Attention Deficit Hyperactivity Disorder: ADHD in Adults
Relationship-Related Impairments Linked to Adult ADHD
Adults with ADHD are more likely to:
- Have more marital problems and multiple marriages
- Have higher incidence of separation and divorce
Much of this functional impairment diminishes with remission of the disorder and can be mitigated by appropriate treatment.
How Is Adult ADHD Diagnosed?
While researchers may disagree about age of childhood onset in diagnosing adult ADHD, all agree that ADHD is not an adult-onset disorder and that symptoms must begin in childhood. An assessment of ADHD symptoms and behavior from childhood may include any or all of the following:
- A questionnaire to determine if the adult had ADHD in childhood.
- School report cards, if available, to look for comments about behavior problems, poor focus, lack of effort, or underachievement relative to the student's potential.
- Discussion with the parents to determine any symptoms during childhood.
- A complete history from the adult with the symptoms. He or she may self report symptoms in childhood.
The developmental history would be consistent with ADHD, including evidence of problems with peers, other delays such as bed wetting, school failure, suspensions, or special interventions such as sitting in front of the class.
A family history of ADHD may also be informative, given the strong genetic component of the disorder.
Other examinations may also be performed, including:
- A physical exam to rule out medical or neurological illness
- Blood tests
- Psychological testing
Medications to Treat Adult ADHD
In the past, the first treatment typically offered to adults with ADHD has been stimulant drugs. Studies show that approximately two thirds of adults with ADHD who are given these medications show significant improvement in ADHD symptoms. Examples of stimulant medications that may be used in adults include Adderall XR, Concerta, Focalin XR, QuillivantXR, and Vyvanse.
However, there are sometimes difficulties in using stimulants to treat ADHD in adults. Stimulants are controlled substances and it is not uncommon for adults with ADHD to have or to have had problems with substance abuse. Short-acting stimulants may wear off quickly, and because adult patients administer the medication themselves and usually have problems with forgetfulness, adherence can be problematic with multiple dosing throughout the day. Adults may experience significant difficulty in the evening when they do housework, pay bills, help children with homework, drive, or are tempted to use substances "to relax." Learn more about stimulant therapy for ADHD.
Strattera is a non-stimulant medication approved by the FDA for the treatment of ADHD for adults as well as children and adolescents.
Behavioral Treatments for Adult ADHD
Adult ADHD may be treated with one or more of the following:
- Individual cognitive and behavioral therapy to enhance self-esteem
- Relaxation training and stress management to reduce anxiety and stress
- Life coaching to help set goals and develop strategies for organizing home and work activities
- Job coaching or mentoring to support better working relationships and improve on-the-job performance
- Family education and therapy
In-depth assessment, treatment planning, medication management, individual therapy, education, and family support are all necessary to help the adult with ADHD function in new ways and build his or her self-esteem. Because ADHD is often associated with other conditions (such as specific learning disabilities, anxiety and mood disorders, obsessive compulsive disorder, and chemical dependency), in-depth assessment is the first step in developing a comprehensive, customized treatment plan.