ADHD in adults

Even though a lot of research into ADHD has gone on around the world, the exact cause is still unknown. What is known is that ADHD is not caused by poor parenting, too much sugar or vaccines.

Studies of brain scans show that children with ADHD seem to have brain circuits that are wired a little differently from other people's, so messages are harder to understand.

There is thought to be a genetic element to most ADHD, that is, it runs in families.

Studies have shown that brothers or sisters of children with ADHD have two to three times more likely to have it as well.

Common issues faced by adults with ADHD can include:

• Poor concentration and focus
  People with ADHD experience problems with attention. You may be easily distracted by irrelevant sights and sounds, quickly bounce from one activity to another, or become bored quickly. This can make it hard to focus on work or study, making it difficult to meet targets and deadlines. As a result, you may find that your marks on assignments, or your achievement at work, do not reflect your true abilities. 
  
  
• Too much concentration and focus
  On the other hand, people with ADHD also can become absorbed in tasks that are stimulating and rewarding to them, such as a new video game. When this happens, you may lose track of time or people around you and find it hard to shift your attention from the task you are fixated on. This can be a real strength when the thing you are fixated on is productive, but it can be challenging when it detracts from other work that you are required to do. 
  
  
• Poor time keeping and prioritising
  There are many reasons for this. You may be easily distracted, for example, on the way to work or to a social event you may decide to clean the car or finish an important home task before you go out. People with ADHD also tend to underestimate how much time it takes to finish a task. They can also incorrectly prioritise work projects and miss deadlines while being distracted elsewhere.
  
  
• Difficulties with listening skills
  Problems with attention can result in poor listening skills in many adults with ADHD, leading to missed appointments and misunderstandings.
   
• Trouble getting organised
  Difficulties with time management and attention can mean that organising the responsibilities of adulthood, such as bills, jobs, and appointments, is difficult. During childhood, organisation difficulties may be less noticeable, as parents often form the structure that helps children with ADHD to manage time and responsibilities. When the young person moves into adulthood, organisational difficulties can become more pronounced. 
  
  
• Difficulty starting hard tasks
  People with adult ADHD often avoid starting tasks that require a lot of attention. This procrastination often adds to existing problems, including relationship disagreements, workplace issues and problems with friends. Again, difficulties starting tasks may become more noticeable in adulthood, as the structure and guidance of school and parents lessens.
  
  
• Restlessness, trouble relaxing
  Unlike childhood ADHD, where children are “hyperactive”, adults with ADHD are more likely to be restless or find they can’t relax. If you have adult ADHD, others might describe you as edgy, tense or always on the go. Adults with ADHD are often drawn to outdoor, active jobs rather than desk jobs. 
  
  
• Difficulty controlling emotions
  People with adult ADHD often find it hard to be patient. Others may notice that an adult with ADHD has a tendency to interrupt other people and finish others’ sentences. They may be quick to explode over minor issues. Many times, their anger fades as quickly as it flared.
  
  
• Relationship issues
  Having ADHD can make relationships with others difficult. The partners and friends of people with undiagnosed or unmanaged ADHD may understand poor listening skills and an inability to meet commitments as a sign that their partner doesn’t care. If you’re the person with ADHD, you may not understand why your partner is upset, and you may feel you’re being nagged or blamed for something that’s not your fault.

With recent research, it is becoming more apparent that the symptoms of ADHD are often different in women, girls, and people assigned female at birth. Often, young women with ADHD may show more subtle symptoms, which often leads to ADHD being missed or not diagnosed until later in life. For example, while a young male who is hyperactive may be noticed as being loud, fidgety and disruptive, a hyperactive female may simply be perceived as very talkative and animated.

It is thought that females are more likely to present with more emphasis on the inattentive aspects of ADHD. Often, this means that a young woman with ADHD may be more likely to daydream or be forgetful. The female presentation of ADHD symptoms can be much less disruptive, and so it is not picked up as a formal disorder of attention. As a result, it is often not until later in life, when difficulties with organisation, time management and task completion become much more evident, that it is identified as a problem. 

If you or a loved one is diagnosed with adult ADHD, you’ll need to work together with your doctor or mental health professional to come up with the best treatment plan. It’s a complicated condition, generally best managed by a mixed treatment programme, which may include the following components:

Stimulants are the main kind of medication used in the treatment of ADHD. These are designed to help you concentrate better, be less impulsive, feel calmer and be able to function in the workplace and at home. A special authority is required to prescribe ADHD medication, so in order for a GP to prescribe stimulants, a formal diagnosis is needed.

If you are prescribed medication, you are entitled to know:

• the names of the medicines
• what symptoms they are supposed to treat
• how long it will be before they take effect
• how long you will have to take them for and what their side effects are (short and long term).

These treatments are talk-based therapies that look at your thinking, behaviour, relationships and environment. 

For ADHD, these treatments include behaviour management, teaching skills to help manage time and work towards goals, and teaching social skills to help support you socially, at work and at home. 

Career counselling can also be a valuable tool in supporting those experiencing ADHD.

Family counselling can also play an important part in helping everyone in the family understand the condition and support you, provided the counsellor has good knowledge of ADHD. Check this with the counsellor before starting.

Any therapy/counselling should be provided in a manner that’s respectful of you, and with which you feel comfortable and free to ask questions. It should be consistent with and incorporate your cultural beliefs and practices.

Thanks to Madeline Dykes, clinical psychologist, and members of the Thriving Madly peer support network in Christchurch for reviewing this content. Date last reviewed: September, 2022.

Thanks also to Sutherland Self-Help Trust for making the 2022 updates possible.