Attention Deficit Hyperactivity Disorder in Adults

Problems at School

Adults With ADHD may have:

• A history of not doing well in school and underachieving
• Gotten in a lot of trouble
• Had to repeat a grade
• Dropped out of school

Problems at Work

Adults With ADHD are more likely to:

• Change jobs a lot and perform poorly
• Be less happy with their jobs and have fewer successes at work

Problems in Life

Adults with ADHD are more likely to:

• Get more speeding tickets, have their license suspended, or be involved in more crashes
• Smoke cigarettes
• Use alcohol or drugs more often
• Have less money
• Say they have psychological trouble like being depressed or have anxiety

Relationship Problems

Adults with ADHD are more likely to:

• Have more marital problems
• Get separated and divorced more often
• Have multiple marriages

How Is Adult ADHD Diagnosed?

Look for a psychiatrist who has experience with diagnosing and treating people with ADHD.

The doctor may:

• Ask you to get a physical exam to make sure there aren’t other medical problems causing your symptoms
• Take some blood from you and run tests on it
• Recommend psychological testing
• Ask you questions about your health history

While experts don’t agree on an age that you can first diagnose ADHD, they do agree that people don’t suddenly develop it as an adult. That’s why when a doctor sees you they will ask about your behavior and any symptoms that you may have had as a child. They may also:

• Look at school report cards. They’ll look for comments about behavior problems, poor focus, lack of effort, or underachievement compared to your potential.
• Talk with your parents to see if you had any symptoms during childhood.

People who have ADHD may have had trouble getting along with others when they were kids or had a hard time in school. Teachers may have had to work with you. For example, maybe you had to sit at the front of the class.

They’ll also ask if anyone else in your family has ADHD. This can be helpful information because it does seem like ADHD runs in families.

How Is Adult ADHD Treated?

Treatment plans can include medicine, therapy, education or learning more about ADHD, and getting family support.

Together these things can help you find new ways to do things that can make day-to-day life easier. That can make you feel better in general and feel better about yourself.

Making sure you get fully checked by a doctor is important. That’s because people with ADHD often face other conditions, too. You may also have a learning disability, anxiety or another mood disorder, obsessive compulsive disorder, or a dependence on drugs or alcohol. Knowing the whole picture can make sure you get the best plan for you.

Medications to Treat Adult ADHD

Stimulants. Adults with ADHD are often prescribed stimulant medications. Studies show that about two-thirds of adults with ADHD who take these medications have big improvements in their symptoms.

Stimulant medications include:

Short-acting stimulants:

• Amphetamine/dextroamphetamine (Adderall)
• Dextroamphetamine (Dexedrine, ProCentra, Zenzedi)
• Dexmethylphenidate (Focalin)
• Methylphenidate (Ritalin)
   

Intermediate-acting stimulants include:

• Amphetamine sulfate (Evekeo)
• Methylphenidate (Ritalin SR, Metadate ER, Methylin ER)
   

Long-acting stimulants include:

• Amphetamine (Adzenys XR-ODT, Dyanavel XR)
• Dexmethylphenidate (Focalin XR)
• Dextroamphetamine (Adderall XR)
• Lisdexamfetamine (Vyvanse)
• Methylphenidate (Concerta, Daytrana, Jornay PM, Metadate CD, Quillivant XR, Quillichew ER, Ritalin LA)
• Mixed salts of a single-entity amphetamine product (Mydayis)
• Serdexmethylphenidate/dexmethylphenidate (Azstarys)

But stimulants are not always ideal. Why? They can be:

• Addictive. Stimulants are controlled substances. That means they can be misused. Some adults with ADHD have substance abuse problems or had them in the past.
• Hard to remember to take. Short-acting types of stimulants (versus long-acting) may wear off quickly. Since people with ADHD can have trouble with forgetfulness, remembering to take them several times a day can be a challenge.
• Hard to time. If people choose to stop taking them in the evening, they can have a hard time focusing to do housework, pay bills, help children with homework, or drive. But if they do take them later in the day, they may be tempted to use alcohol or other things "to relax."

Nonstimulants. Doctors may also recommend a nonstimulant medication for you to take, either on its own or with a stimulant. They are:

• Atomoxetine (Strattera)
• Clonidine (Kapvay)
• Guanfacine (Intuniv)
• Viloxazine (Qelbree)

Therapy and Other Behavioral Treatments

You may want to ask about making these part of your treatment plan, too:

• Cognitive and behavioral therapy. It can help with self-esteem.
• Relaxation training and stress management. These can lower anxiety and stress.
• Life coaching. It may help you set goals. Plus, it can help you learn new ways to stay organized at home and work.
• Job coaching or mentoring. This can help support you at work. It can help you have better working relationships and improve on-the-job performance.
• Family education and therapy. This can help you and loved ones understand ADHD better. It can also help you all find ways to lessen how much it affects everyone’s life.

Other Things You Can Do to Manage ADHD

When you have ADHD, even simple tasks like grocery shopping or paying bills can sometimes feel overwhelming. Anyone can have mood swings, loss of focus, and trouble staying organized, but you might deal with these each day if you have ADHD.

Your doctor can suggest medication or other treatment to help you focus better, but there are things you can do on your own to make life with ADHD more manageable:

• Take medications as directed. If you are taking any medications for ADHD or any other condition, take them exactly as prescribed. Taking two doses at once to catch up on missed doses can be bad for you and others. If you notice side effects or other problems, talk to your doctor as soon as possible.
• Organize. Choose a time that’s quiet and unhurried -- maybe at night before you go to bed -- and plan out the next day, down to each task. Make a realistic list of things to complete. Alternate things you want to do with ones you don’t to help your mind stay engaged. Use a daily planner, reminder app, timer, leave notes for yourself, and set your alarm clock when you need to remember an appointment or other activity.
• Be realistic about time: Your brain is wired differently than other people’s, and it may take you longer to get things done. That’s OK. Figure out a realistic time frame for your daily tasks -- and don’t forget to build in time for breaks if you think you’ll need them.
• Breathe slowly. If you tend to do things you later regret, such as interrupt others or get angry at others, manage the impulse by pausing. Count to 10 while you breathe slowly instead of acting out. Usually the impulse will pass as quickly as it appeared.
• Cut down on distractions. When it’s time to buckle down and get something done, take away the distractions. If you find yourself being distracted by loud music or the television, turn it off or use earplugs or noise-canceling headphones to drown out sounds. Put your phone on silent. Move yourself to a quieter location, or ask others to help make things less distracting. If you can, work in a room with a door you can close. Set up your space in a way that helps you focus.
• Control clutter: Another way to quiet your brain is to clear your space of things you don’t need. It can prevent distractions, and it can help you stay organized because you’ll have fewer things to tidy up. Go paperless -- take your name off junk mailing lists and pay bills online. Get some organizational helpers like under-the-bed containers or over-the-door holders. Ask a friend to help if it seems like you’re swimming in a sea of debris and you don’t know where to start.
• Burn off extra energy.Exercise is good for everyone, but it can do more than improve your heart health if you have ADHD. Even a little regular exercise can ease ADHD symptoms. You may need a way to get rid of some energy if you’re hyperactive or feel restless. Exercise, a hobby, or another pastime can be good choices. Shoot for 20 to 30 minutes a day. If you work in an office, a brisk walk during lunch may be the ticket to beating your brain’s afternoon slump. After you exercise, you’ll feel more focused and have more energy to stay on task.
• Learn to say no: Impulsive behavior can be a side effect of having ADHD. This means your brain might bite off more than it can handle. If you find yourself overwhelmed, try to say no to a few things. Ask yourself: Can I really get this done? Be honest with yourself and with others about what’s possible and what’s not. Once you get comfortable saying no, you’ll be able to enjoy the things you say yes to even more.
• Reward yourself: Sticking to a task can be easier when there’s a mood booster at the end. Before you tackle a project, decide on a reward for yourself once you’re done. Positive reinforcement can help you stay the course.
• Ask for help. We all need help from time to time, and it's important to not be afraid to ask for it. If you have disruptive thoughts or behaviors, ask a counselor if they have any ideas you can try that could help you control them.

Questions to Ask Your Doctor

If you think you could have ADHD or your doctor has diagnosed you, here are some questions to ask them:

• What could have caused it?
• Should I see a counselor to deal with the effects of ADHD at home and at work?
• What can I expect if I go to a psychologist, psychiatrist, or other professional for treatment of adult ADHD?
• How will I be diagnosed? What else could it be?
• Does ADHD happen with other psychiatric problems?
• Have you treated other adults with ADHD? If not, can you refer me to a specialist?
• Which treatments are best for adults with ADHD?
• Do ADHD medications work the same in adults as in children with ADHD?
• Aside from medications, what else can I do to reduce my ADHD symptoms? What about exercise and food? Are there any vitamins or supplements that can help?
• What are the possible side effects of ADHD drugs?
• Are there any herbal supplements or over-the-counter drugs to avoid if I take medication for ADHD? Can I drink alcohol if I take medication?
• Will treatment stigmatize me?
• How long should my treatments last?
• Will I always have to take medication?
• Do people outgrow ADHD? How will we know if we no longer need ADHD medication?
• Where can I find emotional support for my family and for me?
• Could I have passed this on to my children?
• How often do I (or my child) need to see a doctor?
• Can I take medication for ADHD if I become pregnant?
• Where can I find out about clinical trials I could participate in?
• I still have symptoms. Is my medication for ADHD not working? Should I try another medication?

Glossary of ADHD Terms

ADHD, combined type: The most common type of the disorder. People with this type of ADHD have inattention, hyperactivity, and impulsivity.

ADHD, predominantly hyperactive-impulsive type: With this type, people have both hyperactive and impulsive behavior, but they may not show enough symptoms of inattention to fall into the combined type.

ADHD, predominantly inattentive type: People with this type have inattention but not hyperactive or impulsive behavior. This type of ADHD was formerly known as attention deficit disorder (ADD).

Attention deficit hyperactivity disorder (ADHD): A developmental and behavioral disorder. People that have ADHD have inattention, distractibility, hyperactivity, and impulsivity. Typically, symptoms are significant enough to cause problems in everyday life.

Attention deficit disorder (ADD): This is the former name of ADHD, predominantly inattentive type. The term ADD is no longer used.

Executive function deficit: Executive function is a set of mental skills that make sure things get done. Someone with an executive function deficit has a hard time planning or starting tasks and seeing them through. People with ADHD often have this deficit.

Clinical trial: Also called a research study, they test how well new approaches work in people. Clinical trials may compare a new treatment to a treatment that is already available.

Neural: Related to the nervous system.

Neurotransmitter: A chemical in the brain that acts as a messenger to help transmit nerve impulses between brain cells.

Nonstimulants: This type of medication is sometimes used to treat symptoms of ADHD. They work by decreasing impulsive behavior or improving attention span.

Psychostimulants or stimulants: These medicines are often prescribed for people with ADHD. They affect dopamine activity in the brain and can help them focus their thoughts and ignore distractions.