ADHD is NOT just a childhood problem!!

Updated: Jun 2, 2022

Attention Deficit Hyperactivity Disorder represented by the acronym ADHD, is the most common neurobiological difference that exists in the world. Neurobiological difference are sometimes wrongly termed brain conditions. Someone who has ADHD basically has a brain that functions and is wired differently than those without ADHD. Most people notice the neurobiological difference in their early years when they start noticing differences to others their age in their focus, play and interaction. This difference shows up in different areas of a person life as they continue to grow and develop. For many years, ADHD was wrongly thought of as a condition that only affect children. In fact, many health professionals currently practising were trained during a time when they were taught that ADHD is something that kids outgrow. We now know this is not true. ADHD is neurobiological difference that affects individuals across their lifespan.

According to a recent study on the global prevalence of ADHD in adults, is approximately 366 million adults. This highlights how very common ADHD is. This statistic does not include that of the prevalence in Seychelles as we are still yet to talk about ADHD and collect data on it.

So, what is ADHD?

ADHD is best described as a pattern of inattention and/or hyperactivity-impulsivity that persists overtime and interferes with the way a person functions in their everyday life and their development. There are two factors involved in ADHD:

1. Inattention

2. Hyperactivity and impulsivity

There are 3 types of ADHD (Based on DSM V from APA):

1. Predominantly (Mostly) Inattentive Type: This is when a person has difficulty organising or finishing tasks, paying attention to details, or following instructions or conversations. Can often make careless mistakes in the details of works for example projects. S/he can seem easily distracted or forgetful of details in daily routines. These people also present with some other traits but not enough to be considered to have combined ADHD.

2. Predominantly (Mostly) Hyperactive-Impulsive Type: This is when a person may fidget and talk a lot. It can be hard for them to sit still for long (e.g., for a meal, at work or while doing homework). S/he might have a tendency to interrupt others a lot, grab things from people, or speak at inappropriate times. It may be hard for s/he to wait their turn or listen to directions. S/he can have issues with impulsiveness may have more accidents and injuries than others (e.g: falls down more, car accidents, have marks or injuries from falls).

3. Combined Presentation: Difficulties describes are equally experienced to the same degree by the same person.

Adult ADHD?

ADHD is separated into two categories: Childhood ADHD and/or Adult ADHD

Not all people who had ADHD in childhood end up having it as adults and not all adults with ADHD were diagnosed with it in childhood. Difficulties that comes with ADHD is experienced by most people throughout their lifetime (from childhood to adulthood). There are also cases where a person had some traits of ADHD in childhood but then these traits developed to be qualified for a diagnosis in adulthood.

The same criteria that are used for children is also used to make a diagnosis of ADHD in adults. However, the difference is these symptoms looks and affects an adult different as it would a child, which is obvious as adults have different responsibilities and demands in their daily lives.

How does ADHD affect adults?

ADHD affects adults and children differently. The difficulties experienced for an individual usually depends on what stage in life they are at and what are the demands required of them in their daily life. Adults with ADHD often have difficulties at work and in their personal and family lives that are related to their ADHD symptoms.

Many adults with ADHD have difficulty being consistent or motivated at work or in their careers. They have difficulties with maintaining attention and short term/ working memory. Many also have difficulties with day-to-day responsibilities, mood swings and may have chronic feelings of frustration, guilt, or blame. These can happen due to deficits in executive function which plays a huge role in the difficulties experienced in ADHD. Executive function is the brain’s ability to prioritize and manage thoughts and actions. This allows someone to consider the long-term consequences of their actions and guide their behavior more effectively. People who have issues with executive functioning may have difficulties with managing impulsivity or forgetting important things. These often makes life difficult for them and can lead to depressive episodes.

Many adults with ADHD also experience relationship problems as they can often be seen as impulsive, disorganized, aggressive, overly sensitive, intense, emotional, or disruptive. Their social interactions with others including parents, siblings, teachers, friends, co-workers, spouses/partnerscan be filled with misunderstanding and mis-communication.

Those who have difficulties due to ADHD can have a decreased ability to self-regulate their emotions which makes it difficult to manage their response, actions and reactions toward others when feeling stressed, angry, sad, irritated and frustrated. This is called emotional dysregulation. Emotional dysregulation involves a difficulty or inability to keep our emotions in check and within an acceptable range of reactions. Emotional dysregulation is meant to be resolved in childhood as children learns proper emotional regulation skills and strategies. However, often adults were not taught these strategies as children and people with ADHD often end up struggling twice as much with this. This can lead to struggles to stay in and maintain healthy relationships and can cause relationships to be overly tense and fragile.

ADHD at different stages of adulthood

For adults in school or university, their ADHD symptoms might affect them similarly to that of children in school. There might be issues with distractibility, procrastination, forgetfulness, and difficulty doing difficult projects or assignments. This would be more related to inattention. Young adults with ADHD might also find it difficult to manage their impulses and may act rash or without thinking in some situations, they might also experience issues with relationships, trouble with school performance, and the inability to function effectively in their work.

For adults in the workplace, the symptoms of ADHD can create many challenges. Although some adults with ADHD have very successful careers, others may struggle with several challenges such as:

Problems with external/internal distractibility such as noises and movement in the surrounding environment and/or daydreaming
Problems with impulsivity and temper outbursts in the workplace.
Problems with hyperactivity; adults with the hyperactive presentation of ADHD often do better in jobs that allow a great deal of movement, such as sales, but not so much in a sedentary job.
Difficulty or failing to remember deadlines and other responsibilities. This can frustrate coworkers, especially when working on a team.
Boredom especially with detailed paperwork and routine tasks.
Time management
Procrastination
Managing complex or long-term projects
The inability to find important papers, turn in reports and time sheets on time to maintain a filing system.
Individuals with ADHD can struggle with issues with socials skills and may unintentionally offend co-workers by interrupting frequently, talking too much, being too blunt, or not listening well.
Managing salary and finances (includes impulse spending)

ADHD in women

We don’t know much about ADHD in women and if it’s different than ADHD in men as very few studies have been conducted on women. ADHD in young girls is often overlooked and not diagnosed. Most women are diagnosed only as adults. Frequently, woman recognize their own ADHD symptoms after one of her children has received a diagnosis. Some women seek treatment for ADHD because they feel their lives are out of control. Their finances may be in chaos, paperwork, and record-keeping poorly managed, keeping up with their jobs/career might be hard and they may feel even less able to keep up with the daily tasks and manage their lives.

Other women are more successful in hiding their ADHD, struggling every day to keep up with increasingly difficult daily and societal demands. Most woman who eventually get an ADHD diagnosis describe that they are overwhelmed and exhausted. Women with ADHD can also struggle with compulsive overeating, alcohol abuse, dysphoria (unpleasant mood), major depression, anxiety disorders and chronic sleep deprivation. Rates of depressive and anxiety disorders in men and women with ADHD are the same. However, women with ADHD seem to experience more psychological distress and have lower self-image than men with ADHD.

How is ADHD diagnosed in Adults?

Adults with ADHD are often misdiagnosed with anxiety disorders, borderline personality disorder, bipolar disorder, or depression by mental health professionals.

An ADHD evaluation should be conducted by a licensed mental health professional, or a physician trained in ADHD testing and treatment. In the case of Seychelles, these professionals include psychologists, psychiatrist and/or neurologists (if applicable). There is no single medical, physical, or genetic test for ADHD. However, ADHD cannot be diagnosed accurately just from brief office observations or simply by talking to the person. Therefore, evaluations are done through ADHD symptom checklists, standardized behavior rating scales, detailed history of past and current functioning in daily life, and information from family members or significant others. In making the diagnosis, adults should have at least five of the required traits.

These can change over time, so an adult might find that they might not have the same traits as when they were children.

How is ADHD treated?

The most effective treatment approach for ADHD is a combination of behavioural therapy and medication. Usually cognitive behavioural therapy (CBT) is the preferred therapy approach which can be done by a trained mental health professional mostly a psychologist trained in CBT for ADHD. There are several medications used for ADHD and most of them are called psychostimulants widely used for the management of ADHD symptoms in adults, children, and adolescents. The most common ones are Ritalin, Adderall, Concerta and Dexedrine. Some non-stimulants such as Intuniv or Strattera are also used. Some people prefer more naturopathic methods and use calmants or herbs like ginkgo, ginseng, and passionflower to help calm hyperactivity.

How do I know if I need an evaluation for ADHD?

With more information and informal online tests available on the internet, there is a lot of controversy on the topic of self-diagnosis. On that note it is important to keep in mind that you should always seek to receive the proper information required from the proper sources.

You might want to get assessed for ADHD if you experience significant problems with one or more of these:

Inconsistent performance in jobs or careers; losing or quitting jobs frequently
History of academic and/or career underachievement
Poor ability to manage day-to-day responsibilities, such as completing household chores, maintenance tasks, paying bills or organizing things
Relationship problems due to forgetfulness or impulsivity
Forgetting important things or getting upset easily over minor things
Chronic stress and worry due to failure to accomplish goals and meet responsibilities
Chronic and intense feelings of frustration, guilt or blame

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