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Attention deficit disorder in adults

Restless. Messy. Easily distracted. These are just some of the words used to describe people with attention deficit/hyperactivity disorder, more commonly referred to as attention deficit disorder (ADD).

According to the Attention Deficit Disorder Association (ADDA), 5 to 10 percent of children and 3 to 6 percent of adults throughout the world have ADD. Experts estimate that one-half to two-thirds of children with the disorder will continue to have symptoms and behaviors of ADD as adults. Some adults who have ADD may not have been diagnosed as children because their symptoms were not recognized. The symptoms often become more apparent when they begin to take on the demands of adult responsibilities and develop adult relationships.

ADD can have a significant social impact on a person's life, affecting relationships in the family and on the job.

What is ADD?

The official medical term for this condition is attention deficit hyperactivity disorder, or AD/HD. The popular term for the condition has been shortened to ADD.

ADD has been classified into three broad categories, depending on whether the majority of symptoms are hyperactive or attention deficit, or a combination of both. People with symptoms of both hyperactivity and attention deficit have "combined type ADD"; those whose symptoms are mainly attention deficit have "predominantly inattentive type ADD." Those whose symptoms are mainly hyperactivity have "predominantly hyperactive-impulsive type ADD." Symptoms of hyperactivity tend to decrease as a person ages and are less common in adults.

Brain differences

ADD is caused by differences in the parts of the brain that control thoughts, emotions and actions. These differences are probably inherited. They lead people with ADD to act inappropriately and be inattentive, impulsive and disorganized. According to the attention deficit association, people with ADD have problems with these functions:

  • Stopping and thinking before acting or responding

  • Analyzing or anticipating needs and problems, and coming up with effective solutions

  • Short-term working memory; problems receiving, storing and accessing information in short term memory

  • Becoming and staying organized

  • Focusing and starting on a task

  • Maintaining attention and working until a task has been completed

  • Controlling emotions, motivation and activity level; jumping to conclusions, not being able to wait

In most people, the ability to perform all these functions slowly develops as they grow and mature from childhood to adulthood. The demands of adulthood require a person to be able to do all of these complex functions. In some people who have undiagnosed ADD as a child, problems caused by ADD may not become apparent until they are teens or adults and they begin to try to handle more complex functions and demands.

Symptoms

The attention deficit association says that symptoms of ADD can range from mild to severe. Symptoms that may be noticed by friends, family and coworkers include problems with learning, self-control, addiction, independent functioning, social interaction, health maintenance and organizing the tasks of daily life.

ADD can cause problems like these:

  • Being unable to keep a job or not keeping jobs long

  • Not achieving educational goals otherwise within their ability

  • Having marital difficulties

  • Having accidents, traffic violations or arrests

  • Frequent episodes of anger or rage

Symptoms of ADD also can be symptoms of other health, emotional, learning, cognitive and language problems. Experts estimate that 30-50 percent of people with ADD have other psychiatric conditions, such as anxiety, depression and eating disorders. Your health care provider can determine if symptoms are from a developmental, vision, hearing, psychiatric or medical problem. If your provider makes a diagnosis of ADD, he or she may refer you to a specialist who has training and experience treating ADD.

ADD is a lifelong condition. It is often less bothersome for adults than it is for children, but it is not something that goes away. When a problem is so severe that it continues to interfere with your personal life or career, you should seek help.

Under federal law, ADD is considered a disability. If you have ADD, your employer must make appropriate and reasonable accommodations to help you work more efficiently and productively.

Treating ADD

ADD can’t be cured, but the symptoms of ADD may be eased with certain kinds of medication and behavioral therapy or counseling. Medication works on the chemical balance in the brain to relieve symptoms so that you can concentrate on behavioral or cognitive therapy.

You may be prescribed a stimulant or non-stimulant medication, although stimulant medications are probably the more effective treatment. Stimulant medications are generally safe, but can have side effects such as insomnia, nervousness and decreased appetite. If you take a stimulant medication, you should have your blood pressure and heart rate checked periodically.

Non-stimulant medications include norepinephrine reuptake inhibitors, antidepressants and drugs for high blood pressure.

Only two drugs have been approved to treat adults with ADD: the stimulant dextroamphetamine/amphetamine (Adderall XR) and the non-stimulant atomoxetine (Strattera). Multiple studies have been conducted to evaluate other medications—those used for children with ADD. These other medications include the stimulants methylphenidate (Ritalin) and dextroamphetamine (Dexedrine). Ask your health care provider for the latest information.

Behavioral or cognitive therapy can help you to change certain behaviors, deal with the emotional effects, and learn to improve time management and organizational skills.

Your health care provider should evaluate your medication and other treatment methods on a regular basis. Because ADD treatment is tailored to each person, your treatment may change as your life changes.

You can restructure your daily routine to help you to cope with your behavior. Making your day highly structured and your schedule consistent can help.

What to do

If you think you may have ADD, talk to your health care provider or a medical professional who has experience in diagnosing and treating adults with the condition. Be prepared to provide as much early history to that professional as possible, including parent and school records. 

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