That cranky neighbor on your block or irritable colleague at work might not be to blame for their temperament. They might be one of the 8 million-plus adults in the United States suffering from adult attention-deficit/hyperactivity disorder – ADHD – more than 80 percent of whom are undiagnosed.
Dr. Theresa (Terri) Prescott, a psychiatrist who practices in Vero Beach, believes most of those with the condition could have been helped earlier if their problem had been diagnosed and treated. “The adults I see who have ADHD say that as kids they had poor self-esteem and didn’t do well in school. But many of them were not hyperactive and passed their classes so they were not picked up as children with behavioral problems,” she says.
Though it can seem a bit nebulous, “adult ADHD is a very real mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity and impulsive behavior,” according to Mayo Clinic. “Adult ADHD can lead to unstable relationships, poor work or school performance, low self-esteem … struggles with impulsiveness, restlessness and difficulty paying attention.”
No two people suffering from ADHD are exactly alike. One may be able to concentrate if they’re interested in or excited about what they’re doing, but others have trouble focusing under any circumstances.
Some of those afflicted may look for stimulation, while others avoid it. Some people with ADHD can be withdrawn and antisocial. Others can be very social and go from one relationship to the next.
“ADHD tends to run in families and, in most cases, it’s thought the genes you inherit from your parents are a significant factor in developing the condition. Research has identified a number of possible differences in the brains of people with ADHD from those without the condition, although the exact significance of these is not clear,” according to NHS, the United Kingdom’s national health service. “For example, studies involving brain scans have suggested that certain areas of the brain may be smaller in people with ADHD, whereas other areas may be larger.”
Even though the condition is not clearly understood, effective treatments are available, according to Harvard Medical School. Mainstays of treatment for adult ADHD are medications, psychotherapy and various forms of coaching and coping techniques.
Dr. Prescott uses both cognitive behavioral therapy and emotional therapy in her practice.
“I’m a big-picture person,” she says. “I believe that both ‘nature and nurture’ are important in dealing with adult ADHD.”
Cognitive behavioral therapy (CBT) is a form of psychotherapy that helps people change negative thought patterns into positive, healthier ways of thinking. The idea is that if you change the way you think about a situation, your feelings and behaviors can change, too. For example, CBT may help change “all or nothing” thinking, which many people with ADHD succumb to, thinking that their accomplishments must be either perfect or a failure.
Emotional or behavioral therapy can be effective in helping adults with ADHD learn how to deal with frequent emotional ups and downs.
Medical News Today lists three additional types of therapy that can be helpful:
- Mindfulness, which encourages awareness and calmness through various techniques such as breathing exercises.
- Family therapy, which can involve family members or partners engaging in therapy to learn how to handle the behaviors of people with ADHD.
- Group therapy, which typically involves multiple people receiving psychotherapy together, sharing difficulties and successes.
Dr. Prescott believes that ADHD can’t be prevented because the brains of people who have it are hard-wired differently.
The Attention Deficit Disorder Association agrees, stating: “An ADHD brain isn’t wired the same way as a non-ADHD one. Science suggests that specific differences in the brain’s structure, function, and chemistry may be a cause of ADHD.”
Symptoms of adult ADHD are varied and can include problems with:
• Concentration
• Following directions
• Remembering information
• Organizing tasks
• Procrastination
• Boredom
• Anxiety
• Depression
• Controlling anger
• Impulsiveness
• Low self-esteem
• Mood swings
• Relationship problems
• Substance abuse or addiction
• Motivation
• Restlessness
• Talking too much
Dr. Prescott says there are three main types of adult ADHD:
Inattentive ADHD. With this type, your symptoms are mostly about being distracted and having trouble paying attention. You might be disorganized, often lose things or have trouble following instructions.
Hyperactive/impulsive ADHD. If you have this type, most symptoms center on acting impulsively or being overactive. You might feel restless, have a hard time sitting still, or talk a lot. You also may interrupt people or have a hard time waiting your turn.
Combined ADHD. This is the most common type of ADHD. If you have it, you have some symptoms of both other types.
Getting an accurate diagnosis isn’t easy. There isn’t one specific thing that can tell you that you have ADHD. Instead, your doctor will make a diagnosis based on information from numerous sources.
Diagnosis of ADHD in adults can also be difficult because certain symptoms are similar to those that are caused by other conditions, such as anxiety or mood disorders. And many adults with ADHD also have at least one other mental health condition, such as depression or anxiety.
For the best outcome, make an appointment with a healthcare professional who has experience and training in helping people older than 17 with ADHD. This could be a psychiatrist, neurologist, clinical psychologist or clinical social worker.
Ask your primary care doctor for information or a referral to one of these specialists. You can also search for a specialist in your health insurance plan’s online directory. A local support group for adults with ADHD may be able to recommend a doctor near you.
Before or during your appointment, you may take psychological tests, like completing a checklist of symptoms or a behavior rating scale. You may also get tested to check for a learning disability or other problems that might be mistaken for ADHD or that people can have at the same time as ADHD, such as depression or anxiety.
Your history of medical issues and a physical exam can help your doctor rule out a condition like a thyroid problem or seizure disorder that could mimic the effects of ADHD.
Your doctor will ask you questions about the symptoms you’ve noticed at school or work, your use of drugs and alcohol, your driving record, and your relationships with family and friends. Adults need to meet a lower threshold of symptoms than kids – five out of nine over the past six months – for a diagnosis.
“One size does not fit all as far as treatment is concerned,” Dr. Prescott says. “If one thing doesn’t work, try something else. Don’t be married to the idea that one thing is going to do it.”
Dr. Theresa (Terri) Prescott graduated from Rowan University School of Osteopathic Medicine. She trained in General Psychiatry at Albert Einstein Medical Center and completed a Child & Adolescent Psychiatry Fellowship at Children’s Hospital of Philadelphia. Dr. Prescott is board-certified in General Psychiatry and Child & Adolescent Psychiatry and is a Fellow of the American Psychiatric Association. Her practice, Progressive Mind Center PLLC, is located at 333 17th St., Suite Q, Vero Beach, and she is accepting new patients: 772-213-8881.
