Attention Deficit Hyperactivity Disorder is a complex neurocognitive disorder. Symptoms are multi-faceted and exclusive to each person challenged by this condition. Not every person has every characteristic or symptom that will be detailed in this post. The way in which ADHD manifests is as unique as a fingerprint. Although a brain-based disorder, and a medical condition, the impairments are not correlative of a person’s intelligence or IQ. What are the symptoms adult ADHD?
ADHD and Self Regulation
ADHD is characterized by certain patterns that interfere with development and self-regulation. The disorder can impact every aspect of a person’s life from school, work, interpersonal relationships, and the inability to get along with others socially and in the workforce. ADHD is considered one of the most impairing outpatient disorders, surpassing anxiety and depression.
The good news is that ADHD is a highly treatable disorder. Medication, education, and behavioral modification, along with targeted coping strategies are all effective tools. Cognitive behavioral therapy (CBT), which addresses the cognitive distortion inherent in ADHD, is an important management tool as well.
Russell Barkley Ph.D, an internationally recognized authority on ADHD, terms the condition a “performance disorder,” and “the diabetes of psychology.” ADHD encompasses a whole range of destabilizing behaviors. that can greatly affect their emotional, mental, and physical health, as well, as those who love them. It is, in fact, a very “disorderly” disorder, and one characterized by diminished executive function capabilities.
What Are The Symptoms Of Adult ADHD?
Search For Stimulation Syndrome
A chemical disorder of low dopamine, ADHD could more aptly be called, “Search For Stimulation Syndrome.” Stimulation provides the increase in dopamine, a neurotransmitter in the brain, that people with ADHD are lacking. This deficit leads to classic symptoms of ADHD, including inattention, inhibition, and impulsivity. The “H” for “hyperactivity” does not typically apply to adults.
Symptoms of ADHD, on average, start to manifest between three to six years of age, but this is just an average, and many children do not become symptomatic until later in childhood. Generally, symptoms manifest before the age of 13. Some adults with ADHD may not show signs of the disorder during childhood, which could be due in part, to compensatory parenting techniques or effective coping mechanisms that make up for their deficits.
Executive Function Deficit Disorder
A more appropriate name for ADHD would be Executive Function Disorder (EFD), which more aptly describes the condition. Executive functions are mental skills that allow one to accomplish tasks in a timely and efficient manner.
The frontal lobe in the brain houses the executive functions that are so essential for executing these daily tasks. Those with ADHD have chronic difficulties involving follow-through, time-management, sustained-attention, working- memory, organization, and difficulty managing emotions.
Additionally, self-awareness and self-observation are not highly developed in those with ADHD. This is more a function of the brain’s management system, rather than a behavioral problem per se, but behavior will always be more problematic in the face of executive functioning deficits. Deficits also lead to black and white thinking, cognitive distortion, faulty perception, not thinking things through before acting, and the inability to “get” cause and effect.
Learning And Development
The disorder also prevents one from learning from past behavior. ADHD can be likened to having broken filters on one’s perception. There are a myriad of ways these deficits can lead to inappropriate, destructive, and destabilizing behaviors.
ADHD is a result of irregularities in the brain. It’s a developmental disorder, that can cause abnormalities in behavior and problems with self-regulation. There can be tragic consequences of untreated or poorly-managed ADHD.
The inability to deal with difficult decisions maturely and realistically is one unfortunate consequence that impacts every aspect of adult life. However, many destructive behaviors can be minimized with proper treatment.
A Disorder Of Neurocognition
As Russell Barkley says: “The problem isn’t that people with ADHD don’t know what to do. The problem is that they can’t do what they know.” The disorder diminishes a person’s capacity to meet responsibilities for self and others. It’s a legitimate condition of impairment, with symptoms existing along a continuum, ranging from mild to severe.
Left untreated, it can even be associated with narcissism, and a denial that ADHD is not the source of their problems. This denial has a biological basis in the brain. A rickety structure can lead to risky behaviors, and poor behavioral inhibition – i.e. poor impulse control.
Gina Pera states: “ADHD is a neuro-developmental disorder of impaired self-regulation, and more specifically, organizing behavior across time toward desired goals.” If the hard work of deconstructing ADHD is to be accomplished, certain hurdles must be overcome. BREAKING through denial is the first step.
Symptoms Permeate Life And Relationships
In order to make strides, a person with ADHD must be mindful of the impact their symptoms are having on their relationships We all must learn to accept the consequences of our behavior, but this is especially true of those with ADHD. Even if the chaotic behaviors are a function of their disorder, the devastating consequences have the same result.
People with ADHD have a tendency to self-medicate by engaging in activities and behaviors that stimulate dopamine in the brain. These exhausting behaviors are generally not conscious, but are a biologically-based need for stimulation.
Picking fights is one example of these negative behaviors. The ensuing chaos stimulates the brain’s frontal lobes. This stimulation is a form of self-medication. Unrelenting conflict, in untreated ADHD, is a major contributing factor that leads to the higher-than-average divorce rates in those with the disorder.
ADHD’s Effect On Relationships
Untreated and unmanaged ADHD puts a major strain on relationships. Confusion, blame, denial, and avoidance abound. Partners and family members cannot make sense of the sometimes confusing behavior that is characteristic of ADHD. In relationships, it can be the invisible enemy, and put a negative spin on communication and conflict resolution.
Low empathy, also characteristic of ADHD, significantly adds to the strain, and if not addressed, will most likely result in the demise of a relationship. It’s easy to see why the divorce rate is much higher in relationships where one partner has the disorder. Interestingly, it’s not the ADHD itself that leads to divorce, but the denial of it, which is so common with this condition.
The lack of conflict resolution inherent in ADHD partnerships also seriously impacts relationships – most notably, intimate ones. Relationships can’t grow and thrive in the face of avoidance, denial, and lack of cooperation, which ultimately leads to a lack of connection and communication – both vital components of any thriving partnership. It doesn’t help matters that many people with ADHD tend to blurt out hurtful comments without thinking before they speak.
Emotional Whiplash And Disconnection
ADHD has the propensity to destroy relationships. Adding insult to injury, apologies are non-existent because the offender does not even remember saying the crass remark. Those with ADHD also have a tendency to spin the situation away from themselves, blaming their neurotypical partner for the problems in the relationship. These false accusations exacerbate the emotional whiplash and disconnection.
Those with untreated ADHD often have problems managing money judiciously, with impulsivity being a common culprit. When it comes to time, people with ADHD tend to exhibit black and white thinking. In their minds, it’s either “now” or “not now.” There are no areas of gray, which normally permeate life. This black and white thinking, along with a lack of perspective, wreaks havoc on finances and relationships.
Both of the following books discuss the differences in brain structure in those with ADHD:
Gina Pera’s “Is It You Me or Adult ADD”
Russell Barkley’s “When An Adult You Love Has ADHD“
The ADHD Effect
The ADHD “spin” or “effect” can be mystifying and confusing for those suffering from this disorder, as well as, those who are witnessing the behavior on the sidelines. Awareness and cooperation is vital if relationships are to thrive and survive. If these two components are missing, the damage can eventually become irreparable.
Relationships, where one partner has ADHD, tend to fall into destructive patterns that are more indicative of a parent/child relationship. The neurotypical partner is forced into the role of parent because the person with ADHD has to be constantly reminded to “adult.” Their oppositional mindset, lack of cooperation, and poor judgment, erodes relationships over time.
This dysfunctional dynamic breeds anger and resentment. Learning how to implement and sustain new habits is essential to shift these dysfunctional roles. Often, a partner of an ADHD spouse feels ignored or unloved due to their partner’s inability to sustain consistent attention. This perceived neglect leads to resentment, paralyzing the relationship, and hastening its downward trajectory.
Certain tendencies manifest when ADHD is undiagnosed or poorly managed, negatively affecting relationships in a variety of ways. ADHD is stealthy and can suck the life out of any relationship, leaving both partners languishing in a web of chaos and confusion that is impossible to make sense of.
Adult ADHD Medications
It’s important to not underestimate the role medication plays in treating ADHD. Indeed, it’s foundational, and by far the most effective tool available.
“Stimulant medication is the DW40 of ADHD” says Russell Barkley. Just as eyeglasses, using the right prescription, can remedy a vision problem, medication, while not a cure, can mitigate the symptoms of ADHD. It has the potential to normalize behavior in up to 50-65% of those suffering with ADHD.
Substantial improvements are noted in another 20-30% of people. Finding the right medication, at the right dose, is key. Proper treatment can result in significant improvements, in regard to symptom-management.
ADHD stimulant medications have been extensively researched, and used for more than five decades, with no long-term negative side effects. They are extremely effective in the treatment of ADHD. Below is a brief overview of medications that are available.
Two Classes Of Stimulant Medications
- Methylphenidate stimulants: Ritalin, Focalin, Daytrana, and Concerta
- Amphetamine stimulants: Dexedrine, Adderall, Vyvanse
- Non-stimulant medication: Straterra, Catapres, Intuniv
ADHD medication involves trial and error to determine which class of medications work best. Trial and error is necessary because every person’s neurochemistry is unique to them.
Adderall is not a good first choice – it’s an outdated medication that can ratchet up symptoms, such as anxiety, irritability, and insomnia.
Medication should be given for a duration of 12-16 hours during the day to normalize brain chemistry, and provide a therapeutic outcome. Proper dosing can increase focus and concentration, better social interactions, less restlessness and impulsivity, and better working memory – in short, better executive functioning skills.
Optimizing nutrition is important for everyone, but especially for those with ADHD and other neurocognitive disorders. A high-quality vitamin and mineral powder is a good way to get a daily dose of nutrients that support healthy brain function. Essential fatty acids and magnesium are also crucial supplements that should be taken consistently.
Self-esteem is one of the unfortunate casualties in those with untreated ADHD. People with this disorder often feel stupid and incompetent, when in fact, they are not. In order to retain a sense of personal value and dignity, early diagnosis should be sought, since feelings of hopelessness and discouragement are common with this disorder. Compassion and understanding are also essential components that need to be lovingly demonstrated
Please educate yourself about this complicated disorder if you suspect you or someone you love is immersed in an ADHD fog. It’s a complex condition that is hard to unravel, and one that can make you, your partner, and your family feel like you’re on a continual roller coaster ride, minus the thrill.
Executive function deficits can mask talents, obscure stellar qualities, and even thwart potential. Fortunately, the right medication can improve the brain’s management system, making for a much smoother ride. Life is harder than it should be for those with ADHD. It doesn’t have to be…
What are your experiences with ADHD. Let me know in the comments:)
(1) NCBI: Adult ADHD – Diagnosis, Differential Diagnosis, and Medication Management
(2) NCBI: Attention Deficit Hyperactivity Disorder (ADHD)
(3) Russellbarkley.org: Fact Sheet: Attention Deficit Hyperactivity Disorder (ADHD) Topics
(4) Russellbarkley.org: The Important Role of Executive Functioning and Self-Regulation in ADHD©
(5) Russellbarkely.org: What Causes ADHD
(6) NCBI: Treatment of adult ADHD: a clinical perspective
(7) ADDitude: ADHD in Adults: Your Guide to Symptoms, Diagnosis and Treatment
(8) Centers for Disease Control and Prevention: Symptoms and Diagnosis of ADHD
(9) ADHD Roller Coaster with Gina Pera: “I Wish I’d Known Earlier About Adult ADHD”
(10) WebMD: ADHD Medications and Side Effects
Disclaimer: This article is strictly for informational purposes only and is not intended to be medical advice.