ADHD in Adults
Attention deficit hyperactivity disorder (ADHD) is a highly publicized childhood disorder, but you may not be aware that ADHD affects adults who were never diagnosed with this condition as children.
Typically, adults with ADHD are unaware that they have this disorder -- they often just feel that it's impossible to get organized, to stick to a job, to keep an appointment. The everyday tasks of getting up, getting dressed and ready for the day's work, getting to work on time, and being productive on the job can be major challenges for the ADHD adult.
Diagnosing an adult with ADHD is not easy. Many times, when a child is diagnosed with the disorder, a parent will recognize that he or she has many of the same symptoms the child has and, for the first time, will begin to understand some of the traits that have given him or her trouble for years -- distractibility, impulsivity, and restlessness. Other adults will seek professional help for depression or anxiety and will find out that the root cause of some of their emotional problems is ADHD.
The accuracy of the diagnosis of adult ADHD is of utmost importance and should be made by a clinician with expertise in the area of attentional dysfunction. For an accurate diagnosis, a history of the client's childhood behavior, together with an interview with his life partner, a parent, close friend, or other close associate, will be needed. A physical examination and psychological tests may also be given. Co-morbidity with other conditions may exist such as specific learning disabilities, anxiety, or mood disorders.
A correct diagnosis of ADHD can bring a sense of relief. The individual has brought into adulthood many negative perceptions of himself or herself that may have led to low self-esteem. Now he or she can begin to understand the origins of some of their problems and can begin to face them. This may mean not only medication treatment for ADHD, but also psychotherapy that can help him or her cope with the anger they feel about the failure to diagnose the disorder when younger.
Treatment of ADHD in an Adult.
As with children, if adults take a medication for ADHD they often start with a stimulant medication. The stimulant medications affect the regulation of two neurotransmitters, norepinephrine and dopamine. The newest medication approved for ADHD by the FDA, atomoxetine (Strattera®), has been tested in controlled studies in both children and adults and has been found to be effective. Certain antidepressants can also be considered a second line choice for treatment of adults with ADHD.
Education and Psychotherapy.
Although medication gives needed physical support, the individual must develop additional, personal tools and capabilities to succeed. To help in this struggle, both "psycho-education" and individual psychotherapy can be useful. A psychiatrist or psychotherapist can help the ADHD adult learn how to organize his life by using "props" -- a large calendar posted where it will be seen in the morning, date books, lists, reminder notes, and have a special place for keys, bills, and the paperwork of everyday life. Tasks can be organized into sections, so that completion of each part can give a sense of accomplishment. Above all, ADHD adults should learn as much as they can about their disorder and how best to manage it, as opposed to being managed by it.
Psychotherapy is the key to the successful combination of medication and education. Therapy will help change a long-standing poor self-image, by examining the earlier life experiences that produced it. The therapist will encourage the ADHD client to adjust to changes brought into his life by treatment -- the perceived loss of impulsivity and love of risk-taking, the new sensation of thinking before acting. As the client begins to have small successes through a newfound ability to bring organization out of the disorganized complexities of his or her life, he or she can begin to appreciate the characteristics of ADHD that are positive -- boundless energy, warmth, and enthusiasm.
At Potomac Psychiatry our psychiatrists and therapists specialize in adult ADHD. Call us at 301.984.9791 to discuss your needs or to schedule an appointment.
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