ADHD/ADD Folks

[Nat]

I'm curious to know how many of us are out there. I think it's often a misunderstood thing - with people throwing the terms around who don't understand the definitions and with many denying it's an actual condition. Many people laughingly refer to their own "ADHD" or "ADD" when describing one or two occasional behaviors, but without any real knowledge of what it's like to live within an ADHD/ADD brain. In the past also, it was seen as a condition that went away in adulthood, but there's a growing understanding that the symptoms can morph in adulthood rather than go away. I'm going to post some more info in the following posts, but this is just the *getting this started* post. I'm pretty sure there must be others besides myself who live with this "disorder." I'm hoping you join in and contribute to this thread in whatever way you'd most enjoy.

[Nat]

ADHD in Adults

Adults with ADHD may have difficulty following directions, remembering information, concentrating, organizing tasks or completing work within time limits. If these difficulties are not managed appropriately, they can cause associated behavioral, emotional, social, vocational and academic problems.

Adult ADHD Statistics

ADHD afflicts approximately 3% to 5% of school-age children and an estimated 60% of those will maintain the disorder into adulthood.

Prevalence rates for ADHD in adults are not as well determined as rates for children, but fall in the 1% to 5% range.

ADHD affects males at higher rate than females in childhood, but this ratio seems to even out by adulthood.

Common Behaviors and Problems of Adult ADHD

The following behaviors and problems may stem directly from ADHD or may be the result of related adjustment difficulties:

Chronic lateness and forgetfulness.

Anxiety.

Low self-esteem.

Employment problems.

Difficulty controlling anger.

Impulsiveness.

Substance abuse or addiction.

Poor organization skills.

Procrastination.

Low frustration tolerance.

Chronic boredom.

Difficulty concentrating when reading.

Mood swings.

Depression.

Relationship problems.

These behaviors may be mild to severe and can vary with the situation or be present all of the time. Some adults with ADHD may be able to concentrate if they are interested in or excited about what they are doing. Others may have difficulty focusing under any circumstances. Some adults look for stimulation, but others avoid it. In addition, adults with ADHD can be withdrawn and antisocial, or they can be overly social and unable to be alone.

School-Related Impairments Linked to Adult ADHD
Adults with ADHD may have:

Had a history of poorer educational performance and were underachievers.

Had more frequent school disciplinary actions.

Had to repeat a grade.

Dropped out of school more often.

Work-Related Impairments Linked to Adult ADHDAdults with ADHD are more likely to:

Change employers frequently and perform poorly.

Have had fewer occupational achievements, independent of psychiatric status.

Social-Related Impairments Linked to Adult ADHD
Adults with ADHD are more likely to:

Have a lower socioeconomic status.

Have driving violations such as: be cited for speeding; have their licenses suspended; be involved in more crashes; rate themselves and others as using poorer driving habits.

Use illegal substances more frequently.

Smoke cigarettes.

Self-report psychological maladjustment more often.

Relationship-Related Impairments Linked to Adult ADHD

Adults with ADHD are more likely to:

Have more marital problems and multiple marriages.

Have higher incidence of separation and divorce.

Much of this functional impairment diminishes with remission of the disorder and can be mitigated by appropriate treatment.

How Is Adult ADHD Diagnosed?

While researchers may disagree about age of childhood onset in diagnosing adult ADHD, all agree that ADHD is not an adult-onset disorder and must be verified from childhood. An assessment of ADHD symptoms and behavior from childhood may include any or all of the following:

A questionnaire to determine if the adult had ADHD in childhood.

School report cards, if available, to look for comments about behavior problems, poor focus, lack of effort or underachievement relative to the student's potential.

Discussion with the parents to determine any symptoms during childhood.

A complete history from the adult with the symptoms. He or she may self report symptoms in childhood.

The developmental history would be consistent with ADHD, including evidence of problems with peers, other delays such as bed wetting, school failure, suspensions, or special interventions such as sitting in front of the class, etc.

A strong family history of ADHD may also be informative, given the strong genetic component of the disorder.

Other examinations may also be performed, including:

A physical exam to rule out medical or neurological illness.

An EEG, CT, or MRI.

Psychoeducational testing (for example: IQ test, achievement testing) if a learning disability is suspected.

Medications to Treat Adult ADHD
The same drug treatments proven to be efficacious in children appear to benefit adults with ADHD.

Ritalin
Concerta
Vyvanse
Adderall
Focalin
Dexedrin

In the past, the first treatment offered to adults with ADHD has been stimulant drugs. Studies show that approximately two thirds of adults with ADHD who are given these medications show significant improvement in ADHD symptoms.

However, there are some difficulties in using stimulants to treat ADHD in adults. Stimulants are controlled substances and it is not uncommon for adults with ADHD to have or to have had problems with substance abuse. Short acting stimulants may wear off quickly and since adult patients administer the medication themselves, and usually have problems with forgetfulness, compliance can be problematic with multiple day dosing. Adults may experience significant difficulty in the evening when they do housework, pay bills, help children with homework or drive, or are tempted to use substances 'to relax'.

Stratterra is the only nonstimulant medication approved by the Food and Drug Administration (FDA) for the treatment of ADHD, not just for children and adolescents, but for adults as well. This is the first medication to receive an FDA indication for treatment of ADHD in adults.

Strattera does not have abuse potential and does not require a special prescription.

Behavioral Treatments for Adult ADHD
Adult ADHD may be treated with one or more of the following:

Individual cognitive and behavioral therapy to enhance self-esteem.

Relaxation training and stress management to reduce anxiety and stress.

Behavioral coaching to teach the person strategies for organizing home and work activities.

Job coaching or mentoring to support better working relationships and improve on-the-job performance.

Family education and therapy.

In-depth assessment, treatment planning, medication management, individual therapy, education and family support are all necessary to help the adult with ADHD function in new ways and build his or her self-esteem. Because ADHD is often associated with other conditions (such as specific learning disabilities, anxiety and mood disorders, obsessive compulsive disorder and chemical dependency), in-depth assessment is the first step in developing a comprehensive, customized treatment plan.

Adults with ADHD can also benefit from some basic organizational concepts and behavior management strategies to help manage the condition. Here are ways to train yourself to overcome these problems or make them more manageable:

Take medications as directed. If you are taking any medications for ADHD or any other condition, be sure and take them exactly as prescribed. Missing a dose or taking two doses at once to catch up on missed doses can have negative consequences for you and others. If you are noticing side effects or other problems, speak to your health care provider as soon as possible.

Organize yourself. Train yourself to become more organized. Make lists of daily tasks (be reasonable!) and strive to complete them. Use a daily planner, leave notes for yourself and set your alarm clock when you need to remember an appointment or other activity.

Control impulsive behavior. If you have a tendency to do things you later regret, such as interrupting or getting angry at others, manage the impulse by counting to 10 while breathing slowly instead of acting out. Usually the impulse will pass as quickly as it appeared.

Minimize distractions. Find ways to reduce the distractions throughout the day. If you find yourself being distracted by loud music or the television, turn it off or use earplugs. Move yourself to a quieter location or ask others to help reduce distractions.

Find constructive outlets for excess energy. People with ADHD sometimes seem to have more nervous energy than others, and this hyperactivity needs to have an outlet of some sort. A hobby or other pastime can be helpful.
Ask for help. We all need help from time to time and it is important to not be afraid to ask for it when you need it. If you are having disruptive thoughts or behaviors, ask a counselor if they have any techniques that might help control them.

Living with Adult ADHD

Although most people don't outgrow ADHD, they do learn to adapt. If the difficulties associated with ADHD are managed appropriately throughout their lives, adults with ADHD can learn to develop personal strengths and become productive and successful.

[Nat]

DSM-IV Diagnostic Criteria for ADHD
--------------------------------------------------------------------------------

A.Either (1) or (2):

1.Six (or more) of the following symptoms of inattention have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:

Inattention

a.Often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
b.Often has difficulty sustaining attention in tasks or play activities
c.Often does not seem to listen when spoken to directly
d.Often does not follow through on instructions and fails to finish schoolwork, chores or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
e.Often has difficulty organizing tasks and activities
f.Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
g.Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books or tools)
h.Is often easily distracted by extraneous stimuli
i.Is often forgetful in daily activities

2.Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity

a.Often fidgets with hands or feet or squirms in seat
b.Often leaves seat in classroom or in other situations in which remaining seated is expected
c.Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
d.Often has difficulty playing or engaging in leisure activities quietly
e.Is often "on the go" or often acts as if "driven by a motor"
f.Often talks excessively

Impulsivity

g.Often blurts out answers before questions have been completed
h.Often has difficulty awaiting turn
i.Often interrupts or intrudes on others (e.g., butts into conversations or games)
B.Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.
C.Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).
D.There must be clear evidence of clinically significant impairment in social, academic or occupational functioning.

[Nat]

Utah Criteria for ADHD in Adults --------------------------------------------------------------------------------

I. Childhood history consistent with ADHD
II. Adult symptoms
Hyperactivity and poor concentration
Two of the following:
Affective lability
Hot temper
Inability to complete tasks and disorganization
Stress intolerance
Impulsivity

[Nat]

Some children with ADHD continue to have it as adults. And many adults who have the disorder don't know it. They may feel that it is impossible to get organized, stick to a job, or remember and 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 ADHD.

These adults may have a history of failure at school, problems at work, or difficult or failed relationships. Many have had multiple traffic accidents. Like teens, adults with ADHD may seem restless and may try to do several things at once, most of them unsuccessfully. They also tend to prefer "quick fixes," rather than taking the steps needed to achieve greater rewards.

[atomiczombie]

I have ADD but not ADHD.

[Nat]

Keeping in mind that ADHD is unique in each individual, it can be even more difficult to determine symptoms of ADHD in adults. However, the list below will provide a guideline for how symptoms manifest themselves in adults with ADHD. (Please note that this should not be used for diagnostic purposes, if you feel that you may have ADHD, please discuss your concerns with your physician or a medical professional that is qualified to make a diagnosis.)

Inattention can appear in many different ways:

· May lose or misplace items such as keys, important papers, phone numbers and other things used on a daily basis. This often occurs on a regular basis

· Often forgetful, may consistently forget to take out the trash, may forget to pick up the children from activities, may forget to complete tasks, even after instructions have been given

· Beginning, but not completing tasks

· Often distracted, for example, may begin a task such as mowing the grass, but hear the phone ring, go inside, get a drink, pay attention to what is on television, talk with your children and completely forget to finish mowing the lawn until hours later

· May have difficulty following conversations. May be easily distracted and miss important details of conversations

· Lacks self motivation, even if the project sounds like something you would like to complete

· Often loses track of time or misjudges how much time has passed. Can be difficult to follow a timed schedule

· Your mind wanders easily, even if someone is speaking to you or you should be completing a task or project

Hyperactivity in children can be easy to spot. Children can’t sit still for even a few moments or they are constantly in motion. They may act as if driven by a motor and often jump or bounce around the room

· Needs constant motion, may tap feet, play with a pencil, doodle or fidget

· Easily bored. May move from job to job because you become bored once you have learned the job, may not complete projects because you become bored after a short time. You need be intensely interested in something for it to hold your interest

· Although you can sit still, you feel restless after just a few minutes of inactivity. You feel the need to get up, walk around the room or do something

· Active, risky or fast paced activities are more interesting and more apt to hold your interest

Impulsiveness is reacting without thinking first. Children that are impulsive might yell an answer out at school without raising their hand or waiting for their turn. Children may jump from a play set before thinking of the consequences. Adults with ADHD can also be impulsive:

· Consistently interrupts others while talking or answering a question before it has been completed

· Enters conversations while others are still talking

[Nat]

[Nat]

Originally Posted by atomiczombie

I have ADD but not ADHD.

I have the inattentive type.

The only hyper symptoms I have are racing thoughts going off in many directions at one time as well as fast talking and fidgeting. I have low amounts of physical energy and was never physically hyper.

[Nat]

[Nat]

[Nat]

[Mar]

Hi Nat,

Thank you for posting all of this useful information. I have never been diagnosed but it is clear to me I suffer from it because I experience most of the symptoms almost religiously. Luckily for me I am even tempered and do not experience the difficulty controlling anger part..and I have never been an addict to any drugs or alcohol either, but so much other things on the list fit.

[Nat]

[Nat]

Originally Posted by Mar

Hi Nat,

Thank you for posting all of this useful information. I have never been diagnosed but it is clear to me I suffer from it because I experience most of the symptoms almost religiously. Luckily for me I am even tempered and do not experience the difficulty controlling anger part..and I have never been an addict to any drugs or alcohol either, but so much other things on the list fit.

Hi Mar Thanks for posting! I think there are definitely people without diagnosis who live with this.

I've heard the statistic that 50% of people with ADD/ADHD have at some point struggled with alcohol or drug abuse due to high levels of impulsivity and low levels of inhibition. Although I've gone through phases with partying (especially when I first came out), I have thankfully not become addicted to drugs or alcohol. I don't think my relationship with alcohol is perfect, but it's more a see it/want it thing. It's out of sight, out of mind in my regular life. However, I do have addictive behaviors - compulsive overeating, internetting, spending money, some level of hoarding behaviors, etc. Well, and I finally became addicted to cigarettes last year, after socially smoking without being addicted since I was 13. :/ But chemical addictions don't seem to be something my body submits to easily - with the cigs it took 19 years of flirting with the possibility.

[girl_dee]

Lordy, went to watch a video and within 30 seconds moved on to something else! Damn ADD !

[cane]

Hi Nat,

no you are not alone. I was diagnosed as an adult, much to my relief. I wasn't just unreliable, crazy, unpatient, weird, stupid and what else people have called me in the past...
There was a reason, which made it so much easier to deal with, not just for me but for my wife and friends as well.

[Julie]

Nat ~

Great information. I am a child of Ritalin and Dexedrin. For me as a child, this saved my life (believe it or not) - I was absolutely non-functioning without it and physically out of control. I can remember the positive effects this had on my life at (1972) 10 years old. My father was also hyperactive (that's what they called us in the 60's - 70's)

As an adult - The hyperactivity has gone. I am just left with the ADD. My kids pediatrician wanted to put me on Ritalin (lol) as he saw it immediately. My kids are all GREAT and showed no signs growing up, but Ben shows it as he gets older. I was super sensitive to this when they were little.

I have trained my brain to function without the use of drugs as an adult. I have worked from home for 25 years and have had to train myself to create a shield around me. I can absolutely BLOCK out any outside interference now. However, I am unable to function in an office setting - way too many distractions for me.

Thank you for starting this - I am going to (once I can concentrate - hurricane news on) will read your posts in detail and watch your videos. This is a serious issue for so many adults.

Julie

[girl_dee]

I am in the same boat as Mar

I right now should be doing 5 other things, but the list goes over and over in my head and I can't seem to get started. So at the end of the day I will have 5 started but unfinished projects.

Thank you Nat for sharing.

[atomiczombie]

Originally Posted by Cajun_dee

Lordy, went to watch a video and within 30 seconds moved on to something else! Damn ADD !

Yeah I don't have the patience to watch all those videos either, although I would like to

ETA: I am a recovering addict/alchoholic. I therefore can't take any of the stimulant meds for my ADD. So I just live with it.