Attention deficit hyperactivity disorder (ADHD) is commonly associated with childhood. However, adults can also experience symptoms of ADHD.

Per Tracey Peachey, primary care provider at Riverside Healthcare, ADHD in adults is characterized by executive dysfunction, inattention, impulsiveness, restlessness, and emotional dysregulation. Here, she shares important information surrounding the condition and what individuals can do to mitigate it.

Symptoms Specific to Adult ADHD

To better understand ADHD in adults, Peachey expands upon the symptoms mentioned above. For example, emotional dysregulation might include irritability, anger outbursts, low frustration tolerance, or lack of motivation. Executive dysfunction involves self-directed actions needed to choose goals and to create, act, and sustain actions toward those goals.

“In daily life, that might look like trouble remaining focused on a task, organizing activities, time management, completing tasks,” she explains. “Collectively, these symptoms lead to significant issues in a patient's ability to function day to day. In adulthood, inattentiveness is typically more predominant than hyperactivity, which is often seen in children with ADHD.”

Why Is ADHD Under-Diagnosed in Adults?

In children, there’s a long-standing debate about whether or not ADHD is over-diagnosed. The opposite is true in adults, especially in women. The Attention Deficit Disorder Association states that research reveals less than 20% of adults with ADHD are appropriately diagnosed and treated.

One key reason for under-diagnosis is that ADHD symptoms overlap other conditions, such as anxiety, depression, and substance use disorders. Another reason is that it is often thought of as a childhood disorder, so it might not be on a healthcare provider’s radar, at least initially.

In addition, adults might not seek treatment or assessment for their symptoms. “Inattentiveness might not be as obvious, or they develop strategies to compensate for the symptoms they're experiencing every day,” notes Peachey.

The Diagnostic Process

When assessing the potential of an ADHD diagnosis, healthcare professionals employ a number of screening tools. Part of the process is ruling out other conditions that might cause similar symptoms. The patient's symptoms also need to be persistent and severe enough to have contributed to significant psychosocial impairment. Meaning, ADHD is not going to be diagnosed in someone who reports they had trouble focusing last week at work because of a stressful home situation.

For a diagnosis to be made, at least five of the symptoms from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria must be present for at least six months; ones that negatively impact social, academic, or occupational outcomes.

Treating ADHD in Adults

The most recommended initial treatment for adult ADHD is a combination of medication therapy and psychotherapy, specifically cognitive behavioral therapy (CBT). This therapy helps individuals change their thinking and coping strategies. For example, an adult with ADHD who is required to take on a big project at work may need to break it down into several smaller steps to make it more manageable.

The first line for pharmacological treatment for ADHD in adults is typically stimulants, which is very similar to the approach in children. “There are many different types, many different forms. The decision regarding medication is individualized for each patient and should be based between the patient and the provider, considering goals, lifestyle, and any comorbidities,” notes Peachey.

Medication, education, and close monitoring for adverse side effects is always imperative—regardless of what medication is prescribed. It's also important for patients to understand there's no perfect solution. It may take some time to find the best regimen that works. But, Peachey assures there is hope. “There are many different options and things that can be adjusted to help patients achieve the best function possible.”

Additional strategies may include maintaining a healthy lifestyle (eating well, exercising, sleeping); limiting screen time and external stimulation such as noise, lights, smells, crowds; implementing time management and organization tactics; keeping a routine; and enlisting a personal support system.

If you suspect you may have ADHD schedule an appointment with your primary care provider to get started on getting things  back on track.