Adult ADHD- All your questions answered.
What is the difference between ADHD and ADD?
ADHD is Attention Deficit Hyperactivity Disorder which includes all three criteria of inattention, hyperactivity and impulsivity.
ADD is Attention Deficit Disorder which comprises of Inattention alone. Usually adults have ADD as hyperactivity and Impulsivity may remit with age.
What does statistics suggest, how common is Adult ADHD?
According to American psychiatric association, 8.5% children and 2.5% adults suffer from ADHD.
What are the causes of ADHD, is there something in my childhood that was wrong or can I do anything differently now? Why did I get it in the first place?
There are multiple reasons why one may get ADHD. There is ample research to suggest that there is an increased risk in those who have a family member with ADHD, exposure to certain toxins by the mother while they were in her womb, environmentally difficult living conditions causing physical or mental stress early in life. There are many more risks that have been cited in multiple research. These reasons are however risks not causes. It is possible to not have ADHD despite having all these risk factors and vice versa.
How does inattention present in adult life?
“Where did I keep my stuff, I keep searching all the time”
“A very messy, disorganized living space.”
“I want to pay attention in a long meeting, it was an important one, yet I got distracted.”
“I feel I have no control over things I intend to do and end up doing.”
“I can’t keep track of time.I often underestimate the time it will take to complete tasks.”
“I make silly mistakes and find it difficult in reading carefully.”
“I keep making careless mistakes.”
“I get distracted even when I am being directly spoken to after such time.”
“ I overlook small details and there are errors in my work.”
How does hyperactivity present in adult life?
“I cannot sit still, I am constantly fidgeting in my seat.”
“I feel restless and uneasy in my seat.”
Inner restlessness can sometimes be misdiagnosed as anxiety.
How does impulsivity present in adult life?
“My partner always complains that I keep interrupting when she talks.”
“I can’t wait for my turn; I get very impatient.”
“Alcohol, smoking helps my thoughts slow down and I can focus better.”
“I end up lying in silly, obvious situations and end up getting caught.”
“I end up oversharing, much more than I intend to.”
“I blurt out without thinking.”
What are the consequences of untreated ADHD?
“I find it difficult to do monotonous and boring tasks”
“I keep delaying things until the last day”
“Sometimes how much ever I try I miss the deadline.”
“I decide to pay attention, yet zone out of important meetings.”
“My tasks remain incomplete and I cannot get myself to reply to emails.”
“I have had to change multiple jobs.”
“It is irritating as he never pays attention even when I am directly talking to him.”
“He always forgets daily tasks and keeps misplacing things.”
“He ends up in a mess, even if I tidy up.”
“He keeps interrupting and doesn’t let me finish when I want to talk
“He is easily bored and binges on OTT and reels all the time.”
“He has very poor time management, always late.”
As one lives a lifetime of incomplete tasks and procrastination it causes self-blame and decreased confidence. Constantly facing criticism from authorities, partners can decrease self-esteem.
Is it possible to have ADHD and other psychiatric illness? Do other mental health illnesses cause ADHD or does ADHD cause other psychiatric illnesses.
There are three possibilities
1. Inattention is a symptom of Depression, anxiety, mood disorders and certain personality traits independent of ADHD. Treatment of these disorders can improve the symptoms of inattention.
2. It is possible to have ADHD and these psychiatric illnesses at the same time.
3. It has also been observed that living with untreated ADHD itself can make one prone to have secondary anxiety and depression. This in turn worsens the existing inattention.
ADHD patients have a 6 time higher risk of developing anxiety than others.
Is it true that ADD patients can focus on things that interest them and find it difficult to hold attention in boring or routine tasks?
Yes, it is true.
Is ADHD present in adults/children with high/low IQ?
Intelligence and ADHD are independent of each other.
Often people with a borderline or low normal IQ get diagnosed in school life as they face academic difficulties.
High normal or bright normal IQ go undiagnosed until adult life as they can compensate or mask their inattentiveness. They are able to focus for short periods and their academic performance is unaffected.
Are all adults with ADHD having same symptoms and problems?
Not always, some adults have inattention alone, while some others have hyperactivity or impulsivity along with Inattention.
Why do people confuse between ADHD and personality traits?
If you've lived with inattention for a number of years, it becomes a part of who you are, and people often don't see it as a symptom, but say “It’s in my nature to forget things and be lazy.” Or “I am like this since childhood.”
Yes, it could be a personality trait too, or a part of another illness. It is best to get a screening done by a professional to know the difference,
I am already 30 or 45 or 50 years of age, can I get treated for ADHD now?
Yes, there is no age to start treatment. Once treatment has started it is possible to return to optimal functioning.
How is it different from just being lazy?
“You seem to do things you like very well without lapse in attention.”
“I am very lazy, that’s the problem.”
Being lazy could be a defence mechanism (avoidance), a personality trait or a symptom of ADD. A mental health professional can help in differentiating between these symptoms.
As a child, what are things that an ADHD kid hears?
“It’s not that he can’t do it, but he doesn’t put enough effort.”
“Always late and no time management.”
“He can do much better in academics than his score.”
“He makes silly mistakes, doesn’t read the question carefully.”
“He is very messy and disorganised.”
“He is always misplacing things and searching for them all the time.”
“He is often day dreaming often.”
“I have to call out to her multiple times, before he answers.”
“He can sit for hours watching a movie or playing a video game”
“He likes art/particular subject that he will do, there he doesn’t get distracted.”
How can I get diagnosed if I meet all the symptoms?
Meet a mental health professional i.e a psychiatrist or a clinical psychologist.
Do not match your symptoms with a friend or google the answers.
The diagnosis will be done after clinical history and a series of psychometric tests.
Self-diagnosis, diagnosis after watching a reel or reading an article is a common practise. It is often incorrect and misleading.
How does a mental health professional clinically evaluate and conclude if someone has ADHD?
Firstly, they try to rule out whether the inattention, hyperactivity and impulsivity is due to the presence of any other psychiatric disorder like depression, anxiety, mood and personality traits.
Secondly, they try to divulge history from the patient, parents, teachers, guardians and other sources which are available to ascertain whether the symptoms are present since childhood and have persisted into adult life. They will try to get a complete view of your daily life for a couple of years.
It has been observed that hyperactivity and sometimes impulsivity may remit and only inattention may persist into adult life.
Lastly, the level of social and occupational impairment is assessed. This helps in understanding the fallbacks or problems faced in personal and professional setting due to inability to sustain attention. It also gives an understanding of how different the individual’s life would have been had they received treatment for inattention.
How does one understand ADD from a neuropsychiatric perspective?
The mechanism of ADHD can be explained
-fluctuations in arousal (deficit in sustained attention)
-increasing external stimulation like hyperactivity to autoregulate in order to reach stability.
There are structural changes seen on imaging as well. Dopamine and adrenaline are two neurotransmitters responsible for ADHD.
Dr Nahid Dave