Does it Exist?
Although adult ADHD has been well documented through genetic and imaging studies, clinical treatment trials and follow-up studies, skepticism about adult ADHD still exists. Through these studies, we know that about two-thirds of children with ADHD continue to have significant impairment into adulthood. Unfortunately, even among some adult psychiatrists, some skepticism remains about the diagnosis and treatment of adult ADHD. Many of the tools that are used to assess adults for ADHD are unfamiliar to psychiatrists that routinely deal with other psychiatric conditions. You will therefore find that many of the physicians that diagnose and treat adult ADHD have a special interest in ADHD and come from a variety of specialties, such as child and adolescent psychiatry, pediatrics and family medicine, as well as from adult psychiatry.
Getting an Assessment
Adults with ADHD have always lived with their condition so they may not recognize their symptoms as being different from the normal population. They may be very confused as to why they are experiencing problems. Experiences from their childhood may lead them to believe that they are not very smart or capable. They may believe that they are lazy and unmotivated or suffer from other mental illnesses. Many adults seek out an ADHD assessment after their child has been diagnosed and they become familiar with the disorder. With the widespread use of the Internet, information on ADHD is more accessible and many patients come to their doctor asking for confirmation of a self-diagnosis. With the increase in information on ADHD, the demand for assessment and treatment has clearly overwhelmed mental health resources. Many adults are discovering that it is extremely difficult to find a qualified practitioner to assess and diagnose their ADHD, let alone continue with follow-up treatment.
Due to the frequency of associated disorders occurring with ADHD, the adult with ADHD will frequently arrive at the physician’s office complaining of symptoms of insomnia, rage attacks, unstable moods, anxiety, depression, lack of motivation, disorganization and procrastination – but they will not recognize these symptoms as an indication of adult ADHD. It will be important for the adult to be patient while the doctor unravels a history of childhood symptoms and associated disorders to uncover the underlying problem. Unfortunately, an underlying cause of adult ADHD is often missed and years spent treating a coexisting disorder can go by before ADHD is diagnosed. Hopefully. with the increasing information available on ADHD, this will become a thing of the past.
Red Flags for Adult ADHD
- a lifelong history of difficulty with attention
- a history of disruptive or impulsive behaviour
- organizational skill problems (time management difficulties, misses appointments, frequent late and unfinished projects)
- erratic work history (changs jobs frequently, unprepared for meetings, projects not completed on time, reports of coworkers, employers and clients being frustrated with them)
- Anger control problems (argumentative with authority figures, over controlling as a parent, fighting with coworkers or child’s teachers, episodes of rage)
- marital problems (spouse complains that he/she does not listen, speaks without thinking, is impulsive, forgets important events)
- being over-talkative, interrupts frequently or inappropriately, speaks too loudly
- parenting problems ( difficulty establishing and maintaining household routines, inconsistency in dealing with the children)
- money management problems (making impulsive purchases, running out of money, failing to pay bills or do taxes, history of bankruptcy)
- substance use or abuse, especially alcohol or marijuana, or excessive caffeine use
- addictions such as collecting, compulsive shopping, sexual avoidance or addiction, overeating, compulsive exercise or gambling
- frequent accidents
- problems with driving (speeding tickets, serious accidents, license revoked, or being overly cautious when driving to compensate for attention problems)
- being a parent of a child with ADHD
- a college student who is frustrated, having to reduce their course load, or having difficulty completing assignments
- an ADHD diagnosis as a child and continuing to have problems
- reports from those close to the adult that they are just like a child or relative with ADHD or identifying them as having many of the symptoms associated with adult ADHD
- evidence that the adult is not just coping poorly, but is significantly impaired and is at high risk of developing secondary disorders such as anxiety and depression
- the adult may be successful but shows impairment when compared to their potential
- an adult who is expending more energy than others to do the same amount of work
- an adult who is using coping strategies to compensate for their weaknesses, but still experiencing problems with their career and work relations or becoming a workaholic
- an adult who self-diagnoses, but still needs to go through a complete assessment