ADHD in Adults: Symptoms, Diagnosis and Getting Help

ADHD (attention deficit hyperactivity disorder) is a condition that can affect how you focus [1]. Its symptoms begin in childhood and can continue into the teen years and adulthood [2][3]. ADHD affects about 3 to 4 in every 100 adults [4]. Some adults may have ADHD but have never been diagnosed [5].

What Is ADHD?

ADHD is a neurodevelopmental disorder. These are disorders that can affect lots of different brain functions, including learning, communication, movement, emotions and attention [4].

ADHD is not a new idea. The first description by a doctor of a disorder resembling ADHD was in the 18th century, and health care professionals and scientists around the world agree that ADHD is a valid diagnosis [4].

Symptoms of ADHD in Adults

Symptoms of ADHD involve your ability to pay attention to things (being inattentive), having high energy levels (being hyperactive) and your ability to control your impulses (being impulsive) [1].

Signs of being inattentive can include [1]:

• being easily distracted or forgetful
• finding it hard to organise your time
• finding it hard to follow instructions or finish tasks
• losing things often, like your wallet, mobile or keys

Signs of being hyperactive and impulsive can include [1]:

• having a lot of energy or feeling restless
• being very talkative or interrupting conversations
• making quick decisions without thinking about what might happen as a result

Adults with ADHD can also struggle with completing lengthy tasks unless they are interesting and with staying organised [5]. Another sign is avoiding or disliking tasks that require mental effort over a long period of time (such as schoolwork, homework or housework) [4]. These symptoms usually start before the age of 12 [1].

Not all of these symptoms will be obvious to others. People with ADHD will often develop ways to hide their symptoms, and doing so can be very exhausting and negatively affect their mental health [4].

Everyone Gets Distracted Sometimes

It is common for people to show these behaviours some of the time. For people with ADHD, however, the behaviours are frequent and occur across multiple situations, such as at school, at home, at work or with family and friends, and interfere with daily life [2]. For a diagnosis, symptoms need to cause significant difficulties in at least two areas of daily life [4].

Types of ADHD

Most people with ADHD will have symptoms of both the inattentive and hyperactive-impulsive type. Some only show signs of one type [1]. The types of ADHD are [1][3]:

• mainly inattentive
• mainly hyperactive-impulsive
• combined (symptoms of both)

How ADHD Can Change With Age

ADHD symptoms can change over time and may look different at older ages. Hyperactivity, for example, may decrease or may appear as extreme restlessness [5]. Hyperactive and impulsive symptoms tend to be more common in childhood, while inattentive symptoms tend to become more of an issue in teenage years and adulthood [4].

Some people might not experience challenges until adulthood, or these challenges might not be noticed until they are much older [4]. Someone who has lived at home with lots of support might find their ADHD does not cause them problems until they move out of home [4]. Throughout life, new challenges like parenthood might further increase a person's overall level of stress [4], and symptoms may become more severe when the demands of adulthood increase [5].

How ADHD Can Affect Daily Life

For many people with ADHD, symptoms cause problems in daily life. Symptoms can make it hard to get things done, interfere with school, work or other activities and strain social relationships [2]. Teens and adults with ADHD are at increased risk for poor job performance and financial problems [2].

Especially in moments when stress and demands are high, ADHD can cause difficulty with [5]:

• daily tasks
• social relationships
• consistency in healthy behaviours such as exercise, proper nutrition and good sleep
• avoiding health risks such as substance use, infections and injuries

Signs Friends and Family Might Notice

Friends and family might notice signs of ADHD in someone they know. Signs that might indicate unsupported ADHD include [4]:

• problems organising, for example poor time management, missed appointments and frequent late and unfinished projects
• erratic work or academic performance
• family or marriage problems
• lack of routine, for example poor sleeping patterns
• difficulty managing finances
• low self-esteem or chronic under-achievement

Why ADHD Can Be Missed

People with ADHD are frequently diagnosed with other mental and physical health conditions, which can make it difficult to recognise underlying ADHD [4].

ADHD is thought to be recognised less often in women than men. This may be because women with ADHD more commonly have inattentive symptoms, and these can be harder to recognise than hyperactive symptoms [1]. In adults, however, the diagnosis of ADHD in men and women is more equal [4].

Conditions That Can Look Similar or Occur Together

A medical and psychological exam may be needed to rule out other health problems that can cause symptoms like ADHD or that are often present with ADHD [5]. Examples include:

• anxiety [2][5]
• depression [2][5]
• sleep problems [2][5]
• alcohol or substance misuse [5]
• learning disabilities [5]

When ADHD occurs together with other conditions, the conditions can be harder to diagnose and treat [2].

What Causes ADHD?

For most people with ADHD, the condition is caused by a combination of genetic and environmental factors [4]. ADHD may be caused by genetic differences and often runs in families [1].

Several other things are linked to ADHD, including being born premature (before 37 weeks of pregnancy), having epilepsy, a brain injury and being autistic [1].

Getting Help

If your ADHD symptoms are affecting your studies, work or relationships, make an appointment with a GP to find out what support is available [1].

At the appointment, the GP will ask what your symptoms are and how they affect your life. They may also want to consider other conditions that could be causing your symptoms, such as autism, Tourette's or anxiety, and may decide to refer you for an assessment with a mental health professional specialising in ADHD [1]. If you were diagnosed with ADHD in childhood and need help for your symptoms, you can talk to your GP about getting a referral [1].

What Happens at an Assessment

The appointment will be with an ADHD specialist such as a psychiatrist [1]. They will ask about the history of your symptoms, particularly if they started when you were a child, and how these symptoms affected you at school [1]. The assessment will focus on different areas of your life, including work and education, family and friends and your medical history, including any mental health issues [1]. The specialist may want to contact someone who knows you well, such as a family member or close friend [1].

Diagnosing ADHD usually includes a checklist for rating ADHD symptoms and looking at the person's history of behaviour and experiences [5].

Online Questionnaires

You might have used a questionnaire or quiz to find out whether you have ADHD. Questionnaires can help with the assessment process, but ADHD can only be accurately diagnosed with a comprehensive interview and a consultation-based assessment [4].

Waiting Times and Private Assessments

The National Health Service (NHS) says that in the UK, waiting times vary and you may have to wait several months or years to access ADHD specialist services [1]. Many providers also offer ADHD assessments privately, and before getting an assessment from an alternative provider you should make sure that it will be accepted by your local NHS service [4].

After a Diagnosis

A diagnosis can bring mixed feelings. Some people feel relief at getting an explanation for some of their difficulties and finding out that they are not alone, while others feel frustration that the condition was not diagnosed and treated sooner [4].

Treatment and Support

ADHD can be managed in many ways, including lifestyle changes, changes at work or medicines [1]. What works best can depend on the person and their environment [5]. Not everyone needs or wants to take medicine to help manage their ADHD symptoms, and medicines are an option a specialist can discuss [1].

Talking Therapies

Talking therapies, such as cognitive behavioural therapy (CBT) or mindfulness, may be recommended for adults with ADHD [1]. CBT is a structured programme of therapy that helps people identify unhelpful thought patterns and develop techniques for overcoming them. For people with ADHD, it can help with organisational and time management skills [4].

Support Around You

Environmental modification can be one of the most important parts of the support you get for ADHD [4]. Occupational therapists can work with people with ADHD to help them organise their physical and social environment and develop effective planning schedules to help meet job requirements [4].

Peer support groups provide free or low-cost services where people with ADHD can listen and share experiences, advice, strategies and tips [4]. Coaches or mentors can help with building daily life skills, but coaching and mentoring are self-regulated professions without regulatory legal standards [4].

Work and Study

The NHS says that in the UK, you can request changes at your workplace or place of study to help you manage your ADHD. These are called "reasonable adjustments" [1]. They may include having a personalised work space in a quiet area, having written instructions as well as spoken instructions and having help from another person to plan and structure your tasks [1].

Driving

If you live in the UK, you must tell the DVLA if your driving is affected by your ADHD or your ADHD medicine, or both [1].

Supporting Someone With ADHD

If someone close to you has ADHD, ask them if there is anything you can do to help [4]. Finding out more about the condition can help you get a stronger understanding of ADHD, and meeting one person with ADHD does not mean you have met them all [4].

ADHD and Mental Health

People with ADHD are at higher risk of suicide [1].

In the UK, the NHS says: "If you're feeling like you want to end your life, it's important to tell someone. Help and support is available right now if you need it. You do not have to struggle with difficult feelings alone." [1]

Conclusion

Knowing how ADHD shows up in your own life makes it easier to explain your needs to a doctor, an employer and the people close to you, and to ask for the kind of support that suits you.

Medical Disclaimer

This article is for general information and does not replace advice from a qualified health professional. If you think you need urgent medical care, get emergency help straight away.