Attention Deficit Hyperactivity Disorder in Adult

Attention deficit hyperactivity disorder (ADHD) or (ADD) is commonly known as a complex medical condition that is mostly prevalent in young children. This leads to a misconception that it is a condition faced by only young children, but the truth of the matter is that, the symptoms of the disease in 60% of children suffering from it, tend to continue in adulthood, if the disease is left untreated (Bertin, 2011). Statistically, this translates into 4% of the adult U.S population.

ADHD affects males at a higher rate than females in childhood, but facts have proved the ratio evens out by adulthood. Prevalence rates for the condition in adults are not as well determined as they are for children, but are assumed to be between 1% and 5%. Estimates show that 15% of the world population is suffering from ADHD (including cases not yet diagnosed) (Kewley, 1999).

The aim of this paper is to explain the causes, symptoms, treatment and impacts of this medical condition that has become prevalent in adults over the recent past.

ADHD was formally recognized as a disease afflicting adults in 1978, when researchers realized that its symptoms did not always disappear in adolescence, as previously assumed. During that period, some of the symptoms appeared in several parents of the children being treated for the disease.

According to the Diagnostic and Statistical Manual of mental Disorders, 2000 edition, there are three types of ADHD, namely: an inattentive type, an impulsive type, and lastly, a combined type. For an individual to be diagnosed with ADHD, he or she must possess at least six inattentive type symptoms for the inattentive-type, at least six impulsive-type symptoms for the impulsive type and all the above mentioned symptoms for the combine-type. However, the symptoms need to be presented in the individual, before the age of seven years and must be interfered with at least two spheres of his or her life, e.g. work or school, over the last six months. Most adults with ADHD tend to have the inattentive-type, but men are usually inclined to the impulsive or hyperactive-type symptoms, and predominantly have the combined-type of ADHD.

ADHD is usually difficult to diagnose, especially in children, because so many of the symptoms presented are related to the child development, and can be normal at different stages of the child’s growth. As a result, the condition transitions into a person’s adult life, making it more difficult to treat. Teachers and parents, as well as care givers, are often accustomed to the symptoms of ADHD and tend to ignore them as the part of a child’s growth and development behavior. Those interacting with adults, e.g. employers rarely regard behaviors of ADHD patients as symptoms of a disease. This is because; adults with the condition are less likely to exhibit obvious impulsive or hyper active behaviors. Research has shown and proven that adults with ADHD are more likely to be involved in automobile accidents and also are less likely to complete their education.

On more positive note is that research into ADHD has markedly increased over the past ten years. This has made people more aware of its existence in adults, and also how it could be treated.

Up to now, the exact cause or causes of the disease have not yet been determined. However, there are some possible theories that are being looked into by researchers that could give a clear direction, as to the cause or causes of ADHD. ADHD is believed to have a genetic component, because it tends to occur among family members. According to Barklay (1998), close relatives of people with the disease have a five times greater chance of having ADHD themselves, as well as accompanying disorders, such as depression and anxiety. Also, an identical twin is at a greater risk of acquiring the disease from an infected twin.

Ongoing research is focusing on identifying genes that make person be more susceptible to the disease.  For some people, it has been discovered that ADHD is the result of early head trauma and brain injury. Other factors that could also cause an impediment to early normal brain development, such as cigarette smoking or premature delivery, are also known to cause ADHD. Research has shown that children with epilepsy are at an unusually high risk of getting ADHD.  Furthermore, research suggests that food refined sugars may increase the risk of ADHD, because nutrition and diet can affect one’s mood and behavior, as well as proper brain development in the early life.

However, it is necessary to dispel myths of what causes ADHD. These include; poor parenting, laziness, poor teaching and even spending time watching TV. None of these factors cause ADHD, but to some extent, they could worsen the symptoms of the disease.

Symptoms of ADHD are numerous and vary from person to person. The difficulties generated from these symptoms usually range from moderate to extreme. If not properly managed, they are likely to cause the associated emotional, social, vocational and also academic problems. One outstanding symptom is anxiety. Sufferers of this condition tend to be anxious about everything. They also have an extremely low self-esteem. They tend to think they are not smart enough for anything, and as such, they usually miss out on plenty of opportunities. Others have anger management issues and tend to be short-tempered. Their anger can quickly be triggered by a petty issue, such as a child crying. Victims of ADH also exhibit poor time management skills. They lose track of time easily, and can be absorbed into what they are doing in the total disregard of the time. For those who are employed, this becomes an issue especially if it becomes repetitive. With time, it could lead to getting fired at work.

Another common symptom is difficulty in initiating tasks, multitasking and even completion of tasks. This becomes quite a challenge, since their minds are not fully focused on the task at hand. They are also poor at organizing things, ranging from time to work. This could be as a result of procrastination. ADHD victims usually procrastinate a lot. This eventually leads to the low production, both at work and at school.

Some adults with ADHD tend to be withdrawn and antisocial, preferring to spend time alone. Others, on the other hand, can be overly social and unable to stay alone. Both extremes are neither helpful. Furthermore, ADHD causes its victims to have complicated relationship issues. Most of them tend to be in multiple relationships or serial marriages. They also face a higher risk of divorce due to infidelity. Women get unplanned pregnancies due to negligence.

Other symptoms noted include; impatience, severe mood swings, chronic boredom, substance abuse and addiction, poor education performance, frequent school disciplinary actions, frequent change of employers, among others.

Diagnosis of the condition in adults totally depends on the clinic tests. There are needs of establishment on whether the symptoms were present in childhood. However, there is no objective test that is done to diagnose ADHD. Doctors combine history of symptoms, beginning form childhood to adulthood, together with evidence from e family members along with a neuropsychiatric assessment. The neuropsychiatric assessment includes a battery of tests that assess overall intelligence, as well as symptoms reported by the patient, and those reported by others, such as family members or work mates. The screening tests seek to rule out other medical conditions that may have similar symptoms, such as depression and anxiety. Some diseases, such as Asperger syndrome, are also easily mistaken for ADHD because of impairments in the executive function found in some people with the disease. However, in Asperger syndrome, patients have difficulties in social interaction, repetitive patterns of behavior and interests, as well as problems with sensory integration such as hypersensitivity.

Nevertheless, it is necessary to note that everyone exhibits symptoms like those of ADHD occasionally, especially when they are stressed or exhausted. However, for one to be diagnosed with ADHD, the symptoms have to be present from childhood to adulthood, and should also interfere with an individual’s functioning in several spheres, such as work or school. The symptoms that people exhibit when they are young continue to exist even in adulthood, just that, they manifest themselves in a different way, due to the development of compensatory mechanisms to adapt to the environment.

Treatment of ADHD in adults requires a multi-pronged approach.  Symptoms are treated with medicine. The fantastic news is that the medication used for children also works in adults. For adults, doctors usually prescribe stimulants and also suggest cognitive behavioral therapy. Common stimulants that are prescribed include; Adderall, Focalin and Ritalin. Strattera is a non-stimulant that is also widely prescribed by doctors andhas been approved for adult treatment of ADHD. Selecting the right medication for a patient with ADHD is quite a challenge at times. This is because a doctor has to avoid worsening other health problems. For instance, if a patient has an issue with drug and substance abuse, it is not wise to prescribe a stimulant, as stimulants have a high potential for abuse. A patient’s history of taking ADHD medication also matters. Doctors have a duty of monitoring and checking that they are giving the right level of drugs, as well as watching out for side effects.  The side effects range from mild ones to the fatal ones. Mild side effects include the lack of sleep, headaches and even anxiety. Serious side effects, which are rare, include increased risk of heart problems, depression and, unfortunately, for children it could lead to sudden death. For effective treatment of ADHD in adults, medication needs to be combined with psychological therapies. Research has shown that, alongside medication, psychological interventions are quite effective in reducing symptomatic deficiencies (Weiss, Safren, Solanto, Hetchman, Rostan, Ramsay & Murray, 2007). Behavior modification is particularly preferable. Psychotherapy is also a viable option, especially when the patient suffers from the low self-esteem. In isolated cases, doctors try other antidepressant medications, such as Prozac.

ADHD has its own social and economic impacts in the society. The first and foremost, due to the workplace problems, such as lateness and inability to work to full potential, it leads to the dismissal from employment. This, in turn, leads to decrease inproductivity, and consequently, the economy suffers. Most unemployed people become the  victims of depression, and this can lead to the behavior, such as drug and substance abuse, which in the long run can lead to death.

Also, due to its genetic nature, parents who suffer from ADHD are most likely to give birth to children suffering from the same. This can lead to a cycle of problems and difficulties in terms of parenting. In terms of education, ADHD patients tend to drop out or discontinue learning. This can lead to unemployment, due to lack of skills and knowledge. Unemployment in a nation leads to the massive economic losses.

ADHD also decreases morality levels in society. Most victims of the condition tend to practice infidelity which could lead to divorce. This interrupts the normal family setting and could lead to the loss of family values and belief in importance of family in society. Immorality also brings about diseases, such as HIV and AIDS, STDs and STIs which could lead to death.

In addition, treatment of ADHD is quite costly, and could affect family’s economic balance that could lead to increased poverty in society. As mentioned earlier, the treatment of ADHD using stimulants could trigger or increase chances of drug and substance abuse. Another impact of ADHD is that it can lead to loss of lives through the automobile accidents (Weiss, 1993). Researchers have proven that victims of ADHD are more likely to be involved in accidents than their counterparts. Such accidents could lead to death and also life-long disabilities that can inhibit one from working, or whose treatment costs are expensive.

In conclusion, ADHD is similar to any other disease. It has its negative implications, but thanks to technology, it can be treated. In addition, more and more people are becoming more aware of its existence, and as such, children found to have it are treated at an early stage before the disease progresses into one’s adult life. It is unfortunate that the disease is genetic, and so others cannot escape it. However, if detected early, it can be treated. To do this, it is crucial that those with family backgrounds of members suffering from ADHD get medical assessment to check whether they are suffering from the disease. It is also the duty of parents to monitor the progress of their children, both at school and at the social level. Any changes that seem to be out of place should not be ignored, but should be investigated further to rule out ADHD.