ADHD Symptoms In Adults: How Is It Different To In Children? What Does ADHD Look Like In Adults?
We all know the ADHD stereotype – a young boy who can’t sit still or stay quiet, often misunderstood and frequently labelled ‘disruptive’ in school. For the longest time, ADHD talk, treatment and research has focused mainly on ADHD in children. But what about ADHD in adults? The true scope of ADHD extends well beyond the stereotypes we are all familiar with. But these perceptions often prevent undiagnosed adults with ADHD symptoms from seeking help. Things we’ve heard at The London Psychiatry Centre:
- I can’t have ADHD – I’m quite quiet
- I can’t have ADHD – I’m not hyperactive
But ADHD in adults often looks rather different to the hyperactive ADHD boy child – particularly in women, who tend to learn ‘masking’ strategies as they get older. If you regularly find yourself wondering things like:
- Why can’t I focus?
- Why do I leave things to the last minute?
- Why is it so difficult to plan?
- Why am I so disorganised?
- Why am I always late, even though I don’t want to be?
There’s a chance you could have ADHD.
What is adult ADHD?
Adult ADHD (Attention Deficit Hyperactivity Disorder) is a neurological (brain) disorder. In the UK, ADHD is estimated to affect 3-4% of the population, more of them male than female at a ratio of around 3 to 1. ADHD in adults tends to present as persistent problems with inattention and short-term memory, hyperactivity and/or impulsiveness that disrupts work, life admin, the home, and relationships. Neuroscientific research has documented how the ADHD brain has impeded neurotransmitter activity in four regions, including the frontal cortex (executive function) and the limbic system (emotions and attention).
Historically, ADHD was thought to be a childhood disorder, but research has demonstrated that ADHD symptoms often persist into adulthood. Because ADHD is a neurodevelopmental disorder, it has long been understood that ADHD in adults must proceed from ADHD in childhood. In recent years there has been some controversy regarding this. Some have argued that there is a significant category of ‘adult-onset’ ADHD. However, one notable longitudinal study of hundreds of subjects involving repeated assessments found that when different issues such as substance misuse and other mental health problems were analysed, the symptoms could be explained thus, concluding: “Approximately 95% of individuals who initially screened positive on symptom checklists were excluded from late-onset ADHD diagnosis…There was no evidence for adult-onset ADHD independent of a complex psychiatric history.”
This is why here at The London Psychiatry Centre, we believe that if you are wondering do I have ADHD it is best to seek assessment at a centre that deals with a variety of different mental health and neurodevelopmental issues, where expert clinicians are best placed to rule out other problems so that you can be confident in your diagnosis and treatment.
Sometimes symptoms change – for example a person with adult ADHD may be less outwardly fidgety and physically restless than they were in childhood. Generally speaking though, newly diagnosed ADHD in adults is ADHD that went undiagnosed in childhood, for whatever reason. Many such children grew up being told they were ‘wilful’ ‘daydreamers’ or ‘naughty’. Struggling in adulthood now, they may frequently ask themselves: What is wrong with me?
ADHD in adults may present as difficulties with:
- Understanding and/or following instructions
- Staying focused and finishing tasks
- Organising things
- Managing stress
- Risk-taking and impulsivity
- Impatience and feelings of restlessness
Sometimes ADHD in adults can also manifest difficulties in social interactions and relationships.
Types of ADHD
ADHD in adults (and indeed children) can present in different ways, leading to the classification of three ADHD subtypes:
- Inattentive Type ADHD – Problems focusing, planning and organising, sustaining attention, working with detailed instructions, poor short-term memory etc. This ADHD subtype is more frequently diagnosed in adults and girls.
- Hyperactive-Impulsive Type ADHD – More outwardly noticeable, this ADHD subtype is more frequently diagnosed in men and children. Those with hyperactive-impulsive ADHD often struggle to keep still, may talk excessively, interrupt others frequently, and make decisions impulsively.
- Combined Type ADHD – People with combined type ADHD experience both inattentive and hyperactive symptoms. Combined Type ADHD accounts for the majority of ADHD diagnoses.
Do I have ADHD? ADHD Symptoms Quiz
ADHD symptoms include things that everyone can experience from time to time, especially in today’s fast-paced, information-overloaded world of smartphones and distractions. It is normal to lose your keys from time to time or to forget names. However if you struggle a lot to focus, remember things you need to do, and organise your life, to a point that it is causing you and/or those around you distress, it may be time to ask: Do I have ADHD?
A diagnosis of ADHD requires thorough, detailed clinical consultations. You can use the following short ADHD symptoms quiz to help you decide if you wish to see a specialist, but it is not intended to provide diagnosis or replace consultation with a trained clinician.
Ask yourself these questions about the last 6 months:
|How frequently do you struggle to finish off the closing details of a project?|
|How frequently do you struggle to get things in order when you need to conduct a task that calls for organisation?|
|How frequently do you have issues with remembering appointments or things you need to get done?|
|When you need to do something that entails a lot of thought, how frequently do you evade it or put off starting it?|
|How frequently do you find yourself restless, fidgeting or squirming with your hands or feet when you need to sit down for a long time?|
|How frequently do you feel very energetic and compelled to action, as if you were ‘driven by a motor’?|
How frequently do you struggle to finish off the closing details of a project?
How frequently do you struggle to get things in order when you need to conduct a task that calls for organisation?
How frequently do you have issues with remembering appointments or things you need to get done?
When you need to do something that entails a lot of thought, how frequently do you evade it or put off starting it?
How frequently do you find yourself restless, fidgeting or squirming with your hands or feet when you need to sit down for a long time?
How frequently do you feel very energetic and compelled to action, as if you were ‘driven by a motor’?
(This ADHD symptoms quiz is a rewording of the ASRS screener produced by the World Health Organisation and the Workgroup on Adult ADHD.)
How many checkmarks in the darkly shaded boxes did you tick? Four or more checkmarks may signal symptoms consistent with adult ADHD. For clarity, speak to a clinician in more depth about the problems you are experiencing.
ADHD Treatments and ADHD Coping Strategies
There is no ‘cure’ for ADHD, but effective ADHD treatments and ADHD coping strategies can help you gain control over your life.
ADHD treatment may include:
- Stimulant medications such as methylphenidate or lisdexamfetamine to enable focus and self-control
- Non-stimulant medication such as atomoxetine to facilitate better executive function and focus as well
- Talking therapies such as cognitive behavioural therapy (CBT) for ADHD
- ADHD coaching
- Lifestyle changes such as exercise and targeted nutrition plans
Dr Sourabh Singh, Consultant Psychiatrist at The London Psychiatry Centre says: “ADHD is a complex condition and every ADHD treatment comes with potential pros and cons. For example, while stimulant medications tend to be very effective on ADHD symptoms, they may not be suitable for people with a history of substance abuse (which is a very common ADHD comorbidity). However, we can look at alternatives such as non-stimulant medications and psychological interventions or coaching in such situations.
“That is why here at The London Psychiatry Centre, as experts in treating ADHD in adults and children, we believe that for most people, no single ADHD treatment provides the whole best picture. A combination of treatment and ADHD coping strategies is generally helpful, whether that means for example taking medication along with CBT, or exercise, nutrition and coaching.”
Increasingly, there is a movement among people with ADHD and clinicians and coaches to recognise the strengths that people with ADHD tend to have. Yes, people with ADHD tend to struggle with organisation and timekeeping, but they are frequently perceptive, talented and highly creative.
Effective ADHD treatment will help you to live your best life. Here at The London Psychiatry Centre, we have decades of experience in diagnosing and treating ADHD in adults and offer tailored ADHD treatment plans to help you thrive.