Share this information:
  • 3
  •  
  •  
  •  
  •  
  • 1
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
    4
    Shares


1 Star2 Stars3 Stars4 Stars5 Stars (1 votes, average: 5.00 out of 5)
Loading...

ADHD In Children and Adults

Symptoms of ADHD with adults and children

ADHD in Adults

Increasingly adults are seeking help for ADHD. This is a difficult diagnostic problem because there are no criteria for an adult form of the disorder. One study found that only 32% of adults who believed they had ADHD actually fulfilled diagnostic criteria for the disorder, and another 36% met some of the criteria but did not have a history of childhood ADHD. Symptoms in adults may differ from those in children, with severe attention problems being most prominent in older people.

A rating scale using four factors has been developed that may prove to be useful:

  • Inattention and memory problems. (As examples: losing or forgetting things, being absent minded, not finishing things, misjudging time, depending on others for order, having trouble getting started, changing jobs or projects in the middle.)
  • Hyperactivity and restlessness. (Examples: always being on the go, fidgety, easily bored, taking risks, liking active and fast paced activities.)
  • Impulsivity and emotional instability. (Examples: saying things without thinking first, interrupting others, being annoying others, easily frustrated, easily angered, or having unpredictable moods.)
  • Problems with self worth. (Examples: Avoids new challenges, appears confident to others but not to oneself.)

A study published in 2000 suggested that adults can also provide an accurate report of their childhood behaviors, which physicians may also be able to rely on when searching for clues for a diagnosis.

Paying Attention to Adult ADD

Attention deficit disorder used to be considered a childhood condition. But experts suspect it can follow you for life.

Children with ADHD

In what he refers to as “my life before Ritalin,” Smith (who asked that his real name not be used) couldn’t hold a job, balance his checkbook, or complete any of the many projects he had going at once. And his wife of 23 years, Linda, had one foot out the door. “I was a flake,” he says.

Today, the 42-year-old San Franciscan has a successful carpentry career doing intricate finish trim work, his savings account balance is at $30,000, he has finished writing not one but two screenplays, and his wife says she couldn’t be happier.

It all started three years ago, when Smith’s mother-in-law began to suspect he might be suffering from more than absentmindedness.

“She’s one of those people who reads the Merck Manual, the book doctors use to diagnose people, for fun,” he says. So when she came knocking with a 100-question diagnostic test from a book on attention deficit disorder (ADD), he figured why not?

Linda answered yes to 16 questions, a friend said yes to 37, but Smith answered yes to a whopping 89 out of 100.

“That’s when we knew,” Linda says. A doctor confirmed their suspicion by making the diagnosis of ADD with further testing, and Smith began a multifaceted treatment program that included counseling, behavior management, and Ritalin.

Life with ADD

Attention deficit disorder affects an estimated 6% to 8% of the general population, according to the national Attention Deficit Disorder Association (ADDA) — and as many as half of them are never diagnosed. ADD may continue over a lifetime; the ADDA says about half of children with the disorder will develop strategies to compensate, while others, like Smith, will continue to struggle into adulthood.

“People pay a high price for doing so,” says Craig Liden, MD, who has worked with more than 8,000 children and adults with ADD. “Most of these people make living on the edge a way of life, and they pay for it physically and emotionally.”

But the diagnosis of ADD is itself controversial, says Leslie Rubin, MD, director of developmental pediatrics and associate professor of pediatrics at Emory University School of Medicine. He believes ADD is the “diagnosis of the day.” If such large numbers of people in fact have the condition, he says, it is either an epidemic or a variation of the norm.

ADHD with adults

He wonders if the symptoms called ADD aren’t in fact personality traits that while advantageous in certain situations, don’t fit well into a life that requires sitting at a desk eight hours a day. “Unless someone’s life is severely affected, I don’t recommend medication,” Rubin says. Instead he suggests they consider these traits positives and find a way to work them to their advantage. “I bet a lot of those people who work on the floor of the stock exchange have ADD,” he says. “I don’t like to label it as a bad thing.”

But after 39 years of erratic behavior, Smith’s life was severely affected in nearly every area. When asked about life with ADD, he says he doesn’t remember a lot of his own behavior, except a general feeling that things seemed to run more smoothly for others. Life was lived in the moment, with little awareness of how past experiences connected to present ones.

“If I got a parking ticket, for example, I would obsess over it for weeks,” he says. “I always felt like everyone was out to get me.” Looking back, Smith feels that his own behavior — like parking in a no-parking zone — led to such consequences. But at the time, he couldn’t make that connection. When others were upset with him or his actions, at work or at home, he couldn’t understand why.

“It’s like if I needed glasses to read,” says Liden. “And then I was put into situations every day where I had to read without my glasses. Pretty soon I would become frustrated and angry. That’s what life is like with ADD. The ability to pay attention and sustain concentration is a prerequisite for almost every life task.”

But with ADD, paying attention, especially to something not particularly interesting but critical like keeping track of the balance in the checking account, can be a major challenge.

Those with ADD also may have trouble with impulsiveness, self-monitoring (knowing when behavior is inappropriate), distractibility, sleeping too much or too little, and a short attention span. However, when interested in something they can stay highly, almost obsessively, focused, according to the ADDA.

Liden says for the most part, life can be molded around the ADD, but when expectations rise — an important report is due at work, for example — that’s when the ADD comes to the foreground. “It is often others who notice it,” he says. “The person with ADD is usually the last to know.”

Consequently, those with undiagnosed adult ADD may struggle to keep a job, sustain a marriage, control finances, and even avoid trouble with the law, says Leon Zacharowicz, MD, MA, a neurologist at Nassau University Medical Center in Long Island, N.Y.

“If someone has poor impulse control, they might mouth off to a police officer when pulled over for running a traffic light,” he says, making the situation far worse. For many, it is just such a life crisis — a car accident, a run-in with the law, a pending divorce, the loss of a job — that finally draws attention to the disorder and leads to a diagnosis.

Finding answers

“Attention deficit doesn’t begin at age 35,” says Zacharowicz. “You’re looking for patterns that have been there since childhood.” These are patterns that people have gotten so used to working around, they have almost become invisible. Zacharowicz sees a lot of parents that bring their children to be evaluated for ADD, only to realize they have it as well. “There seems to be a genetic component to this,” he says.

Smith missed making that genetic connection in two ways. He and Linda don’t have children and Smith, who was adopted, has no knowledge of his biological family’s medical history.

If someone suspects adult ADD, Sherry Span, PhD, a professor of psychology who researches attention deficit disorders and their persistence into adulthood at California State University, Long Beach, recommends seeking out a doctor or psychiatrist who is knowledgeable about the condition.

Because there is no blood test or CAT scan that can diagnose ADD, she says, the approach involves a myriad of tests that all add up to a final diagnosis. These may include a medical examination to rule out other causes, an ADD questionnaire, an assessment of current and past behavior, neuropsychological tests, and even performance tests that measure the ability to pay attention.

Contrary to appearances, says Span, the brains of people with ADD are under-, not over-, stimulated, which is why they have trouble paying attention. Unless a situation is especially exciting — viewing an action movie, for example — the brain simply cannot focus.

Treating the individual

After a diagnosis is made, “you have to evaluate each patient’s strengths and weaknesses and go from there,” says Liden. Some patients will go on medication long term, others may only take it initially, and still others may not take medication at all. In any case, treatment should go beyond medication, he says, to include counseling for the person affected and the family, so everyone understands how to minimize the impact of ADD on their lives.

Smith has decided to stay on his medication long term. “I never want to go back to the way things were before,” he says. He also works with a psychiatrist to learn how he can change his habits to cope with his remaining ADD traits. At first he went often; now he goes just to check in periodically.

While some of his friends have had a hard time accepting the diagnosis and claim he doesn’t need the medication, Smith disagrees. “My friends who I work with, the ones who had to deal with it when I didn’t show up for a job, they support my taking medication 100%,” he says. “My life has changed for the better.”

What Else Can I Do to Help My Child With ADHD?

This question reflects the complexity of caring for kids diagnosed with ADHD. Often, there are other problems going on as well that are not completely addressed with a simple pill.

Question:
I have a 9-year-old boy with ADHD who is on Adderall, but he cries when I have him do his homework or read a book. He gets angry when anyone asks him a little question. What else can I do?

Answer:

This question reflects the complexity of caring for kids diagnosed with ADHD. Often, there are other problems going on as well that are not completely addressed with a simple pill.

Underlying problems such as depression or anxiety may contribute to his problem. If there are family conflicts or a recent death or move — these are all stressful conditions that can amplify any existing behavioral problems.

There may be other things going on at school or in the community that are stressful as well. Just watching the nightly news and hearing about kids getting shot at school and day care centers can make kids (and adults) pretty tense and anxious about the world.

There may also be a great benefit for you and your family in seeing a professional psychotherapist who can help you look at some of the underlying problems and help you find successful strategies for dealing with them.





Share this information:
  • 3
  •  
  •  
  •  
  •  
  • 1
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
    4
    Shares
  •  
    4
    Shares
  • 3
  •  
  •  
  •  
  •  
  • 1
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •