ADHD in adults: still not well known

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January 9, 2023

Attention deficit disorder with or without hyperactivity in adults: how to recognize it and what are the implications?

1. What is attention deficit disorder with or without hyperactivity in adults?

Attention deficit disorder with or without hyperactivity (ADD/ADHD) is a neuropsychiatric disorder in which executive functions (working memory, inhibition and mental flexibility) are affected. It is manifested by persistent and disabling inattention and/or hyperactivity-impulsivity. To be included in the diagnostic spectrum, these disabling characteristics must be persistent over time (present since childhood) and in several areas of the individual's life (work, studies, family life, etc.).

The symptoms of ADHD can interfere with daily life, work, studies or social relationships. ADHD is common: it is estimated that it affects between 2.5% and 5% of adults, or about 1 in 40 adults, and affects both men and women of all ages.

2. How is ADHD diagnosed in adults?

In Switzerland, general practitioners, psychotherapists/psychologists and psychiatrists are authorized to make the diagnosis. The clinical test and DSM-5 provide a series of criteria for making a diagnosis. Then, often a neuropsychological assessment will complete the analysis by providing detailed data.

If you think you may have ADD/ADHD, talk to your doctor or psychotherapist.

3. ADHD symptoms in adults

Adult Attention Deficit Disorder (ADD) is a neurological disorder that is characterized by difficulty maintaining attention and regulating mental activity. People with ADD often have trouble finishing what they start, following instructions and staying organized. They may also have difficulty managing time, planning and making decisions. Adult ADD is sometimes associated with other disorders such as mood disorder, anxiety disorder or personality disorder.

Be aware that stress, changes, fatigue and other factors can mimic the symptoms of ADD/ADHD.

The symptom from the point of view of the person with ADD/ADHD, from the point of view of those around them

  • irritability ("why are you getting so upset, it's not a big deal, just let it go")
  • volatile attention ("do you listen to me when I talk to you?")
  • inability to sit still - mental and/or physical and/or emotional hyperactivity ("sit down, you're stressing me out with all that fidgeting", "why are you thinking about this? Stop thinking", "
  • hyperfocus ("is this your new fad?", "why are you so obsessed with this topic?")
  • impatience ("you can't have everything in a second")
  • clumsiness
  • orientation difficulties
  • poor and/or selective memory ("you remember the name of your neighbor's cat when you were 5 and not my birthday")
  • different sense of priorities ("why do you start with the least urgent thing?")
  • ETC...

4. How ADD/ADHD can affect an adult's life

Precarious financial situation

Adults with ADD/ADHD may struggle to pay their bills on time and stay on top of administrative matters. Combined with impulsivity (impulse buying, for example), this can lead to a precarious financial situation.

Social relations

One can also notice in some people a strong irritability or a reaction that seems disproportionate when faced with a situation that seems "not so serious". This emotional dysregulation complicates relations with those around them, creating misunderstanding. In others, there is excessive talkativeness and a tendency to share "too much" and a "lack of respect" for social etiquette.

In the family

Other people may have difficulty staying focused during discussions and have a memory where appointments, birthdays and shopping lists are not remembered. The person may feel like an "alien" in the family.

Risk behaviors

In seeking stimulation and trying to soothe their unhappiness, people with ADD/ADHD may engage in risky behavior. They may engage in extreme sports, have a very active and not always safe sexuality or turn to substances in an attempt to soothe themselves.  

Work

In a professional setting, the adult may have difficulty keeping up with the pace of a team. Because they are "sprinters" and not marathon runners, adults with ADD/ADHD function better with a flexible framework and an end goal than by conforming to a "step-by-step" procedure. By default they work well under stress and get to work more easily when the chance is near. This can affect team functioning or make them look like procrastinators. They need to learn to implement strategies so that their functioning affects their work situation as little as possible.

Inner world

Imposter syndrome, feeling of being misunderstood, overflowing creativity, hypersensitivity, adults with ADD/ADHD have a very rich, often chaotic inner world in which motions and thoughts are jostling each other in an incessant flow. This can affect their self-esteem, making them anxious or complexed by a "difference" they cannot name.

A large proportion of adults have implemented "masking" strategies = masking their particularities in order to conform to their environment, often resulting in frustration and an attitude of "people pleasing" in which the person can forget themselves.

In the body

ADD/ADHD is frequently coupled with high sensitivity, even hypersensitivity. Thus, bright lights, smells, noises, certain textures or touches and many emotions can trigger waves of sensations (conscious or not) that are extremely unpleasant for them. This is a trait that is common to many neurodivergent profiles. Adults with ADD/ADHD may also be clumsy, have difficulty coordinating their movements and be prone to regular muscle tension. Regulation of food intake may also be a problem.

5. How to manage ADD/ADHD in an adult

Depending on the person's wishes, the physician will propose an approach with or without medication. The first-line treatment approach for adults consists of methylphenidate or a similar molecule that inhibits the reuptake of dopamine. In addition, the physician may recommend psychotherapy and/or coaching/hypnosis to implement effective strategies to better manage ADD/ADHD and better manage one's life.

6. ADD/ADHD, hypnosis and coaching

Adults with ADD/ADHD can benefit from hypnosis or coaching to help them manage the above issues and live better with the disorder. These interventions must take into account the specificities of the disorder (difficulty to motivate oneself, volatile attention, hypersensitivity...) to be effective. Do not hesitate to contact us to discuss this.