Adult Attention Deficit Hyperactivity Disorder

In the last two decades, a lot of progress has been made in understanding the culmination of Attention Deficit/Hyperactivity Disorder (ADHD) throughout the lifespan. ADHD was listed in the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000) as a childhood disorder. In the last two decades, it was found through studies and clinical practice that if left unresolved or if it was not diagnosed in childhood, ADHD can affect people throughout their lifetime. This research paper will discuss adult ADHD. Adult ADHD will be defined. The advances to understanding ADHD in adults will first be discussed in terms of changes reflected in the new The Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013), which are based upon nearly twenty years of research and clinical practice. The symptoms of adult ADHD, the diagnosis, and treatment of adult ADHD will be explained.

Adult ADHD Defined

The American Psychological Association (APA) (2013) defines ADHD as a behavioral condition. People with ADHD often find completing everyday tasks difficult because of a deficit in the ability to focus for an extended length of time, a lack of skills needed for planning and organizing tasks, and poor impulse control. People with ADHD also are challenged when assessing tasks in a realistic manner. While Attention Deficit Disorder (ADD) and ADHD are often used interchangeably, and in the DSM-5 (American Psychiatric Association, 2013), Attention Deficit/Hyperactivity Disorder, differentiates between inattentive and hyperactive, or combined types, ADHD is often used to denote the deficits in attention, organization, and planning with the added component of hyperactivity, and ADD is often referred to as Attention Deficit Disorder without the hyperactivity component. For the purposes of this paper, ADHD will be defined to include both types to adhere to the DSM definition.

Advances in the Understanding of Adult ADHD

Originally diagnosed in children, the last twenty years has revealed much about ADHD across the lifespan and how it culminates in the lives of adults. As Smith (2012) stated, findings suggest that over half of adults that were diagnosed with ADHD in childhood continued to have symptoms as an adult, which have affected a broad range of life activities, events, and functions. Hyperactive and distractible children were notated in the DSM-2, Smith observed. However, the syndrome was not understood forty or fifty years ago, and many middle aged and elderly adults went undiagnosed. Even as recently as 2000, the DSM-4 listed ADHD as a primarily childhood disorder, and the descriptions for the disorder were described in childhood behaviors for the most part (American Psychiatric Association, 2000). It was found that changes in diagnosis and treatment needed to be made for adults with ADHD to address their symptoms. The DSM-4 did not fully address the disorder in this context, which the current revision, the DSM-5 has remedied.

According to Grohol (2013), the changes made to the newest version of the DSM-5 are based upon new knowledge regarding the diagnosis and treatment of adult ADHD. While onset of ADHD is still noted to be during childhood and not adulthood, changes have been made to the ADHD description to acknowledge the life long aspects with the disorder.

Grohol (2013) stated the description of ADHD is fairly the same between the DSM-4 and the DSM-5, but with some differences in the descriptions:

• Inattentive, hyperactive, and other problematic behavior descriptions were altered to include descriptions of what adults experience, such as inability to hold jobs down for any length of time, or difficulties with relationships.

• The onset description was altered from symptoms experienced prior to age 7 to age 12.

• The subtype descriptions are described in more detail.

• Co-morbidity with autism spectrum disorder has been noted in clinical experiences and was changed in the DSM-5 to reflect this observation.

• For adults to be diagnosed with a clinically significant case of ADHD, adults need to exhibit five of the lack of attention and hyperactivity/impulsivity categories, rather than the six required for children.

As Grohol (2013) stated, these changes reflect twenty years of culminated knowledge of research and clinical practice, as adults present with the symptoms of the disorder, and how adults experience the disorder in different ways than children due to the maturity levels and different life circumstances and environment.

Adult ADHD Symptoms

As stated previously, the DSM-5 includes descriptions of the symptoms of ADHD as they present in adulthood. The following paragraphs will describe the major criteria for symptoms of adult ADHD. Certain criteria describe areas deficits in attention and concentration: concentration/inattention/distractibility, deficit in organizational skills and absentmindedness. The hyperactivity associated with the disorder culminates in the following areas:&; impulsiveness and hyperactivity. The symptoms are explained below as stated in the DSM-5 (American Psychiatric Association, 2013). Following the description of adult ADHD is a description of other ways ADHD might become evident in the life of an adult. The manifestation of adult ADHD will be tracked across the lifespan.

Inattentive Adult Attention Deficit/Hyperactivity Disorder

Concentration/Inattention/Distractibility. Adults with ADHD have problems remaining focused upon the daily tasks that for others are effortless to concentrate upon and complete. Adults with ADHD might not be able to pay attention or focus long enough to complete a task, finish a conversation, listen to another person speak, have five tasks going at once but may never complete one of them, are easily distracted and bored, does not notice details, produce sloppy work, and difficulty recalling conversations and instructions.

Deficit in Organizational Skills and Absentmindedness. Adults with ADHD lack skills necessary for task orientation, organization, categorization, prioritization, and time management. Adults with ADHD might exhibit the following behaviors:

• be messy and disorganized in any setting,

• put off important tasks to the last minute,

• miss deadlines for task completion,

• be habitually late,

• forget promises, deadlines, and preset arrangements to meet or see others,

• continuously misplace important items,

• have cluttered surroundings (home, office, car),

• and underestimate the amount of time it takes to finish a task.

Hyperactive/Impulsive Adult Attention Deficit/Hyperactivity Disorder

Impulsiveness. Impulsive behaviors often associated with ADHD include failure to think before acting, poor verbal control over comments or verbal responses, unable to keep oneself from interrupting others, and bypassing important steps in tasks and other situations. Other symptoms include a low tolerance of down time or periods where waiting is required, leaping into situations that are potentially dangerous, lack of self-monitoring ability, have addictions, often act without any thought behind the consequences of the action, and difficulties in adhering to social norms, such as sitting still for extended periods of time or talking in turn.

Hyperactivity. Hyperactivity is the one domain that is similar the behavior of adults with ADHD as in children. Hyperactivity describes a set of behaviors that are categorized by an abundance of energy. If unproductive, this excessive energy can lead to a person not being able to settle down, sit still, and having a constant need to keep moving. Symptoms often become subtler as adults learn to negotiate within their surroundings. Adults with the hyperactive aspect of ADD may always feel restless and anxious, exhibit risk-taking behaviors, are easily bored, feel like their thoughts are stuck in fast forward mode, may constantly fidget, be a thrill-seeker, talk a lot without picking up on social cues in conversation, and have several projects going at the same time.

Other Manifestations of ADHD in Adult Life

Mental disorders have a tendency to manifest in different ways across many life spectrums. Adult ADHD is no different, and it has been found that adults with ADHD have difficulties in a broad range of life situations.

Hyperfocusing. Hyperfocusing is seen more as means to cope with distractibility. Adults and children may from time to time phase out their environment to concentrate on a task, so much so that it’s seen as over concentration and can be dysfunctional. The person loses all sense of time and surroundings, often forsaking daily responsibilities or phasing out other people around them. This can be turned into a skill rather than a deficit when focused upon task completion, but this can cause issues with personal relationships and problems at work.

Emotional Issues. According to the ADD and ADHD Health Center (2013), because of difficulties with poor impulse control and disorganized thoughts, adults with ADHD might experience a spillover of these effects into the emotional realm. It is found adults of ADHD could and often do experience a loss of self-esteem, become easily frustrated, have low stress tolerance, are irritable or fluctuate between emotional extremes, problems with motivation, are oversensitive to criticism, motivational problems, and have issues anger management issues.

Higher Rates of Substance Abuse. The ADD and ADHD Health Center (2013) stated ADHD can culminate in adult’s lives in other ways. Adults with ADHD might abuse controlled and uncontrolled substances.

Behavioral Extremes. Not all people act the same way when experiencing symptoms of ADHD. Each person is different in the way they cope with the symptoms, explained the ADD and ADHD Health Center (2013). Some might avoid stimulation completely, while others might seek out overstimulation as they pursue thrill-seeking activities. Some might be social butterflies, while others might avoid socializing altogether.

Driving Habits. The ADD and ADHD Health Center (2013) elaborated upon other areas of life that might demonstrate the problematic behaviors associated with ADHD. If an adult has had multiple automobile accidents or has accumulated multiple driving citations, this could also be indicative of dysfunction associated with ADHD.

Low Financial Achievement. Adults with ADHD often earn less, are promoted less often, underachieve in their jobs, can drift from job to job, and have higher rates of unemployment, according to the ADD and ADHD Health Center (2013).

History of Poor Academic Performance and/or Higher Education Performance. In adults with ADHD have had problems in academic settings, and might have a childhood performance of underachievement or behavioral problems, according to the ADD and ADHD Health Center (2013). Moreover, adults with ADHD have higher rates of dropout from high school or college. Some adults might not have had problems in academic settings until they attend college, where students suddenly find themselves in an unstructured environment and the deficits in organizational skills and task planning and completion are demonstrated, stated Smith (2012).

Neurological Deficits. Barkley (2010) explained adult ADHD functioning in terms of neurological deficits caused by dysfunction in neurotransmitters and brain functioning. Neuropsychological deficits occur in organizational functioning of the brain that regulates the behavior of individuals. “Executive function” (p. e17) is “broadly defined as a set of neurocognitive processes that allow for the organization of behavior across time so as to attain future goals” (p. e17). Barkley delineates two areas of executive function – “inhibition and metacognition” (p. e17). Inhibition allows one to regulate physical movement, speech, mental processes, and feelings. If inhibition is dysfunctional, executive function is affected in metacognition: short-term memory, organizational skills, and emotional reasoning. These affected areas of functioning are unique to ADHD and can be used in a differential diagnosis.

With many undiagnosed cases of adult ADHD, and cases of ADHD diagnosed in childhood that carry over into adulthood, a differential diagnosis is important in the diagnosis and treatment of adult ADHD.; The following section will describe the assessment and diagnosis of adult ADHD.

Assessment and Diagnosis of Adult ADHD

The diagnosis of adult ADHD can be tricky because it can mimic other disorders, such as depression, and it can be co-morbid with depression. The following sections will describe the diagnosis criteria in ADHD according to the DSM-5 and how these criteria has translated into clinical practice in diagnosis of the disorder. The progression of the disorder from childhood to adulthood is an important part in diagnosis and will be explained. Assessment techniques and tools used to evaluate the disorder in individuals will be discussed. Differential diagnosis techniques will be explained, as well as disorders that are often co-morbid with adult ADHD.

Diagnosis According to the DSM-5 (American Psychiatric Association, 2013)

In the DSM-5, ADHD falls under the title Attention Deficit/Hyperactivity Disorder. Attention Deficit Disorder (ADD) is often used as a title to differentiate the two types of diagnoses under the Attention Deficit/Hyperactivity Disorder – mainly inattentive type, and mainly hyperactive type.

In the diagnosis of ADHD, an adult must exhibit five of the symptom criteria. If an adult has five symptoms from the inattentive criteria, the person is diagnosed with the inattentive category, with a diagnosis code of 314.00. If a person has five or more of the hyperactive/impulsivity criteria, the person is diagnosed with the hyperactive/impulsive category as the prevalent type, diagnosis code 314.01. The same code, 314.01 is used for combined category, where a person exhibits five or more symptoms from both types, inattentive and hyperactive/impulsive. Attention-Deficit/Hyperactivity Disorder Not Otherwise Specified, code 314.9, is used for adults who do not meet all the criteria for the disorder, but some of the symptoms observed are of clinical significance, such as inattention, and cannot be associated with any other disorder.

The DSM-5 also contains other stipulations to consider in diagnosing adults with ADHD. The disorder is said to be noticed before the age of 12. There has to be dysfunction in at least two settings that are clinically noteworthy. Also, the disorder must occur independently of other disorders, such as psychotic disorders, and must be differentiated between other disorders with similar symptoms, such as mood and personality disorders. In order to differentiate between disorders, the process of differential diagnosis is useful to eliminate other disorders that can mimic or contain many of the same criteria as adult ADHD. A clinical assessment is an important part of this process. An explanation of the assessment process is explained in the following sections and its role in the accurate diagnosis of adult ADHD.

Assessment of Adult ADHD

There isn’t one official way to diagnose adult ADHD, observed ETS (2008) Rather, the recommended tactics for diagnosing the disorder is to use a multifaceted approach including a variety of assessments and the clinical interview.

Understanding Adult ADHD Across the Lifespan – Comparison of Childhood Symptoms Versus Adult Symptoms. In diagnosing adult ADHD, accurate diagnosis is achieved by understanding how the disorder morphs as the person grows from adult to child. In clinical practice, it has been observed that as a person matures, symptoms may change and matriculate into behaviors that might be less noticeable on the surface and show in subtler ways. Moreover, since ADHD begins in childhood, mapping the progression of this disorder from childhood to adulthood is an important part in the diagnosis of ADHD, leaving less room for misdiagnosis.

Inattention. According to Donnelly, Reimherr, and Young (2006), adults experience symptoms of inattention and hyperactivity in different ways than children. Children might chronically lose their belongings, daydream or cannot pay attention in the classroom for more than a few minutes at a time, or cannot complete a test because of poor management skills, resulting in poorer or underachieving grades. In adults, inattention could matriculate as difficulty with judging how long a task will take, putting off important projects until the last minute, trouble starting or finishing tasks, and looking for jobs that change often, such as a job with a high amount of travel.

Hyperactivity. Donnelly et al. (2006) stated children with hyperactivity might have trouble sitting in their seats for long periods of time, have trouble sitting still and are fidgety, and just have trouble slowing down in general. As adolescents and adults learn to adapt to their surroundings and deal with their symptoms, they might still squirm and fidget more than most adults, but they also might internalize their discomfort and feel impatient when in a situation where movement is restricted, such as sitting for a show or movie.

Impulsivity. As Donnelly et al. (2006) noted, impulsive behavior changes as children mature into adults. Children might inappropriately speak out of turn in the classroom or jump from large heights on the playground (risktaking). Adults might get frustrated easily. The lack of coping mechanisms can lead to adults acting without thinking, which can have long lasting effects on relationships and careers. Adults with ADHD could act impulsively in any given situation, even leading to instances of road rage.

Tracking Changes from Childhood to Adulthood. As Donnelly et al. (2006) noted gathering evidence to support a diagnosis includes a childhood assessment of symptoms. Since the disorder first appears in childhood, it is an efficient way to make a differential diagnosis between ADHD and other disorders. If inattention or impulsiveness was not present in childhood before the age of twelve, for instance, these symptoms are most likely due to another disorder, such as depression. Depression can occur at any age, in children and adults, therefore if symptoms of inattention manifest as an adult, it is not ADHD. However, if an adult recalls being disciplined for interrupting others in the classroom or constantly getting up to walk around, the chances of an accurate diagnosis for adult ADHD become higher.

This information can be gathered during the clinical interview. The clinical interview is an invaluable assessment technique. The following section relays the usefulness of the clinical interview and the aspects gathered in order to assess the diagnosis of adult ADHD.

The Clinical Interview. The clinical interview should focus upon four goals: establish that the symptoms of ADHD were present in childhood; note any difficulties in developmental milestones; assess for comorbidity with other disorders; and perform a differential diagnosis. Client history should address:

• Familial relations

• Neurological findings, if any

• ADHD symptoms experienced within the last half of a year

• Clinical impairment over at least two areas such as in work and relationships and degree of dysfunction

• Medical information regarding health issues and medications

• Pathology of symptoms, including periods of time where symptom severity was decreased or increased

Also, observations during the interview regarding affect, mannerisms, speech pattern, etc. should be noted. For instance, does the person seem anxious, short tempered, disorganized, or fidgety? Clinical observations can confirm the presence of adult ADHD.

Adult ADHD Assessments. Various assessments are available that can be used to evaluate if a client is experiencing adult ADHD. As ETS (2008) suggested, assessments should be used as a part of the overall evaluation process, rather than being used as the sole determinant of whether or not a client has adult ADHD.

Assessments are used to evaluate the multifaceted effects ADHD has in a person’s life, conveyed ETS (2008). Tests are available to evaluate the symptoms experienced (ADHD Rating Scale-IV, ADHD Symptom Checklist–4 [ADHD-SC4], Conners' Adult ADHD Rating Scales [CAARS]), possible cognitive and neurological deficits (Wechsler Adult Intelligence Scale – III [WAIS-III]), mood (Beck Anxiety Inventory [BAI]), attentiveness (Attention Capacity Test [ACT]), recall (WAIS-III Working Memory Index, Wechsler Memory Scales – III [WMS-III]), learning (Detroit Test of Learning Aptitude-Adult [DTLA-A]), brain function and reasoning (Delis-Kaplan Executive Function System), and educational knowledge (Wechsler Individual Achievement Test – II [WIAT-II]). One assessment should never be used, ETS stated. Rather, more than one test should be selected and used in conjunction with a multidimensional evaluation process.

Interviewing the Significant Others of Clients. If possible, the clinician should speak to the relatives and friends of the client to determine if ADHD was present in childhood, ETS (2008) stated. Old school records are useful resources to obtain for evaluative purposes.

Medical Evaluation. According to ETS (2008), there can be medical causes for ADHD symptoms. If there are medical reasons for ADHD-like symptoms, the client does not have ADHD. It is important to weed out medical causes first before making a diagnosis. Thyroid functioning, neurological dysfunction, certain medications, and sleep dysfunction can cause ADHD-like symptoms. Searight, Burke, and Rottnik (2000) stated:The medical evaluation should include a neurologic examination. There are suggestions that patients with ADHD exhibit a greater incidence of “soft neurologic signs,” including problems with right-left discrimination, motor overflow movements and sequencing difficulties.13 Laboratory tests may include a serum lead level and thyroid function tests. (Evaluation, para. 5).

Moreover, Searight et al. (2000) added: Medical conditions that may mimic adult ADHD include hyperthyroidism, petit mal and partial complex seizures, hearing deficits, hepatic disease and lead toxicity. In addition, sleep apnea and drug interactions should be considered as possible causes of inattention and hyperactivity. Patients with a history of head injury may also have problems with attention, concentration and memory. (Differential Diagnosis, para. 3)

These aspects, plus assessing clients for other disorders that mimic adult ADHD and comorbidity are aspects in diagnosis that should be evaluated to make an accurate diagnosis of adult ADHD, as explained in the following section.

Differential Diagnosis and Comorbidity with Adult ADHD

Searight et al. (2000) stated a differential diagnosis aids in teasing out overlapping symptoms of disorders that have similar symptoms. Differential diagnosis refers to a process where all other possibilities for symptoms experienced are ruled out in order to diagnose a client with a disorder.

In conducting a differential diagnosis, comorbidity is also an issue to consider. Not only does adult ADHD share similar symptoms with other disorders, but also these same disorders can be comorbid with adult ADHD. As Searight et al. stated, “Comorbidity is more likely to be the rule than the exception” (Differential Diagnosis, para. 2) when it comes to the diagnosis of ADHD. The DSM-5 (American Psychiatric Association, 2013) changed the criteria for ADHD to include comorbidity with Autism Spectrum Disorder. Other disorders are commonly comorbid with adult ADHD. Haavik, Halmøy, Lundervold, and Fasmer (2010) listed several mental disorders that share key symptoms of adult ADHD: Depressive Disorders, Anxiety Disorders, Bipolar Disorder, Borderline Personality Disorder, and Alcohol and Substance Abuse.

Depressive Disorder. As Haavik et al. (2010) stated, depressive disorders and adult ADHD symptoms share many similar traits. Both list symptoms for a lack of concentration, a sense of restiveness, physical discomfort, a lack of self-worth, and inability to sleep, stay sleeping, or frequent waking. Moreover, clients can suffer from depression in childhood. The characteristics differentiating the disorders are that depressive symptoms fluctuate from period to period, whereas the client will experience ADHD symptoms consistently. If it is determined that ADHD is comorbid with depression, Haavik et al. suggest to treat the depression first, then if there are still any symptoms experienced with ADHD, to treat them after, although there are times when the comorbidity of the two disorders are so clear, they can be treated at the same time, especially when combining different therapies, such as medication and therapy.

Anxiety Disorders. Haavik et al. (2010) observed inattention is an inextricable part of anxiety disorders. Because of the deficits in self-regulation, adults with ADHD could have emotional episodes that could seem like a panic attack and some symptoms of post-traumatic stress disorder. Also, because of poor impulse control, clients with ADHD might have higher incidences of traumatic experiences. These disorders can also occur at any time throughout childhood and adulthood. It is helpful if the clinician can assist the client in establishing which usually comes first, the anxiety, which causes inattention, or the inattention, which causes anxiety.

Bipolar Disorders. Haavik et al. (2010) stated ADHD and bipolar disorders share characteristics of dysfunction of manic-like energy accompanied with impulsive tendencies. Haavik et al. observed that the progression of Bipolar I Disorder, for instance, is clearly differentiated from ADHD. However, if there is any doubt, manic bipolar episodes tend to be intermitten, while clients presenting with hyperactive symptoms report an every day struggle.

Yet, new findings continue to challenge the differentiation between the two disorders, according to Haavik et al. (2010). Recent findings with bipolar disorder seem to share characteristics in understanding bipolar disorders, such as “affective temperaments, life-long dysregulation of mood, and other chronic symptoms are important parts of the phenomenology of bipolar spectrum disorders. Furthermore, increased motor activity has been found to be even more characteristic of hypomanic episodes than elevated mood” (Haavik et al., 2010, para. Bipolar Disorders). Also, including the childhood occurrences of bipolar disorder is currently being debated. Differentiating between the two disorders can be revealed in a skillful clinical interview. Clinicians should be aware of advances in bipolar disorder as well as advances for ADHD. Moreover, Haavik et al. detected, the two disorders are not commonly comorbid.

Borderline Personality Disorder. Haavik et al. (2010) observed the similarities between borderline personality disorder and ADHD. Age cannot be used as a determining factor, because borderline personality disorder symptoms might also be prevalent in childhood. ADHD and borderline personality disorder also share common concurrent disorders, such as alcoholism or legal and illegal substance abuse, anxiety, depression, and bipolar disorders. Borderline personality disorder does have differentiating features, “such as suicidal or self-mutilating behavior, chronic feeling of emptiness and stress-related paranoid symptoms” Haavik et al., 2010, Borderline Personality Disorder, para. 1). The two disorders are also commonly comorbid. Therefore just because one is present, it does not necessarily mean that the other is not present as well.

Alcohol and Drug Abuse. Haavik et al. (2010) affirmed in treating adults with ADHD and comorbid alcoholism or drug addiction, it can be challenging to assess clients for underlying disorders. The client should be treated for their addiction first to uncover the underlying symptoms for mental disorders. A full client history should be conducted to document the progression of ADHD into adulthood, and clients should be monitored closely for abuse of medications for ADHD.

After a full assessment and diagnosis of adult ADHD, treatment protocols should be initiated to help the client. The treatments are aimed to provide relief for symptoms for behavioral and cognitive development, as well as address the biochemical imbalances thought to cause many of the symptoms.

Treatment for Adult ADHD

There are a number of medications available for the treatment of adult ADHD. Used in conjunction with therapeutic techniques such as psychotherapy and cognitive therapy, a client can be treated for adult ADHD successfully.

Medications Available for the Treatment of ADHD

Stimulants. According to Searight et al. (2000), methylphenidate (Ritalin) and dextroamphetamine (Dexedrine), similar in chemical composition, and pemoline (Cylert), although chemically different from the former two but has the same action upon the body’s system, have been found to help symptoms of ADHD. Adults taking the medications experience increased attention span and ability to focus for longer periods of time, as well as a decrease in impulsive behaviors. However, there is considerable concern over the addictive nature of the pills. They accelerate the release of catecholamines, a chemical stored and located at nervous system receptors sites. Catecholamines are located throughout the nervous system, so the reason why stimulants are effective are not known. It is theorized that the stimulants help regulate norepinephrine and dopamine, which are thought to help concentration and focus.

Antidepressants. As Searight et al. (2000) stated, some antidepressants have had some success with treating adult ADHD in the areas of increasing focus because of their ability to raise the amount of catecholamines by decreasing the the absorption of norepinephrine and serotonin, such as tricyclic antidepressants (TCAs), and secondary TCAs desipramine (Norpramin) and nortriptyline (Pamelor), are more successful because of their concentration on norepinephrine and less upon serotonin. Serotonin reuptake inhibitors (SSRIs) have not enjoyed as much success because they only regulate serotonin. Bupropion (Wellbutrin) is more of a stimulant and in the class of atypical antidepressants, and is effective because of this fact. Monoamine oxidase (MAO) inhibitors do not have as much success, but can be tried if other therapies have not produced positive effects. Antidepressants have been helpful in decreasing mood swings and other interpersonal issues ADHD can cause, as well as their usefulness in treating comorbid disorders. However, antidepressants and stimulants have different actions upon the central nervous system and can be taken together to yield maximum results for the client.

Therapies Used to Treat Adult ADHD

A number of therapeutic techniques have been found to be effective in the treatment of adult ADHD and management of the symptoms. There are a number of therapies available, according to the ADD and ADHD Health Center (2013). Therapies need to be tailored towards concrete solutions, such as skill building. The concentration on building the skills that the client has been deprived the possible chemical imbalance caused helps adults with ADHD contend issues that arise more with daily life rather than just interpersonal emotions and issues, and is more task oriented than other therapies. Even if a client knows, for instance, that he or she needs to stop being late to appointments or to work is needed, the client does not know how to get from point A to point B. Therapies are aimed at client education about the condition, organizational skills, building constructive habits, addressing negative thought patterns, building social skills, and maintaining relationships.

One therapy that seems promising in the treatment of adult ADHD is meta-cognitive therapy. Meta-cognitive therapy, which focuses upon increasing skills for “time management, organization, and planning” (Solanto, Marks, Wasserstein, Mitchell, Abikoff, Alvir, and Kofman, 2010, p. 958), was found to alleviate many of the symptoms of the disorder. Solanto et al. found that using therapy in conjunction with medication was effective in the treatment of adult ADHD.

As Searight et al. (2010) noted, adults with ADHD often have interpersonal issues associated with the disorder. Their self-esteem and relationships suffer because of the broad spectrum the disorder has upon functioning in almost any area of life. Mongia and Hechtman (2012) found cognitive behavioral therapy and dialectical therapy useful in treating adults with ADHD.

Conclusions

As this research paper has demonstrated, the differentiation between childhood ADHD and adult ADHD is deceptive. Adult ADHD is actually a reflection of a lifelong disorder. Diagnosis of the disorder can be challenging because it shares aspects of several different mental disorders. Because of the research and clinical treatment of adults with ADHD in the last two decades, many advances have been made in understanding the progression of the disorder and successful treatment. The most successful measures are through medication combined with cognitive therapy.

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