When you think about ADHD, you probably think about high-energy kids who need extra help in school. But what happens when those kids become adults?
In the past, it was thought that most kids outgrew attention-deficit/hyperactivity disorder (ADHD). Today, experts believe only 1 out of 8 children truly outgrows the condition.
Robert P. Wilfahrt, M.D., a family medicine physician at Mayo Clinic, is an expert on ADHD. He says, "For a long time, parents were told, 'Oh, Johnny's having trouble in fourth grade, but he'll be a great adult.' He probably will be. But he'll probably be a great adult with ADHD."
About 5% of U.S. adults — 8 million people — have adult ADHD. But less than 20% get diagnosed or treated for it. Unfortunately, ADHD that's not treated may negatively affect daily life, work opportunities, relationships and life expectancy.
What is ADHD?
Adult ADHD is a mental health disorder that can include a combination of problems. An adult with ADHD may be restless, have difficulty paying attention and experience impulsive behavior.
"A person who suffers from that distractibility and impulsivity was born that way," says Dr. Wilfahrt. "It's not a behavioral choice. It's not a result of their upbringing. It's not a result of any habits that they might have grown up with. They came out of the womb with ADHD."
Symptoms of ADHD in adults
Symptoms of ADHD are similar in adults and children, but many adults have learned to make their symptoms less obvious.
Typical symptoms include:
- Difficulty focusing on or completing tasks.
- Trouble deciding which tasks are most important.
- Poor planning and time management skills.
- Difficulty doing 2 tasks at once, for example, checking a pot on the stove while chopping vegetables.
- Disorganization.
- Trouble managing stress.
- A hot temper or being more easily frustrated.
- Feeling restless or moving around a lot.
According to Dr. Wilfahrt, "The hyperactivity tends to fade away with time. But impulsivity and emotional ups and downs can persist. So, I might not fidget as an adult, but I might not finish the bathroom remodeling project that I started 6 months ago."
Dr. Wilfahrt says 2 symptoms he sees often in adults are:
- Difficulty controlling emotions. People with ADHD have emotions that bounce with intensity and speed. For example, a minor slight from a co-worker could cause a strong emotional reaction. But 15 minutes later, the person with ADHD is fine again.
- Trouble sleeping. At bedtime, people with ADHD can feel physically tired, but their minds jump with thoughts. After hours of exhaustion, they fall asleep. But with little time spent sleeping, they're tired and may have trouble starting the day the next morning.
ADHD and lower life expectancy
Getting treatment for adult ADHD is important. One study showed that when ADHD that's not treated continues into adulthood, it can reduce life expectancy by more than 11 years.
One reason behind this could be the "snowballing effect" with ADHD. When someone has experienced the symptoms of ADHD their whole life, they may develop depressive symptoms and anxiety about daily performance.
"Because they're stressed from being unsuccessful, they might adopt coping mechanisms like alcohol or smoking, or make other bad choices," says Dr. Wilfahrt. These choices can negatively affect health and life span.
ADHD that's not treated is also linked to more accidents and accidental death. And ADHD can make it harder for people to manage chronic health conditions.
Dr. Wilfahrt says, "Maybe they get diabetes later in life. They may have to test themselves and adjust doses of insulin 4 times a day. And if you have ADHD, you're not good at that kind of complexity. So, caring for yourself later in life is difficult."
Tests for ADHD in adults
There's no single screening test for adult ADHD. To get an adult ADHD diagnosis, your doctor may recommend:
- A physical exam to help rule out other possible medical causes for your symptoms.
- A medical history interview to learn about your current and past symptoms, health history, and family medical history.
- Rating scales and checklists to help collect and evaluate information about your symptoms. You'll rate yourself on a variety of factors. Your doctor may also ask your family members, friends or colleagues to complete similar surveys.
ADHD treatment for adults
While there's no cure for ADHD, there are several effective treatments that can manage your symptoms and help you live a more rewarding life.
The most effective treatment for ADHD is a combination of medicine, psychological counseling, education and skills training. However, everyone is different. Be sure to talk to a doctor before taking any medicines or supplements for ADHD.
Adult ADHD medicine
If you have adult ADHD, you'll work with your doctor to choose what medicines to use. There are 2 categories of medicines for adult ADHD:
- Stimulants work quickly and effectively to help people control ADHD symptoms. Long-term studies have shown that they're safe, but there are risks of side effects. Plus, the benefits don't tend to last all day.
- Nonstimulants don't work immediately, taking between 3 days and a month or more to kick in. But once working, they're effective all day. Nonstimulants are helpful for people who also have anxiety, depression or issues with the side effects of stimulants. And nonstimulants can be particularly effective in helping shut off ADHD brain at bedtime, improving sleep.
Home remedies for ADHD
The best home remedy for ADHD is exercise: Both 'big' efforts, like going for a jog or bike ride, and 'little' movements, like pacing while talking on the phone, can improve focus and mood.
Although people have used supplements — like vitamins or minerals — to improve their health for decades, using natural supplements to manage ADHD is a relatively new idea.
Some research shows that iron supplements help people manage ADHD if they have iron deficiencies. Evidence from children also suggests that taking a lot of fish oil — 2 grams twice a day — may have a tiny effect on ADHD. But it's small enough that it won't likely replace prescription meds.
ADHD counseling for adults
Counseling can be helpful for people with adult ADHD and their loved ones.
- People with adult ADHD can learn to improve organizational skills, reduce impulsive behavior, understand past failures, develop problem-solving skills and improve relationships.
- Loved ones of an adult with ADHD can benefit from counseling too. Sessions with a counselor can help loved ones manage the stress of living with a person with ADHD, improve communication and learn problem-solving skills.