Why is it important to diagnose and treat ADHD in adulthood?

Diagnosis and treatment of ADHD in adulthood is important because many adults have lived with feelings of failure, anxiety, poor self-esteem, depression and other negative emotions for years, never understanding that there is a reason for the challenges they have faced.  For those adults who have always felt “off” or like they just didn’t fit in easily with others, discovering that they have ADHD can be life changing,  Imagine the relief that comes with knowing that there is a reason for all of the lost keys, missed meetings – and opportunities, emotional outbursts and failures at work, relationships and/or finances.  I should know since I experienced that ah-ha moment for myself as an adult!

infographic diagnose adhd adults

Once you KNOW you can seek answers, treatment and solutions.  Even if you have managed to be relatively successful and don’t feel the need to seek further treatment just knowing can make a positive difference.  I did not seek treatment immediately after my diagnosis at the age of 41. I was a busy single parent, raising two sons and successfully navigating my career.  I’d not only survived but thrived up until that point. But then came the fluctuating hormones of menopause and a new demanding job that required more paper pushing than interactions with people.  It was such a relief to realize right away that I could seek multiple treatment paths to help me get through this rough patch. Knowing there was a reason I was having such difficulty made all the difference.  So whether you’ve been successful all your life, or have struggled because of undiagnosed ADHD, just KNOWING can open up new possibilities and provide new paths to self-acceptance and inner peace. 

Download Printable article
Infographic as Image or PDF


About the Author

Evelyn Polk Green

Evelyn Polk Green, MSEd, is a past president of both ADDA, the Attention Deficit Disorder Association, and CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder). Evelyn is an adult with ADHD and the mother of two adult sons who also have ADHD. She has been active in ADHD and mental health advocacy for more than 25 years.

What does a comprehensive treatment plan for children with ADHD look like/include?

After diagnosis by a specialist, a comprehensive treatment plan should include a full explanation of the condition and the available treatments in understandable terms, together with an assessment of any other problems for learning and behavioural and emotional life that are associated with or complicate the ADHD. 

Infographic comprehensive treatement children ADHD

Interventions to be considered should include medication and/ or evidence-based psychological treatment such as cognitive-behavioural therapy; how to access them if recommended; potential benefits and harms; advice on education, exercise, and diet. There should be alternative plans if any one intervention is declined. There should be information on local and national support groups and voluntary organizations and on the right to a second opinion. 


Download Printable article
Infographic as Image or PDF


About the Author

Dr. Eric Taylor

Eric Taylor is Emeritus Professor of Child and Adolescent Psychiatry at King’s College London and the Maudsley Hospital. He retired after a lifetime of ADHD research, clinical practice and leading the department at the Institute of Psychiatry for over 15 years.

What does a comprehensive treatment plan for adults with ADHD look like/include?

ADHD is a neurological condition that makes it harder for some people to stay focused, manage time, and get things done. This can affect how they interact with others and how they feel about themselves. Therefore, a comprehensive treatment program begins with effective medication to help the person with ADHD better manage the demands of life at work/school and home. Extended release stimulants are very effective and safe. It is also really important that the adult with ADHD (and also their romantic partner) educate themselves about ADHD, to better understand why they have had the struggles that they do and also to learn new strategies to get organized, prioritize tasks, pay attention, and manage time. These ADHD-friendly strategies tend to work better than the general good advice that they have been given all their lives.

infographic Treatment Plan for adults with ADHD

ADHD is not caused by psychological problems or bad parenting, and talking to a therapist won’t change the brain wiring that causes ADHD. But living with the additional struggles that come with ADHD, especially if it wasn’t diagnosed until adulthood, can affect how someone sees themselves, interacts with others, and handles the demands in their life. This is why it can be helpful to work with a therapist or coach who can help you understand your past struggles in a different way and help you manage your life better today. Therapy can also be helpful in addressing the anxiety, depression, substance abuse, and relationship problems that untreated ADHD can cause. Managing ADHD takes effort, but a comprehensive treatment program can reduce many of the symptoms and make your life much happier.

Download Printable article
Infographic as Image or PDF


About the Author

Ari Tuckman

Ari Tuckman, PsyD, CST is a psychologist, author, and international speaker specializing in ADHD, particularly how it impacts relationships.

Further Reading

Safren SA. Cognitive-behavioral approaches to ADHD treatment in adulthood. The Journal of Clinical Psychiatry. 2006 ;67 Suppl 8:46-50.(https://europepmc.org/article/med/16961430)

Wilens, T, et al. ADHD Treatment With Once-Daily OROS Methylphenidate: Interim 12-Month Results From a Long-Term Open-Label Study. Journal of the American Academy of Child & Adolescent Psychiatry. Volume 42, Issue 4, April 2003, Pages 424-433 )

Weiss, M., Murray, C., Wasdell, M. et al. A randomized controlled trial of CBT therapy for adults with ADHD with and without medication. BMC Psychiatry 12, 30 (2012). https://doi.org/10.1186/1471-244X-12-30

https://link.springer.com/article/10.1186/1471-244X-12-30

What are the advantages and disadvantages of taking ADHD medication?

The medications used to treat ADHD have many advantages. By reducing symptoms of hyperactivity, impulsivity and inattention, they help patients with ADHD to do better at school and work. They also improve interactions with family members and friends. Treatment with ADHD improves motor vehicle driving skills and decreases accidents of all kinds. From large medical registry studies of stimulant medications, we know that consistent medication use reduces delinquency, substance abuse, criminality and suicidality. 

infographic Advantages and disadvantages of ADHD medication

There are two types of disadvantages of the mediations used to treat ADHD. The first type of problem is that these medications can cause unwanted side effects such as insomnia, appetite loss or nausea. But for most patients, these side effects can be controlled by reducing the dose or changing medications. 

The second type of problem applies to the stimulant medications, which are addictive substances. Although taking stimulant medications as prescribed will not lead to addiction, they can be misused in a way that leads to addiction. They can also be diverted to others for either substance abuse or performance enhancement. This is especially problematic for immediate release stimulants.

Download Printable article
Infographic as Image or PDF


About the Author

Stephen Faraone, PhD,

Professor. Faraone is Distinguished Professor and Vice Chair for Research in the Department of Psychiatry at SUNY Upstate Medical University. He is also Senior Scientific Advisor to the Research Program Pediatric Psychopharmacology at the Massachusetts General Hospital.  Prof. Faraone studies the nature and causes of mental disorders in childhood and has ongoing research in psychiatric genetics, psychopharmacology, with a current focus on machine learning approaches to these areas. An author on over 1000 journal articles, editorials, chapters and books, in 2005, the Institute for Scientific Information determined him to be the second highest cited author in the area of Attention Deficit Hyperactivity Disorder and the fourth most highly cited researcher in psychiatry for the preceding decade.  From 2014 to 2019 he has been listed as a highly cited researcher by Thomson Reuters/Clarivate Analytics.  In 2019, his citation metrics placed him in the top 0.01% of scientists across all fields .  His lifetime H-Index as of March 2020 was 208. Prof. Faraone is Editor for the journal Neuropsychiatric Genetics.  He heads the educational website www.adhdinadults.com. He is President of the World Federation for ADHD and a Board member for the American Professional Society of ADHD and Related Disorders. In 2002, Professor Faraone was inducted into the CHADD Hall of Fame in recognition of outstanding achievement in medicine and education research on attention disorders.  In 2010 he received the Chancellor’s Award for Excellence in Scholarship and Creative Activities from the State University of New York.  In 2018 he received the Lifetime Achievement Award from the International Society of Psychiatric Genetics and in 2019 he received the Paul Hoch Award from the American Psychopathological Association.


References

  • Cortese, S., N. Adamo, C. Del Giovane, C. Mohr-Jensen, A. J. Hayes, S. Carucci, L. Z. Atkinson, L. Tessari, T. Banaschewski, D. Coghill, C. Hollis, E. Simonoff, A. Zuddas, C. Barbui, M. Purgato, H. C. Steinhausen, F. Shokraneh, J. Xia and A. Cipriani (2018). “Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis.” Lancet Psychiatry 5(9): 727-738.
  • Faraone, S. V., P. Asherson, T. Banaschewski, J. Biederman, J. K. Buitelaar, J. A. Ramos-Quiroga, L. A. Rohde, E. J. Sonuga-Barke, R. Tannock and B. Franke (2015). “Attention-deficit/hyperactivity disorder.” Nat Rev Dis Primers 1: 15020.
  • Chang, Z., L. Ghirardi, P. D. Quinn, P. Asherson, B. M. D’Onofrio and H. Larsson (2019). “Risks and Benefits of Attention-Deficit/Hyperactivity Disorder Medication on Behavioral and Neuropsychiatric Outcomes: A Qualitative Review of Pharmacoepidemiology Studies Using Linked Prescription Databases.” Biol Psychiatry.

What are some ways to reduce stress with ADHD?

Infographic What are sme ways to reduce stress with ADHD

Having ADHD often means living with an increased stress or processing stress in unique ways.  The ADHD symptoms, such as trouble focusing, disorganization, forgetfulness, impulsive actions and other executive function problems, can get in the way of effective problem-solving, managing emotions, or feeling in control of one’s life.  The difficulties can set up a stage for feeling overwhelmed or discouraged. Research shows high rates of family or marital conflict and stress, academic or job underachievement, financial difficulties and increased burden of other mental and physical disorders in ADHD (1). Overall, ADHD is a risk factor for chronic stress, and chronic stress often makes having ADHD more challenging. 

Strategies to manage stress

If you have ADHD and are feeling a great deal of stress because of it, there are ways to manage it. 

Medication can minimize core ADHD symptoms of inattention or restlessness, and ADHD-focused psychotherapy or coaching can help identify and tackle your main triggers for stress.  If you are feeling unfocused, overwhelmed and getting in your own way, starting or optimizing these ADHD treatments can help you feel more in control of your day and relieve a great deal of stress.  At the same time, it is important to have a healthy lifestyle and learn some strategies for stress resilience. 

If your daily routine is irregular or not so healthy, the stress can be addressed by setting up a work and break schedule, having adequate sleep, and exercising.  Eating a Mediterranean style diet rich in fruits, vegetables and healthy protein and fats may also help offset ADHD symptoms and support overall mental health (2, 3). 

Exposure to nature or green spaces has also been found helpful with ADHD symptoms (4) and is known to support stress coping.  Lifestyle changes should be tackled one at a time so they are not overwhelming.

Mindful awareness or mindfulness training is also proving helpful for the core ADHD symptoms as well as associated difficulties of anxiety, depression or stress (5).  This training uses meditation practice and brief awareness exercises in daily life to train attention, balance negative emotions and increase experience of positive emotions such as self-compassion.  The mindful practice of pausing to check in and look inward, can help you recognize signs of stress such as tight shoulders, or thoughts of overwhelm, and address it before the tipping point.  Breathing exercises and mind-body movement often encourage relaxation response and can mitigate the in-the-moment feeling of overwhelm or stress. 

Last but not least, effective communication, such as good listening, being assertive and clear about your needs, setting self-boundaries or navigating conflict can relieve relationship stress in families.

Bottom line:

Identify your sources of stress and prioritize which one you want to tackle first.  If unsure or stuck, ask a friend/partner for help or engage with an ADHD professional.  Acknowledge with self-compassion that tackling stress may not be easy but even a small first step can create an upward spiral.

Download Printable article
Infographic as Image or PDF


About the Author

Lidia Zylowska

Lidia Zylowska MD is an Associate Professor at the University of Minnesota Department of Psychiatry and Behavioral Sciences.   She led the development of the Mindful Awareness Practices (MAPs) for ADHD program and is an author of Mindfulness Prescription for Adult ADHD.


References

1 Kooij SJ, Bejerot S, Blackwell A, et al.  European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry. 2010 Sep 3;10:67. doi: 10.1186/1471-244X-10-67. PMID: 20815868; PMCID: PMC2942810.

2.Ismael San Mauro Martín, Javier Andrés Blumenfeld Olivares, Elena Garicano Vilar, et al (2018) Nutritional and environmental factors in attention-deficit hyperactivity disorder (ADHD): A cross-sectional study, Nutritional Neuroscience, 21:9, 641-647, DOI: 10.1080/1028415X.2017.1331952

3Camille Lassale et al. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies, Molecular Psychiatry (2018). DOI: 10.1038/s41380-018-0237-8

4 Kuo FE, Taylor AF. A potential natural treatment for attention-deficit/hyperactivity disorder: evidence from a national study. Am J Public Health. 2004;94(9):1580-1586. doi:10.2105/ajph.94.9.1580

5Mitchell, J. T., Zylowska, L., & Kollins, S. H. (2015). Mindfulness meditation training for attention-deficit/hyperactivity disorder in adulthood: Current empirical support, treatment overview, and future directions. Cognitive and Behavioral Practice, 22(2), 172–191.