Attention-Deficit/Hyperactivity Disorder, otherwise known as ADHD, is a common neurodevelopmental condition, often diagnosed in childhood but with symptoms that may persist into adulthood. It involves difficulties with self-regulation, meaning that it’s very challenging for a person with ADHD to monitor and regulate their feelings, thoughts, and responses, in ways deemed socially acceptable to other people. The symptoms of ADHD can have negative impacts on a person’s daily functioning in work, home, and social environments.
Changes to the Diagnostic Statistical Manual (DSM) has see the removal of the distinction between ADD and ADHD. In present times diagnosis is made of ADHD with three different specifications which can also range in severity.
1. ADHD - Predominantly Inattentive Type (previously known as ADD)
This can include distractibility, difficulties in sustaining concentration, finishing tasks, and following instructions.
2. Predominantly Hyperactive-impulsive Type (previously referred to as ADHD)
As stated in the name, this may involve difficulty waiting, fidgeting, interrupting people, and impulsiveness.
3. Combined Inattentive and Hyperactive-impulsive type
This consists of a combination of the first two types and is the most common type of ADHD.
There is no determined single cause for ADHD, but it is believed to be impacted by genetics, and a person’s environment with things such as family stress and problematic parenting styles increasing its severity. It is also considered hereditary with some research indicating that the heritability of ADHD could be as high as 70–80%.
It is important to realise that ADHD is sometimes only diagnosed when one is an adult and that it can appear differently in adults to children. What might present as hyperactivity in a child, may present as restlessness in an adult. Other symptoms present in adult ADHD include:
· Impulsivity
· Difficulty focusing on work and staying organised
· Problems following through with tasks and time-management
· Difficulties with stress-management
· Emotional difficulties such as feelings of anger or irritability
Adults (and children) with ADHD may also experience other psychological disorders (such as in children with ADHD) like learning, mood, and anxiety disorders or substance use/abuse disorders. Sometimes ADHD in adults is mistaken for another disorder and so looking at what behaviours someone exhibited as a child is helpful in determining if they have ADHD in adulthood. While it used to be considered that individuals could “grow out of ADHD”, it has been found that this is not always the case. It is often due to the person learning coping mechanisms to manage more mild ADHD symptoms, or life stressors that were increasing the severity of a person’s symptoms have lessened. The presentation of ADHD symptoms may change over time, often changing from an external presentation such as hyperactivity to an internal presentation such as feeling all worked up inside but seeming calm on the outside.
Treatment for ADHD in adults can include, medication, learning behavioural management techniques, working with a coach to develop skills that support day-to-day management and goal achievement and psychological counselling, especially for those with severe emotional difficulties.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (5th ed.). American Psychiatric Publishing.
Brikell, I., Kuja‐Halkola, R., & Larsson, H. (2015). Heritability of attention‐deficit hyperactivity disorder in adults. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 168(6), 406–413. https://doi.org/10.1002/ajmg.b.32335
Champ, R. E., Adamou, M., & Tolchard, B. (2021). The impact of psychological theory on the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults: A scoping review. PLoS ONE, 16(12), e0261247.
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