All rights reserved.
Mark Hutten, M.A.
Re: Adult ADHD

Can adults have ADHD?

Some kids with ADHD continue to have it as grown-ups. And many adults who have the disorder don't know it. They
may feel that it is impossible to get organized, stick to a job, or remember and keep appointments. Daily tasks such as
getting up in the morning, preparing to leave the house for work, arriving at work on time, and being productive on the
job can be especially challenging for grown-ups with ADHD.

These adults may have a history of failure at school, problems at work, or difficult or failed relationships. Many have
had multiple traffic accidents. Like teens, grown-ups with ADHD may seem restless and may try to do several things at
once, most of them unsuccessfully. They also tend to prefer "quick fixes," rather than taking the steps needed to
achieve greater rewards.
How is ADHD diagnosed in adults?  Like kids,
grown-ups who suspect they have ADHD should be
evaluated by a licensed mental health professional. But
the professional may need to consider a wider range of
symptoms when assessing adults for ADHD because
their symptoms tend to be more varied and possibly not
as clear cut as symptoms seen in kids.

To be diagnosed with the condition, an adult must have
ADHD symptoms that began in childhood and continued
throughout adulthood.15 Health professionals use
certain rating scales to determine if an adult meets the
diagnostic criteria for ADHD. The mental health
professional also will look at the person's history of
childhood behavior and school experiences, and will
interview spouses or partners, parents, close friends,
and other associates. The person will also undergo a
physical exam and various psychological tests.
For some grown-ups, a diagnosis of ADHD can bring a sense of relief. Adults who have had the disorder since
childhood, but who have not been diagnosed, may have developed negative feelings about themselves over the
years. Receiving a diagnosis allows them to understand the reasons for their problems, and treatment will allow them
to deal with their problems more effectively.

How is ADHD treated in adults?

Much like kids with the disorder, grown-ups with ADHD are treated with medication, psychotherapy, or a combination of
treatments.
Medications—

ADHD medications, including extended-release forms,
often are prescribed for adults with ADHD, but not all of
these medications are approved for adults.16 However,
those not approved for adults still may be prescribed by
a doctor on an "off-label" basis. Although not FDA-
approved specifically for the treatment of ADHD,
antidepressants are sometimes used to treat grown-ups
with ADHD. Older antidepressants, called tricyclics,
sometimes are used because they, like stimulants, affect
the brain chemicals norepinephrine and dopamine. A
newer antidepressant, venlafaxine (Effexor), also may
be prescribed for its effect on the brain chemical
norepinephrine. And in recent clinical trials, the
antidepressant bupropion (Wellbutrin), which affects the
brain chemical dopamine, showed benefits for grown-
ups with ADHD.17
Adult prescriptions for stimulants and other medications require special considerations. For example, adults often
require other medications for physical problems, such as diabetes or high blood pressure, or for anxiety and
depression. Some of these medications may interact badly with stimulants. An adult with ADHD should discuss
potential medication options with his or her doctor. These and other issues must be taken into account when a
medication is prescribed.

Education and Psychotherapy—

A professional counselor or therapist can help an adult with ADHD learn how to organize his or her life with tools such
as a large calendar or date book, lists, reminder notes, and by assigning a special place for keys, bills, and paperwork.
Large tasks can be broken down into more manageable, smaller steps so that completing each part of the task
provides a sense of accomplishment.

Psychotherapy, including cognitive behavioral therapy, also can help change one's poor self-image by examining the
experiences that produced it. The therapist encourages the adult with ADHD to adjust to the life changes that come
with treatment, such as thinking before acting, or resisting the urge to take unnecessary risks.