Adult ADHD

Attention deficit hyperactivity disorder (ADHD) is a mental health condition.In people with ADHD, there are differences in the parts of the brain that control our ability to plan, organise and focus.Symptoms start in childhood. About half of children with ADHD continue to have problems into adulthood. Sometimes ADHD is missed in childhood and only gets noticed later in life.The main features of ADHD are:

• difficulty paying attention (for example to workplace tasks, conversations, or personal belongings)
• hyperactivity (for example fidgeting or being unable to sit still, talking a lot)
• impulsivity (for example interrupting conversations, being unable to wait in line)

A recent study found that up to 3% of Australian adults have ADHD. This is likely to be the same across different countries.Having ADHD can make family life, study, work and friendships difficult.There are effective treatments available for ADHD. You should seek help if you are worried about yourself or someone close to you.

ADHD is known to run in families.The exact causes of ADHD are unknown, but there are factors that are thought to contribute:

• brain injury or infection
• a lack of oxygen, or exposure to alcohol or nicotine before birth
• premature birth
• difficult experiences in early childhood.

Inattention (problems with paying attention) and hyperactivity (being unusually active) and impulsivity are the key symptoms of ADHD.Examples of inattention symptoms are:

• inability to focus on a task for a long time
• poor attention to detail
• being disorganised (for example being unable to use diaries or calendars regularly)
• forgetting things
• being easily distracted
• delaying attending to tasks
• unreliable work habits
• forgetting appointments
• having more accidents
• day dreaming or switching off in classes or meetings
• poor time management.

Some people with ADHD can concentrate when they really enjoy something, but lose track when they get bored.

I’d describe having ADHD as having 1000 browser tabs open in my mind at the same time. Everything is as important as everything else.

Cass, BrisbanePeople with symptoms of hyperactivity may:

• seem agitated or nervous
• be unable to sit still and concentrate
• talk non-stop without being aware of their surroundings
• have rapid thoughts or be unable to stop thinking
• have sleep problems.

Some people with ADHD may have symptoms of impulsivity.They might:

• start things and not finish them
• not consider the consequences of their actions
• interrupt other people
• take over what someone else is doing
• have problems with money
• change jobs frequently
• use drugs or alcohol
• have a hot temper or be irritable.

You don’t need to have all these symptoms to be diagnosed with ADHD.Often, people with ADHD feel quite frustrated and can become anxious or depressed at not being able to achieve their full potential. Sleep problems and relationship issues can be the reason that people initially seek treatment.If symptoms are affecting your daily life, work or relationships you should seek help.

As a first step, see your GP (family doctor).A GP can assess your symptoms and write you a referral to see a psychiatrist or clinical psychologist if you need it.First steps to get help

A diagnosis of ADHD in an adult is usually made by a psychiatrist who is experienced in the field.Diagnosis might involve:

• tests of your thinking (psychological tests)
• a physical check-up that might involve testing your heart, blood tests or a brain scan (if needed)
• questions about your childhood
• an interview with a partner, parent or close friend about your behaviour
• review of documents like old school reports.

Generally, adults are only diagnosed with ADHD if there is evidence that they had symptoms as a child.Symptoms also have to be present in more than one situation (for example at work and at home) and affect daily life.

Recommended treatment for adults with ADHD involves:

• medication
• behavioural training and coaching
• education about your condition. 

Stimulant medication is known to help people with ADHD to focus and complete tasks. Medication is used to support other changes to your lifestyle and behaviour.The two main stimulant medications used for ADHD are methylphenidate and dexamphetamine. These medications can be addictive, but in the doses used to treat ADHD they usually aren’t.If you are unable to use stimulants, the non-stimulant medication used in Australia is atomoxetine.You might be prescribed other medications to help with sleep problems or other symptoms.More about medications

Behaviour therapy, ADHD coaching and mentoring will help you to deal with the symptoms of ADHD.This usually involves practical advice on organising your work or home, planning ahead, social skills and working to your strengths.Psychologists with experience managing ADHD can be helpful.  There are also a small number of accredited ADHD coaches in Australia.Your GP or psychiatrist can help you to find the right person to talk to.

Learning about ADHD will help you to identify your own set of symptoms and ways to manage them.

Some people find that ADHD can have positive aspects as well.  The ability to multitask can be as much an advantage as a disadvantage, depending on your social and work circumstances.

The ability to focus on a number of different things at the same time can be an advantage. For example in a soccer game where the goal keeper keeps track of movements of all the players as well as knowing when the ball is coming to the goal.

Dr Mahendra Perera, psychiatrist

Psychiatrists are the best-placed specialists to diagnose and treat adults with ADHD.A psychiatrist can:

• make a diagnosis of ADHD
• devise a management plan for ADHD
• diagnose and treat any other mental health issues, including depression or alcohol and drug use
• prescribe medication
• keep track of any medication side effects and your physical health
• link you to counselling and mentoring for people with ADHD
• provide referrals to other health professionals.

 Some psychiatrists are more experienced in diagnosing and treating ADHD than others.Find a psychiatrist near you who has an interest in ADHD

• Build routines and structure into your study, work or home life.
• Look for an accredited ADHD coach to help you.
• Learn about your condition and teach others about what you’re going through.
• Join a support group in-person or online

Australia  New Zealand

• Be aware of the signs of depression.

A person with ADHD needs encouragement and lots of structure.You can help by:

• using routines, schedules and visible lists
• encouraging regular exercise
• focusing on the positive aspects rather than the negative behaviour.

Many people who are diagnosed with ADHD in childhood have fewer symptoms as they get older.Other people will have some symptoms for their whole life. With the right approach, chances are you will be able to manage your illness well.

• ADDults with ADHD: Supporting adults and families with ADHD
• ADHD Australia
• ADHD New Zealand
• ADHD in Practice UK

• ADHD is a mental health condition that runs in families.
• There are benefits to having ADHD, as well as problems.
• Medication is effective and works best when combined with structure, routines and changes to study, work and home life.
• Find a psychiatrist with an interest in ADHD.

 Source: RANZCP website