Biology 103
2003 Second Paper
On Serendip

Attention Deficit/Hyperactivity Disorder (ADHD). Everyone has heard of it. A few years ago every newspaper and weekly magazine had a feature about the disorder. The disorder was mostly associated with school-aged children because that was the time when most of the symptoms surfaced. Today ADHD is the most common behavior disorder diagnosed in children and teens. ADHD refers to a group of symptoms that begin in early childhood and can continue into adulthood, causing difficulties at home, at school, at work, and within the community if not recognized and treated (1). But what most people never hear was that ADHD also affects adults and if left untreated can have serious effects.

ADHD is a condition that makes it difficult for children and adults to pay attention, control their activity level and limit their behavior in age appropriate ways (2). Inattention is the most common symptom. In addition to having difficulty paying attention, people with this ADHD symptom often are unable to consistently focus, remember, and organize. They may be careless and have a hard time starting and completing tasks that are boring, repetitive, or challenging., impulsiveness and hyperactivity. With impulsivity, people who frequently act before thinking may not make sound judgments or solve problems well. They may also have trouble developing and maintaining personal relationships. An adult may not keep the same job for long or spend money wisely. A hyperactive child may squirm, fidget, and climb or run when it is not appropriate. These children often have difficulty playing with others. They may talk a great deal and not be able to sit still for even a short time. Teenagers and adults who are hyperactive don't usually have the more obvious physical behaviors seen in children. Rather, they often feel restless and fidgety, and are not able to enjoy reading or other quiet activities.

There are a couple of reasons why it is more difficult to diagnose an adult with ADHD than it is to identify a child with the same problem. One of the problems is that there is no real test for ADHD. Instead there are a series of evaluations that must be done that rule out other problems (2). The American Psychiatric Association describes the symptoms and criteria for diagnosing mental disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Information used to diagnose the condition includes: an interview with the person, medical history, to include asking about the social, emotional, educational, and behavioral history of the person, physical exam, behavior rating scales or checklists for ADHD to evaluate the person's symptoms.

In the past these questions were geared towards children. Now researchers have realized that as a child with ADHD matures, the symptoms evolve so that they may be harder to detect. Adults with ADHD usually develop coping mechanisms that make up for their problems. Specific tools have been developed to aid in the diagnosis in adults. An example, physical hyperactivity may evolve into excessive talking or foot tapping. Impulsivity can be expressed as having a very short temper, quitting jobs or ending personal relationships suddenly and being prone to emotional outbursts. Inattention leads to poor time management, difficulty finishing tasks, and a tendency to miss deadlines and other important details at work, home and in social settings. All these symptoms can create enormous stress for adults with ADHD and their families. Unfortunately, this evolution of symptoms from childhood to adulthood isn't reflected well in the DSM-IV criteria. As a result, some experts believe the apparent remission of ADHD symptoms in many adolescents and adults is due primarily to the limitations of current diagnostic criteria. These criteria for diagnosis may be modified for use in adults. With adults, special care must be taken in the diagnostic process to distinguish between ADHD and other psychological disorders and/or other life stressors (2).

Now it is known that 60% of children with ADHD continue to struggle with the disorder into their adult life. In past years ADHD was very hard to diagnose among adults and it is estimated that 2.5% of the adult population have ADHD (3). However, only an estimated 1.5% of these adults are being treated for it. There is no cure for ADHD but there is treatment. Treatment ranges from therapy to medication.

Adults with untreated ADHD have been found to be more likely to have a substance abuse problem, which makes some people edgy about taking a controlled substance such as Ritilan because when used incorrectly can become addictive. However, when taken properly, medication can prove very helpful, allowing a person to concentrate on activities and be more productive. Therapy is especially helpful for adults in relationships because it allows them to bridge the gap in communication.

References

1)WebMD, Topics and Overview of ADHD

2)ADHD in Adults

3)Ruhrold, Richard, PhD Adult ADHD


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