What is ADHD?

Attention deficit hyperactivity disorder (ADHD or ADD) is a neurodevelopmental condition. This impacts the prefrontal cortex of the brain. Symptoms appear along a spectrum of severity and include difficulty paying attention, being overly active, and trouble controlling impulsive behavior.

Although ADHD is a disorder that begins in childhood, it can continue through adulthood for some people. People with ADHD may struggle to sustain relationships or careers.

It is evident from some studies that ADHD does not fade at a specific age, individuals who were tracked for years or even decades after their initial childhood diagnosis continue to experience the disorder as adults.

It is estimated that approximately 4.4 percent of US adults live with symptoms with a diminished quality of life and suffer the devastating effects of ADHD without even identifying the source of their struggles.

2 types of ADHD

1. Hyperactive or impulsive
   • Restless
   • Fidgety
   • Interrupts
   • Impatient
2. Inattentive
   • Unfocused
   • Easily distracted
   • Careless
   • Makes mistakes
   • Forgets or loses things
   • Trouble staying organized

3 causes of adult ADHD

It is commonly believed that attention deficit hyperactivity disorder (ADHD) is a condition that only children suffer, but this is not exactly true. It can occur in youngsters, teenagers, and even adults.

Although there may be various causes of ADHD, experts believe the following are the most frequent ones:

1. Genetics
   • According to some studies, a child diagnosed with ADHD most of the time has a parent with ADHD or has a close family member who has the illness.
   • ADHD could be a result of decreased production of neurotransmitters in specific sections of the brain that aid with mental organization.
2. Certain biological factors
3. ADHD is often underdiagnosed or misdiagnosed
   • Most of the time, symptoms of adult ADHD are often present in childhood but are either unidentified or attributed to other illnesses.
   • In some cases, ADHD symptoms may go unnoticed or are less noticeable.
   • People, who have grown up in a controlled school setting along with excessive parental support, may not be aware of ADHD until they start living on their own.

What are the symptoms of ADHD in adults?

Symptoms of ADHD are divided into two main groups:

1. Symptoms of hyperactivity and impulsivity
   • Fidgets with or taps hands and feet or squirms in the seat
   • Leaves seat in situations when remaining seated is expected
   • Unable to engage in leisure activities quietly
   • Often runs and climbs in situations where it is inappropriate (feeling restless)
   • Is “on the go,” acting as if “driven by a motor”
   • Blurts out answers before a question has been completed
   • Difficulty waiting their turn
   • Interrupts or intrudes on others
   • Talks excessively
2. Symptoms of inattention
   • Fails to give close attention to detail or makes mistakes
   • Difficulty sustaining attention while completing tasks or partaking in activities
   • Does not seem to listen when spoken to directly
   • Does not follow through with instructions and fails to finish workplace duties
   • Difficulty organizing tasks and activities
   • Avoids dislikes or is reluctant to engage in tasks that require sustained mental effort
   • Loses materials necessary for tasks or activities
   • Easily distracted by extraneous stimuli
   • Forgetful in daily activities

According to the guidelines in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), to be diagnosed with ADHD, children (younger than 12 years) must have at least six symptoms out of the nine symptoms. However, older adolescents and adults (older than 17 years) must present with at least five of them from either or both the groups (hyperactivity or impulsivity and inattention) for at least six months.

Who should be tested for adult ADHD?

Someone who has significant problems with any of the following categories needs to get evaluated for attention deficit hyperactivity disorder (ADHD):

• Work: Not performing up to the capacity or ability.
• Day-to-day tasks: Unable to do household chores appropriately, fail to pay bills on time or organize things.
• Job or career: Losing or quitting jobs frequently for no good reason.
• Relationships: Forgetting essential things, having difficulty completing tasks, getting upset over minor and trivial issues
• Emotions: Experiencing ongoing stress and worry because of not meeting goals or fulfilling responsibilities.

A self-screening questionnaire “Adult Self-Report Scale (ASRS) Screener” prepared by the World Health Organization helps recognize the signs and symptoms of adult ADHD.

The ASRS comprises six questions that are ranked on a scale of zero to four. If someone has at least four of these six symptoms significantly, they may have ADHD and should seek out a formal diagnosis.

How is ADHD diagnosed?

Because attention deficit hyperactivity disorder (ADHD) looks different in every person and is often unrecognized, its diagnosis is difficult. There is no specific physical, medical, or laboratory test available to detect ADHD in adults. However, the doctor can make a confirmed diagnosis based on multiple tests and evaluations, such as:

• Medical history: The doctor may ask questions about the current symptoms, serious issues at work, school, or home, use of drugs and alcohol, driving record, and relationships with family and friends.
• Childhood experiences: Most symptoms might have started in childhood (younger than 12 years). Although they might have been different at other times in life, they may not have caused problems until now.
• Physical examination: To rule out conditions, such as thyroid problems or seizure disorder.
• Consultation with family or friends: The doctor would interview someone who knows the patient well, such as the spouse, sibling, or parents.
• Psychological tests: Completing a checklist of symptoms or a behavior rating scale.
  • ADHD rating scales: A questionnaire that can identify specific symptoms of ADHD that may not emerge in the clinical interview.
  • Intelligence tests: A standard part of thorough evaluations to measure intelligence quotient and detect certain learning disabilities common in people with ADHD.
  • Broad-spectrum scales: To screen for social, emotional, and psychiatric problems.
  • Specific ability tests: Language development, vocabulary, memory recall, and motor skills.
  • Continuous performance tests (CPT): A series of visual targets that appear on the screen. The user responds to prompts while the computer measures their ability to stay on the task.
• Neuropsychological testing: To rule out overlapping disorders, such as learning disabilities, mood disorders, or autism spectrum disorder.
• Neuroimaging procedures: Positron emission tomography scans, single-photon emission computed tomography scans, and magnetic resonance imaging to rule out structural brain abnormalities.