ADHD IN ADULTS
Attention deficit/hyperactivity disorder (ADHD) is a developmental disorder characterised by difficulties with concentration, attention and impulse control which impact on the person’s day-to-day life. Adults with ADHD often have difficulty concentrating for long periods of time, are easily distracted, or might act or speak before thinking things through. Whilst we might all have these difficulties from time to time, people with ADHD have significant and ongoing difficulties in these areas, which can affect their broader lives, particularly their study, work and relationships.
About 2-3% of adults are diagnosed with ADHD.2 Whilst ADHD begins in childhood and symptoms typically improve as children get older, about 15% continue to have ADHD as adults.
Treatment varies according to the needs of the person. Those with mild ADHD without other developmental or mental health issues generally do well with a range of psychological strategies. Those with more difficult to manage symptoms or other mental health concerns often benefit from a combination of medication and psychological support.
There is no single cause of ADHD; rather, there are a range of factors relating to a person’s genes, neurobiology (the structure and function of the brain) and environment that increase the chance of developing ADHD.
There appears to be a strong genetic component to ADHD, and ADHD often runs in families. Research suggests a number of genes might be involved, rather than one single gene.
In adults with ADHD, research has found some differences in areas of the brain and brain activity that relate to short term memory, the ability to focus, and the ability to make choices.
Differences have also been found in brain activity associated with attention and self-regulation, that is, the ability to focus attention, as well as manage emotions, thinking and behaviour.
Certain environmental factors might also play a role in the development of symptoms of ADHD. These include:
Pregnancy and birth factors: Maternal smoking, alcohol and substance misuse, and stress during pregnancy, as well as infant low birth weight and prematurity are all factors linked to ADHD.
Early life relationships and opportunities to learn: Growing up in a family with high conflict, or without good opportunities to learn skills for self-regulation, attention and concentration can lead to difficulties in these areas.
Certain environmental toxins: Toxins such as lead can affect brain development and behaviour.
Dietary factors: For some people (even without ADHD) attention and concentration might be affected by nutritional deficiencies (e.g., zinc, magnesium, polyunsaturated fatty acids) and sensitivities to certain foods (e.g., sugar, artificial food colourings). There is no evidence however that these cause ADHD and a medical practitioner should be involved to evaluate these issues if they are considered of possible concern.
There are a range of treatments which show good outcomes for adult ADHD. These include medication, cognitive-behavioural therapy for adult ADHD, and couples counselling for those experiencing relationship difficulties.
There is significant evidence supporting the use of medication in the treatment of ADHD in adults. Using medication in combination with psychological strategies is likely to lead to the best outcomes.
CBT for adult ADHD
Research suggests that cognitive-behavioural therapy (CBT) for adult ADHD is the most helpful approach to managing problems associated with ADHD in adulthood. In CBT for adult ADHD, a psychologist or other qualified health professional helps the person learn a range of skills that can reduce the impact of ADHD.
CBT for adult ADHD includes:
Education about adult ADHD, and how it can affect different areas of people’s lives
Organisation, planning, and time-management skills training, including strategies such as the use of calendars and task lists, prioritising, and breaking down large tasks into smaller, more manageable goals
Problem-solving skills training: Effective problem-solving involves defining the problem, brainstorming solutions, trying out a solution, and evaluating its success
Strategies for reducing distractions and increasing attention span, for example, structuring small tasks around the person’s realistic attention span, removing environmental distractions, and setting reminders.
Thinking in more helpful and realistic ways, particularly around situations that cause distress. Overly negative thoughts and assumptions can prevent people from using skills that may help them manage, and may contribute to other problems such as depression and low self-worth. Learning to identify and challenge these thoughts can be particularly helpful.
Whilst not a treatment for ADHD, couples therapy might be useful for those experiencing difficulties in their relationships, which is not uncommon for adults with ADHD. Couples counselling involves helping both partners understand how their attitudes and behaviours influence the relationship, learn to express caring and accepting emotions, improve communication, identify and change problem behaviours, and focus on the positive aspects of the relationship.
Tips for improving your attention and concentration
Set up your work space to be free from distraction - away from the door (where people come and go), away from the window (and distractions outside), and make sure your workspace is free from clutter, electronic media, and other distractions.
Use time management and organisational strategies to streamline your day. To help get more organised, you can:
write to-do lists, and use these to plan and prioritise tasks for the day
use a diary and set reminders for jobs that need doing
group similar tasks that can be done together.
Break tasks down into smaller chunks
Smaller tasks are easier to complete, easier to organise and are less overwhelming. They are also more easily done whilst your mind is fresh and before your concentration wanes.
Include breaks in activities and tasks
Breaks after work is completed can help you to refocus on the next task.
Effective problem-solving includes defining a problem you want to work on, brainstorming solutions, selecting a solution and trying it out, and reviewing the outcome.
ADULT ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)
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WHAT IS ADHD?
WHAT CAUSES ADHD?
DO I HAVE ADHD?
The key signs and symptoms of ADHD cover two main areas of difficulty; inattention, and hyperactivity/impulsivity, although in adults hyperactivity and impulsivity may be less obvious.
Difficulty staying focused
Trouble organising tasks and activities
Tendency to lose thing
Fidgeting and restlessness
Difficulty sitting for long periods of time
Difficulty engaging in quiet activities
Difficulty waiting turn
Acting or speaking before thinking things through.
For a person to be diagnosed with ADHD, they must currently have several symptoms, symptoms must have started before the age of 12, and difficulties must be present in two or more settings (such as at home and at work).
Symptoms that arise later in life are unlikely to be ADHD and should be assessed immediately.
There are three types of ADHD, depending on the main difficulties the person is experiencing. These are:
Predominantly inattentive: The person mostly has symptoms of inattention, rather than hyperactivity or impulsivity.
Predominantly hyperactive-impulsive: The person mostly has symptoms of hyperactivity and impulsivity, rather than inattention.
Combined: The person has symptoms of both inattention and hyperactivity-impulsivity.
WHAT CAN I DO?
This information was sourced from the Australian Psychological Society