- Causes and Risk Factors
- Symptoms and Signs
- Support Groups
- More Info
What is attention deficit hyperactivity disorder (ADHD)?
Attention deficit hyperactivity disorder, often called ADHD or ADD (attention deficit disorder), is a behavioral condition that is characterized by symptoms of distractibility, impulsivity, and/or hyperactivity. This disorder often results in the sufferer having relationship problems, as well as difficulty performing well at work or in their community.
How prevalent is adult ADHD?
Although it is estimated that 2%-6% of adults have ADHD, this illness begins during childhood. While the condition is assessed more often in boys than in girls, it appears to occur in men and women at equal rates. Nearly two-thirds of children with ADHD retain some symptoms of the illness as adults, and about half have just as many symptoms of sufficient severity to still qualify for the diagnosis of ADHD. Other key statistics include that more than 90% of adults with the condition describe having trouble focusing, and more than 50% have both distractibility and hyperactivity/impulsivity, while more than one-third have just distractibility.
What are causes and risk factors for adult ADHD?
While there is no one specific cause for ADHD, there are a number of biologically and socially based risk factors that can increase the likelihood of a person developing the illness. Children with ADHD are more likely to grow into teens and adults with the condition. Brain-imaging studies indicate that traits of the brains of people who have ADHD include a tendency to be smaller, to have less connection between certain areas of the brain, and have less regulation of the neurochemical dopamine compared to people who do not have the disorder.
In addition to being risk factors for other neuropsychological issues, factors prior to birth that can increase the likelihood of developing ADHD include
- maternal stress,
- smoking during pregnancy,
- prematurity and low birth weight, as well as
- an early life stressor in the individual with ADHD.
Males and having a family history of this disorder increase the chances that a person will be diagnosed with ADHD. Low family income and low educational achievement for a person's father are social risk factors for developing ADHD.
What are adult ADHD symptoms and signs?
What is thought to be partly the result of maturity, adults with ADHD may show little to no signs of hyperactivity or the hyperactivity may look more like restlessness and a tendency to become bored easily. For those who do, symptoms and signs of hyperactivity, impulsivity, and inattention may resemble those that are exhibited by children and teens. However, how those symptoms are exhibited tends to vary with age. Symptoms of ADHD include the following:
- Often makes careless mistakes or pays inadequate attention to detail
- Trouble focusing during work or leisure activities
- Does not appear to be listening when spoken to directly
- Is often unable to complete directions, work tasks, or chores
- Frequently disorganized when trying to complete a task or activity
- Has a tendency to avoid, dislike, or resist (procrastinate) engaging in activities that require sustained attention
- Often loses things that are necessary to complete tasks or activities
- Easily distracted by extraneous or unrelated stimuli
- Frequent forgetfulness
While the excessive focus, often described as hyperfocus, is not included as a formal symptom of ADHD, it is often described by people who suffer from this condition or their family members. This symptom is thought by many to be a manifestation of the ineffective focus that is associated with this condition.
- Frequently fidgety or moves hands or feet
- Frequently has trouble remaining seated
- Has a tendency to feel restless
- Has difficulty participating in leisure activities quietly
- Performs multiple activities at once
- Excessive talking
- Often interrupts others talking
- Trouble waiting for his or her turn
- Frequently intrudes on other people
- Often does something without thinking about it first (behavioral impulsiveness)
- Women's Gymnastics Brings High Risk for Concussion
- Going Solo: Masturbation May Give Humans an Evolutionary Edge
- Longer Breastfeeding in Infancy, Better School Grades for Kids?
- Kids With ADHD, Behavior Issues Have Poorer Trajectories as Adults
- FDA Finalizes Limit on How Much Arsenic Can Be in Apple Juice
- More Health News »
How is adult ADHD diagnosed?
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), in order to be diagnosed with ADHD, an older teen or adult need only demonstrate five of each group of symptoms. Diagnostic criteria further state that symptoms should occur in more than one setting (like home and work), be significant enough to cause difficulties for the person, and not be able to be better explained by another illness. There are three types of ADHD: predominately inattentive presentation, predominately hyperactive/impulsive presentation, and the combined (inattentive, hyperactive, and impulsive) presentation.
Many health care professionals, like psychiatrists, psychologists, social workers, mental health physician's assistants and nurse practitioners, may help diagnose ADHD. A professional will likely perform or refer for a thorough medical interview and physical exam as part of the evaluation. Since ADHD can be associated with other mental health conditions, like depression, bipolar disorder, obsessive compulsive disorder, and other anxiety disorders, as well as with autism-spectrum disorders, the evaluator will likely screen for signs of those and other forms of mental illness. The signs and symptoms of adult ADHD may also be caused by many medical conditions or can be a side effect of a number of medications. Therefore, blood tests are frequently done as part of the initial assessment. Occasionally, an imaging study like an X-ray or CAT scan may be necessary. As part of the evaluation, the individual may be asked questions from a standardized questionnaire or self-test to assist in determining the diagnosis. Some ADHD symptom checklists for children have been adapted to screen for the condition in adults. Examples of such diagnostic tools include the Conners' Adult ADHD Rating Scale (CAARS) and the Adult Self Report Scale.
What is the treatment for adult ADHD?
Treatments for ADHD in adults that do not involve medication include education about the illness, participation in an ADHD support group, and instructional training for a number of issues, including career counseling, organizational skills building, parent counseling, financial training, and development of time-management skills. Many people with this condition may benefit from cognitive behavior therapy, a form of psychotherapy that seeks to help the individual alter patterns of thinking that may interfere with their functioning.
Adults often benefit from being treated with a stimulant medication. Commonly, the first prescribed stimulant for the treatment of this condition in children is a derivative of methylphenidate (Ritalin) or dextroamphetamine (Dexedrine). Given the longer days and increased responsibilities that adolescents and adults have compared to young children, longer-acting stimulants are usually prescribed. Examples of those medications include long-acting methylphenidate, like Daytrana patches, Concerta, Quillivant XR, and dexmethylphenidate (Focalin-XR).
Adults whose symptoms early in the morning or late in the evening are an issue, or whom have a history or propensity to a drug use disorder, stimulants may not be the optimal medication treatment and, therefore, they may respond better to a nonstimulant medication for treatment of ADHD. Side effects like low appetite, trouble sleeping, tremors, emotional inhibition, irritability or depression, less frequently tics, and rarely hallucinations may make taking a stimulant medication unwise. Using a stimulant to treat ADHD in people who have no history of drug abuse tends to decrease the likelihood of their ever developing a substance abuse problem. However, people with a recent history of alcohol or other drug abuse may want to avoid the small but possible addiction potential of stimulant medication. The long-term impact of addiction to a stimulant may be serious, potentially resulting in having a stroke or heart attack.
Individuals who either had less-than-optimal effects or had significant side effects to taking stimulants may respond better to a nonstimulant medication like guanfacine (Tenex or Intuniv), clonidine (Catapres or Kapvay), or atomoxetine (Strattera), or to taking the prescription supplement phosphatidylserine-omega-3 (Vayarin), which has a specialized delivery system compared to over-the-counter preparations of the omega-3 supplement.
People with ADHD are more likely to develop mood problems as adults. They therefore may benefit from medications like bupropion (Wellbutrin) or venlafaxine (Effexor) that treat both ADHD and depression or anxiety.
Are there any home remedies for adult ADHD?
Further research is needed to determine the potential effectiveness of natural remedies for treating adult ADHD. Examples of such remedies include dietary restrictions and vitamin supplements. The limited research available on the effectiveness of these remedies does not usually include studies on adults.
Lifestyle changes that have been found to be useful in reducing some symptoms of ADHD in children and may be considered for adults include regular exercise and improving sleep every night.
Subscribe to MedicineNet's General Health Newsletter
What is the prognosis of adult ADHD?
The prognosis for ADHD adults seems to be influenced by the severity of symptoms, scores on intelligence tests, whether the person with the condition has other mental health problems, as well as if there are family issues, such as parental mental health problems, family problems, socioeconomic challenges, and if the individual with ADHD receives treatment. Studies show that stimulant treatment of this condition often improves the prognosis for adults, decreasing the risk for developing other psychiatric problems, failing in school and in the world of work.
What are complications of adult ADHD?
Adults living with ADHD are more likely to have low self-esteem, depression, anxiety, and are not as adaptive with their social abilities compared to adults without the illness. The presence of other mental health disorders (co-morbidity) is more likely in adults who are hyperactive and/or impulsive as opposed to being distractible as part of ADHD. Adults with this condition are also more at risk for underachievement in school or at work, being in more car accidents, using tobacco products or other drugs, having problems managing their anger, and are more likely to develop antisocial behaviors, particularly if not treated. Given the cost effectiveness of treating ADHD and the potentially dire consequences of this illness going undiagnosed and untreated, the importance of identifying ADHD is clear.
ADHD adults tend to have more marital problems, as well as troubles getting along with peers and authority figures. They may, therefore, become isolated socially.
Education and career
Adults with ADHD are at risk for completing fewer years of education compared to their non-ADHD counterparts. They are often more interested in careers for which forgetfulness is less of an obstacle for good performance, as well as those that provide immediate gratification and other forms of excitement, like sales. They are often at risk for procrastinating on tasks, frequently changing jobs, and losing more jobs.
Is it possible to prevent adult ADHD?
Research indicates that breastfeeding up to 6 months of age may help prevent the development of ADHD. Since environmental and social problems like drug use in the mother, medical, and emotional challenges increase the likelihood of developing this condition, prevention or treatment of those issues can help prevent ADHD. In addition, early treatment of children with ADHD can decrease the impact the illness has on the individual's life into adulthood.
Are support groups available for those living with adult ADHD?
CHADD (Children and Adults With Attention Deficit Hyperactivity Disorder)
Where can people find additional information on adult attention deficit hyperactivity disorder?
American Counseling Association
American Psychiatric Association
American Psychological Association
National Association of Social Workers
National Mental Health Association
Health Solutions From Our Sponsors
Health Solutions From Our Sponsors
Arnold, V.K., D. Feifel, C.Q. Earl, et al. "A 9-Week, randomized, double-blind, placebo-controlled, parallel-group, dose-finding study to evaluate the efficacy and safety of modafinil as treatment for adults with ADHD." Journal of Attention Disorders May 2012.
Baker, A., Lee, N.K. & Jenner, L. (Eds) (2004). Models of intervention and care for psychostimulant users, 2nd Edition, National Drug Strategy Monograph Series No. 51.
Biederman, J., M.C. Monuteaux, T. Spencer, et al. "Do stimulants protect against psychiatric disorders in youth with ADHD? A 10-year follow-up study." Pediatrics 124.1 July 2009: 71-78.
Bussing, R., D.M. Mason, L. Bell, P. Porter, and C. Garvan. "Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample." Journal of the American Academy of Child and Adolescent Psychiatry 49.6 June 2010: 595-605.
Clay, R.A. "Easing ADHD without meds." Monitor on Psychology 44.2 Feb. 2013.
Conners, C.K., D. Erhardt, J.N. Epstein, et al. "Self-ratings of ADHD symptoms in adults I: Factor structure and normative data." Journal of Attention Disorders 3.3 Oct. 1999: 141-151.
Curatolo, P., E. D'Agati, and R. Moavero. "The neurobiological basis of ADHD." Italian Journal of Pediatrics 36 (2010): 79.
Hines, J.L., T.S. King, and W.J. Curry. "The adult ADHD self-report scale for screening for adult attention deficit-hyperactivity disorder (ADHD)." Journal of the American Board of Family Medicine 25.6 Nov.-Dec. 2012: 847-853.
Ingram, S., L. Hechtman, and G. Morgenstern. "Outcome issues in ADHD: Adolescent and adult long-term outcome." Mental Retardation and Developmental Disabilities Research Reviews 5.3 (1999): 243-250.
Lake, J. "Integrative management of ADHD: What the evidence suggests." Psychiatric Times July 2010.
Martinez-Raga, J., A. Ferreros, C. Knecht, R. de Alvaro, and E. Carabal. "Attention-deficit hyperactivity disorder medication use: factors involved in prescribing, safety aspects and outcomes." Therapeutic Advances in Drug Safety 8.3 March 2017: 87-99.
Maucieri, L. "ADHD hyperfocus: What is it and how to use it." Psychology Today November 2014.
Millstein, R.B., T.E. Wilens, J. Biederman, and T.J. Spencer. "Presenting ADHD symptoms and subtypes in clinically referred adults with ADHD." Journal of Attention Disorders 2.3 Oct. 1997: 159-166.
Mimouni-Bloch, A., A. Kachevanskaya, F.B. Mimouni, et al. "Breastfeeding may protect from developing attention-deficit hyperactivity disorder." Breastfeeding Medicine May 2013.
Quintero, J., M. Loro, B. Jimenez, and N. Garcia Campos. "Evolutionary issues in attention deficit hyperactivity disorder (ADHD); from risk factors to comorbidity and social and academic impact." Vertex 22.96 Mar.-Apr. 2011: 101-108.
Sagiv, S.K., J.N. Epstein, D.C. Bellinger, and S.A. Korrick. "Pre- and Postnatal Risk Factors for ADHD in a Nonclinical Pediatric Population." Journal of Attention Disorders 17.1 Jan. 2013: 47-57.
Taylor, F.B., and J. Russo. "Efficacy of modafinil compared to dextroamphetamine for the treatment of attention deficit hyperactivity disorder in adults." Journal of Child and Adolescent Psychopharmacology 10.4 Winter 2000: 311-320.
Thapar, A., and M. Rutter. "Do prenatal risk factors cause psychiatric disorder? Be wary of causal claims." The British Journal of Psychiatry 195 (2009): 100-101.
Thapar, A., M. Cooper, R. Jefferies, et al. "What causes attention deficit hyperactivity disorder?" Archives of Disease in Childhood 97.3 March 2012: 260-265.
Weiss, M., and C. Murray. "Assessment and management of attention-deficit hyperactivity disorder in adults." Canadian Medical Association Journal 168.6 Mar. 2003.
Wilens, T.E., S.V. Faraone, J. Biederman, and S. Gunawardene. "Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature." Pediatrics 111.1 Jan. 2003: 179-185.
Top Adult ADHD Related Articles
Adult ADHD SlideshowMost people don't associate adults with the term ADHD (attention deficit hyperactivity disorder) but it is a common disorder in adulthood. Learn about symptoms, tests, treatment and medications for ADHD.
ADHD in ChildrenAttention deficit hyperactivity disorder (ADHD) causes the following symptoms in children: excessive activity, problems concentrating, and difficulty controlling impulses. Stimulant medications are the most common medication used to treat ADHD.
Childhood ADHD QuizFind out causes, symptoms, and treatments for Attention Deficit Hyperactivity Disorder, a widespread behavioral condition commonly seen in children. Take the Childhood ADHD Quiz.
Adult ADHD QuizWhat are the symptoms of adult ADHD? Take this quiz to learn what it means for an adult to suffer from ADHD and what can be done about it.
Anxiety DisordersAnxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
Brain Foods SlideshowLearn how to increase concentration and boost memory. Brain foods such as fish (omega 3 fatty acids), berries, fruits, nuts, chocolate, vitamins and more can help.
BullyingBullying is repeated physical or verbal aggression that involves an imbalance of power. Types of bullying include physical, verbal, relational, reactive, and assaults on a person's property.
CT Scan (Computerized Tomography)A CT scan is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional and three-dimensional images of internal organs and structures of the body. A CT scan is a low-risk procedure. Contrast material may be injected into a vein or the spinal fluid to enhance the scan.
DepressionDepression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Drug Interactions: What Foods, Drugs, Herbs Affect Medications?What foods, drugs, and herbal supplements interact with your pharmaceuticals? Learn about grapefruit and other common drug interactions to medications like warfarin, tramadol, Zoloft, trazodone, gabapentin, melatonin, Xanax, Lexapro, lithium, Lisinopril, Mucinex, and more.
Electroencephalogram (EEG)An Electroencephalogram also called an EEG, is a test that can help diagnose epilepsy. The electrical signals of the brain are recorded during an EEG. This electrical activity is detected by electrodes or sensors, placed on the patient's scalp and transmitted to a polygraph that records the activity. Electrical signals produced by the brain neurons are picked up by the electrodes and transmitted to a polygraph, where they produce separate graphs on moving paper using an ink writing pen or on a computer screen.
MRI (Magnetic Resonance Imaging Scan)MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
Omega-3 Fatty AcidsWhat does research say are the best omega 3 supplements? What are the benefits of omega 3 fatty acids? Learn how Omega 3 rich foods like fish oil, salmon, walnuts, & more can boost brain power, save you from joint pain, ease depression and create a healthier you.
StressStress is a normal part of life, but chronic or severe stress can be harmful to your health. Learn what happens in your body when you are stressed and how you can manage your response.
What Are the Types of Cognitive Behavioral Therapy (CBT)?Cognitive behavioral therapy (CBT) is a form of psychotherapy. It helps people manage their emotional and behavioral problems by changing the way they perceive the world and react to it.
What Is the Best Treatment for ADHD in Adults?The best treatment of attention deficit hyperactivity disorder (ADHD) involves a combination of medication, education, skills training, and psychological counseling.