Attention-Deficit/Hyperactivity Disorder (ADHD) in Adults
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What is adult attention-deficit/hyperactivity disorder?
Attention-deficit/hyperactivity disorder is a condition that affects the development of your brain. It starts in childhood. While people commonly outgrow this condition, many don’t.
In children, ADHD can affect things like school performance and social skills. It can have very similar effects in adults, affecting things like work performance, friendships, relationships and mental health.
How does this condition affect my body?
People with ADHD are “neurodivergent.” This term means your brain developed differently. When those differences are big enough, they can cause conditions like ADHD. People who don’t have those brain differences are “neurotypical,” meaning their brains developed in a typical way.
People with ADHD tend to have lower-than-expected activity in certain brain areas. The affected areas regulate communication between other brain areas, giving you a set of abilities known as “executive functions.” These include your ability to plan, reason, make decisions and steer and focus your attention. ADHD disrupts these abilities, a symptom known as “executive dysfunction.”
Symptoms and Causes
What are the symptoms?
Adult ADHD symptoms look very similar to childhood symptoms. However, they may look slightly different because adult life involves different activities. For example, you may experience job-related symptoms or effects instead of school-related symptoms or effects.
There are three subtypes of ADHD, and the symptoms can vary depending on your subtype. Your symptoms determine if you have the inattention, hyperactivity/impulsivity or combined subtype. Your healthcare provider will also determine the severity of your ADHD. The severity levels are:
- Mild: This level means you meet the criteria for diagnosis, but your symptoms don’t go much beyond the minimum criteria.
- Moderate: This means your symptoms cause noticeable disruptions in your work or social interactions.
- Severe: This means your symptoms seriously affect your work and/or social life. People with severe symptoms may have trouble keeping a job and maintaining relationships.
Inattention symptoms can negatively impact your social relationships, work and schoolwork. To have the inattention subtype of ADHD, you must have at least six of the following, lasting over six months:
- Errors because of inattention. This leads to careless mistakes, missed details and accuracy problems. This can cause problems with work performance and academic performance (if you’re in school).
- Difficulty staying focused. This can cause your attention to drift during conversations, meetings, lectures or seminars, and lengthy reading or studying.
- Difficulty listening or paying attention when others speak to you. This can look like distraction, daydreaming or staring off into space (sometimes known as a “thousand-yard stare”).
- Trouble following through and completing tasks. This means you’re quick to start new tasks or projects. However, you also tend to “run out of gas” and have trouble finishing them.
- Difficulty organizing and prioritizing. This means you have trouble planning and reaching goals, especially goals that take multiple steps to reach. It can make you appear messy or disorganized, or cause problems with being on time or meeting deadlines.
- Dislike or avoidance of tedious work. This makes it harder for you to complete boring or mindless tasks that require you to pay attention. Examples of this include chores, housework and doing busy work.
- Prone to losing, misplacing or forgetting things. This looks like being absent-minded or careless. You may misplace items like your purse or wallet, cell phone or keys. Sometimes, you’ll leave items in odd places — for example, you might unintentionally leave your keys in the fridge and then struggle to find them later.
- Easily distracted. This can happen either because of things happening around you or because you’re distracted by your mind’s tendency to wander.
- Forgetful or absentminded in your daily routine. You may struggle to keep appointments, do errands, pay bills and buy household necessities.
Hyperactivity and impulsivity are very common with ADHD. Impulsivity can cause problems with social skills and interactions. To have the hyperactivity/impulsivity subtype of ADHD, you must have at least six of the following, lasting over six months:
- Frequent fidgeting. This may look like bouncing your leg, tapping your feet, playing with a pen or checking your phone repeatedly, among other things.
- Difficult staying seated when it’s expected. This causes frequent interruptions for you to stand up or walk around.
- Restlessness. In children, this causes running and climbing behaviors, especially when it’s not appropriate. In adults, this looks like feeling uncomfortable being still.
- Trouble doing things you enjoy quietly. This is especially true during downtime, hobbies or other fun or relaxing activities. You may talk to yourself or habitually say nonsensical words or phrases aloud.
- Unusually high activity level. This can make you look like you’re constantly busy or in a hurry. Others may have trouble keeping up with you.
- Excessive talking. This looks like talking as if you have no filter, over-explaining yourself or "info dumping" (an informal term that means excitedly talking at length about a topic you enjoy).
- Conversational self-restraint problems. This means you have trouble in conversations because you impulsively speak. You often interrupt others, finish others’ sentences or talk without thinking about how others will feel about what you say.
- Struggles with being patient for your turn. An example is having trouble waiting in line or finding it hard to patiently wait for something you want or need.
- Problems with reading situational social boundaries. This can cause you to intrude on or interrupt others frequently. You might insert yourself into conversations, activities or games without realizing that others could find this rude.
This subtype of ADHD is when a person has at least six of the hyperactivity/impulsivity symptoms and at least six of the inattention symptoms.
What causes the condition?
Experts don’t fully understand why or how ADHD happens. There’s evidence that it may involve differences in your brain structure, brain chemistry or both. But experts do know it can be genetic. That means you can inherit ADHD from one or both parents. However, some people also develop it spontaneously without a family history.
Brain structure differences
Having ADHD means you’re likely to have subtle — but important — differences in your brain structure. A key part of how your brain works is how it forms connections between its different areas. People with ADHD seem to have fewer connections in certain areas, or those areas may be slightly smaller or less dense than they are in people without ADHD. The affected areas are key in managing executive functions.
Brain chemistry changes
Your brain relies on networks of specialized cells known as neurons, which send and relay signals throughout your brain. Those signals are how you form thoughts, move your muscles and more. Your brain needs special chemicals known as neurotransmitters to transfer signals from neuron to neuron.
Research indicates ADHD might cause an imbalance or shortage of certain neurotransmitters, especially dopamine and norepinephrine (also known as noradrenaline in certain parts of the world). Without the right amount or mix of neurotransmitters, your brain can’t function as it should.
Diagnosis and Tests
How is ADHD in adults diagnosed?
A healthcare provider, usually a psychologist or psychiatrist, can diagnose ADHD based on your medical history and current symptoms. As part of diagnosing ADHD, your provider will ask you about your current symptoms and symptoms you had when you were a child. This usually involves a questionnaire designed specifically for diagnosing ADHD. Currently, there aren’t any lab or medical tests that can help diagnose ADHD.
Management and Treatment
How is ADHD in adults treated?
There’s no cure for ADHD, but it’s very treatable.
Medication is the most common and effective way to treat ADHD, and multiple types of medications can treat it. A few examples of those types include stimulants, non-stimulants and antidepressants.
You may need to try different medications and dosages to find one that works for you. Your healthcare provider can also tell you about the possible complications and side effects of these medications.
Psychotherapy and adaptation strategies
Many adults with ADHD benefit from treatments like psychotherapy (the technical term for mental health therapy). They may also use adaptation strategies, such as setting consistent routines, keeping a planner or notebook and using smartphone apps. Your healthcare provider can tell you more about therapy methods and lifestyle adjustments that might help.
Care for related conditions
It’s common for adults with ADHD to have other health conditions, especially certain mental health or brain development-related conditions. Examples of these include:
- Anxiety, especially social anxiety.
- Specific learning disorders, such as dyslexia or dyscalculia.
- Stress and related health problems.
- Substance use disorders.
Accommodations are tools or changes in your work environment that help you manage a condition. These are like step stools for someone who’s shorter than average; a step stool allows a shorter person to reach the same heights as taller people. Likewise, accommodations make it possible for you to achieve and succeed like people without the condition.
In the U.S., under the Americans with Disabilities Act (ADA), some individuals with ADHD symptoms that interfere with their work may qualify for reasonable work accommodations. More information about workplace accommodations is available through government agencies.
The main agency responsible is the Department of Labor, including its Office of Disability Employment Policy (ODEP). That office also runs the Job Accommodation Network (JAN), which offers free, confidential assistance and guidance to people needing help with job accommodation concerns and questions.
ADHD accommodation examples include:
- Breaks that allow you time to stand up and walk around.
- Noise-canceling headphones to minimize distractions from noise.
- Working from home (when possible).
- Mentoring or job coaching assistance.
Outlook / Prognosis
What can I expect if I have adult ADHD?
If you have adult ADHD, the effects that you experience depend on which subtype you have and symptom severity. Medication, therapy and other conventional approaches are usually enough for most people to manage this condition. These treatments allow most people with ADHD to have careers, relationships and families.
People with ADHD have brains that developed differently, and those differences aren’t always negative. Research shows that they can often become advantages or strengths. Some of those include:
- Creativity. People with ADHD commonly excel in creative professions. Differences in how your brain works can make it easier to find unconventional or innovative solutions.
- Energy and motivation. Hyperactivity can be a powerful driving force, propelling you to achieve goals.
- Hyper-focus. You can “hyper-focus” on interesting or fun tasks. Instead of being distractible, you tune out everything else and apply yourself entirely to what you’re doing. Experts associate this ability with higher levels of productivity and achievement.
- Agreeableness. People with ADHD are often more agreeable and empathetic to those around them. You can be a strong “team player” and often want to help to others.
Businesses and corporations are also aware of the positive aspects of ADHD. Many corporations seek to hire neurodivergent people (including those with ADHD) for positions where their brain differences are an advantage.
How long does adult ADHD last?
ADHD is a lifelong condition. It doesn’t go away and there’s no way to cure it. However, research shows that the severity of the symptoms tends to decrease in older adults, especially after age 60.
What’s the outlook for this condition?
ADHD isn’t a dangerous condition on its own. If adult ADHD goes untreated — especially when it’s more severe — it can negatively affect your life in several ways. These include a higher risk for:
- Injury. Key ADHD symptoms like impulsivity, hyperactivity and inattention can all contribute to injuries. This can also increase the risk of mental health conditions like anxiety and post-traumatic stress disorder (PTSD).
- Substance use disorders. People with ADHD are more likely to self-medicate with alcohol or non-prescribed drugs. That contributes to an increased risk of substance use disorders.
- Legal problems and incarceration. Having ADHD means you have a higher risk of developing conditions with strong links to criminal behavior, such as antisocial personality disorder and conduct disorder. Experts suspect that’s part of why ADHD rates are higher than average among people with criminal convictions.
How do I take care of myself?
If you have ADHD, your healthcare provider can prescribe medication and recommend treatments and adjustments you can make in your life that can help with this condition. Some of the best things you can do include:
- Taking your medication as prescribed. It’s important to take ADHD medications exactly as prescribed. Taking them that way makes it more likely that you’ll get their full benefits. If you take stimulants, taking them as prescribed also prevents dependence or addiction.
- Finding ways to adapt and compensate. ADHD can look very different from person to person, so the strategies to help you compensate can vary widely. Find what works for you and build those strategies into your life. They can make it easier to live with and work around the effects of ADHD.
- Taking advantage of technology. Smartphone apps and other technological means can help you adapt to this condition. There are also online communities where people with ADHD share information and discuss their experiences. Those can be resources to help you better understand and adapt to this condition.
When should I see my healthcare provider?
You should see your healthcare provider as recommended, especially if you take medication or receive any other type of treatment. If you take stimulant medications, state or national laws may require you to see your provider regularly so they can continue to prescribe your medication. Your healthcare provider can tell you more about this and recommend a schedule for these visits.
Frequently Asked Questions
Who does it affect?
ADHD can affect anyone, but people assigned male at birth (AMAB) are more likely to receive this diagnosis. However, there’s evidence that ADHD in people assigned female at birth (AFAB) is often undiagnosed or misdiagnosed. There’s also disagreement on whether the condition affects people differently based on race or ethnicity. More research is necessary to determine if these factors can cause differences in the way the condition affects people.
How common is this condition?
ADHD in adults is relatively common. Experts estimate it affects between 2.5% and 6.76% of adults worldwide. That means this condition affects between 139 million and 360 million people worldwide.
Experts estimate that 15% to 20% of adults diagnosed as children still fully meet the criteria for it, and another 40% to 60% continue to have at least some of the symptoms.
What is the difference between adult ADD vs. adult ADHD?
ADD is an outdated name that refers to the inattention subtype of ADHD. In 1987, the American Psychiatric Association set this condition’s name to what it is today, “attention-deficit/hyperactivity disorder.” The most recent text revision of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5-TR™), breaks the condition down into inattentive, hyperactivity/impulsivity and combined subtypes.
A note from Cleveland Clinic
Attention-deficit/hyperactivity disorder (ADHD) is a condition that affects brain development, causing hyperactivity, impulsive behavior or inattention. This condition starts in childhood, and many children — but not all — grow out of it. ADHD in adults can affect your work performance, social relationships and more.
While this condition can be disruptive, it’s also very treatable. There are many medication options and other ways to treat it. It’s even possible to turn this condition’s effects into advantages that can help you in the workplace and your personal life. If you think you have ADHD, getting diagnosed can help. With treatment, it’s possible to harness the effects and turn them into tools for success.
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