ADHD in adults | Mate mauri rere

• Attention deficit hyperactivity disorder (ADHD) is a neurological condition. This means in people with ADHD, there are differences in the parts of the brain that control your ability to plan, organise and focus compared to those without it.
• ADHD affects around one in 20 adults, mainly men. Until recently, scientists thought that children outgrew ADHD during adolescence due to developmental changes in their brain chemistry. But now they believe that 7 out of 10 children with ADHD will mature into adults with ADHD.
• ADHD is usually diagnosed in childhood, but some people are not diagnosed until they are adults.
• ADHD can make it more difficult to manage your daily life, especially tasks that require organisation, planning and focus. 
• People with ADHD often have higher energy and creativity, and if channelled well, this can help you learn how to manage the more challenging aspects of adult ADHD.

Image credit: pixabay

ADHD is a neurological condition. Studies of brain scans show that people with ADHD seem to have brain circuits that are wired a little differently from other people's, which makes messages harder to understand. The physical and chemical differences in the brains of those with ADHD affects the executive functioning of the brain, which is like the CEO of a company. This means it makes it harder to concentrate and to regulate (be in charge of) your behaviour. 

The main features of ADHD are:

• difficulty paying attention (eg, to workplace tasks, conversations, or personal belongings)
• hyperactivity (eg, fidgeting or being unable to sit still, talking a lot)
• impulsivity (eg, interrupting conversations, being unable to wait in line).

ADHD is not caused by poor parenting, too much sugar, food additives, absent fathers or vaccines. These are all myths. It is most likely a genetic condition as ADHD is known to run in families. You have a 70–80% chance of a child inheriting ADHD from just one parent who has the genes. It occurs in about 5–7% of people from all ethnicities, although is more common in boys and men. However, this may be because it is missed more often in girls and only diagnosed later.  

Other factors that are thought might contribute to developing ADHD include:

• a brain injury or infection
• a lack of oxygen or exposure to alcohol or nicotine before birth
• premature birth
• difficult experiences in early childhood.

The key symptoms of ADHD are:

• inattention (problems with paying attention)
• hyperactivity (being unusually active)
• impulsivity.

Because of the challenges people with ADHD can experience, they may develop relationship, emotional and lifestyle difficulties. 

However, ADHD has other attributes that can be supportive of your wellbeing, such as:

• having high energy
• being creative and a good problem solver
• being intuitive and insightful
• good sense of humour
• being entrepreneurial and enterprising
• having tenacity
• being able to hyper-focus on favoured activities, games, sport etc.

There is no simple test for ADHD. The diagnosis needs to be made by a mental health professional with experience in treating ADHD. This is usually a psychiatrist. Diagnosis might involve:

• tests of your thinking (psychological tests)
• a physical check-up that might involve testing your heart, blood tests or a brain scan (if needed)
• questions about your childhood
• an interview with a partner, parent or close friend about your behaviour
• review of documents like old school reports.

Generally, adults are only diagnosed with ADHD if there is evidence that they had symptoms as a child. Symptoms also have to be present in more than one situation (eg, at work and at home) and affect daily life.

Symptom checklists 

A range of checklists and assessment tools may be used. Do not diagnose yourself. However, if doing such a checklist suggests you may have ADHD, take this to discuss with your doctor.

• Adult Self-Report Scale (ASRS v1.1) for ADHD(external link) MDCalc, US
• Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist(external link) Instructions Attention Deficit Disorder Association, US

The treatment is with a mental health practitioner with experience in treating ADHD. It includes:

• making lifestyle changes and developing systems to improve your time management and ability to complete tasks
• addressing any drug or alcohol addiction
• educating you to help direct your attention in useful rather than random ways
• helping you get support from friends or family who can be encouraging rather than critical or controlling
• medication for some people – this may be methylphenidate or dexamphetamine, or if these do not suit, atomoxetine.

Medication is used to support other changes to your lifestyle and behaviour. Medications can help you to concentrate better, be less impulsive, feel calmer and learn and practise new skills.

In New Zealand, medications used to treat ADHD in adults include:

• methylphenidate (Concerta, Ritalin, Rubifen)
• dexamphetamine (Dexedrine)
• atomoxetine (Strattera).

Find out more about medications for ADHD in adults

These tips can help you manage your ADHD:

• make lists, keep diaries, stick up reminders and regularly set aside time to plan what you need to do
• let off steam by exercising regularly
• find ways to help you relax, such as listening to music or learning relaxation techniques
• talk to your doctor about your suitability to drive – driving is much safer on medication than without it.

What support is available with ADHD?

ADHD Association(external link)(external link) New Zealand
See also other ADHD support