Attention deficit hyperactive disorder, or ADHD, is a condition characterized by inattention, hyperactivity, impulsiveness, or a combination.
About 60 percent of children with ADHD in the United States become adults with ADHD; that’s about 4 percent of the adult population, or 8 million adults.*
Less than 20 percent of adults with ADHD have been diagnosed or treated, and only about one-quarter of those adults seek help.*
Thought to be biological and most often genetic, ADHD takes place very early in brain development. Adults with ADHD may exhibit the same symptoms they had as children, and although hyperactivity often diminishes by adulthood, inattentiveness and impulsivity may persist.
ADHD symptoms often include an inability to focus, disorganization, and restlessness. Adults with ADHD may have a hard time organizing things, listening to instructions, remembering details, or difficulty completing tasks, which can affect their relationships at home, school, and work.
People who have ADHD may exhibit different symptoms, and they may experience them at different levels of severity, ranging from mild to significant impairment.
ADHD and mental health disorders
Adults with ADHD are likely to have an anxiety disorder, depression, bipolar disorder, or other comorbid psychiatric disorder. (The term “comorbid” refers to a condition that exists with another.)
About 50 percent of adults with ADHD also suffer from an anxiety disorder. Adult ADHD symptoms that coexist with an anxiety disorder or other disorders may significantly impair the ability to function.
Proper diagnosis relies on a comprehensive clinical evaluation by a health professional, who will take into account personal history, self-reported symptoms, and mental-status testing, as well as early development problems and symptoms of inattention, distractibility, impulsivity, and emotional instability.
Overlapping symptoms of comorbid psychiatric conditions often complicate getting an accurate diagnosis.
A health professional will ask questions like these during a consultation:
- Do your behaviors and feelings show that you have problems with attention and hyperactivity?
- Do you have a hard time keeping your temper or staying in a good mood?
- Do these problems happen to you at work and at home?
- Do family members and friends see that you have these problems?
- Have you had these problems since you were a child?
- Do you have any physical or mental health problems that might affect your behavior?
Medication is a cornerstone of treatment for adults with ADHD. Research has shown that stimulants and some nonstimulants can improve the symptoms of ADHD, helping people pay attention, concentrate, and control their impulses.
Most people also benefit from behavioral, psychological, educational, and coaching interventions. A helpful resource for locating support groups or professionals with appropriate expertise is CHADD (Children and Adults with Attention Deficit Hyperactivity Disorder).
Anxiety disorders and other comorbid conditions may come about as a result of living with ADHD. Having a comorbid anxiety disorder can make treatment more complicated. A health professional will define the areas of impairment (such as problems relating to attention or impulsivity at work or school, sleeping, or family life) and help select the most favorable treatment option.
In addition to prescribing medication for ADHD, a health professional may recommend CBT (cognitive-behavior therapy) for comorbid anxiety. Some stimulant-drug treatments for ADHD may worsen anxiety symptoms in patients with comorbid anxiety disorders.
A health professional should focus on the disorder associated with the highest degree of impairment. If ADHD is the cause of anxiety, treating the ADHD may reduce the anxiety. If anxiety is independent of ADHD, however, a doctor will determine the proper medication. One health professional may decide to treat the anxiety first; another may treat both conditions simultaneously.
Among those with ADHD persisting into adulthood, only about one-quarter report having received treatment for their symptoms in the past year" 18. Kessler RC, Adler L, Barkley R, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. American Journal of Psychiatry. 2006;163:716–723.
In terms of treatment-seeking - First Treatment Contact for ADHD: Predictors of and Gender Differences in Treatment Seeking Elias Dakwar, M.D, Frances R. Levin, M.D, [...], and Carlos Blanco, M.D., Ph.D http://ps.psychiatryonline.org/doi/ref/10.1176/appi.ps.201300298
ADHD symptoms were found in 20.3% of the sample, but only 7.3% of these subjects had ever received a formal diagnosis. https://www.ncbi.nlm.nih.gov/pubmed/27680974