ADHD in Adulthood
Adult ADHD is poorly misunderstood. In order to be diagnosed in adulthood attention issues have to have been present before the age of 12 years. Adult ADHD does not involve a sudden onset of inattention or hyperactivity and it is essential that if these symptoms present suddenly you immediately see your GP (or even go to your local emergency room if very severe). Attention issues are very common to many illnesses. Even the basis flu can make us feel sluggish and inattentive. Any neurological insult is likely to cause some level of attention weaknesses, for example, attention weaknesses are common after a concussion or head injury.
One of the most common misdiagnoses we see in our clinics is that of sleep apnoea. Sleep-based issues have been shown to have very detrimental impacts upon attention skills, and the longer the sleep issues present for, the worse the attention issues. If you snore and you find your attention skills are becoming worse as you age, particularly as you gain weight, you should speak with your GP about testing for sleep apnoea. Sleep-based attention disorders should not be treated with the classic stimulant medication, even though they are likely to boost attention skills in the short-term. Proper treatment of the cause of the inattention is necessary as otherwise the brain will continue to get worse and worse if the sleep issue is not treated.
One of the most common issues that impair adults with ADHD is actually the executive issues that are often present. Adults with ADHD often have issues with planning and organisation. They can often run late to appointments and miss deadlines. This creates issues both in the workplace as well as socially. Adults with ADHD tend to change jobs more quickly than others, sometimes out of boredom, sometimes because they struggle to keep a job and can get fired for being disorganised at work and not completing work in a timely fashion.
Many adults with ADHD seek out medication, however for adults this can actually have some disadvantages, particularly on the social level. We have seen many adults with ADHD do well during work hours when the medication is still working, but as it often wears off in 8-10 hours, it is often out of the system by around 5pm when the person goes home. Some people rebound off medication and get irritable, taking out this irritability on family members. Once the medication is out of their system, all the ADHD symptoms return and again the person is inattentive when listening to family and partners, frustrating those around them. For these reasons, we suggest that adults with ADHD consider more long-term techniques such as neurofeedback, cognitive skill training, and psychological therapy. The goal would be to make home life as smooth as possible and minimise the effects of adult ADHD.