Understanding Adult ADHD
Dr Marinus Klijnsma, Consultant Psychiatrist at Priory Hospital Chelmsford, gives an overview of adult ADHD
What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is a common disorder with approximately 3 to 4% of primary school children being affected and 1% of adults. Hopefully, ADHD would have been picked up during school years but this is not always the case. Not infrequently, adults become aware that they might have this condition when their child is diagnosed with ADHD, or relatives or friends recognise symptoms and bring it to their attention.
As to what causes ADHD, there is not a conclusive answer. We know that it tends to run in families but it is also known that a significant number of children who have this condition, ‘grow out of it’. It seems to be a condition of the brain rather than a condition you pick up due to difficulties in your life. For that reason, symptoms have to be present from childhood onwards for a diagnosis to be made.
There are two groups of symptoms, those to do with distractibility and those to do with hyperactivity and impulsivity. Distractibility shows in different ways. Mistakes are being made because no attention is being paid to detail. It is also hard to keep up attention, particularly with activities that are not interesting. Listening is difficult and also following instructions is hard. There are difficulties with being organised, and tasks that require a lot of effort and attention are avoided. There is a tendency to be forgetful and to lose things. Hyperactivity and impulsivity can show by being fidgety and restless. It is hard to stay seated and there is a tendency to be on the go. At times there is excessive talk, or talk can be quite loud. Answers are given before the question has been completed and there is a tendency to interrupt. It is also hard to wait your turn in conversations.
ADHD can have a big impact on various aspects in people’s lives. Common problems have to do with under-achieving at school and finding it difficult to stay in work. It also frequently affects the relationships with people around you.
Diagnosis should be made by a practitioner with experience in ADHD. Most Priory hospitals have psychiatrists who would be able to make the diagnosis and offer treatment. There is also a helpful questionnaire online, the ADHD Adult Self Report Scale (ASRS V1.1). Four or more answers in the grey area on the first six questions points towards a diagnosis of ADHD. During childhood, the hyperactivity symptoms are often more pronounced and with growing older they play less of a role but this is not always the case.
The first choice of treatment according to National Institute for Health and Care Excellence (NICE) guidelines is medication. The first drug of choice would be Methylphenidate but there are different drugs that could also help. Psychological treatment is also available which can help to manage the symptoms of ADHD better. This can also be used in combination with drug treatment.