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Attention Deficit Hyperactivity Disorder in Adults

Have you experienced challenges with concentration, impulsivity, restlessness, and organization throughout your life? Have you ever wondered whether you might have attention deficit hyperactivity disorder (ADHD)? Although ADHD is well known as a condition that affects children, many adults also experience it. ADHD can be harmful to an individual's social relationships and work and school performance, but effective treatments are available to manage the symptoms of ADHD. Learn about the signs and symptoms of ADHD and when to discuss it with your health care provider.

What is ADHD?

ADHD is a developmental disorder associated with an ongoing pattern of inattention, hyperactivity, and/or impulsivity. The symptoms of ADHD can interfere significantly with an individual's daily activities and relationships. ADHD begins in childhood and can continue into the teenage years and adulthood.

What are the symptoms of ADHD?

People with ADHD experience an ongoing pattern of the following types of symptoms:

• Inattention—having difficulty paying attention
• Hyperactivity—having too much energy or moving and talking too much
• Impulsivity—acting without thinking or having difficulty with self-control

Some people with ADHD mainly have symptoms of inattention. Others mostly have symptoms of hyperactivity-impulsivity. Some people have both types of symptoms.

Signs of inattention may include challenges with

• Paying close attention to details or making seemingly careless mistakes at work or during other activities
• Sustaining attention for long tasks, such as preparing reports, completing forms, or reviewing lengthy papers
• Listening closely when spoken to directly
• Following instructions and finishing duties in the workplace
• Organizing tasks and activities and managing time
• Engaging in tasks that require sustained attention
• Losing things, such as keys, wallets, and phones
• Being easily distracted by unrelated thoughts or stimuli
• Being forgetful in daily activities, such as paying bills, keeping appointments, or returning calls

Signs of hyperactivity and impulsivity may include

• Experiencing extreme restlessness, difficulty sitting still for extended periods, and/or wearing others out with one's activity
• Fidgeting with or tapping hands or feet or squirming in seat
• Being unable to engage quietly in leisure activities
• Talking excessively
• Answering questions before they are asked completely
• Having difficulty waiting one's turn, such as when waiting in line
• Interrupting or intruding on others

Other mental disorders may occur with ADHD, including anxiety, mood, and substance-use disorders.

How is ADHD diagnosed in adults?

ADHD is a disorder that begins in childhood and continues into adulthood. Adults diagnosed with ADHD have experienced several symptoms of this disorder before the age of 12. As adults, they currently experience at least five persistent symptoms of either inattention and/or hyperactivity-impulsivity. These symptoms must be present in two or more settings (e.g. home, work, or school; with friends or relatives; in other activities) and interfere with, or reduce the quality of, social, school, or work functioning.

Adults who think they may have ADHD should talk to their health care provider. Primary care providers routinely diagnose and treat ADHD and may refer individuals to mental health professionals.

Stress, other mental health conditions, and physical conditions or illnesses can cause similar symptoms to those of ADHD. Therefore, a thorough evaluation by a health care provider or mental health professional is necessary to determine the cause of the symptoms and identify effective treatments. During this evaluation, the health care provider or mental health professional will examine factors including the person's mood, medical history, and whether they struggle with other issues, such as alcohol or substance misuse.

A thorough evaluation also includes looking at the person's history of childhood behavior and school experiences. To obtain this information, an individual's health care provider may ask for permission to talk with partners, family members, close friends, and others who know the individual well. A health care provider or mental health professional may use standardized behavior rating scales or ADHD symptom checklists to determine whether an adult meets the criteria for a diagnosis of ADHD. An individual may complete psychological tests that look at working memory, executive functioning (abilities such as planning and decision-making), visual and spatial (related to space), or reasoning (thinking) skills. Such tests can help identify psychological or cognitive (thinking-related) strengths and challenges and can be used to identify or rule out possible learning disabilities.

How does ADHD affect adults?

Some adults with ADHD don't know they have it. These adults may feel it is impossible to get organized, stick to a job, or remember to keep appointments. Daily tasks, such as getting up in the morning, preparing to leave the house for work, arriving at work on time, and being productive on the job, can be especially challenging for adults with undiagnosed ADHD. These adults may have a history of problems with school, work, and relationships. Adults with ADHD may seem restless and may try to do several things at the same time—most of them unsuccessfully. They sometimes prefer quick fixes rather than taking the steps needed to gain greater rewards.

A person may not be diagnosed with ADHD until adulthood because teachers or family did not recognize the condition at a younger age, they had a mild form of ADHD, or they managed fairly well until they experienced the demands of adulthood, especially at work. Sometimes, young adults with undiagnosed ADHD have academic problems in college because of the intense concentration needed for college courses.

It is never too late to seek a diagnosis and treatment for ADHD and any other mental health condition that may occur with it. Effective treatment can make day-to-day life easier for many adults and their families.

What causes ADHD?

Researchers are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other disorders, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors that might raise the risk of developing ADHD and are studying how brain injuries, nutrition, and social environments might play a role in ADHD.