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In the 1970’s, experts began using the term
“Attention Deficit Disorder” to describe the condition.
While the condition is most often associated with children, there
has been a more recent understanding the Attention Deficit
Disorders (ADD, ADHD) continue into adulthood for many individuals.
Symptoms such as inattention, impulsivity and overactivity are now
known to continue into adulthood for a significant percentage of
children with ADD. Unfortunately, relatively few adults are
diagnosed or treated for ADD.
What Causes ADD?
The exact cause or causes of ADD are not conclusively known.
Scientific evidence suggests that in many cases the disorder is
genetically transmitted and is caused by an imbalance or deficiency
in certain chemicals that regulate the efficiency with which the
brain controls behavior. A 1990 study at the National Institute of
Mental Health correlated ADD with a series of metabolic
abnormalities in the brain, providing further evidence that ADD is
a neurobiological disorder.
While heredity is often indicated, problems in prenatal
development, birth complications, or later neurological damage can
contribute to ADD. There is little scientific evidence to suggest
that environmental factors, dietary factors such as food dyes or
sugar, inner-ear problems or “visual motor”
difficulties are the underlying cause of ADD.
The Prevalence Of ADD In Adults
The prevalence of ADD in adults is unknown; very few have been
studied. In the few treatment studies of adults, there does not
appear to be a significant sex difference. About two-thirds of the
children who are diagnosed in or before elementary school with ADD
continue to have behavioral symptoms in adolescence. During this
time period, associated behavioral, learning, and emotional
problems also manifest themselves. Approximately one-third to
one-half of these adolescents continue to have symptoms of ADD
during their adult years.
The Diagnosis Of ADD In Adults
A multifactored evaluation of an individual is important in the
diagnosis of ADD. Diagnostic assessment of adults should be made by
a clinician or a team of clinicians with expertise in the area of
attentional dysfunction and related conditions.
The assessment is designed to look for the presence of lifelong
patterns of behavior that indicate underlying attention and impulse
problems. An evaluation should make use of information from a
variety of sources. These may include:
- A thorough medical and family history.
- A physical examination.
- Interviews or rating scales completed by others who can comment
on the person’s behavior, such as a parent, friend or
spouse.
- Observation of the individual.
- Psychological tests which measure cognitive abilities, social
and emotional adjustment, as well as screen for learning
disabilities.
Various symptoms of ADD may reflect developmental differences in
some individuals while in others, they may indicate that other
conditions co-exist with ADD, including specific learning
disabilities, anxiety disorders, affective disorders,
Tourette’s syndrome, borderline personality disorders, and
obsessive compulsive disorder.
ADD With Hyperactivity
ADD with hyperactivity is characterized by symptoms of
inattention, impulsivity and hyperactivity which have an onset
before age seven, which persist for at least six months, and which
are not due primarily to other psychiatric disorders or
environmental circumstance, such as reaction to family
stresses.
ADD Without Hyperactivity
The primary characteristic of ADD without hyperactivity is
significant inattentiveness. Studies of children with this
diagnosis indicate that they show more signs of anxiety and
learning problems, and qualitatively different inattention.
Although there have been no adult follow-up studies, it is
projected that children who have ADD without hyperactivity may have
different outcomes than the hyperactive group, who show more
externalizing behavior problems associated with oppositional and
conduct disorders.
Characteristics Of Adults With
ADD
Adults who are living with the condition, and especially those
who are undiagnosed and untreated, may be experiencing a number of
problems, some of which stem directly from the disorder and others
that are the result of associated adjustment patterns.
Current symptoms of an adult
with ADD may include:
- Distractibility
- Disorganization
- Forgetfulness
- Procrastination
- Chronic lateness
- Chronic boredom
- Anxiety
- Depression
- Low self-esteem
- Mood swing
- Employment problems
- Restlessness
- Substance abuse or addictions
- Relationship problems
The symptoms of ADD can be variable and situational, or
constant. Some people with ADD can concentrate if they are
interested or excited, while others have difficulty concentrating
under any circumstances. Some avidly seek stimulation, while others
avoid it. Some become oppositional, ill-behaved and, later,
antisocial; others may become ardent people-pleasers. Some are
outgoing, and other, withdrawn.
Why Identify ADD In
Adults?
Identification of adults who have ADD and appropriate management
of their educational, personal, and social development improves
their chances for a successful outcome. Effective intervention can
improve self-esteem, work performance and skills, and educational
achievement.
A proper diagnosis of ADD can help an adult put his or her
difficulties into perspective. These individuals have often
developed low self-esteem and negative perceptions of themselves as
a result of cumulative academic, social, and vocational failures.
Many have been labeled as “having a bad attitude,”
“a slow learner,” “lacking motivation”,
“immature,” “lazy,” “spacey,”
or “self-centered.” Rather than viewing their
difficulties as the result of an inherited or acquired
neurobiological disorder, many have come to accept the
unsubstantiated belief that they themselves are to blame for their
problems.
After Diagnosis
The methods of treatment supported by professionals may include
a combination of education for the adult and his or her family and
close friends, educational/employment accommodations, medication,
and counseling. Appropriate treatment is determined according to
the severity of an individual’s disorder and the type and
number of associated problems.
Many people have benefited from a treatment plan that includes
medication. Used in conjunction with education and counseling, it
can provide a base from which adults can build new successes. The
purpose of medication is to help the adult to help him or herself.
It provides the biological support needed for self-control. As
such, the individual is not “controlled” by medication;
the efforts to succeed are his or her own.
Some tips that adults with ADD
have found useful include:
- Use internal structure. This include using datebooks, lists,
notes to oneself, colorcoding, routines, reminders and files.
- Choose “Good Addictions.” Select exercise or other
healthy, favorite activities for a regular structured
“blow-out” time.
- Set up a Rewarding Environment. Design projects, tasks, etc.,
to minimize or eliminate frustration. Break large tasks into
smaller ones; prioritize.
- Use Time-outs. Take time to calm down and regain perspective
when upset, overwhelmed or angry. Walk away from a situation if
needed.
- Use Humor. It’s useful if partners and colleagues are
constantly providing an aggressive push to help one stay on track
as long as it’s done with humor and sensitivity. Learn to
view symptoms of ADD with humor and to joke with close friends and
relatives about symptoms such as getting lost, forgetfulness,
etc.
- Become Educated and an Educator. Read books. Talk to
professionals. Talk to other adults who have ADD. Let people who
matter know about personal strengths and weaknesses related to ADD.
Be an advocate.
FOR MORE INFORMATION:
Contact your local Mental Health Association, community mental
health center,
or for additional resources, please call 1-800-969-NMHA.
National Mental
Health Association
2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311
Phone 703/684-7722
Fax 703/684-5968
Mental Health Resource
Center 800/969-NMHA
TTY Line 800/433-5959
Children and Adults with Attention Deficit Disorders (CHADD)
8181 Professional Place
Suite 201
Landover, MD 20785
Phone 301-306-7070
www.chadd.org
Information Obtained From The C.H.A.D.D Fact Sheet: Attention
Deficit Disorders Not Just For Children
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