Adult ADHD: Symptoms, treatment, where to start
Many people may incorrectly think ADHD, or attention-deficit/hyperactivity disorder, only impacts children.
After all, according to the Centers for Disease Control and Prevention (CDC), “ADHD is one of the most common neurodevelopmental disorders of childhood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.”
However, adults can also be diagnosed with ADHD. In fact, according to data from the National Comorbidity Survey Replication (NCS-R), the National Institute of Mental Health (NIMH) reports as many as 4.4 percent of adults may have ADHD.
Adults with ADHD may have different and sometimes less visible symptoms – and these symptoms could cause difficulty at work, at home, or with relationships.
Common adult ADHD symptoms
“You’re walking around with a fog around your brain. Just getting through normal daily behavior is hard, getting up, getting dressed, getting shaved, getting out the door on time,” Drew Brody, a 39-year-old father of two with ADHD, tells Monitor on Psychology, a publication of the American Psychological Association. “All of that stuff is 10 times harder than it should be.”
Not everyone with ADHD feels exactly the same things. Yet, there are some common symptoms of adult ADHD.
Signs of inattention, hyperactivity and/or impulsivity
The NIMH says people with ADHD experience a pattern of symptoms related to inattention, hyperactivity and/or impulsivity. They may experience mostly one type of symptoms, or a combination of types. According to the NIMH, people who have ADHD may have trouble with attention to detail, paying attention for long periods of time (including “for long tasks, such as preparing reports, completing forms, or reviewing lengthy papers”), listening closely or following directions. Additionally, the NIMH says that adults with ADHD can also have challenges with organization and time management. Forgetfulness, losing things and being easily distracted can also be signs of adult ADHD.
The NIMH says that signs of hyperactivity and impulsivity may include:
- “Experiencing extreme restlessness, difficulty sitting still for extended periods, and/or wearing others out with one’s activity
- Fidgeting with or tapping hands or feet or squirming in seat
- Being unable to engage quietly in leisure activities
- Talking excessively
- Answering questions before they are asked completely
- Having difficulty waiting one’s turn, such as when waiting in line
- Interrupting or intruding on others”
Understanding the whole picture
After getting diagnosed with ADHD, many adults look back at their childhood experiences and see why they might have struggled with things that seemed to come easily to their peers.
Ari Tuckman, PsyD, and author of four books on ADHD, tells Psychology Today:
“Just the act of getting diagnosed can be a real game-changer in how someone sees themself and understands their past struggles. I say that it’s like reading the last chapter of a mystery novel, where everything comes together and all of a sudden their life makes much more sense—such as, ‘no wonder I kept shooting myself in the foot like that, despite knowing better.’”
How dual diagnoses may impact your health
One of the challenges with ADHD in adults is that it can often be present with another mental health condition.
Based on data from the NCS-R study, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), the national resource center on ADHD, reports that nearly 40% of adults with ADHD had co-existing mood disorders. In fact, nearly 19% had major depressive disorder, 12% had mild, chronic depression and approximately19% had bipolar disorder. Further, 47% of adults with ADHD had a co-existing anxiety disorder.
The evaluation to diagnose adult ADHD must be thorough to rule out other potential causes for symptoms and to see if additional conditions are present.
“For adults, diagnosis also involves gathering information from multiple sources, which can include ADHD symptom checklists, standardized behavior rating scales, a detailed history of past and current functioning, and information obtained from family members or significant others who know the person well,” according to CHADD. “ADHD cannot be diagnosed accurately just from brief office observations or just by talking to the person.”
Treatment options for adults
If you think you might have attention-deficit/hyperactivity disorder, talk to your healthcare provider. They may either perform a thorough evaluation or refer you a mental health professional. Regardless of provider, they will likely work with you to understand what’s causing your symptoms and identify treatment options.
The NIMH notes that “stimulants are the most common type of medication used to treat ADHD. Research shows these medications can be highly effective. Like all medications, they can have side effects and require an individual’s health care provider to monitor how they may be reacting to the medication. Nonstimulant medications are also available.”
Adding psychotherapy, or talk therapy, to an ADHD treatment plan may help some people better cope with daily challenges, but it may not be effective in treating the core symptoms of ADHD, according to the NIMH.
As with any other treatment, your healthcare provider will consider your symptoms, health concerns and any other medications you are taking.
A pharmacogenomic test, like the GeneSight® test, can inform a healthcare provider about how your genes may impact how you metabolize or respond to certain psychiatric medications. The GeneSight test was updated in 2021 to include stimulants and non-stimulants approved for the treatment of ADHD. The test must be ordered by a clinician who prescribes medication.
In addition to medication, healthcare providers might recommend other therapies to help a patient manage ADHD symptoms in their daily lives. One-on-one coaching is a relatively new but growing field supporting adults with ADHD.
According to CHADD, coaching aims to help people carry out practical activities such as “planning, time management, goal setting, organization and problem solving.”
“Coaches primarily ask questions to help the client reflect and discover their own answers to these questions. The following are examples of questions coaches may ask:
- What changes do you want to make in your daily life?
- What small steps can you take today in the direction of your goals?
- How can you motivate yourself to take action towards this goal?
- When must this action be completed?
- What steps have you taken already, and when will you take the remaining steps?
- How will you evaluate the impact of your plan?”
How do I know if I have adult ADHD?
Only a medical professional can provide an ADHD diagnosis. If you’re not sure where to start, schedule an appointment with your primary care provider. The NIMH offers tips to help you get ready for your appointment; for example, you may want to prepare a list of concerns you have in advance and talk with your family to see if there’s any family history with ADHD.
Conversations with a healthcare provider are private, so you can and should be open and honest about the challenges you are facing. Describe all your symptoms – including when and how they started, when they seem to be most intense, and the frequency in which they occur.
Some people consider taking a close family member or friend to the appointment so that others can hear and understand what the treatment plan is.
Finally, don’t be afraid to ask a lot of questions.
“If you have questions or even doubts about a diagnosis or treatment your health care provider gives, ask for more information. If your provider suggests a treatment you’re not comfortable or familiar with, express your concerns and ask if there are other options,” according to the NIMH website. “You may need to try a few different health care providers and several different treatments, or a combination of treatments, before finding one that works best for you.”
Taking the next step
The signs of adult ADHD may be less visible than childhood ADHD, but they can still make life challenging. Research-backed treatments and therapies are available to help. If you’re wondering about ADHD in your own life, a conversation with a healthcare provider could be a beneficial next step forward.
For more information about this and other important topics, please visit:
Our articles are for informational purposes only and are reviewed by our Medical Information team, which includes PharmDs, MDs, and PhDs. Do not make any changes to your current medications or dosing without consulting your healthcare provider.
The GeneSight test must be ordered by and used only in consultation with a healthcare provider who can prescribe medications. As with all genetic tests, the GeneSight test results have limitations and do not constitute medical advice. The test results are designed to be just one part of a larger, complete patient assessment, which would include proper diagnosis and consideration of your medical history, other medications you may be taking, your family history, and other factors.
If you are a healthcare provider and interested in learning more about the GeneSight test, please call us at 855.891.9415. If you are a patient, please talk with your doctor to see if the GeneSight test may be helpful.