Attention deficit hyperactivity disorder - adults

Attention deficit hyperactivity disorder (ADHD) is a common behavioural disorder that affects around one in 20 adults, mainly men. Until recently, scientists thought that children outgrew ADHD during adolescence, due to developmental changes in their brain. But now they believe that seven out of 10 children with ADHD will mature into adults with ADHD. A person with ADHD has difficulty paying attention, controlling impulsive behaviours and keeping their thoughts on track.

Symptoms of ADHD

A person with ADHD may: 

• have unpredictable mood swings
• make careless mistakes at work
• find it hard to sustain attention in work or leisure
• not seem to listen when spoken to directly
• not follow instructions or finish tasks
• find it hard to organise tasks and activities
• avoid sustained mental effort in work
• lose things like keys, paperwork and things needed for tasks
• be easily distracted by other stimuli
• be forgetful in daily activities
• fidget with hands or feet, or squirm in their seat
• find it hard to remain seated
• constantly run to do things
• be impatient
• have trouble doing things quietly
• talk excessively
• blurt out things without thinking
• have trouble waiting their turn in queues and other such situations
• butt into conversations or other activities.
• have sleep difficulties.

ADHD and quality of life

ADHD can affect a person’s quality of life. People with ADHD may find it difficult to maintain relationships or keep a job. If their condition was undiagnosed and untreated in childhood, they may not have done well in school. A lifetime of grappling with this behavioural disorder sometimes causes low self-esteem. 

Some people with ADHD experiment with drugs or alcohol to try and cope with their feelings. People with ADHD are more likely to have personality disorders and other psychological problems, such as anxiety or mood disorders. 

On the other hand, being ‘neuro-atypical’ can also have its advantages. Adults with properly managed ADHD often show great imagination and creative flair. New ways of working are leading to the design of working environments better able to suit people with ADHD. 

Causes of ADHD

The exact cause of ADHD is not known. Many potential causes affecting the structure and chemistry of the brain are being investigated. The leading theory is that ADHD is an inherited neurodevelopmental disorder. 

Contributing factors to ADHD may include: 

• neurophysiology – which includes differences in brain anatomy, electrical activity and metabolism
• genetics – some research suggests possible gene changes may be present
• drugs – the child’s mother having used nicotine or cocaine during pregnancy
• lead – chronic exposure to low levels of the metal lead may influence behaviour and brain chemistry
• lack of early attachment – if a baby does not bond with their parent or caregiver, or has traumatic experiences related to the attachment, this can contribute to their inattention and hyperactivity.

One theory is that a lack of a particular group of brain chemicals, called monoamines, may play a part. The fact that nearly two thirds of people can manage their ADHD with stimulant medication suggests that brain chemicals are at least partially involved. 

Diagnosis of ADHD

It is important to obtain an accurate diagnosis of ADHD. Symptoms of ADHD can be similar to symptoms of anxiety, depression or other mental illness. 

There is no biological test to see whether or not a person has ADHD. Diagnosis is currently made by subjectively rating the person’s behaviour in settings such as home and school. 

Diagnosis may include: 

• ruling out other psychological problems that have similar symptoms to ADHD
• ruling out alcohol or drug abuse that might be causing the symptoms (although a person with ADHD may also have alcohol or drug problems)
• rating the person’s current behaviour and lifestyle
• checking back to see if the person showed ADHD symptoms in childhood
• interviewing their partner, family, friends, and others about the person’s behaviour

Read more about diagnosis of ADHD in children. 

Treatment for ADHD

Treatment for ADHD can include: 

• education – to help the person understand and better manage their condition
• lifestyle improvement – such as cutting back or quitting drugs and alcohol, and taking up regular exercise
• medication – stimulant and non-stimulant medications are used
• psychotherapy – to address self-esteem problems or substance abuse
• therapy – such as behaviour therapy and cognitive behaviour therapy, to teach anger management, organisational skills or social skills, depending on the needs of the individual. 
• vocational counselling – to increase the person’s chances of success and satisfaction in the workplace
• family therapy – when one family member has ADHD, the whole family needs support
• joining a support group.

Brain imaging techniques and function measures of how your brain solves problems hold current promise for being able to better understand and personalise treatments. 

Where to get help

• Your GP (doctor)
• Psychiatrist
• Psychologist
• The ADHD Centre (NSW) and Helpline Tel. (02) 9889 5977
• ADHD Australia
• Adult ADHD Melbourne
• ADHDWA Centre and Helpline Tel. (08) 6457 7544