Lazy, forgetful, impulsive, restless, irresponsible – these are just some of the phrases that adults suffering from ADHD have been called. ADHD was once believed to be a childhood disorder that kids outgrew before entering adulthood. Now it’s clear that the symptoms of ADHD often follow children into adulthood where they can cause a number of relationship and social problems and make it challenging to advance in the job world or hold down a career. Signs of symptoms of ADHD in adults may be more subtle in adults than in children and often manifest in different ways. How do the signs of ADHD differ in adults?
How Adult ADHD Differs from Childhood ADHD
When most people think of ADHD, they think of a high-strung child who’s hyperactive, impulsive at home and can’t focus at school. Many ADHD children DO have these characteristics. In fact the DSM-IV criteria doctors use to diagnose ADHD in children states that a child must manifest at least six symptoms of hyperactivity or impulsivity or six or more symptoms of inattention to be diagnosed with ADHD. Hyperactive and impulsive kids may fidget, talk excessively, have difficulty sitting still, interrupt others and have difficulty waiting their turn. Inattentiveness may manifest as problems with organization and completing tasks, problems remembering things, being easily distracted, not completing tasks and making careless mistakes on homework.
Adults with ADHD still have the same underlying problems with attention and impulsiveness as children with ADHD but they often manifest differently. Signs of ADHD like fidgeting, hyperactivity, excessive talking and interrupting and intruding on others are usually more obvious in ADHD kids because they have fewer social constraints limiting their behavior. Adults with ADHD are likely to show more restraint due to their higher level of maturity and social conditioning, but the inner restlessness remains and may be re-channeled into activities like thrill-seeking behavior, alcohol, drug abuse, reckless driving, incursions with the law, overspending and other socially unacceptable behaviors.
Some adults with ADHD have more subtle signs and symptoms. Instead of actively channeling their inner restlessness into high-risk behaviors, they’re easily distracted, have difficulty organizing and completing tasks, can’t make decisions, are forgetful, and lack the focus to follow through on tasks. These signs don’t draw as much attention as a restless, high-strung child with ADHD who’s always on the move and visibly acts the part of an ADHD child.
Adults are also more likely to “internalize” their inner restlessness rather than act it out as children do. This may manifest as mood swings, difficulty getting along with others, problems holding down a job, substance abuse problems and a pattern of being irresponsible and making poor decisions. These behaviors may be incorrectly attributed to personality problems, anxiety or depression rather than ADHD, which explains why adults frequently go undiagnosed.
One area where adult ADHD can take its toll is at home. Some adults with this disorder learn to compensate at work to protect their livelihood or have a staff that makes up for their lack of organization – but take their frustrations home to their family. Not surprisingly, the divorce rate is twice as high in marriages where one partner has ADHD. When the healthy spouse has to take on extra responsibilities due to the ADHD spouse’s inability to focus or take responsibility, it can lead to relationship problems that threaten a marriage. A spouse with ADHD may seem more like a child than a marriage partner when they can’t maintain focus long enough to complete tasks or share responsibilities at home.
From a social standpoint, adult ADHD signs are often more subtle than those of a child. Many adults have learned to suppress and redirect some of the hyperactivity and impulsivity they had as a child to maintain social appropriateness. This is especially true of women. Unfortunately, some redirect it into unhealthy activities like smoking, drinking, recreational drug use or unlawful activities. Adults with ADHD are more likely to be arrested and serve jail time than normal adults. In fact, one study showed that one out of four prison inmates has ADHD.
Adult ADHD is More of a Diagnostic Challenge
Adult ADHD starts out as childhood ADHD. In fact, evidence of ADHD symptoms during childhood is one of the criteria doctors use to diagnose adult ADHD. That’s not always an easy task since not all kids with ADHD were formally diagnosed with the disorder when they were young. In adults without a childhood ADHD diagnosis, doctors look for a long history of problems with attention and self-control. Since an adult ADHD sufferer may not always have insight into their actions, it may be necessary to interview other family members or look back at the adult’s past by reviewing report cards etc.
Having a family member with ADHD also makes the diagnosis more likely since there’s a genetic component to ADHD. In addition, other medical conditions and psychological problems have to be ruled out. Problems like an overactive thyroid, the effects of certain medications and illegal drugs, anxiety, depression, bipolar disorder, nutritional deficiencies and other health issues can cause problems with inattentiveness, hyperactivity or impulsivity. Not surprisingly, some adult ADHD sufferers go through life without a diagnosis.
The Bottom Line?
Adult ADHD is an extension of childhood ADHD but the symptoms in adults may manifest differently and are often more subtle. Still, ADHD can significantly disrupt an adult’s life making it difficult to have a relationship, build a career, set goals or even manage their day-to-day life. Some adults are able to compensate enough to lead a relatively normal life without treatment but many lead lives of quiet desperation unable to channel their energy into meaningful goals and activities. That’s why it’s important to know the signs and symptoms and realize that up to half of all kids who have ADHD will have it as an adult. It isn’t something kids necessarily outgrow. There’s a 50% chance the symptoms will persist even after they cross over the threshold into adulthood.
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