An Introduction to Adult ADD
ADHD stands for attention deficit hyperactivity disorder. ADHD used to be known as attention deficit disorder, or
ADD. In 1994, it was renamed. However, in today's society, ADD, ADHD, and AD/HD are all used interchangeably to mean the same condition. For this article, we will use the terms interchangeably.
Attention deficit hyperactivity disorder is a highly publicized childhood disorder that affects approximately 3 to 5 percent of all children.
The number of people with adult ADD is unknown, and medical experts continue to debate whether children can expect to outgrow the symptoms of ADD by the time they reach adulthood. Some studies have shown a significant decline in symptoms as a person ages. Others estimate that between 30 and 70 percent of children with ADD will continue to have symptoms into adulthood.
Adult ADD is a much more elaborate disorder than in children. It's more than simply paying attention and controlling impulses; the problem is developing self-regulation. This self-control affects an adult's ability not just to do tasks, but also to determine when they need to be done. You don't expect four- or five-year-olds to have a sense of time and organization, but adults need goal-directed behavior; they need help in planning for the future and remembering things that have to get done.
The exact causes of adult
ADD are unknown. ADD was once looked upon as a discipline and behavioral problem resulting from bad parenting. Some suggested it was caused by high sugar intake, food additives, excessive TV viewing, and family problems. However, none of these explanations is supported by scientific evidence.
Most scientists agree that ADD (whether in adults or children) is a biologically based disorder of the nervous system. Brain imaging research using a technique called magnetic resonance imaging (MRI) has shown that differences exist between the brains of children with the condition and those without, but the exact mechanism of brain function causing the symptoms is unknown. Scientists caution that MRIs used in studies are research tools and cannot be used to diagnose ADD in a specific person.
Recently published research suggests that ADD tends to run in families. In these studies, children with the condition have, on average, at least one close relative with ADD. Over the years, other theories have suggested that other factors -- such as exposure to lead in the environment, premature birth, birth trauma, and brain injury -- may lead to the development of ADD.
At times, everyone has trouble sitting still, problems with managing time, or difficulty completing a task. The behavior of people with adult ADD, however, goes beyond occasional fidgeting, disorganization, and procrastination. For them, performing tasks can be so hard that it interferes with their ability to function at work, home, school, and in social settings.
A diagnostic manual compiled by the American Psychiatric Association identifies three types of ADD:
- Inattentive
- Hyperactive-impulsive
- Combined.
A person with inattentive adult ADD has trouble focusing on activities, organizing and finishing tasks, and following instructions.
Hyperactive and impulsive adults feel restless, are constantly "on the go," and try to perform multiple tasks at once. They are often perceived as not thinking before they act or speak.
Individuals with the combined form of adult ADD show symptoms of both inattention and hyperactivity-impulsivity.
The first studies on adults who were never diagnosed as children as having
ADD but who showed symptoms as adults were done in the late 1970s by Drs. Paul Wender, Frederick Reimherr, and David Wood. These symptomatic adults were retrospectively diagnosed with ADD after the researchers' interviews with their parents.
The researchers developed clinical criteria for diagnosing ADD in adults (the Utah Criteria), which combined past history of the condition with current evidence of typical behaviors.
Other diagnostic assessments for adult ADD are now available. Among them are the widely used Conners Rating Scale and the Brown Attention Deficit Disorder Scale.
Typically, people with adult ADD are unaware that they have this disorder -- they often just feel that it's impossible to get organized, stick to a job, or simply keep an appointment. The everyday tasks of getting up from bed, getting dressed and ready for the day's work, arriving at work on time, and being productive on the job can be major challenges for someone with this condition.
Treatment for adult ADD with medications and behavioral therapy can help with the symptoms of the disorder. The U.S. Food and Drug Administration has approved five drugs for adult ADD treatment, but the decision to take medication should be considered carefully and discussed with a physician. Although medication gives needed support, the person must succeed on his or her own. To help in this struggle, both "psychoeducation" and individual psychotherapy can be helpful components of adult ADD treatment.
Consequences of Having Adult ADD
ADD can have serious consequences, whether in a child or an adult. Compared to adults who don't have it, those with adult ADD are more likely to suffer from
depression and
anxiety, low self-esteem, be fired from jobs, and get divorced.
Teens and adults with ADD have two to three times more auto accidents and twice the number of severe accidents resulting in vehicle damage and bodily injury as those without. They have coordination deficits, less skill in maneuvering vehicles in traffic, slower reaction time, and inattention.
