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Attention Deficit Disorder (ADHD) in Adults

Summary: Attention Deficit Hyperactivity Disorder (ADHD) is a condition where individuals have troubles with inattention (unless in a sufficiently stimulating situation or environment) to the point that it can cause problems with school, work and relationships.

Classic strengths associated with ADHD include being high energy, spontaneous and creative. Unfortunately, individuals with undiagnosed ADHD can struggle in school, work or other environments that are not adapted to their unique needs.

The good news is that proper identification of ADHD can help with ensuring appropriate accommodations and modifications to help those with ADHD succeed more easily with school, work and relationships.
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Inattentive Ivan...

Ivan is a 40-year old adult who never liked school. He found it painfully boring to sit through classes, and never did his homework nor studied for tests. He managed to get by, and was so happy when he left high school...

 

He thought things would get easier once he got out of school, and in some ways they have. But as an adult, there are many other problems he has...

 

With work, he finds that he gets bored of his jobs quickly, and as a result, has had troubles keeping work... In addition, he forgets deadlines, and has trouble organizing himself to get work done...

 

In relationships, although things go well in the beginning of relationships when things are interesting and exciting, he gets bored quickly. As a result, he has been through numerous relationships....

 

At home, he finds that he is constantly losing important things that he needs, and his friends complain about how he is always late for things... As he gets older, and sees his friends around him succeed with work and personal life, he wonders if there might be something going on with him...

 

Ivan is smart and fun to be with, yet why haven't things fully worked out for him with work and personal life?

What is ADHD / ADD?

Attention Deficit Disorder (ADD) and Attention Deficit/Hyperactivity Disorder (ADHD) are brain conditions that make it hard to pay attention. Although everyone has trouble paying attention from time to time, in ADHD, it is so severe that it causes problems with school, work and relationships.

The main types of ADHD are:

  • ADHD, Combined Type, where individuals have troubles with
    • Inattention (so its hard to remember what people are talking about, or its hard to get tasks done), and
    • Hyperactivity (where a person tends to need to move or fidget a lot). Unlike children and youth, who can be so hyperactive that they can't even sit still in their seat, adults with ADHD can usually sit still, but they may still need to fidget with their hands, feet or mouth (i.e. need to chew things).
    • Impulsivity (where a person tends to act impulsively without first thinking through the consequences of their actions). 
  • ADHD, Primarily Inattentive Type (also commonly known as simply Attention Deficit Disorder or ADD), where a person has troubles with
    • Inattention, however is not particularly hyperactivity nor impulsive.
  • ADHD, Primarily Hyperactive-Impulsive Type, where a person has troubles with being
    • Hyperactive (i.e. needing to move constantly) or
    • Impulsive (i.e. acting on things without fully thinking through the consequences)

Other symptoms that may be seen in individuals with ADHD

  • Easily frustrated with mood swings: many individuals with ADHD report getting frustrated easily, and having strong emotions. Strong emotions can make someone passionate and fun to be with, but the unpleasant emotions can cause troubles with anger and frustration.
  • Easily bored: individuals with ADHD crave stimulation, which can be a problem when there isn't enough stimulation around, because many situations in life (like school work and chores) aren't that exciting. This contributes to other difficulties such as troubles finishing tasks or being organized, both of which aren't terribly exciting things to do...

Strengths of ADHD

It is important to note that although many of the symptoms of ADHD can cause problems in some situations, in other situations, many features of ADHD can be seen as strengths.Classic strengths of those with ADHD include:

  • Function well with excitement: People with ADHD do well in exciting, stimulating jobs, which tend to be jobs where you have to deal with people, as opposed to jobs where you are mainly dealing with paperwork. This includes the entertainment industry (like actors, comedians, performers such as dancers, musicians); hospitality industry (working in restaurants, hotels, tourism); or "911" professions, such as police, fire fighters, paramedics, or working in hospital emergency rooms (such as doctors or nurses)...
  • Great ability to move around: People with the hyperactive type of ADHD do well in jobs where they can move around. Examples include outdoor work, trades (such as carpentry, construction, etc..), certain medical fields (e.g. nursing, surgery, etc..) On the other hand, people with ADHD do not tend to do well in clerical jobs where they sit behind a desk all day... !
  • Creativity: People with ADHD tend to do well in jobs where they can be creative and use their imagination, as opposed to jobs where they are doing the same, boring tasks over and over again. This may explain why so many artists and performers report having ADHD...

If you suspect ADHD

If you believe that you, then start by seeing your family physician. Your doctor can help make sure that there aren't any medical problems (such as low iron or hormone imbalances) that might be contributing to your problems. The doctor might suggest more specialized mental health services or professionals such as a psychologist or psychiatrist.

 

If you are concerned that your loved one may have ADHD, then recommending that they seek help might be a sensitive topic. it is probably not best to start by telling them that you think that they have ADHD and that they should see their doctor. Start first by ensuring that you have a good relationship and connection built up with them. Spend 1:1 time with them. Ask general questions to see if they agree or not that they may have a problem, e.g. "I notice that its been hard for you to keep a stable job / relationship... I wonder if its because its really hard to focus on things? Do you think that you have problems focusing, when things aren't exciting enough?" If they agree, then offer to accompany them to their doctor's appointment. 

Medications

When strategies alone are not enough, then medications can be helpful.

 

In children and youth, studies show that the best treatment is usually a combination of medications plus coping/behavioral strategies. The MTA (Multimodal Treatment of ADHD Study by the NIMH in 1999 showed that medication treatment alone was more effective that non-medication strategies alone. Commonly used medications include, but are not limited to:

  • Stimulant medications (which stimulate the focus and impulse control centres of the brain) such as Methylphenidate (Ritalin ® regular, Ritalin SR ®, or Concerta ® and Dextroamphetamine (Dexedrine ® , or Adderall XR ®)
  • Non-stimulant medications such as Buproprion (Welbutrin SR ®) and Atomoxetine (Strattera ®)

Note that many adults with ADHD find caffeine (found in coffee, tea, cola and energy drinks) helpful. Indeed, adults having more then 2-4 cups of coffee a day may in fact be 'self-medicating' their ADHD...

What you can do about ADHD, i.e. how to cope with ADHD

Self-Regulation and ADHD

 

Remember the story of Goldilocks and the Three Bears? She tries the bear's porridge, and the porridge was either too hot, too cold, or "just right".

 

Our nervous systems are the same way - they can be "too hot" (overstimulated), "too cold" (understimulated), or "just right".

 

We are "too hot" when we are overstimulated. For example, after a loud, noisy day where you've been given too much work to do ...

 

We are "too cold" when we are understimulated. For example, having a very boring day or job where you had nothing to do, and where you just sat around all day doing nothing.

 

Neither too hot or too cold is good. People function best when they are "just right". There needs to be "just enough" stimulation - which includes sensory stimulation (such as movement, touch, sound, smell, visual) and emotional stimulation (such as getting along with others, doing interesting things in life), etc...

 

Self-regulation is about knowing what to do to make sure that you are getting "just enough" stimulation:

  • If you are "too cold" or underwhelmed:

    • Increase stimulation, or use soothing/calming stimulation. People with ADHD tend to need lots of physical stimulation, which is why they often do better if they have opportunities to move around, take frequent "body breaks", and have things to fidget with (e.g. stress balls to squeeze, or chewing gum to chew...)
       
  • If you are "too hot" or overstimulated:

    • Reduce the stimulation, or use soothing/calming stimulation. People with inattention can be easily overstimulated visually, which explains why they often do better if they clean up their work environments and reduce visual clutter. It also explains why people with ADHD shouldn't be doing important work sitting in front of a window, because its too easy to get distracted by stuff outside.
       
  • If you are "just right":

    • Keep doing what you are doing!

Organization

  • Learn how to organize in a way that works for you. People with ADHD often have trouble organizing, a fact that has been pointed out by others. But because they have ADHD, they may need different organization strategies compared to other non-ADHD people. Often times, visual strategies which involve writing things down on paper, or making diagrams or drawings are helpful. It might include things such as 1) writing a daily schedule, 2) writing a list of tasks to do, and crossing things off when they are done; 3) having Post-It notes to write down important things to do; 4) using personal data assistants (PDAs) such as a Blackberry or iPhone to organize things.

 

There are many other coping strategies for ADHD, and more information is available from the websites below...

Recommended websites

  • Centre for ADHD/ADD Advocacy, Canada (CADDAC)
    http://www.caddac.ca  
     
  • CHADD Canada (Children and Adults with AD/HD, Canada)
    http://www.chaddcanada.org
     
  • Learning Disabilities Association of Canada (LDAC). Although ADHD is not a "learning disability", because it affects learning, the LDAC does have excellent information on their website.
    http://www.ldac-taac.ca

About this Document

Written by the eMentalHealth Team and Partners.

Disclaimer

Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.

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Date Posted: Nov 16, 2009
Date of Last Revision: Oct 8, 2016

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