Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood, and it is usually diagnosed in children. But ADHD tends to be underdiagnosed in Women And People of colorwhich can cause some people to reach adulthood before realizing they may have the disease.
Busy Philipps is one of them. The actress recently revealed that she was diagnosed with ADHD after going to a doctor’s appointment for her daughter. “My older daughter was having some problems at school and we took her for a check-up. And literally at the check-up, my ex-husband Marc, we looked at each other, because with everything the doctor asked Birdie and talked about, I thought: “But that’s me. That’s what I have,” said the 44-year-old We weekly.
Philipps said she had felt like “something was wrong” before her diagnosis, only to learn that her problems completing tasks and planning were likely due to ADHD. “There are ways to deal with it, there are medications. It’s changed my life,” she said.
Philipps is not the only person who has gone through this. In recent years, “the number of people seeking an ADHD diagnosis has increased significantly,” says Justin A. Barterian, PhD, psychologist and assistant professor at Ohio State University – Wexner Medical Center. “There seems to be less stigma around ADHD and other mental disorders in our culture these days, leading some people who meet the criteria for ADHD to seek a diagnosis for the first time,” he adds.
But Barterian says there are also “misleading” social media and influencer accounts that “misrepresent” the symptoms of the condition, leading “many to believe they have the disorder even though they don’t meet all the criteria.”
All this raises many questions about ADHD in adults and its diagnosis. Specialists who treat these patients will explain it to you.
How does ADHD differ in adults and children?
ADHD is the same disorder in children and adults, but can manifest itself differently in adults, says Joshua M. Langberg, PhD, licensed clinical psychologist at the Rutgers Graduate School of Applied and Professional Psychology and director of the Center for Social and Emotional Well-Being of Adolescents.
“ADHD in childhood is often characterized by high levels of inattention, hyperactivity and impulsivity,” he says. “In contrast, ADHD in adulthood is mainly characterized by problems with inattention, concentration, organization and time management.”
While hyperactivity is more obvious in children who suffer from it, it is more likely to cause inner turmoil in adults, Langberg says. “Although the symptoms of ADHD in adulthood may not be as visible to others, they are just as important and debilitating,” he says. “Difficulties with sustained attention, attention to detail, and with organization and planning can lead to significant problems with success after high school, job performance, and relationships.”
Symptoms of ADHD in adults
People with ADHD regularly struggle with certain symptoms. These include inattention, i.e. difficulty paying attention, hyperactivity or too much energy, and impulsivity, i.e. acting without thinking or having problems with self-control, says Dr. James McGoughProfessor of clinical psychiatry and co-director of the ADHD Clinic at UCLA.
People with ADHD may have mainly symptoms of inattention or mainly symptoms of hyperactivity-impulsivity, while some may have both types of symptoms that National Institute of Mental Health (NIMH) says.
According to NIMH, people with inattentive ADHD may have difficulty with these tasks:
- Special attention to details
- Focus on long tasks, such as creating reports, filling out forms, or reviewing long documents.
- Listen carefully when spoken to directly
- Following instructions and completing tasks at work
- Organizing tasks and activities
- Managing time
- Completing tasks that require sustained attention
They may also lose things like keys, wallets and phones, become easily distracted and forget to do things like pay bills, keep appointments or return calls.
According to NIMH, people with hyperactivity and inactivity may have the following symptoms:
- Extreme restlessness and difficulty sitting still for long periods of time
- Fidgeting or tapping with hands or feet or shifting around in the seat
- Difficulty in engaging in quiet leisure activities
- Excessive talking
- Answering questions before they are fully asked
- Problems waiting in line
- Interrupting others
But Hillary AmmonPsyD, clinical psychologist at the Center for Women’s Anxiety and Emotional Well-Beingstresses that all adults experience some of these symptoms from time to time. “Every now and then you might find it difficult to accomplish everything you want to accomplish, or you might notice that you’re forgetful,” she says. “Maybe it’s not ADHD, but you have too much on your plate at once and that leads to forgetfulness or mistakes.”
People with ADHD often have a chronic history of having endless to-do lists that they rarely complete, they consistently choose fun over boring tasks, they face real consequences when they make mistakes or don’t complete tasks, or they procrastinate on tasks that seem “too big” or “overwhelming,” Ammon says.
However, if you suddenly develop symptoms of ADHD, it’s probably not the disorder, McGough says. “You don’t turn 50, become a partner in a law firm, and suddenly have ADHD,” he says. “It would be hard to believe.”
How is ADHD diagnosed in adults?
An adult ADHD diagnosis usually starts with someone recognizing they have problems, McGough says. “Some people who are more intelligent or have families with more means may make it to college or beyond without realizing there’s something wrong,” he says. But suddenly being faced with more difficult life situations can bring these problems to light.
“I’ve met people who wanted to go to medical school or law school and were smart enough or had enough support in the past that it was never a problem,” McGough says.
Doctors usually ask a lot of questions during an initial consultation, says Dr. Shazia Savula psychiatrist at Penn Medicine. “We ask them what’s going on and what difficulties they’re having,” she says. People with ADHD tend to have problems in multiple areas of life – work, studies and relationships – and hearing how things are going in those areas can be insightful for doctors, she says.
But doctors also want to know something about your past. “We will also ask if you had these problems as a child – whether you had similar symptoms in elementary or middle school,” says Savul.
Savul points out that factors such as severe depression or severe anxiety can also mimic the symptoms of ADHD, so it’s important to rule those out as well. “People who smoke marijuana frequently also develop symptoms very similar to those of ADHD,” Savul says. “We need to take these things into account.”
While your doctor will have you fill out questionnaires, you should also expect an in-person or virtual meeting that will last a few hours, Langberg says. “The doctor’s main job is to determine why the symptoms of inattention are concerning and whether they are best attributed to ADHD, anxiety, depression, sleep problems, stress, contextual changes, etc.,” he says. “There is a diagnostic manual that doctors use, and to meet the criteria for ADHD, specific and well-defined symptom thresholds must be met currently and in childhood.”
Langberg stresses that there is no one-size-fits-all test for ADHD. “If someone tells you they can look at your blood type, your brain waves, or your performance on a computer task and use that information alone to diagnose ADHD, they are not following recommended or best practices and are not acting ethically,” he says.
What is the treatment for ADHD in adults?
Treatment for adult ADHD is similar in children and adults, Barterian says. This includes the use of stimulants such as amphetamine/dextroamphetamine salts (Adderall) or lisdexamfetamine (Vyvanse, Elvanse), which come with potential side effects such as headaches, anxiety and sleep disturbances, according to the Mayo Clinic.
Other options include non-stimulant medications and drug-free treatments, according to Savul.
“Adults may also benefit from cognitive behavioral therapy, which aims to address deficits in executive function,” says Barterian. “Skills learned through therapy can help a person with ADHD modify their environment in ways that reduce the impairments associated with ADHD symptoms.”
If you suspect you have ADHD, doctors stress the importance of getting evaluated by a licensed mental health professional. “Sometimes I see anxiety misdiagnosed as ADHD,” says Ammon. “To be clear, people can have both anxiety and ADHD. However, I have evaluated patients who suspected they had ADHD when the cause of their procrastination habits was actually anxiety. That’s why a proper evaluation is so important.”
If you’re diagnosed with ADHD, McGough says getting the right treatment can be life-changing. “I have a friend who got the right ADHD medication and got a glowing review at work. Lawyers say, ‘I’m triple billed now,'” he says. “Those are very clear results.”
Savul agrees that the right treatment can have a big impact. “The majority of patients respond,” she says. “They feel better and are able to function better in their work and school lives. We have many stories of people who did well after starting treatment.”