Adult attention-deficit disorder (Adult ADD, Adult ADHD, or AADD) is informal terminology commonly used to describe the neurological condition "attention-deficit hyperactivity disorder" (ADHD) when it occurs in adults. Prior to 1987, ADHD (with or without a hyperactivity component) was formally known as ADD under the DSM-III issued in 1980. It has been estimated that about eight million adults have ADHD in the United States.
Although the exact prevalence of ADHD is unknown, studies thus far reveal that the condition, marked by inattentiveness, difficulty getting work done, procrastination, and/or organization problems, according to epidemiological data, involves approximately 3% to 5% of the U.S. population. It usually persists throughout a person's lifetime; approximately one-half to two-thirds of children with ADHD will continue to have significant problems with ADHD symptoms and behaviors as adults, which impacts their lives on the job, within the family, and in social relationships.
Untreated adults with ADHD often have chaotic life-styles, may appear to be disorganized, and may rely on non-prescribed drugs and alcohol to get by. They often have such associated psychiatric comorbidities as depression, anxiety, bipolar disorder, substance abuse, or a learning disability. In 2004, noted researchers estimated the yearly income loss for adults with ADHD in the United States as $77 billion. This may be partially because it is also estimated that only 15% of adults in the U.S. with ADHD are aware that they have the disorder, although many adults struggle with it.
A diagnosis of ADHD may offer an adult insight into their behaviors and allow the patient to become more aware and seek help with coping and treatment strategies. Studies show that adult ADHD is treated successfully with a combination of medication and behavior therapy. Some clinical professionals believe Adult ADHD should be categorized as a separate condition, even though it may have arisen from a childhood ADHD diagnosis. However, under the DSM-IV, the diagnostic criteria for ADHD in adults follow the same as in children. Although the disorder may not have been diagnosed in an individual during childhood, for adults to be diagnosed, the criteria require that they must have had symptoms in childhood. The neurological basis of ADHD is a lifelong condition. Some adults prefer to designate the condition as ADD or AADD (as opposed to the ADHD) because often the symptoms associated with a hyperactivity component, when present at all, are generally less pronounced. In fact, the prevalence of ADHD in adults as a clinical disorder is difficult to determine because individuals differ in their level of affliction. Those who seek treatment as children, and others, over time, may develop coping skills which make the disorder less noticeable; indeed, if the underlying conditions do not cause functional problems in their lives, they may no longer meet the diagnostic criteria at all. However, those whose symptoms continue to significantly negatively affect their functioning in adulthood in multiple settings (i.e., academic, relationship, and occupational) can be labeled as having the adult version of ADHD.
ADHD in adults (as with children) is recognized as a disability under U.S. federal legislation including the Rehabilitation Act of 1973 and the Americans With Disabilities Act (ADA). Appropriate and reasonable accommodations are sometimes made in the workplace for adults with ADHD, which help the individual to work more efficiently and productively.
In the book Driven To Distraction, Edward M. Hallowell described an experience of the "hyperactive" aspect of the ADHD disorder from a patient's perspective:
...It's like being super-charged all the time. You get one idea and you have to act on it, and then, what do you know, but you've got another idea before you've finished up with the first one, and so you go for that one, but of course a third idea intercepts the second, and you just have to follow that one, and pretty soon people are calling you disorganized and impulsive and all sorts of impolite words that miss the point completely. Because you're trying really hard. It's just that you have all these invisible vectors pulling you this way and that, which makes it really hard to stay on task. Brain feels "cluttered", or sometimes light in weight (slightly light-headed). Sometimes difficult to sleep.
Many people express that they feel this way in their lives, but that does not necessarily mean that the person has ADHD. It is important to be tested if you choose to seek treatment.
Attention-Deficit/Hyperactivity Disorder, combined type (ADHD-C) is characterized by symptoms of inattention, impulsivity, and hyperactivity with childhood onset, although the condition may not have been diagnosed in childhood. Hyperactivity symptoms tend to be less noticeable in adults than in children. Some adults with ADHD are predominantly inattentive (ADHD-I) and, rarely, some are predominantly hyperactive/impulsive (ADHD-HI).
ADHD in adults can cause moderate to extreme difficulties in functioning at work, home, or school. In adults the problem can manifest as an inability to structure their lives and plan simple daily tasks. ADHD can also lead to loss of relationships, job hopping, or difficulty with people or work. The difficulty is not due to the ADHD person's direct behaviour, but usually more due to the simple things that the ADHD person will miss, especially when an adult of their age or experience should catch onto or know.
Generally, symptoms may manifest themselves differently in adults than in children. Adults with hyperactive-impulsive symptoms feel extremely driven, sometimes restless. To calm themselves down, they tend to stay constantly on the go and attempt to do but usually fail to complete multiple tasks at once. They are often perceived as not thinking before they act or speak. Generally, the biggest problem is developing self-regulation. The mechanism for self-regulation is delayed or deficient in people with ADHD. This is what is treated medically in the ADHD person. This lack of self-understanding and what looks like a lack of control affects an adult's ability not just to do tasks, but to determine when and how they need to be done, as well as how other people perceive them.
Symptoms of ADHD can vary widely between individuals and throughout the lifetime of an individual. The most prominent characteristic in ADHD often is difficulty with the brain activity known as executive functioning, which oversees the ability to monitor a person's own behaviour by planning and organizing. Other symptoms include inattention, impulsivity, and restlessness as well as frequently accompanying behavioral problems and learning disabilities. Growing up with all these deficits often leads to emotional problems.
The Hallowell Center identifies the following indicators to consider when ADHD is suspected and recommends that individuals with at least twelve of the following behaviours since childhood—provided these symptoms are not associated with any other medical or psychiatric conditions—consider professional diagnosis:
The diagnostic criteria for ADHD in adults are identical to those for children. It is important to note that adult diagnosis requires establishing whether the symptoms were also present in childhood, even if not previously recognized. Diagnosis must also exclude other medical or psychiatric causes of symptoms. The diagnostic criteria require multiple symptoms observed in multiple settings (school, home, work, etc.) within the preceding 6 months.
Assessment of adult patients seeking a possible diagnosis can be better than in children due to the adult's greater ability to provide their own history, input, and insight. However, it has bene noted that many individuals, particularly those with high intelligence, develop coping strategies that mask ADHD impairments.
Generally, medical and mental health professionals follow the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association. Periodic updates to the DSM incorporate changes in knowledge and treatments. Under the DSM-IV (published in 1994, with corrections and minor changes in 2000), the diagnostic criteria for ADHD in adults follow the same as in children. Many professionals have speculated that in the next DSM (tentatively DSM-V), ADHD in adults may be differentiated from the syndrome as it occurs children. Only recognized as occuring in adults in 1977, it is currently not addressed separately. Obstacles that clinicians face when assessing adults who may have ADHD include developmentally inappropriate diagnostic criteria, age-related changes, comorbidities, and the possibility that high intelligence or situational factors can mask ADHD symptoms.
Generally, treatments that have proved effective for children have been observed to work equally well or better in adults with a similar diagnosis. Studies show that adult ADHD is treated successfully with a combination of medication and behavior therapy.
The therapeutic process may also see more benefit in behavioral solutions with adults because these can be designed more collaboratively with mature individuals.
From the "Born to Explore" website, examples of studies that show the link between nutrition and ADD:
A 1994 study at Purdue University found that boys diagnosed with ADHD had lower levels of the omega-3 essential fatty acid DHA (American Journal of Clinical Nutrition) 1997 study found that 95% of ADHD children tested were deficient in magnesium (Magnesium Research, 1997,10) A 1996 study found that ADHD children had zinc levels that were only 2/3 the level of those without ADHD (Biological Psychiatry 40, 1996)
Clinical Trials Update: Jan. 18, 2010; Adult Attention-Deficit Disorder (ADD) Osteoarthritis of the Knee or Hip Flu Symptoms.(brief)(Brief article)
Jan 18, 2010; (HealthDay News) -- Here are the latest clinical trials, courtesy of ClinicalConnection.com: Adult Attention-Deficit Disorder...
Clinical Trials Update: Feb. 22, 2010; Adult Attention-Deficit Disorder (ADD) with Nicotine Use Flu Overactive Bladder.(brief)(Brief article)
Feb 22, 2010; (HealthDay News) -- Here are the latest clinical trials, courtesy of ClinicalConnection.com: Adult Attention-Deficit Disorder...