Childhood vs Adult

Children vs Adult ADHD

By Tammy Preston, MS

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.

Relationship Issues

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.

Sources

1. Centers for Disease Control and Prevention. “Attention-Deficit / Hyperactivity Disorder (ADHD)”
2. Am Fam Physician. 2000 Nov 1;62(9):2077-2086.
3. Medscape Education. “ADHD and Crime: Considering the Connections”
4. Ann. N Y Acad Sci. 2001 Jun; 931: 1-16.

Comments

  1. Vicky Cruz says:

    Check your grammar. Grammatical errors detract from this article.

  2. Kim Smith says:

    I think people make too much of a big deal about grammar usage. I think it only is a distraction for Vicky.

  3. I have ADHD, and have had it since I was a child. My problem with this article is that according to it; I am a sufferer. Indeed it is a condition I have, and it has given a certain aspect of difficulty in my life, but I am hardly a sufferer. It is terminology like that that perpetuates misunderstandings of mental conditions.

  4. Fair point Brad. I’ll change the wording.

  5. Yara Klein says:

    I need help. I took up Special Education as a second course and somehow has an understanding of such disability. I’m currently living with a bf whom I suspect to have an Adult ADHD. I can see symptoms like being disorganized, poor financial management, easily gets distracted, can’t stay in one job for more than 3 months etc. His mom and dad was separated when he was still in his mother’s womb. He grew up to be a problem child. Despite of all those, I can also see that he has a good heart. Now, I’m not gonna ask for opinions if I should keep the relationship or not but I want to know if there are chances for him to get treated even though he is already 29. Thanks

  6. I have been married for 17 yrs to a man with ADHD. Like you I can say he has a big heart but honestly the gap between our maturity levels has become impossible to ignore as we have aged. He was diagnosed when he was a child and was on Ritalin for a while. I urged him to get the diagnosis confirmed after we met (coincidently at age 29) which he did.
    He is currently on concerta which does not seem to be all that effective. He is on the brand version but he cannot handle any stress without becoming irritated or angry. Along with medication he really needs to do some CBT to gain greater insight into his automatic thoughts and subsequent emotions and behaviours. Even then I don’t know if it will help that much. Bottom line is I think anyone with ADHD as an adult needs to do more than take meds to manage their situation especially if they have any other issues such as depression or substance use. Try not to get into the role of the supportive, caring and understanding girl friend until he deals with his own issues. You will become resentful and disillusioned over time as your patience wears thin.

  7. I can’t do math unless the concepts are written in a step by step order. Stastics is a nightmare. I believe that i have been diagnosed with ADHD because of my largely because of my poor educational background. We moved seven times in five years. I made it to college, and had a 3.5 GPA, until I hit math and stat. I didn’t go back to college until late in life because of my fear of math. I am just sorry that I didn’t get tested when I was much younger. Now, I can get help through with my LD, and maybe I can graduate on the ten year plan.

  8. I am a 57 yr. old. female. I’m going again to my physc. and I just told him I might haveADHD. Put me on a new non
    addictive med. Does not work for me. I can’t focus or really concentrate. I see him tomorrow. Wish me luck lol.
    I’ve been married for 18 yrs. andleft the state of Fl. only going back to NJ. Only again back to Fl. I just can’t make up my mind on where to live. Left a relationship after 15 yrs. and I’m so confused. Has any one have this things. I have a bad driving record but, not loss of drivers license. Any clues do you thing I have adhd?

  9. I’m starting to believe that hyperactivity and impulsiveness is a natural trait for most children. Expecting a five year old to sit still and not figit or intturupt is like expecting my houseplant to do a dance out of the living room. Telling a child they are wrong for those behaviours and not reinforcing that is natural behaviour is indicative of an abusive adult. Now giving that child drugs, because they can’t sit still, (ie METHylphenate(Ritalin)), is down right criminal. Despicable.

  10. I think ADHD and its effects on adulthood are overrated. Address it as any other problem rather than label or stigmatise anybody with ADHD especially kids.
    Identify skills that are impaired. The book Smart but scattered is an excellent resource for identifying and addressing behavioral imbalance associated with ADHD. There are extremely effective if inculcated at a young age and these kids tend to internalise the skills into adulthood. I have tried a few especial ly organising on a 10 year old and it has been effectively practiced in less than a year.
    Change the environment. Usually environment plays a key role in emphasizing or reducing the problems related to ADHD.
    Never ever stigmatise or alienate an ADHD person as it tends to further weaken all the weak skills and causes more damage.

    Be mindful of some of these things and there won’t be any problems for adults or kids alike.

    On the positive side ADHDs have abundant energy, are child-like (not childish, there’s a difference! ) and always full of life.

    Look at the positive, eliminate and manage the weaknesses and the phrases will be organised, problem solver, focussed, time efficient etc etc

  11. can a adult with adhd revert back to childlike behavior. also very explosive behavior when he don’t get what he wants. is that natural in adults with adhd?

  12. one more thing can he have blackouts or forgets or cant remember what he has done?

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