Adult attention-deficit disorder

Adult attention deficit disorder (AADD) is the common terminology for the psychiatric condition currently known as attention-deficit hyperactivity disorder (ADHD), also known as attention deficit disorder (ADD), when it occurs in adulthood. Although the exact prevalence in adults is unknown, epidemiologic studies thus far reveal that the condition, marked by inattentiveness, difficulty getting work done, procrastination, or organization problems, probably exists in about 2-4% of adults. The condition persists to adulthood in about half of children diagnosed with the disorder.

Symptoms and hallmarks

Adults are more likely than children to realize that they might have ADD/ADHD. Because the very nature of the condition makes a person likely to be poor at self-observation, it is important to seek a professional diagnosis. In Driven To Distraction Edward M. Hallowell describes the disorder from the patient's perspective:

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::... It's like being super-charged all the time. You get one idea and you have to act on it, and then, what do you know, but you've got another idea before you've finished up with the first one, and so you go for that one, but of course a third idea intercepts the second, and you just have to follow that one, and pretty soon people are calling you disorganized and impulsive and all sorts of impolite words that miss the point completely. Because you're trying really hard. It's just that you have all these invisible vectors pulling you this way and that, which makes it really hard to stay on task.

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The behavior of people with ADHD goes beyond occasional fidgeting, disorganization, and procrastination. For them, performing tasks can be so hard that it interferes with their ability to function at work, at home, at school, and socially. http://www.fda.gov/fdac/features/2004/604_adhd.html

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• In children the disorder is characterized by inattentiveness to external direction, impulsive behavior and restlessness. However, children with the inattentive type are actually often sluggish and hypo-active.
• In adults the problem is often an inability to structure their lives and plan simple daily tasks. Thus, inattentiveness and restlessness often become secondary problems.

Symptoms or hallmarks of ADD/ADHD vary widely between individuals, just as no two human brains are exactly alike. They also vary throughout a lifetime as the individual matures, and are affected by life experiences and learned behavior. However, the ADD/ADHD diagnosis is defined by multiple factors.

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ADD with hyperactivity (ADHD) is characterized by symptoms of inattention, impulsivity and/or hyperactivity which have an onset during childhood, although the condition may have been undiagnosed. Some hyperactivity symptoms are less noticeable in adults. One subset of the current ADHD criteria does not require hyperactivity at all. This was formerly known as simply ADD.

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An adult with ADHD or ADD has a different complex of symptoms than a child does. Often the most prominent characteristic in ADHD adults is difficulty with executive functioning, which is the brain activity that oversees the ability to monitor one's own behavior, to plan, and to organize. Other symptoms observed in adults include inattention, impulsivity, over-activity, behavioral, learning, and emotional problems.

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Hyperactive and impulsive with ADD adults feel restless, are constantly "on the go," and try to do multiple tasks at once. They are often perceived as not thinking before they act or speak.

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"In adults, it's a much more elaborate disorder than in children," says Russell Barkley, Ph.D., a psychiatry professor at the Medical University of South Carolina. "It's more than paying attention and controlling impulses. The problem is developing self-regulation." This self-control affects an adult's ability not just to do tasks, but to determine when they need to be done, says Barkley. "You don't expect 4- or 5-year-olds to have a sense of time and organization, but adults need goal-directed behavior--they need help in planning for the future and remembering things that have to get done." http://www.fda.gov/fdac/features/2004/604_adhd.html

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Studies have indicated that adults with ADD are much more likely to have substance abuse problems than adults who do not have ADD. They are also more likely to suffer from depression and anxiety, be fired from jobs, and get divorced than non-ADHD adults.

Related Topics:
Substance abuse - Depression

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For adults, the most common symptom is a sense of underachieving. According to Hallowell, "No matter how well you are doing, you always have a sense of missing a lot in work, school, jobs relationships. That is what most often finally brings adults in for diagnosis and treatment."

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The Hallowell Center identifies the following indicators to consider in an individual when ADD is suspected and recommends that individuals with at least twelve of the following behaviors since childhood -- provided these symptoms are not associated with any other medical or psychiatric condition -- consider professional diagnosis:

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• A sense of underachievement, of not meeting one's goals (regardless of how much one has actually accomplished).
• Difficulty getting organized.
• Chronic procrastination or trouble getting started.
• Many projects going simultaneously; trouble with follow through.
• A tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark.
• A frequent search for high stimulation.
• An intolerance of boredom.
• Easy distractibility; trouble focusing attention, tendency to tune out or drift away in the middle of a page or conversation, often coupled with an inability to focus at times.
• Often creative, intuitive, highly intelligent.
• Trouble in going through established channels and following "proper" procedure.
• Impatient; low tolerance of frustration.
• Impulsive, either verbally or in action, as an impulsive spending of money.
• Changing plans, enacting new schemes or career plans and the like; hot-tempered.
• A tendency to worry needlessly, endlessly; a tendency to scan the horizon looking for something to worry about, alternating with attention to or disregard for actual dangers.
• A sense of insecurity.
• Mood swings, mood instability, especially when disengaged from a person or a project.
• Physical or cognitive restlessness.
• A tendency toward addictive behavior.
• Chronic problems with self-esteem.
• Inaccurate self-observation.
• Family history of AD/HD or manic depressive illness or depression or substance abuse or other disorders of impulse control or mood.

http://www.drhallowell.com/resources/articles/diagnostic_adults.html

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