Impact of ADHD on Adults

Many adults with ADHD are undiagnosed and have a limited awareness of how ADHD-related behaviors cause problems for themselves and others.

ADHD Makes You Feel Driven to Distraction

If your idea of someone who has attention deficit hyperactivity disorder (ADHD) is a school-age boy or girl who can't sit still in class, can't complete assignments, distracts other children, talks inappropriately, and has poor impulse control, then you're missing a big part of the ADHD picture.

"About 5% of school-age children have ADHD, but this is a chronic condition, it doesn't go away, and what we see is that as many as two-thirds of children with ADHD will become adults with ADHD," says Oscar Bukstein, MD, associate professor of psychiatry at the University of Pittsburgh Medical Center's Western Psychiatric Institute and Clinic.

For adults, untreated or undiagnosed ADHD is a particularly nasty condition. Children with behavioral problems may get poor marks and have difficulty fitting in with others. But many adults with ADHD have to deal with difficulty holding jobs, financial problems due to poor decision making, substance abuse, and troubled interpersonal relationships.

Trouble at Home and Work

"Most adults with ADHD are not hyperactive, but they may seem fidgety and verbally impulsive," says Bukstein. "Family troubles are common because these people may say stupid things and forget birthdays and anniversaries and have trouble at work. We often see ADHD combined with other problems, such as depression and learning disability."

This combination of disorders -- what doctors call comorbidity -- was highlighted in a recent report from the CDC.

According to the report, which used data collected in 1997-98, about one-half of the 1.6 million school-aged children diagnosed with ADHD have been identified with an accompanying learning disability. And this also appears to hold true of adults.

"This report reinforces what the leading scientific institutions have been telling us all along," says Clarke Ross, CEO of Children and Adults with Attention-Deficit/Hyperactivity Disorder, or CHADD, a nonprofit support group. "Nearly 70% of those with ADHD simultaneously cope with other conditions such as learning disabilities, mood disorders, anxiety, and more."

But these complex problems have nothing to do with a lack of intelligence or motivation.

"Many people with ADHD are labeled lazy, incompetent or stupid," says Bukstein. "But that's not the case. I've had very bright patients with ADHD. One computer programmer I treated had an IQ of 170, but outside of the tasks of computer programming he couldn't think his way out of a wet paper bag."

Treating ADHD in Adults

Despite increased awareness and identification of the disorder in adults, many adults remain unidentified and untreated, says Ross. Part of the problem is that while ADHD is well-documented in children, it's symptoms tend to be vague in adults. That's one reason, according to CHADD, that the disorder should only be diagnosed by an experienced and qualified medical professional.

"Many AD/HD patients initially seek help for other problems," says Bukstein, such as difficulty with relationships, organization, mood disorders, substance abuse, employment, or after the person's child has been diagnosed with it.

The good news about ADHD is that it is highly treatable. In children, stimulants like Ritalin and dexedrine are effective in up to 80% of cases, says Bukstein, and works for about 60% of adults.

"Talk therapy for ADHD adults can be useful," he says, adding that improving decision making, time management, and organization are often the goals of such therapy.

"Some studies have shown that buproprion (Wellbutrin) can work as well as stimulants in some people, and it has the advantage of being an antidepressant, so, obviously, that can work well for people who have depression along with ADHD," says Bukstein.

A non-stimulant drug, Strattera, has also proven helpful in the treatment of adult ADHD. "It's not looking as good as stimulants, but it seems like it is better than any of the other non-stimulant medications," says Bukstein.

But it's getting that diagnosis that is all-important.

"The tragedy here is that many people still don't know that this very treatable problem can affect adults," says Bukstein. "It's even worse than adults who have high blood pressure or diabetes without knowing it because these people live with the ongoing damage their whole lives."

SOURCES: Oscar Bukstein, MD, associate professor of psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic - Clarke Ross, CEO, Children and Adults with Attention-Deficit/Hyperactivity Disorder - CDC

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