Attention Deficit Hyperactivity Disorder (ADHD) – also known as Attention Deficit Disorder (ADD) – is a common behavioural disorder that affects around one in 20 people, mainly men.
The diagnosis is most commonly made in childhood and children with ADHD present constant challenges for parents, teachers and medical profession. Until recently, it was thought that a child outgrew ADHD during adolescence, due to developmental changes in brain chemistry. However, it seems that seven out of 10 children with ADHD mature into adults with ADHD.
Adults with ADHD, like kids with ADHD, have difficulty paying attention, controlling impulsive behaviours and keeping thoughts on track.
The most common symptoms of ADHD in both children and adults are:
A patient with ADHD may have difficulty in school, home, maintaining relationships or holding down a job. If their condition was undiagnosed and untreated in childhood, their academic record may be poor. A lifetime of grappling with this behavioural disorder often means the person has low self-esteem.
In many cases, a person with ADHD turns to drugs or alcohol in an attempt to cope with their feelings of frustration and failure. Rates of personality disorders and other psychological problems, such as anxiety or mood disorders, are high. On the other hand, an adult with properly managed ADHD often shows great imagination and creative flair.
Attention deficit hyperactivity disorder is not limited to children — 30% to 70% of kids with ADHD continue having symptoms when they grow up. In addition, people who were never diagnosed as kids may develop more obvious symptoms in adulthood, causing trouble on the job or in relationships. Many adults don’t realize they have ADHD, leaving them mystified about why their goals seem to slip out of reach.
ADHD in adults follows a slightly different pattern than in children. Adults may be chronically late for work or important events. Adults may realize that their tardiness is undermining their goals, but they just can’t seem to be on time.
One of the hallmarks of ADHD is difficulty keeping your mind on the task at hand. That spells trouble for teens and adults when they’re behind the wheel of a vehicle. Studies show that people with ADHD are more likely to speed, have accidents, and lose their drivers’ licenses.
Adults with ADHD may have trouble prioritizing, starting, and finishing tasks. They tend to be disorganized, restless, and easily distracted. Some people with ADHD have trouble concentrating while reading. The inability to stay focused and follow through on tasks can derail careers, ambitions, and relationships.
Adults with ADHD may have problems with self-control. This can lead to:
Some adults with ADHD can focus intently on things they enjoy or find interesting — the ability to hyperfocus. But they struggle to pay attention to tasks that bore them. The trouble is that many tasks necessary for success in everyday life are dull, from making a grocery list to filing documents at work. People with ADHD tend to put off boring tasks in favor of more enjoyable activities.
It may seem like everyone has ADHD these days, as we respond to text messages, email, calls, and fast-paced work environments. While all of this can be distracting, most people manage to focus on important responsibilities. In people with ADHD, distractions interfere with the completion of vital tasks at home and at work.
If you are often restless and have trouble concentrating, don’t jump to the conclusion that you have ADHD. These symptoms are also common in other conditions. Poor concentration is a classic sign of depression. Restlessness or anxiety could indicate an overactive thyroid or anxiety disorder. Your health care provider will investigate whether these conditions could be causing your symptoms instead of — or in addition to — ADHD.
In people with ADHD, brain chemicals called neurotransmitters are less active in areas of the brain that control attention. Researchers don’t know exactly what causes this chemical imbalance, but they think genes may play a role, because ADHD often runs in families. Studies have also linked ADHD to prenatal exposure to cigarettes and alcohol.
One genetic variation that causes ADHD-like traits is more common in the world’s nomadic peoples. Researchers think that traits such as impulsive behavior, novelty-seeking, and unpredictability might help nomads track down food and other resources. So the same qualities that make it challenging to excel at a desk job may have been an advantage to nomadic ancestor
Many adults don’t learn that they have ADHD until they get help for another problem, such as anxiety or depression. Discussing poor habits, troubles at work, or marital conflicts often reveals that ADHD is at fault. To confirm the diagnosis, the disorder must have been present during childhood, even if it was never diagnosed. Old report cards or talking with relatives can document childhood problems, such as poor focus and hyperactivity.
During an evaluation for ADHD, some mental health professionals use neuropsychological tests. These can include timed, computer-based tests that measure attention and problem-solving skills. Neuropsychological testing is not needed to make a diagnosis, but it can shed light on how ADHD affects a person’s daily life. It can also uncover coexisting conditions, such as learning disabilities.
Coping with the symptoms of adult ADHD can be frustrating in itself. At the same time, many adults with ADHD struggle with depression, anxiety, or obsessive compulsive disorder. They’re also more likely to smoke or abuse drugs. People with ADHD can limit these problems by seeking proper treatment.
The most common medicines for ADHD are stimulants. It may seem ironic that people who are restless or hyperactive get help from stimulants. But there is good evidence that these drugs sharpen concentration by correcting an imbalance of brain chemicals. If stimulants aren’t sufficient, your doctor may prescribe an antidepressant to stabilize mood or a selective norepinephrine reuptake inhibitor, such as atomoxetine, which can help control impulsive behaviors.
There have been far fewer studies of ADHD drugs in adults than in children, but the research to date is promising. Studies have consistently shown adults taking stimulants have fewer ADHD symptoms. The benefits kick in within 30 minutes of the first dose and can last all day in the case of controlled-release medications.
Most adults with ADHD improve when they start medication, but they may continue to struggle with poor habits and low self-esteem. Counseling for ADHD focuses on getting organized, setting helpful routines, repairing relationships, and improving social skills. There is evidence that cognitive-behavioral therapy is particularly helpful in managing problems of daily life that are associated with ADHD.
Holding down a job can be tough for people with ADHD. They often have trouble breaking down tasks and following directions, staying organized, and making deadlines. They’re also prone to tardiness and careless mistakes. In one national survey, only half of adults with ADHD were employed full time, compared to 72% of adults without the disorder. People with ADHD also tend to earn less than their peers.
There’s not much research yet into the careers where people with ADHD are likely to thrive. But ADHD expert Russell A. Barkely, MD, reports that his patients have excelled in sales, acting, the military, photography, athletic coaching, and many trade professions. Having ADHD does not prevent you from pursuing any career that interests you.
People with ADHD may be able to boost their job performance with coaching or mentoring. The mentor will help with organization skills, such as taking notes, keeping a daily planner and prioritizing a to-do list. A quiet workspace with few distractions may help. ADHD is a disability under the Americans with Disabilities Act. This means employers must make adjustments to support a worker’s needs.
ADHD can sabotage marriage and other relationships. The condition makes it difficult to remember social commitments, birthdays, or anniversaries, finish household chores, and pay bills on time. Adults with ADHD may lose their tempers easily or engage in reckless behavior. This leads to higher rates of separation and divorce.
Like having a mentor in the workplace, some people with ADHD benefit from having a coach for everyday life. Coaching is generally a supplement to more formal psychological counseling. The mentor helps the patient put newly learned skills into practice in real-life situations, whether organizing the home or planning a trip.
Smart phone “organizer” apps can be especially useful for people with ADHD. Use an app to create a new to-do list every night, and you’ll always have it with you on your phone. Keep your list organized by using four categories: calls, emails, tasks, and errands. Other apps can help you keep your schedule up to date, so you won’t miss important events.
Some experts believe foods that provide quality brain fuel could reduce symptoms of ADHD. High-protein foods, including nuts, meat, beans, and eggs, may improve concentration. Replacing simple carbs with complex carbs, like whole-grain pasta or brown rice, can help ward off mood swings and stabilize energy levels.
The idea that sugar makes people hyperactive is popular, but there is no evidence that sweets cause ADHD or make its symptoms worse. Research in children indicates switching to a sugar substitute, such as aspartame, does not reduce symptoms of ADHD.
Adults with ADHD don’t outgrow the condition, but many learn to manage it successfully. Long-term treatment can reduce problems at home and at work, bringing patients closer to their families and their professional goals
Despite intensive research, the exact causes of ADHD remain unknown. Studies so far indicate that ADHD could be caused by structural and chemical differences in the brain.
One theory is that a lack of a particular group of brain chemicals, called monoamines, may play a part. The fact that ADHD can, in some cases, be managed with drugs seems to support the theory that brain chemicals are at least partially involved.
It is important to obtain an accurate diagnosis. Symptoms of ADHD can be similar to those for anxiety, depression or other mental illness. To date, there is no single test to determine whether or not ADHD is present.
A typical investigation might include :
The treatment of ADHD depends on the severity of the disorder, but can include :
The staff at MMBC has developed a comprehensive assessment and treatment program for children and adults with ADHD based on worldwide scientific opinion and experience.
Reference EEG analysis may be used to dictate medication choice. Quantitative EEG and biofeedback may be used. A targeted day treatment program is used at MMBC to assist with many aspects of management of ADHD and its impact on one’s life.
MMBC continues to work closely with International Institute of Psychopharmacology, US based CNS response, and Melbourne based Neurotherapy clinics and the industry in ongoing research and clinical activities to improve understanding and treatment of Attention Deficit Hyperactivity Disorder.
The University of Sydney researchers have confirmed that use of omputerized neurocognitive assessment improves accuracy and efficiency of identifying ADHD.
The assessment used at Melbourne MediBrain Centre NeuroTrax Mindstreams battery detects variations in a person’s sustained attention, impulsivity, intrusions, executive memory, information processing speed and provides robust information in addition to the clinical interview.
The use of such testing has been implemented at Melbourne MediBrain Centre for the last five years as part of assessment for ADHD, to reliably diagnose it and to support treatment decisions and monitor treatment outcomes.
“ADHD is of immense concern with at least one child affected in every classroom worldwide” said Dr.Leanna Williams, Professor of cognitive Neuropsychiatry. “Yet, there is currently no consensus on objective medical tests to help doctors make diagnostic and treatment decisions.”
A review of the literature can be found here
Cognitive behavioural therapy (CBT) significantly improved attention deficit symptoms in adult patients who were already taking medication compared with patients who used relaxation with educational support, according to data from a study of 86 adults aged 18-65. The study was published in Journal of the American Medical Association, 2010.
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