Adult ADHD symptoms are similar to the distractibility, impulsivity, and restlessness identified in childhood ADHD but it is likely that the manifestations of the symptoms will have changed as the individual matured (Adler 8). Over time there may also be cumulative consequences of the disorder that can affect the quality of life as an adult (Das 2). Unfortunately, for adults who have lived with ADHD their entire life they may not truly recognize the chronic and problematic consequences of their behavior (Weiss & Weiss 29). Many adults with ADHD have learned to develop effective coping strategies and skills to overcome or compensate for their difficulties (Young & Amarasinghe 126). Furthermore, ADHD can go unnoticed and undiagnosed because the individual's behavior may be considered merely an enduring personality trait (ADHD 129). Success in adult life can be severely impacted for those adults who do not develop coping skills for their ADHD (Young & Amarasinghe 126). Although many adults with ADHD and associated comorbid disorders have developed their own strategies to compensate for their dysfunctional behavior, self-awareness, self-monitoring, and determined self-control of inappropriate and socially unacceptable behavior is essential for a better-quality life.
Attention-deficit hyperactivity disorder (ADHD); a chronic psychiatric disorder (Encyclopedia n. pag.) characterized by inattention, hyperactivity, and impulsivity, has long been considered a modern disease, yet there are reports of the syndrome in scientific psychiatric literature written during the 1800 to 1900's (Trott 21). ADHD is one of the most common neurobiological disorders of childhood, with symptomatic behavior commonly observed before the age of 7 (Barkley "Response" 177). Although viewed as a childhood disorder, it is estimated that of the 4% to 12% of children affected by ADHD, approximately 50% of those children continue into adulthood with the disorder (Weiss & Murray 715).
While traumatic events and psychosocial stressors, such as poverty and family dysfunction, complicate ADHD, they are not considered to be a cause of the disorder (Encyclopedia n. pag.). Research indicates that ADHD and the associated behaviors and disorders are transmitted genetically. Studies have shown that up to 95% of the ADHD deficits in behavioral inhibition and inattention tend to run in families (Encyclopedia n. pag.). Factors such as low birth weight, prenatal maternal smoking, and additional prenatal problems may contribute cases of ADHD (What #1 3).
A formal diagnosis of childhood ADHD is not required to identify and determine ADHD in an adult. Typically a diagnosis of adult ADHD begins with de novo diagnosis, leading to a self-reporting self-diagnosis. The adult will most often describe a history of significant childhood problems with attention or self-control, or both. A comprehensive evaluation by a clinical psychologist, clinical social worker, nurse practitioners, neurologist, or psychiatrist is necessary to establish an appropriate diagnosis (What #1 2). To rule out other medical problems that may cause symptoms that are similar to ADHD or to determine the presence of co-existing or comorbid disorders, a medical exam by a physician should be included in the patient assessment.
The core symptoms of ADHD are inattention, impulsivity, and hyperactivity. Inattention is identified when "an individual has difficulty with paying attention, organization, and following through on [a] task" (Interacting n. pag.). Adults with inattention symptoms will randomly switch from one subject to another, be disorganized, have difficulty sustaining attention on tasks or play activities, lose things, and talk excessively. This inattention can result in the individual making careless mistakes, missing pieces of information, critical instruction, or parts of conversation. A person who demonstrates inattentive behavior can make others feel ignored or unimportant. Impulsivity is considered the "predisposition toward rapid, unplanned reactions to internal or external stimuli without regard to the negative consequences of these reactions to the impulsive individual or to others" (Moeller 2). Behavior due to impulsivity can be observed when the individual does not use proper manners, misses social cues, interrupts or intrudes on others, talks or acts before thinking, blurts out answers before the question has been asked, has difficulty waiting turn, or makes inappropriate comments. "The negative consequences of impulsivity are greater for adults than for children" (Trott 24). Adults with impaired self-control and poor decision-making will often express aggressive behavior that ultimately damages relationships. Hyperactivity is observed when an individual feels restless and acts as if always on the go - fidgets, squirms, kicks or taps foot, talk excessively, runs or climbs where inappropriate, or is unable to remain seated. Taking part in activities such as concerts, educational events, religious ceremonies, sports events, educational events, or vacations can be very difficult for those with physical hyperactivity (Interacting n. pag.). This inability to sit still and concentrate may be perceived by others as not caring or lacking concern (Interacting n. pag.). These core symptoms of ADHD can lead to impairments in all facets of life activities, including school, family, social relations, work, and self-care (Encyclopedia n. pag.).
Many adults with ADHD have one or more co-existing or comorbid disorders. These comorbid conditions can include any combination of behavioral inhibitions, disruptive behavior disorders, antisocial personality disorders, mood and anxiety disorders, tics and Tourette syndrome, learning disabilities, health risk behaviors, substance abuse, social and adaptive impairments, and criminality. Understanding the symptoms and different diagnoses of other disorders similar to or comorbid with ADHD is very important (Weiss & Weiss 29). Because these comorbid conditions have similar symptoms of ADHD, a physical exam should be done to rule out other medical causes for the symptoms (Weiss & Weiss 31).
A central deficiency in adult ADHD and commonly found comorbid conditions is behavior inhibition. Behavior inhibition refers to the inability to self-regulate a response or chain of responses to an event by the individual and is a (Barkley "Behavior" 68). Because of the inability to self-regulate responses, individuals with ADHD have difficulties resisting temptation, performing tasks that require delayed gratification, and stopping an ongoing response regardless of signals to so (Barkley "Behavior" 76). Even when feedback is given about their ineffective or maladaptive errors they have a trouble adjusting their behavior (Barkley "Behavior" 76). Furthermore, in social settings that are unfamiliar, individuals with ADHD may be very social, talkative and excessively spontaneous (Barkley "Behavior" 68). The resulting consequences of the inability of the adult with ADHD to self-regulate is that friends, spouses, and employers may eventually become exhausted and grow weary of the continued inappropriate behavior and ultimately give up on the friendship or marriage, or terminate employment.
Disruptive behavior disorders such as Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) are often found coexisting with ADHD. Oppositional Defiant Disorder is defined as the "persistent and frequent disobedience and opposition to authority figures (such as ...other adults), characterised [sic] by negative, hostile or defiant behavior" (ADHD 24). The comorbidity rate for ODD in adults can be up 35% (Encyclopedia n. pag.). Behavior associated with ODD includes arguing with all manner of adults, loss of temper, the refusal to follow rules, placing blame on others, intentionally irritating others, and being angry, bitter, vindictive, and spiteful (What #5 2). Adults with ODD may also repeat behavior even when they know they should not do so, such as cheat on their taxes, run red lights, or act cruel or inappropriate with employees or service personnel (Weiss & Weiss 30). Another disruptive behavior association with ADHD is Conduct Disorder (CD), a severe behavioral problem that involves a "persistent pattern of behavior [sic] that violates the societal rules and the rights of others" (ADHD 24). CD behavior includes bullying, cruelty to animals, tireless lying, theft, and the destruction of property (ADHD 22). An individual's efforts to break the rules but not get caught is another behavior linked to Conduct Disorder (What #5 2).
Certain mood disorders are also associated with ADHD, such as depression, anxiety, mania, and bipolar disorder. Emotional fluctuations and rapid mood changes without any apparent reason (Schmidt 4), feelings of frustration or anger, in addition to sleep disturbances, are also comorbid characteristics of ADHD. The comorbidity rate for anxiety in ADHD adults is 43% (Encyclopedia n. pag.) and up to 47% of adults with ADHD report some level of depression (What #5 2) that they often describe as a feeling of boredom (Trott 24). ADHD individuals who manifest Bipolar Disorder (BPD) will exhibit periodic occurrences of abnormally elevated mood set apart by periods of clinical depression. Those ADHD individuals observed with comorbid characteristics of mania will experience long periods where they talk incessantly, be ridiculously happy, and go without sleep (What #5 3).
Due to potential risk-taking behavior, increased social impairments, and the tendency for self-medication, there is an increased risk factor for substance use and abuse in adults with ADHD (ADHD 36). Marijuana or other drugs are used by 24% (Encyclopedia n. pag.) of adults in the attempt to diminish symptoms associated with ADHD (ADHD 36). There is also a 35% comorbidity rate for alcohol dependence or abuse (Encyclopedia n. pag.). Although tobacco use is more common in adolescents with ADHD, adults report a higher rate of smoking accompanied by a greater difficulty quitting (What #5 4).
Adult ADHD has also been associated with multiple forms of social and adaptive impairments (Murphy 398). Individuals with ADHD have difficulty paying attention, focusing on the conversation, being polite, acting responsible, and controlling their impulses in social situations. The development of the necessary social skills to overcome these behaviors typically begins in childhood and is learned by watching people, copying their behaviors, practicing the behavior they observe, and getting feedback (Interacting n. pag.).
Although not a true disorder, educational and occupational disadvantages often co-exist with adult ADHD. Because the expectations for assuming greater personal responsibilities, structuring and organizing time, prioritizing tasks, and meeting deadlines increase in adulthood (Young & Amarasinghe 126), an adult with ADHD may drop out of school or underachieve academically and have unauthorized absences or be fired from their job. Employment for the ADHD adult often results in lower ranking job status, high job turnover with frequent periods of unemployment, and the tendency to seek out occupations that are exciting or busy and have an element of risk, such as sales, stockbroking, and entrepreneurial ventures (Weiss & Murray 716).
The approach to treatment for an adult ADHD is similar to the treatment approach to childhood ADHD. Stimulant medication has been found to be helpful in managing ADHD core symptoms of distractibility, short attention span, and impulsivity, and is the first-line drug treatment for children and adults. Medication alone is usually not enough to make the essential symptomatic and purposeful changes necessary for the behavior modification and the acquisition of skills needed to function well in society (Interacting n. pag.). The addition of behavioral therapies to drug therapy has proven to be helpful in improving self-management skills and emotional and interpersonal self-regulation. Several methods of non-drug interventions used to treat adults with ADHD include coaching and counseling, cognitive-behavior therapy (CBT), psychoeducation, skills training, and use of support groups (ADHD 35). Adult treatment may also include family and couples therapy, in addition to occupational therapy and career counseling (Encyclopedia n. pag.).
Whether the treatment is drug therapy, behavioral therapy or the combination, there are many obstacles in treating an adult with ADHD. Effective behavioral therapy that requires self-monitoring and self-control, and cognitive therapy which requires higher level thinking may not succeed with ADHD patients. Adult Patients with ADHD impulsive characteristics have difficulty self-monitoring, delaying gratification, or sticking to a plan (Weiss & Weiss 35), such as is required with pill taking or keeping doctor appointments. Patients with adult ADHD may be over-compliant or under-compliant with regards to their program of treatment (Weiss & Weiss 33). For adults with ADHD that seem to recognize only two units of time, now or never, it must be understood by all parties involved that although it may only take a few weeks or months for areas of impairment to show improvement, it could take years to identify changes in development (Weiss & Weiss 33). "The aim is to help people develop methods to give structure to daily living and to improve interpersonal skills so they may function more successfully and achieve their potential" (ADHD 37). Fortunately, with proper assessment, treatment, and education the prognosis for an adult with ADHD is good.
Although adults with ADHD may continue to have difficulty seeing how their behaviors exasperate others, their maturity and willingness to learn new social skills can reduce the negative impact ADHD symptoms have on their friends, family, health, and quality of life. In order to interact effectively with others an adult with ADHD must take the steps necessary to improve their behavior, gain social skills, and understand others. To help improve social skills the individual with ADHD can pay close attention to what others do or say; be aware of body language; and notice a person's choice of words to better understand the meaning (Interacting n. pag.). In addition, the ADHD adult can gain more knowledge about their own behavior and about social skills, set personal goals, use "I heard you say" technique to check what was heard, role play, use visualization to imagine using proper social skills, have a positive attitude, and use visual, verbal, physical or gesture prompts (What #15).
Adult ADHD is a legitimate, chronic and widespread disorder that can be clinically identified and is associated with significant co-occurring impairments. These impairments can negatively affect all facets of life. For the adult with ADHD, impairments exist within education performances, workplace functioning, job stability, occupational attainment, finance management, marital and interpersonal relationships, social isolation, family conflict, disorganization, and risk for substance abuse. Although "...those with ADHD have more trouble doing what they know than knowing what to do" (Barkley "Behavior" 78), there are many resources available to assist the individual to identify and learn to modify their own behavior. If an adult with ADHD has the opinion that "...you don't grow out of ADHD; you just get better at coping with it" (Weiss & Weiss 28), then they may never accept or modify their dysfunctional behavior. The choice is up to the individual. An intentional unwillingness to recognize one's inappropriate and socially unacceptable behavior will have serious negative consequences on all life activities. When an adult finally admits to their ADHD disorder and recognizes that their behavior and so called "personality traits" are negatively affecting the quality of their life into adulthood and those around them, the obvious decision is for them to seek help to actively modify that behavior.
Works Cited
Adler, Lenard A. "Clinical presentations of adult patients with ADHD." Journal of Clinical Psychiatry 65 (2004): 8-11. Medline. Web. 4 Aug. 2013.
"Attention Deficit Hyperactivity Disorder: Diagnosis and management of ADHD in children, young people and adults." National Institute for Health and Care Excellence. The British Psychological Society & the Royal College of Psychiatrists, 2009. Web. 9 Aug. 2013.
"Attention Deficit/Hyperactivity Disorders (ADHD)." Encyclopedia of Applied Psychology. Oxford: Elsevier Science & Technology, 2004. Credo Reference. Web. 9 Aug. 2013.
Barkley, Russell A. "Behavioral Inhibition, Sustained Attention, And Executive Functions: Constructing A Unifying Theory Of ADHD." Psychological Bulletin 121.1 (1997): 65-94. PsycARTICLES. Web. 8 Sept. 2013.
Barkley, Russell A. "Response inhibition in attention‐deficit hyperactivity disorder." Mental Retardation and Developmental Disabilities Research Reviews 5.3 (1999): 177-184. Academic Search Primer. Web. 4 Aug. 2013.
Das, Debjani, et al. "A population-based study of attention deficit/hyperactivity disorder symptoms and associated impairment in middle-aged adults." PloS one 7.2 (2012): e31500. Academic Search Primer. Web. 4 Aug. 2013.
"Interacting with Others: Tips for Adults with ADHD (WWK 15 short version)." National Resource Center on AD/HD: A Program of CHADD. N.p., n.d. Web. 9 Aug. 2013.
Moeller, F. Gerard, et al. "Psychiatric aspects of impulsivity." American journal of psychiatry 158.11 (2001): 1783-1793. Medline. Web. 4 Aug. 2013.
Murphy, Kevin and Russell A Barkley, "Attention deficit hyperactivity disorder adults: Comorbidities and adaptive impairments." Comprehensive Psychiatry, Volume 37, Issue 6, November-December 1996, Pages 393-401. Elsevier Inc. Web. 8 Sept. 2013.
Schmidt, Sören, and Franz Petermann. "Developmental psychopathology: attention deficit hyperactivity disorder (ADHD)." BMC psychiatry 9.1 (2009): 58. Medline. Web. 4 Aug. 2013.
Trott, Götz-Erik. "Attention-deficit/hyperactivity disorder (ADHD) in the course of life." European archives of psychiatry and clinical neuroscience 256 (2006): i21-i25. Academic Search Primer. Web. 4 Aug. 2013.
Weiss, Margaret, and Candice Murray. "Assessment and management of attention-deficit hyperactivity disorder in adults." Canadian Medical Association Journal 168.6 (2003): 715-722. Medline. Web. 4 Aug. 2013.
Weiss, Margaret D., and Jacqueline R. Weiss. "A guide to the treatment of adults with ADHD." Journal of Clinical Psychiatry 65 (2004): 27-37. Medline. Web. 4 Aug. 2013.
"What We Know #1: The Disorder Named ADHD." National Resource Center on AD/HD: A Program of CHADD. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), Feb. 2008. Web. 9 Aug. 2013.
"What We Know #5: ADHD and Coexisting Disorders." National Resource Center on AD/HD: A Program of CHADD. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), 2003. Web. 9 Aug. 2013.
"What We Know #15: Social Skills I Adults with AD/HD." National Resource Center on AD/HD: A Program of CHADD. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), 2003. Web. 9 Aug. 2013.
Young, Susan, and J. Myanthi Amarasinghe. "Practitioner Review: Non‐pharmacological treatments for ADHD: A lifespan approach." Journal of Child Psychology and Psychiatry 51.2 (2010): 116-133. Medline. Web. 4 Aug. 2013.
Attention-deficit hyperactivity disorder (ADHD); a chronic psychiatric disorder (Encyclopedia n. pag.) characterized by inattention, hyperactivity, and impulsivity, has long been considered a modern disease, yet there are reports of the syndrome in scientific psychiatric literature written during the 1800 to 1900's (Trott 21). ADHD is one of the most common neurobiological disorders of childhood, with symptomatic behavior commonly observed before the age of 7 (Barkley "Response" 177). Although viewed as a childhood disorder, it is estimated that of the 4% to 12% of children affected by ADHD, approximately 50% of those children continue into adulthood with the disorder (Weiss & Murray 715).
While traumatic events and psychosocial stressors, such as poverty and family dysfunction, complicate ADHD, they are not considered to be a cause of the disorder (Encyclopedia n. pag.). Research indicates that ADHD and the associated behaviors and disorders are transmitted genetically. Studies have shown that up to 95% of the ADHD deficits in behavioral inhibition and inattention tend to run in families (Encyclopedia n. pag.). Factors such as low birth weight, prenatal maternal smoking, and additional prenatal problems may contribute cases of ADHD (What #1 3).
A formal diagnosis of childhood ADHD is not required to identify and determine ADHD in an adult. Typically a diagnosis of adult ADHD begins with de novo diagnosis, leading to a self-reporting self-diagnosis. The adult will most often describe a history of significant childhood problems with attention or self-control, or both. A comprehensive evaluation by a clinical psychologist, clinical social worker, nurse practitioners, neurologist, or psychiatrist is necessary to establish an appropriate diagnosis (What #1 2). To rule out other medical problems that may cause symptoms that are similar to ADHD or to determine the presence of co-existing or comorbid disorders, a medical exam by a physician should be included in the patient assessment.
The core symptoms of ADHD are inattention, impulsivity, and hyperactivity. Inattention is identified when "an individual has difficulty with paying attention, organization, and following through on [a] task" (Interacting n. pag.). Adults with inattention symptoms will randomly switch from one subject to another, be disorganized, have difficulty sustaining attention on tasks or play activities, lose things, and talk excessively. This inattention can result in the individual making careless mistakes, missing pieces of information, critical instruction, or parts of conversation. A person who demonstrates inattentive behavior can make others feel ignored or unimportant. Impulsivity is considered the "predisposition toward rapid, unplanned reactions to internal or external stimuli without regard to the negative consequences of these reactions to the impulsive individual or to others" (Moeller 2). Behavior due to impulsivity can be observed when the individual does not use proper manners, misses social cues, interrupts or intrudes on others, talks or acts before thinking, blurts out answers before the question has been asked, has difficulty waiting turn, or makes inappropriate comments. "The negative consequences of impulsivity are greater for adults than for children" (Trott 24). Adults with impaired self-control and poor decision-making will often express aggressive behavior that ultimately damages relationships. Hyperactivity is observed when an individual feels restless and acts as if always on the go - fidgets, squirms, kicks or taps foot, talk excessively, runs or climbs where inappropriate, or is unable to remain seated. Taking part in activities such as concerts, educational events, religious ceremonies, sports events, educational events, or vacations can be very difficult for those with physical hyperactivity (Interacting n. pag.). This inability to sit still and concentrate may be perceived by others as not caring or lacking concern (Interacting n. pag.). These core symptoms of ADHD can lead to impairments in all facets of life activities, including school, family, social relations, work, and self-care (Encyclopedia n. pag.).
Many adults with ADHD have one or more co-existing or comorbid disorders. These comorbid conditions can include any combination of behavioral inhibitions, disruptive behavior disorders, antisocial personality disorders, mood and anxiety disorders, tics and Tourette syndrome, learning disabilities, health risk behaviors, substance abuse, social and adaptive impairments, and criminality. Understanding the symptoms and different diagnoses of other disorders similar to or comorbid with ADHD is very important (Weiss & Weiss 29). Because these comorbid conditions have similar symptoms of ADHD, a physical exam should be done to rule out other medical causes for the symptoms (Weiss & Weiss 31).
A central deficiency in adult ADHD and commonly found comorbid conditions is behavior inhibition. Behavior inhibition refers to the inability to self-regulate a response or chain of responses to an event by the individual and is a (Barkley "Behavior" 68). Because of the inability to self-regulate responses, individuals with ADHD have difficulties resisting temptation, performing tasks that require delayed gratification, and stopping an ongoing response regardless of signals to so (Barkley "Behavior" 76). Even when feedback is given about their ineffective or maladaptive errors they have a trouble adjusting their behavior (Barkley "Behavior" 76). Furthermore, in social settings that are unfamiliar, individuals with ADHD may be very social, talkative and excessively spontaneous (Barkley "Behavior" 68). The resulting consequences of the inability of the adult with ADHD to self-regulate is that friends, spouses, and employers may eventually become exhausted and grow weary of the continued inappropriate behavior and ultimately give up on the friendship or marriage, or terminate employment.
Disruptive behavior disorders such as Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) are often found coexisting with ADHD. Oppositional Defiant Disorder is defined as the "persistent and frequent disobedience and opposition to authority figures (such as ...other adults), characterised [sic] by negative, hostile or defiant behavior" (ADHD 24). The comorbidity rate for ODD in adults can be up 35% (Encyclopedia n. pag.). Behavior associated with ODD includes arguing with all manner of adults, loss of temper, the refusal to follow rules, placing blame on others, intentionally irritating others, and being angry, bitter, vindictive, and spiteful (What #5 2). Adults with ODD may also repeat behavior even when they know they should not do so, such as cheat on their taxes, run red lights, or act cruel or inappropriate with employees or service personnel (Weiss & Weiss 30). Another disruptive behavior association with ADHD is Conduct Disorder (CD), a severe behavioral problem that involves a "persistent pattern of behavior [sic] that violates the societal rules and the rights of others" (ADHD 24). CD behavior includes bullying, cruelty to animals, tireless lying, theft, and the destruction of property (ADHD 22). An individual's efforts to break the rules but not get caught is another behavior linked to Conduct Disorder (What #5 2).
Certain mood disorders are also associated with ADHD, such as depression, anxiety, mania, and bipolar disorder. Emotional fluctuations and rapid mood changes without any apparent reason (Schmidt 4), feelings of frustration or anger, in addition to sleep disturbances, are also comorbid characteristics of ADHD. The comorbidity rate for anxiety in ADHD adults is 43% (Encyclopedia n. pag.) and up to 47% of adults with ADHD report some level of depression (What #5 2) that they often describe as a feeling of boredom (Trott 24). ADHD individuals who manifest Bipolar Disorder (BPD) will exhibit periodic occurrences of abnormally elevated mood set apart by periods of clinical depression. Those ADHD individuals observed with comorbid characteristics of mania will experience long periods where they talk incessantly, be ridiculously happy, and go without sleep (What #5 3).
Due to potential risk-taking behavior, increased social impairments, and the tendency for self-medication, there is an increased risk factor for substance use and abuse in adults with ADHD (ADHD 36). Marijuana or other drugs are used by 24% (Encyclopedia n. pag.) of adults in the attempt to diminish symptoms associated with ADHD (ADHD 36). There is also a 35% comorbidity rate for alcohol dependence or abuse (Encyclopedia n. pag.). Although tobacco use is more common in adolescents with ADHD, adults report a higher rate of smoking accompanied by a greater difficulty quitting (What #5 4).
Adult ADHD has also been associated with multiple forms of social and adaptive impairments (Murphy 398). Individuals with ADHD have difficulty paying attention, focusing on the conversation, being polite, acting responsible, and controlling their impulses in social situations. The development of the necessary social skills to overcome these behaviors typically begins in childhood and is learned by watching people, copying their behaviors, practicing the behavior they observe, and getting feedback (Interacting n. pag.).
Although not a true disorder, educational and occupational disadvantages often co-exist with adult ADHD. Because the expectations for assuming greater personal responsibilities, structuring and organizing time, prioritizing tasks, and meeting deadlines increase in adulthood (Young & Amarasinghe 126), an adult with ADHD may drop out of school or underachieve academically and have unauthorized absences or be fired from their job. Employment for the ADHD adult often results in lower ranking job status, high job turnover with frequent periods of unemployment, and the tendency to seek out occupations that are exciting or busy and have an element of risk, such as sales, stockbroking, and entrepreneurial ventures (Weiss & Murray 716).
The approach to treatment for an adult ADHD is similar to the treatment approach to childhood ADHD. Stimulant medication has been found to be helpful in managing ADHD core symptoms of distractibility, short attention span, and impulsivity, and is the first-line drug treatment for children and adults. Medication alone is usually not enough to make the essential symptomatic and purposeful changes necessary for the behavior modification and the acquisition of skills needed to function well in society (Interacting n. pag.). The addition of behavioral therapies to drug therapy has proven to be helpful in improving self-management skills and emotional and interpersonal self-regulation. Several methods of non-drug interventions used to treat adults with ADHD include coaching and counseling, cognitive-behavior therapy (CBT), psychoeducation, skills training, and use of support groups (ADHD 35). Adult treatment may also include family and couples therapy, in addition to occupational therapy and career counseling (Encyclopedia n. pag.).
Whether the treatment is drug therapy, behavioral therapy or the combination, there are many obstacles in treating an adult with ADHD. Effective behavioral therapy that requires self-monitoring and self-control, and cognitive therapy which requires higher level thinking may not succeed with ADHD patients. Adult Patients with ADHD impulsive characteristics have difficulty self-monitoring, delaying gratification, or sticking to a plan (Weiss & Weiss 35), such as is required with pill taking or keeping doctor appointments. Patients with adult ADHD may be over-compliant or under-compliant with regards to their program of treatment (Weiss & Weiss 33). For adults with ADHD that seem to recognize only two units of time, now or never, it must be understood by all parties involved that although it may only take a few weeks or months for areas of impairment to show improvement, it could take years to identify changes in development (Weiss & Weiss 33). "The aim is to help people develop methods to give structure to daily living and to improve interpersonal skills so they may function more successfully and achieve their potential" (ADHD 37). Fortunately, with proper assessment, treatment, and education the prognosis for an adult with ADHD is good.
Although adults with ADHD may continue to have difficulty seeing how their behaviors exasperate others, their maturity and willingness to learn new social skills can reduce the negative impact ADHD symptoms have on their friends, family, health, and quality of life. In order to interact effectively with others an adult with ADHD must take the steps necessary to improve their behavior, gain social skills, and understand others. To help improve social skills the individual with ADHD can pay close attention to what others do or say; be aware of body language; and notice a person's choice of words to better understand the meaning (Interacting n. pag.). In addition, the ADHD adult can gain more knowledge about their own behavior and about social skills, set personal goals, use "I heard you say" technique to check what was heard, role play, use visualization to imagine using proper social skills, have a positive attitude, and use visual, verbal, physical or gesture prompts (What #15).
Adult ADHD is a legitimate, chronic and widespread disorder that can be clinically identified and is associated with significant co-occurring impairments. These impairments can negatively affect all facets of life. For the adult with ADHD, impairments exist within education performances, workplace functioning, job stability, occupational attainment, finance management, marital and interpersonal relationships, social isolation, family conflict, disorganization, and risk for substance abuse. Although "...those with ADHD have more trouble doing what they know than knowing what to do" (Barkley "Behavior" 78), there are many resources available to assist the individual to identify and learn to modify their own behavior. If an adult with ADHD has the opinion that "...you don't grow out of ADHD; you just get better at coping with it" (Weiss & Weiss 28), then they may never accept or modify their dysfunctional behavior. The choice is up to the individual. An intentional unwillingness to recognize one's inappropriate and socially unacceptable behavior will have serious negative consequences on all life activities. When an adult finally admits to their ADHD disorder and recognizes that their behavior and so called "personality traits" are negatively affecting the quality of their life into adulthood and those around them, the obvious decision is for them to seek help to actively modify that behavior.
Works Cited
Adler, Lenard A. "Clinical presentations of adult patients with ADHD." Journal of Clinical Psychiatry 65 (2004): 8-11. Medline. Web. 4 Aug. 2013.
"Attention Deficit Hyperactivity Disorder: Diagnosis and management of ADHD in children, young people and adults." National Institute for Health and Care Excellence. The British Psychological Society & the Royal College of Psychiatrists, 2009. Web. 9 Aug. 2013.
"Attention Deficit/Hyperactivity Disorders (ADHD)." Encyclopedia of Applied Psychology. Oxford: Elsevier Science & Technology, 2004. Credo Reference. Web. 9 Aug. 2013.
Barkley, Russell A. "Behavioral Inhibition, Sustained Attention, And Executive Functions: Constructing A Unifying Theory Of ADHD." Psychological Bulletin 121.1 (1997): 65-94. PsycARTICLES. Web. 8 Sept. 2013.
Barkley, Russell A. "Response inhibition in attention‐deficit hyperactivity disorder." Mental Retardation and Developmental Disabilities Research Reviews 5.3 (1999): 177-184. Academic Search Primer. Web. 4 Aug. 2013.
Das, Debjani, et al. "A population-based study of attention deficit/hyperactivity disorder symptoms and associated impairment in middle-aged adults." PloS one 7.2 (2012): e31500. Academic Search Primer. Web. 4 Aug. 2013.
"Interacting with Others: Tips for Adults with ADHD (WWK 15 short version)." National Resource Center on AD/HD: A Program of CHADD. N.p., n.d. Web. 9 Aug. 2013.
Moeller, F. Gerard, et al. "Psychiatric aspects of impulsivity." American journal of psychiatry 158.11 (2001): 1783-1793. Medline. Web. 4 Aug. 2013.
Murphy, Kevin and Russell A Barkley, "Attention deficit hyperactivity disorder adults: Comorbidities and adaptive impairments." Comprehensive Psychiatry, Volume 37, Issue 6, November-December 1996, Pages 393-401. Elsevier Inc. Web. 8 Sept. 2013.
Schmidt, Sören, and Franz Petermann. "Developmental psychopathology: attention deficit hyperactivity disorder (ADHD)." BMC psychiatry 9.1 (2009): 58. Medline. Web. 4 Aug. 2013.
Trott, Götz-Erik. "Attention-deficit/hyperactivity disorder (ADHD) in the course of life." European archives of psychiatry and clinical neuroscience 256 (2006): i21-i25. Academic Search Primer. Web. 4 Aug. 2013.
Weiss, Margaret, and Candice Murray. "Assessment and management of attention-deficit hyperactivity disorder in adults." Canadian Medical Association Journal 168.6 (2003): 715-722. Medline. Web. 4 Aug. 2013.
Weiss, Margaret D., and Jacqueline R. Weiss. "A guide to the treatment of adults with ADHD." Journal of Clinical Psychiatry 65 (2004): 27-37. Medline. Web. 4 Aug. 2013.
"What We Know #1: The Disorder Named ADHD." National Resource Center on AD/HD: A Program of CHADD. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), Feb. 2008. Web. 9 Aug. 2013.
"What We Know #5: ADHD and Coexisting Disorders." National Resource Center on AD/HD: A Program of CHADD. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), 2003. Web. 9 Aug. 2013.
"What We Know #15: Social Skills I Adults with AD/HD." National Resource Center on AD/HD: A Program of CHADD. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), 2003. Web. 9 Aug. 2013.
Young, Susan, and J. Myanthi Amarasinghe. "Practitioner Review: Non‐pharmacological treatments for ADHD: A lifespan approach." Journal of Child Psychology and Psychiatry 51.2 (2010): 116-133. Medline. Web. 4 Aug. 2013.
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