Adult ADD/ADHD

Most of us have heard of Attention Deficit Disorder (ADD) or Attention Deficit/Hyperactivity Disorder (ADHD) with respect to children. It’s estimated that approximately 3 to 5 per cent of children suffer from the disorder, which is characterized by an inability to focus, over-activity, and impulsivity.

It’s less common to consider that adults may have ADD or ADHD. But researchers have estimated that between 30 to 70 per cent of children may go on to exhibit symptoms of the disorder in their adult years. And if the disorder has gone undiagnosed or untreated, it can have had devastating effects on an adult’s self-esteem and relationships.

Typically adults are unaware that they have the disorder. Instead they just feel that it’s impossible to get organized or to focus. They may have come to believe that they are stupid or lazy. In some cases they may have turned to drugs or alcohol to provide a “high” and out of despair.

“It’s like driving in the rain with bad windshield wipers,” describes Edward M. Hallowell, M.D., in an article published online at HealthyPlace.com. “Everything is smudged and blurred and you’re speeding along, and it’s reeeeally frustrating not being able to see very well…. In other ways it’s like being super-charged all the time. You get one idea and you have to act on it, and then, what do you know, but you’ve got another idea before you’ve finished up with the first one, and so you go for that one, but of course a third idea intercepts the second, and you just have to follow that one, and pretty soon people are calling you disorganized and impulsive and all sorts of impolite words that miss the point completely. Because you’re trying really hard.”

Relationship woes
Grown ups who suffer from ADD can find themselves having difficulty in grown-up relationships. Spouses of ADD sufferers often complain that it seems like having another child rather than a partner – they find their husband or wife is often late, frequently fails to finish tasks or projects, and can be messy and disorganized.

Even more damaging to a relationship are the consequences of difficulty communicating, which often accompanies ADD. Speaking to a spouse who can’t concentrate or can’t remember what you said if he or she was distracted can have a long-term negative effect on a marriage.

Yet communication is also the solution. As an adult becomes aware that he or she suffers from ADD or ADHD, it can help a relationship immensely. The partner with ADD can begin to untangle the ways in which the disorder has impacted on his or her life, as well as begin to appreciate the positive coping mechanisms he or she has developed and bring them to bear on other areas. The supporter of that partner is able to begin to see annoying or negative behaviours as a part of the disorder and not as a “slap in the face” or a relationship issue.

Together both partners can begin to compensate for the disorder. Dr. Hallowell suggests:
• Make sure you have an accurate diagnosis.
• Educate yourselves about ADD
• Declare a truce. What’s past is past.
• Set up a time for talking – without distractions.
• Write down your complaints and your commendations, as well as to-do lists.
• Avoid the pattern of mess-maker and cleaner-upper.
• Let the one who is better organized take on the job of organization. However, this job must then be adequately appreciated, noticed, and compensated.
• Make time for each other.

Deficit in the workplace
Adult sufferers of ADHD can find the workplace difficult to navigate. A 2005 paper published in the Journal of Occupational and Environmental Medicine described results of a telephone survey. A total of 4.2 per cent of workers had ADHD. ADHD was associated with 35.0 days of annual lost work performance, with higher associations among blue collar (55.8 days) than professional (12.2 days), technical (19.8 days), or service (32.6 days) workers. These associations represent 120 million days of annual lost work in the U.S. labor force, equivalent to $19.5 billion lost human capital – serious losses.

However a few accommodations can make a workplace friendlier for people with ADD. Some hire coaches to help them to develop organizational system to help stay on track and keep tabs on paperwork. Others ask their employers for help. Flexible start times, extra breaks (or breaks on a flexible schedule, when an employee is becoming overwhelmed) or even the ability to close an office door and keep noise at bay can be small aids that deliver big results.

Choosing an appropriate line of work is also important. Some ADD sufferers choose highly structured jobs that provide the organization around them that they may feel they lack internally; others look for jobs that allow them to hyperfocus for a short period of time and then move on to other projects.

Diagnosing adults
There is no single test for ADD or ADHD. Instead individuals are assessed using diagnostic criteria from the latest (text) edition of the Diagnostic and Statistical Manual of Mental Disorders).

Symptoms of Inattention
• Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
• Often has difficulty sustaining attention in tasks or play activities
• Often does not seem to listen when spoken to directly
• 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)
• Often has difficulty organizing tasks and activities
• Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
• Often loses things necessary for tasks or activities
• Is often easily distracted by extraneous stimuli
• Is often forgetful in daily activities

Symptoms of Hyperactivity
• Often fidgets with hands or feet or squirms in seat
• Often leaves seat in classroom or in other situations in which remaining seated is expected
• 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)
• Often has difficulty playing or engaging in leisure activities quietly
• Is often “on the go” or often acts as if “driven by a motor”
• Often talks excessively

Symptoms of Impulsivity
• Often blurts out answers before questions have been completed
• Often has difficulty awaiting turn
• Often interrupts or intrudes on others (e.g. butts into conversations or games)

Treatment
Therapy, particularly cognitive therapy, can be an important part of treating adult ADD or ADHD. Coaching for organizational or behavioural issues can also be beneficial, along with training for relaxation techniques and stress management. In some cases family counseling is also helpful.

There is also a growing arsenal of drugs available to treat ADD and ADHD. Many have been developed for children but are still effective on adults. Most are either stimulants (which have the opposite effect on sufferers of ADD/ADHD) such as Ritalin, or anti-depressants.

For more information:
The AD/HD Foundation of Canada: http://www.adhdfoundation.ca/
CH.A.D.D. Canada: http://www.chaddcanada.org/

READ MORE
Dealing with panic disorder
Switching off depression
Will your personality affect how long you live?