add on to those

anxiety symptoms that eventually become

clinical there's also a subset of ADHD

children and adults that experience

substance issues and so individuals with

ADHD tend to have a higher risk for

substance use later they tend to try

substances earlier than their peers and

as adults they tend to have more

difficulties with substance use I think

another really important correlating

factor is that adults with ADHD have a

higher risk for suicidal ideation

than the average population so they are

more at risk for a number of different

types of psychological issues and on top

of that they're also oftentimes comorbid

with other types of learning

disabilities and again sometimes it's

hard to tease out if the learning

disability is really its own disorder or

if the learning difficulties really come

from the ADHD right it originates from

the fact that they can't pay attention

so they haven't been able to take in the

kind of information they should have by

a certain age or by a certain grade so

if I'm an adult

and I have been diagnosed with

depression and ADHD do I treat one

before the other or both at the same

time I think it's always helpful to

address both the same time because at

that point I feel like for adults they

really have seen the interplay between

those two conditions you know they kind

of reinforce each other the ADHD leads

to more emotional dysregulation that

could include mood dysregulation and

that mood dysregulation makes the ADHD

worse one of the symptoms of depression

and not everybody has but some people do

is that they have difficulty making

decisions and problems concentrating so

when somebody also has ADHD it's gonna

be interesting to delineate where does

that concentration problem come from is

it part of the depression or is it part

of the ADHD and maybe it doesn't really

matter that much

it's just that they obviously are

related and probably the best way

forward is to treat both at the same

time know you have a private practice as

well as the hundred other things that

you do and part of that private practice

I'm assuming you've seen adults come in

with ADHD what are they struggling with

with untreated ADHD so untreated HD for

adults it can wreak a lot of havoc into

their lives it's hard for them to stay

motivated to accomplish to not get in

trouble at work to hold the job in fact

I have found a lot of individuals with

ADHD as adults they've managed their

work-life in such a way that kind of

makes the ADHD less prominent so what I

mean by this is a lot of adults with

ADHD they become their own bosses

because then no one's disciplining them

they have to discipline themselves

though so it could get in the way of

their level of success but if they're

running their own store or they're an

entrepreneur and running their own

company then

sometimes I see adults with ADHD

fielding out tasks that they're not very

good at because of their ADHD conditions

that there are people who can work on it

for them and then they only focus on the

types of tasks that they really want to

do themselves but the caveat of course

is that people with adulthood ADHD they

don't love schedules and so they tend to

have these more entrepreneurial type

positions where they can wake up and

start working when they want to and

maybe they'll work at night too but it's

kind of on their own time but that

sometimes can make the ADHD worse

because people with ADHD need structure

and so maybe as a way of them trying to

design their life around their condition

sometimes they make those symptoms

actually a little less easy to manage

because they're not sleeping at the

right time right they're up at all hours

and then it cuts into their next day and

the productivity and the concentration

that they need yeah understood well we

have a lot to talk about in this series

and we'll start in our next session

talking about the causes and different

risk factors associated with adult ADHD

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