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ADHD – not just in children anymore

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Dr. Charkawi
November 09, 2009
ADHD is a relatively common psychiatric disorder among adults. The prevalence is thought to be 3.5%-5.3%, which accounts for more than 11 million cases in the United States alone. With increased public awareness, adult ADHD became a topic of great interest so clinicians should be able to diagnose, treat, and manage patients with this disorder.

Etiology is still uncertain. Genetics however is believed to play a prominent role, followed in importance by acquired injuries to the brain. ADHD was widely thought to be strictly a disorder of childhood. Now there are numerous scientific papers and clinical trials that acknowledge the existence of an adult version of this disorder, which can be traced back to the younger years. Before this time ADHD in adults was known as Minimal Brain Damage or Dysfunction (MBD).

Adult ADHD is associated with multiple co-morbidities such as anxiety, depression, bipolar disorder and other personality disorders. Adult ADHD is a valid psychiatric disorder of adulthood distinct from these other conditions.

Adult attention deficit disorder differs from the childhood variant because the hyperactivity in adults may be replaced by other symptoms such as anxiety, impulsivity and inattentiveness. In fact, prior to 2002 there were no diagnostic guidelines, but there have been great advances since. Seven symptoms were earlier proposed to characterize adult ADHD:

1. Inattentiveness

2. Hyperactivity

3. Mood Liability

4. Irritability

and angry temper

5. Impaired stress

coping behavior

6. Disorganization

7. Impulsivity

Some children with ADHD continue to have it as adults. And many adults who have the disorder don't know it. They may feel that it is impossible to get organized, keep a job, or remember and keep appointments. Daily tasks such as getting up in the morning, preparing to leave the house for work, arriving at work on time, and being productive on the job can be especially challenging for adults with ADHD.

These adults may have a history of failure at school, problems at work, failed relationships and traffic accidents. Like teens, adults with ADHD may seem restless and may try to complete several tasks as once, most of them unsuccessfully. They also tend to prefer "quick fixes," rather than taking the steps needed to achieve greater rewards.

Treatment is very rewarding. The first medications to be approved by the FDA belonged to a non-stimulant group of medications: Atomoxetine. The FDA later approved stimulants such as methylphenidate and mixed amphetamine salts. Group delivered cognitive behavioral therapy is recommended in some cases as a supportive treatment. If you or someone you know may have Adult ADHD, call Johns Creek Family Medicine at 770-771-6591 and schedule an appointment with Dr. Zack Charkawi.

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