Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common childhood disorders. However, for many people, it can persist into adulthood. ADHD in adults is often unrecognised or misdiagnosed.
In recent years, we’ve seen more visibility and diagnosis of ADHD in adults, largely because of a number of cases of high-profile adults with ADHD featuring in the headlines and on social media. This has helped to build greater awareness and open up the conversation around this neurodivergence.
Previously an individual may have struggled to understand the symptoms they’ve experienced, for example, persistent distractibility, inattention, and forgetfulness. Now, this increased awareness has caused more individuals to reflect on their own experiences, research the condition, begin to make sense of their own behaviours, and seek help.
In this post, we speak with Dr Lauren Coles, Clinic Manager and Highly Specialist Psychologist at Altum Health, to understand more about ADHD in adults, in particular: the symptoms, the process of gaining a diagnosis, and the treatment options available.
What are the symptoms of ADHD in adults?
Symptoms of ADHD in adults can be categorised into three types of category: attention deficit, hyperactive/impulsive deficit, or a combination of both.
The symptoms of ADHD look different for each person, but some of the key traits we see in adults with ADHD include:
- Poor attention to detail and carelessness, for example making lots of mistakes and spelling errors in written work
- Not finishing one task before moving onto a new one
- Poor organisational skills
- Finding it hard to stick to routines
- Being forgetful, constantly losing and misplacing things
- An inability to focus on things that aren’t interesting to you. For example, were you able to force yourself to pay attention during that class in school that you really disliked because you knew you had to?
- Impulsive purchasing
- Impulsively starting new hobbies
- Repetitive thought patterns
- Interrupting others, talking over them, sometimes talking a bit too much, or finishing other peoples’ sentences
- Finding it difficult to sit still, for example, finding excuses to get up and move around the office
- Being impatient, for example, does the thought of sitting in traffic or standing in a queue irritate you to the point of not wanting to be in that situation?
- Risk taking activities, for example taking drugs or alcohol
- Hyperfocusing on something – getting really drawn into it, to the extent that you might spend hours on a task and forget to eat, or to go to the toilet.
While many people will recognise elements of these behaviours in their own lives, for someone with ADHD, these symptoms can be traced back to childhood and are persistent and debilitating, causing ongoing challenges on a daily basis.
Is ADHD in adults hard to diagnose?
There are a number of reasons why ADHD in adults can be hard to diagnose.
Firstly, there are stereotypes. For many people, the term, ‘ADHD’ conjures up an image of a young, hyperactive school boy who can’t sit still in class, not, for example, an adult female in the workplace.
An additional challenge for clinicians has been the diagnostic criteria, which is normally based on men, despite the fact that ADHD symptoms present very differently in women. For women, symptoms may include challenges with time management, poor emotional regulation, and being more withdrawn.
Additionally, as those with ADHD move into adulthood, they may have developed coping strategies to help manage their symptoms. These make it harder to diagnose ADHD or lead to misdiagnosis.
ADHD and eating disorders
There’s evidence to show that if you have ADHD, you are more likely to experience other mental health issues, such as anxiety or depression. Addiction is also very common.
As a specialist eating disorder clinic, at Altum Health, we see many clients with ADHD who also have binge eating disorder or bulimia.
Dopamine, or, the ‘feel-good’ hormone, gives you a sense of pleasure. It’s been found that many people with ADHD have a dopamine deficit; they either don’t produce enough of it or their brain doesn’t respond to it.
If you’re lacking in dopamine and hence that feeling of pleasure, you seek it out. This is one of the reasons why people with ADHD often develop disordered eating; bingeing on high-sugar foods stimulates the release of dopamine.
Also, for women with ADHD in particular, low self-esteem, feelings of low self-worth, and shame are common, driven by self-criticism of their own inability to stick to things. A low perception of oneself is also something we frequently see in those living with an eating disorder.
How to get a diagnosis for ADHD
At Altum Health, we use robust diagnostic tools to make an informed assessment of someone who suspects they have ADHD.
Our multi-disciplinary expertise means there’s the option to complete an ADHD assessment with a highly specialist psychologist or a psychiatrist, the latter being in a position to prescribe medication, if this is something you wish to consider.
Before your ADHD assessment, you will complete a questionnaire to provide more background information. The overall assessment itself typically takes two to three hours, with the first hour being an interview based on your personal history.
The interview covers a range of topics including your medical history, your school life, relationships, socialising, self-esteem, your approach to risk-taking, and more. We’ll also speak with someone who knew you in childhood – a parent or sibling – or ask to look at school reports.
After this first stage of assessment, we’ll evaluate whether we believe it’d be beneficial to progress onto the second stage of the assessment: The DIVA.
The DIVA is the diagnostic interview for ADHD in adults. It covers the core symptoms of ADHD as outlined in the DSM criteria for diagnosing this condition. The DSM being the Diagnostic and Statistical Manual of Mental Disorders – a handbook used by healthcare professionals as the authoritative guide to the diagnosis of mental health and brain-related conditions and disorders.
Once both stages of the assessment are complete, we’ll reach a diagnosis and provide a thorough written report for you to keep. Often clients want to share this with their wider treatment team or their employer.
What are the treatment options for adult ADHD?
For an adult living with ADHD, receiving a diagnosis is often incredibly validating. Things that you may have struggled with – for example, finding it challenging to complete a task – now begin to make more sense. It’s not due to laziness or a lack of motivation, it’s simply that your brain works a little differently.
And if you do receive an ADHD diagnosis, there are many sources of help and resources available.
Therapy helps those with ADHD to gain a better understanding of their condition, while building acceptance and self-esteem, and learning healthy coping strategies.
In therapy, we discuss different strategies that could be useful, for example, setting timers on your phone, making notes, and asking others around you for help with the aspects you find challenging. For example, if you’re really good at kick-starting a project, but struggle to see it through, could you find a way to let this be an advantage?
We often work on ‘habit stacking’ with clients, which helps to develop ways to complete tasks that might otherwise have felt challenging. For example, if you struggle with completing admin tasks or filling in applications, one suggestion is to have some music on in the background that keeps you going. Or listen to an audiobook while doing chores to help finish the task.
Finally, if a client has ADHD and an eating disorder, therapy from a specialist healthcare provider is especially important. At Altum Health, our multi-disciplinary expertise makes it possible for your treatment plan to include a therapist, dietician, and psychiatrist, all within one practice.
There are also medications that can be incredibly effective for people with ADHD. However, different medications work for different people, so it’s quite typical for this to take a little time – working alongside your healthcare provider – to find the right balance for your needs.
Social media and the internet provide the opportunity to learn more about ADHD and hear others’ experience of living with the condition. There are also plenty of resources online – podcasts and YouTube videos, for example – that can offer some help and guidance for people living with ADHD.
And if you go to your GP, it’s often best to let them know you think you may have ADHD as a starting point for your consultation. As we’ve mentioned, the condition can be hard to diagnose, so doing your research and even completing an online self-screening test in advance is a good place to start.
If your symptoms are so severe that they interfere with your ability to function on a daily basis, we recommend you speak with a healthcare professional. Gaining a diagnosis and seeking help and support will help you to work with your ADHD rather than against it to better manage tasks, relationships, and responsibilities.
If you suspect you or someone you know could have ADHD, we can help. Please get in touch to book a free, 20 minute consultation with our team.
Dr Lauren Coles