About 11% of all children are diagnosed with attention deficit hyperactivity (ADHD) at some point, but some of these children grow into adults without ADHD. A new study suggests that these changes aren’t subjective. Instead, adults who recover from ADHD show distinct brain differences.

How Recovery from ADHD Changes the Brain

Researchers already know that, among adults and children with ADHD who aren’t focusing on a task, the brain’s posterior cingulate cortex and medial prefrontal cortex don’t synchronize their activity. The new study examined how these brain areas work together in adults who had previously been diagnosed with ADHD to see if recovery from ADHD changed the brain.

The study looked at 35 adults diagnosed with ADHD as children. Thirteen still had symptoms of the ADHD, while 22 had recovered. The researchers used resting-state functional magnetic resonance imaging (fMRI) to examine how the subjects’ brains behaved when they weren’t focused on a specific task. In a surprising twist, though, the new study found that adults who recovered from ADHD showed synchronicity between the two brain regions—a brain pattern identical to the brain patterns shown in people who have never been diagnosed with ADHD.

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Environment, Medication, and the Brain

This study might seem to suggest a biological basis for ADHD, and even a potential test for the condition. But environmental and lifestyle choices can change the brain. Carey Heller, PsyD, a GoodTherapy.org ADHD topic expert, points out that both medication and therapy can change the brain, and he emphasizes the way lifestyle choices can affect both the symptoms of ADHD and the way the disorder looks on a brain scan.

“Children have little control over their environments, but adults may be able to choose jobs, working environments, or habits that minimize their symptoms,” said Heller. Perhaps these changed brain scans are the result of a concerted effort to cope more effectively with ADHD. If that’s the case, then this research points to the importance of early interventions for helping children recover from ADHD in adulthood.

Heller is also skeptical about whether ADHD actually goes away, or just changes. “It’s unclear whether ADHD actually goes away in adulthood, or if the symptoms change,” he says. Maybe some adults with ADHD experience atypical symptoms that look different on a brain scan.

No matter how you interpret the data, though, brain differences in adults previously diagnosed with ADHD can help lead the way toward future research. The study was small, so more research is necessary to determine whether and how the adult brain changes in response to both ADHD and treatment for ADHD.

Reference:

Inside the adult ADHD brain: Differences between adults who have recovered, and those who have not. (2014, June 10). Retrieved from http://www.sciencedaily.com/releases/2014/06/140610112812.htm

Parents often focus so much on their children and teens having attention-deficit hyperactivity (ADHD) that they lose sight of the specific symptoms. As a result, many parents tell their kids that they cannot do something because they have ADHD. Other parents may continually remind their children about their diagnosis. Both of these parenting tactics can lead kids over time to internalize negative perceptions of themselves. In some cases, children and teens, and even adults, may learn to use having ADHD as an excuse to avoid doing certain things or attribute negative behaviors to it.

Clearly, all of this focus on having ADHD can lead to short- and long-term negative consequences. Therefore, it is important that parents focus on specific difficulties that their child or teen has in a domain, rather than blaming everything on ADHD. For instance, if you do not want your 10-year-old to walk with his or her friends to a local convenience store after school, it is recommended that you explain your concerns instead of saying, “You can’t go because you have ADHD.” It may be that your child is not attentive to watching for traffic, so you are concerned that he or she will not be careful when crossing the street. As another example, if you do not want your 13-year-old to go to the mall with his or her friends without adult supervision, explain why. It may be that he/she is impulsive, and you worry about your teen being disruptive or otherwise getting into trouble.

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It is also important to look at ways to assist your child/teen to allow him or her to participate in age-appropriate activities. Related to this, you should also determine ways for your child or teen to prove to you that he or she is capable of participating in the desired activity without difficulty. Using the example above of the 10-year-old who wants to go to the convenience store with his or her friends, one could handle the situation in the following manner: Sit down with your child and explain your concerns about his or her ability to watch for traffic. Then, provide opportunities in a controlled environment to prove that he or she can watch for traffic. You could do this by having your child walk places with you and take the lead when crossing the street. Of course, if he or she starts darting out into traffic, stop and discuss the situation in the moment, if possible. Once you feel comfortable that your child can watch for traffic in your presence, have him or her practice crossing the street when with you and a few friends. At 10 years old, it is fairly age appropriate to be walking places with an adult.

Only use the situation with your child’s friends and you if it is deemed age appropriate. For instance, if you are having the same issue with a 17-year-old, it would be much less appropriate to make him or her practice crossing the street with you and his/her friends. Also, when helping your child practice crossing the street in this situation with friends, don’t mention to the friends that you are helping your child practice crossing the street safely. Once your child proves that he or she can cross the street safely with you and friends, consider letting him/her walk independently with friends provided that he/she does not have to cross any major intersections. After a small amount of time being able to walk independently and proving that he or she is capable of being careful, you could allow your child to walk places with friends that involve crossing busier streets.

With the examples above, the point is to explain your rationale to your child or teen if you feel uncomfortable letting him or her do something. It is important that the explanation revolve around specific skills rather than concerns about having ADHD. Furthermore, it is important to discuss ways to improve these skills and then demonstrate success with them. Taking this approach, along with other strategies, will help improve your child’s confidence and make him or her less likely to fall prey to negative self-perceptions due to having ADHD.

Despite decades of work to educate the public about the nature of mental health conditions, mental health issues are still accompanied by stigma. Many people perceive that mental health issues happen to people they never see and certainly never care about.

The reality is that almost everyone knows someone with a mental health diagnosis, and such a diagnosis does not in any way mean that a person cannot live a normal, healthy, happy life. About 26% of Americans experience a mental health diagnosis in any given year. Most of these diagnoses are highly treatable conditions.

Anxiety Issues

Anxiety issues make up the most common group of mental health conditions in the United States, with 40 million American adults—or about 18% of the population—experiencing anxiety in any given year. Obsessive compulsion, panic, posttraumatic stress, generalized anxiety, and social phobia are all examples of anxiety disorders. Among people who experience such a disorder, social phobia is the most common, with 15 million people experiencing this condition each year.

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Mood Issues

Mood issues undermine a person’s ability to regulate mood. About 9% of the adult population, or 21 million people, experiences a mood disorder such as depression, bipolar, or dysthymia each year. Depression is the most common mood disorder, affecting almost 15 million people every year. It is also the leading cause of disability among adults.

Attention Deficit

About 11% of children have been diagnosed with attention deficit disorder or attention deficit hyperactivity. This diagnosis isn’t limited to children, though; ADHD affects 4% of adults every year.

Personality Issues

While many therapists and mental health practitioners do not support diagnoses of personality disorders of any kind, the Diagnostic and Statistical Manual (DSM) lists several types of personality diagnoses, and they are still frequently used. Rather than changing the way a person behaves in a specific context, personality disorders fundamentally alter a person’s thoughts, feelings, and behavior. Avoidant personality, which leads to avoidance of social situations and chronic feelings of inadequacy, is the most common personality issue, affecting 5% of adults every year. Overall, personality issues affect 9% of adults every year.

Substance Abuse

Substance abuse can lead to addiction to substances ranging from alcohol to illicit drugs. About 23 million Americans experience an addiction each year, with only about 10% receiving proper psychological and medical treatment.

If you or someone you know is experiencing any of these common mental health issues, help is available. Find a therapist near you on by searching the GoodTherapy.org Directory.

References:

1. Attention deficit/hyperactivity disorder data & statistics. (2013, November 13). Retrieved from http://www.cdc.gov/ncbddd/adhd/data.html

2. The numbers count: Mental disorders in America. (n.d.). Retrieved from http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml

3. The science of addiction: Drugs, brains, and behavior. (2007). Retrieved from http://www.nlm.nih.gov/medlineplus/magazine/issues/spring07/articles/spring07pg14-17.html

When trying to determine if a child or teen is experiencing attention-deficit hyperactivity (ADHD), it is important to obtain an accurate diagnosis and sense of how he or she is functioning in different domains. This can help guide treatment and other interventions.

As parents begin the process of determining if a child or teen has ADHD, many wonder what is entailed in a formal evaluation by a psychologist—and what benefits it may provide. As a psychologist who provides evaluations to diagnose ADHD and treats the issue through psychotherapy, I thought I could shed some light here. The methods used vary from professional to professional, but here is a general overview of a formal evaluation for ADHD, as completed by a psychologist.

In-Depth Clinical Interview

The time frame may vary somewhat, but on average this lasts one to two hours and provides the clinician with an opportunity to gather comprehensive background information about the child or teen, current symptoms, and other difficulties. The psychologist generally spends time meeting with the child or teen and his or her parents, together and/or separately.

Consultations with Relevant Professionals

Many psychologists consult with other service providers working with the child/teen, including mental health therapists, speech/language therapists, occupational therapists, and psychiatrists. In a lot of cases, the clinician will endeavor to complete a school observation and interview teachers. (Depending on the circumstances and the comfort level of those involved, this may not always be warranted or feasible.)

Formal Testing

The exact measures used and amount of time needed to complete testing vary, to some degree, for a variety of reasons. On average, formal testing for ADHD lasts between four and nine hours. Many clinicians opt to break up testing into two or three sessions on different days.

A variety of standardized measures involving direct interaction between the psychologist and child/teen—computerized measures, self-report and parent/teacher report questionnaires, and other types—are used to look at several areas of functioning, including cognitive functioning, academic achievement in a variety of domains, reading/language skills, attention/impulsivity, visual-motor skills, and emotional functioning.

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Completed Report/Formal Feedback Session

Reports can take several weeks to complete; it takes considerable time to carefully review/interpret results and document it all.

The feedback session is an opportunity to learn about the results of the evaluation and begin talking about specific recommendations to assist the child/teen in improving areas in which he or she is struggling.

Diagnosing ADHD in children/teens is often not as simple as one might think; many issues, such as depression, anxiety, sensory issues, learning difficulties, auditory processing disorder, and even autism spectrum issues, have symptoms that can mimic ADHD. A formal evaluation is helpful in ruling out other issues to ensure an accurate diagnosis.

Nonetheless, depending on the presenting issues, an evaluation doesn’t always lead to definitive conclusions about diagnoses. In these cases, a parent still would come away with a clear sense of how the child/teen is functioning, and would have recommendations to assist him or her.

Benefits Beyond Diagnosis

Aside from obtaining an accurate diagnosis, here are a few possible benefits of having a formal evaluation conducted:

1. Good understanding of the child/teen’s strengths and limitations
2. Recommendations for teachers at school
3. Recommendations for helping the child/teen at home (suggestions to improve organization, time management, behavior, etc.)
4. Information and specific recommendations to help current and future service providers (psychiatrists, mental health therapists, etc.) best assist the child/teen
5. Documentation of the issue that may qualify the child/teen for special education services in the form of a 504 plan or individualized education program (IEP). This may entitle the child/teen to accommodations such as extended time, private or small group testing environment to reduce distractions, use of a word processor in class, etc. Older teens may qualify for accommodations on college board exams as well as services in college. (Not all public school systems/private schools use outside evaluations in the same way, so depending on the school system, ADHD alone may not qualify a child for services.)

If you believe that your child/teen has ADHD and he or she is struggling academically, socially, or in other areas, it is important to get a clear sense of his or her difficulties, determine if it is indeed ADHD, and obtain appropriate treatment.

Disclaimer: The preceding article is intended as general guidance based on the author’s professional opinion, does not constitute an established professional relationship, and should not replace the recommendations of a psychologist or other licensed professional with whom you initiate or maintain a professional relationship.

Great question! I see this dynamic a lot in my own practice—parents or teachers feel a child could benefit from therapy, but the child is reluctant. Therapy is going to be helpful only if your son is a willing participant. Forcing the issue will not only produce minimal results, if any, but may turn him off from seeking out counseling support in the future.

It is not a lost cause, however. There are many things you can do to increase the likelihood of your son being willing to participate in counseling. First, give him a voice. What was it about therapy that he hated? Really listen to his answers. They might seem silly or arbitrary, but if you hear what didn’t work, you are much more likely to find someone who won’t recreate that negative experience. Second, give him some control. Let him know that he gets to choose the person he is going to work with. Get together and look through online profiles (such as the ones on GoodTherapy.org) that you’ve already pre-selected as viable options, and let him read through and indicate which ones he might be willing to meet with and interview. Many therapists offer a brief consultation to give client and therapist a chance to assess for fit. Let him select a few (I recommend no more than three or four) to have a brief chat with, and let him choose which one he is willing to talk with. You can let the therapist know that your son is reluctant about therapy so that he/she can address those concerns head-on.

When I meet with reluctant potential clients, particularly children, I often find that the barriers include a lack of understanding of what counseling is really all about. When they realize that they can tell me basically anything and I’m not going to judge and they aren’t going to get in trouble, that this time and space is all about them—their feelings, their needs, their experiences—I see even skeptical faces light up. When I tell them that we can do therapy while playing with my dog, going for a walk, or even playing basketball, they can even get pretty enthusiastic.

Finally, give him an out. Ask him to commit to four to six sessions with one therapist. If at the end of that time he isn’t getting anything from it or finds it unpleasant or objectionable, then he can decide to stop. Even if he goes six times and says virtually nothing, stick to your bargain. If he trusts he has some control, he may be more willing to try the next time.

One thing to keep in mind is that the single greatest predictor of positive therapeutic outcomes is the relationship and rapport the client has with the therapist. If your son really connects with someone, he can get a lot out of therapy. If he doesn’t, he probably won’t get much from it. As long as therapy is something that is being done TO him, he’s likely to be more closed to the experience. If he gets invested in the process of choosing someone, there’s a much greater chance of counseling being a positive experience.

Best of luck!
Erika

Attention deficit hyperactivity (ADHD) is characterized by cognitive disorganization, low attention, and impaired focus. Among the many symptoms and behaviors associated with ADHD are excess energy and externalizing behavior. Research has shown that as children with ADHD mature, their symptoms often decrease.

However, some children also exhibit signs of conduct disorder and personality problems, which exacerbate and perpetuate symptoms. This combination of psychological conditions can lead to violent behavior in some individuals. But does ADHD itself cause violent behavior?

That was the question posed by Rafael A. Gonzalez of the Forensic Psychiatry Research Unit at the University of London as the subject of a recent study. Gonzalez and his colleagues wanted to determine if ADHD by itself was linked directly to violent behavior in adults. And if so, what aspects of ADHD were most influential on violence?

To answer this question, Gonzalez reviewed responses from over 7,300 adults in the general population, using the Adult Self-Report Scale for ADHD. He also asked about violence, recurrence of violence acts, level of violence, and other comorbid issues. Gonzalez found that ADHD alone was only slightly predictive of violence. More specifically, the hyperactive behavior linked with ADHD, not the inattentive aspect, was the impetus for violence.

When Gonzalez examined levels of ADHD in relation to levels of violence, he discovered that the mild and moderate symptoms of ADHD were most closely related to repeated violent perpetration. However, severe ADHD was only associated with violence in the context of comorbidity. The most common conditions that appeared to be responsible for violent behavior in the adults with severe ADHD were personality problems, anxiety, and substance abuse.

“We thereby conclude that repetitive violence among persons with severe ADHD is associated with multiple forms of coexisting psychopathology but not ADHD,” said Gonzalez. Therefore, it is imperative that people with ADHD and co-existing psychological problems address the issues that could make them more susceptible to violent behavior. Future research should address the most effective ways to accomplish this.

Reference:
González, R.A., Kallis, C., Coid, J.W. (2013). Adult attention deficit hyperactivity disorder and violence in the population of England: Does comorbidity matter? PLoS ONE 8(9): e75575. doi:10.1371/journal.pone.0075575

Research has shown that people with attention deficit hyperactivity (ADHD) have cognitive and functioning deficits. They often have high levels of impulsivity and low levels of task attention. These deficits can result in social, personal, and academic difficulties. In the study of ADHD, numerous strategies have been tested to improve attention and decrease impulsivity. Among them are behavioral and cognitive approaches, some of which have been shown to be successful.

But an existing theory at the core of ADHD research is that of reward motivation, which suggests that people with ADHD respond better and demonstrate less impulsivity and more attention when rewarded compared to when there is no reward for a task. To test this theory further, Ivo Marx of the Department of Psychiatry and Psychotherapy at the University of Rostock in Germany recently recruited 38 adults with ADHD and 40 without ADHD for a controlled experiment. In the experiment, the participants underwent a battery of cognitive tests with and without rewards. The response times, false positives, impulsivity rates, and overall performances were measured and compared.

Marx found that the individuals with ADHD exhibited higher levels of impulsivity and lower levels of attention when there was no reward present. However, when a reward was offered, they were less impulsive and their outcomes had fewer false positives. In other words, their performance was better and far improved in the presence of a reward. In fact, the participants with ADHD performed similarly to those without ADHD when they were motivated by a reward.

Marx believes that these findings, which are in line with existing research, underscore the importance of reward motivation for people who tend to be impulsive. The results suggest that perhaps being motivated by a reward encourages individuals with ADHD to slow down their reaction times and engage a “stop-and-think” strategy. Additionally, these results show the importance of such a strategy for improving outcomes for cognitive tasks. This could be extremely useful at helping ADHD individuals improve their cognitive outcomes in various settings, including personal, academic and professional arenas. Marx added, “Taken together, our results support the existence of both cognitive and motivational mechanisms for the disorder, which is in line with current models of ADHD.”

Reference:
Marx, I., Höpcke, C., Berger, C., Wandschneider, R., Herpertz, S.C. (2013). The impact of financial reward contingencies on cognitive function profiles in adult ADHD. PLoS ONE 8(6): e67002. doi:10.1371/journal.pone.0067002

Conduct issues are becoming a global problem for parents, educators, and children. They usually first appear and early childhood and can be identified through behavioral and psychological screenings, such as the Strengths and Difficulties Questionnaire (SDQ). The issues that arise from conduct problems include anger, aggression, hostility, academic challenges, social problems, and other behavioral and emotional issues.

Although the SDQ has been shown to be effective at identifying symptoms of conduct disorder, it is lengthy and time consuming. Therefore, Melissa E. Duncombe of the Psychological Sciences Department at the University of Melbourne in Australia wanted to see if an alternative brief assessment would be as effective and provide results that are equal to that of the SDQ.

For her study, Duncombe used the Conduct Problems Risk Screen (CPRS), a seven-item scale, to identify conduct problems in a group of over 4,700 elementary school children. Because traits found in oppositional defiance (ODD) and attention-deficit hyperactivity (ADHD) have been shown to be precursors for later conduct problems, the CPRS was designed to reveal any specific inattentive or aggressive behaviors as well.

Parents and teachers reported their evaluations of children, and Duncombe found that although there was a much higher rating of conduct issues in the parents’ reports, the overall consistency between the two groups was high. Duncombe believes that parents may witness more behavioral problems and may also incorporate family reactions, disciplinary consequences, and other factors into their assessments when filling out the CPRS. Teachers, on the other hand, can only report on what they witness and experience during the school day.

Another strength of the CPRS is that it only takes a few minutes to administer. Unlike the lengthy SDQ, the CPRS can be completed in under two minutes, and may be viewed as more applicable tool with younger children. This can be especially important for early identification of the children at risk for later conduct, ADHD, or ODD issues. Dunscombe added, “The CPRS is a valid and reliable instrument and could be used effectively as a screening tool to identify those children at risk of developing conduct disorder.”

Reference:
Duncombe, Melissa E., Sophie S. Havighurst, Kerry A. Holland, and Emma J. Frankling. (2012). Psychometric evaluation of a brief parent- and teacher-rated screen for children at risk of conduct disorder. Australian Journal of Educational & Developmental Psychology 12 (2012): 1-11. Print.

Contextual information surrounding memories is crucial to memory encoding, storage, and retrieval. When a person experiences an event that is marked by vivid emotional reactions, they often are able to remember specific contextual facts related to that event. For example, a particularly joyous moment could be recalled with the exact details of where a person was when it happened and exactly when the moment occurred in life. However, this source discrimination of being able to isolate when and where appears to be diminished in people with attention deficit hyperactivity (ADHD).

According to a recent study by Anselm B.M. Fuermaier of the Department of Clinical and Developmental Neuropsychology at the University of Groningen in the Netherlands, people with ADHD show deficits in some areas of memory processing, but not in others. Fuermaier used a word paradigm to test memory induction, storage, and retrieval in a sample of 77 participants, 37 of whom had ADHD. The participants were assessed for memory encoding, memory retention, and memory recall with source discrimination.

Fuermaier discovered that although memory encoding, learning of new material, and memory recall or retrieval of information were equal between the ADHD and non-ADHD participants, source discrimination was not. Specifically, the participants with ADHD had much lower levels of source discrimination than the controls. In other words, they were less able to describe when and where a prior autobiographical event had occurred and were unclear about the context of their memories.

This finding is extremely relevant, as it shows that people with ADHD have impairment attaching contextual meaning to memories. Fuermaier said, “Inefficient source discrimination in adults with ADHD can affect daily functioning by limiting biographic awareness and disturbing general cognitive processes.” Identifying these deficits and empowering individuals with ADHD by teaching them effective memory retrieval techniques could improve overall functioning and increase well-being in all domains of life.

Reference:
Fuermaier, A.B.M., Tucha, L., Koerts, J., Aschenbrenner, S., Weisbrod, M., et al. (2013). Source Discrimination in adults with attention deficit hyperactivity disorder. PLoS ONE 8(5): e65134. doi:10.1371/journal.pone.0065134

Attention deficit hyperactivity (ADHD) manifests with symptoms of inattention, hyperactivity, and impulsivity. In the criminal population, impulsive behavior is a common thread. However, few studies have sought to determine whether ADHD increases the likelihood that a person will engage in criminal behavior. The effects of ADHD are broad, varied, and long term. To accurately predict how ADHD will influence future behavior, one must look at other environmental and familial factors. To this end, Jean-Baptiste Pingault of the Research Unit on Children’s Psychosocial Maladjustment at the University of Montreal and Sainte-Justine Hospital in Canada recently led a longitudinal study involving more than 2,700 individuals.

The participants were first evaluated for ADHD, physical aggression, inattention, and family adversity when they were 6 years old. They were reassessed annually for seven years. When they were 25, criminal records and teacher and parent reports were examined in order to find any association between the measured risk factors and criminal behavior. Pingault discovered that in certain analyses, childhood ADHD was linked to criminal behavior. But in the most sensitive analysis, the association was weak at best. However, childhood physical aggression was directly predictive of later criminal behavior.

The findings revealed that while less than 10% of the total sample exhibited physical aggression in childhood, this small group represented 30% of the criminal activity in adolescence and young adulthood. Further, these same participants were responsible for almost half of the criminal charges on record and nearly 60% of all the violent criminal charges. Family adversity also increased the risk for criminal behavior in the aggressive participants. Pingault believes these results show that not all children with ADHD are at risk of engaging in criminal behavior. But children with aggressive traits, and especially those with ADHD and family adversity, are more vulnerable to criminal activities. Therefore, efforts to reduce crime may not be most effective if focused solely on children and young people with ADHD. “Crime prevention should instead target children with the highest levels of childhood physical aggression and family adversity,” said Pingault.

Reference:
Pingault, J-B., Côté, S.M., Lacourse, E., Galéra, C., Vitaro, F., et al. (2013). Childhood hyperactivity, physical aggression and criminality: A 19-year prospective population-based study. PLoS ONE 8(5): e62594. doi:10.1371/journal.pone.0062594

Prospective memory describes the ability to remember to do something in the future, like go to a doctor’s appointment or attend a meeting. Research on attention deficit hyperactivity (ADHD) in children has shown that deficits exist in numerous areas of cognitive functioning and behavior control. In fact, behavioral and cognitive difficulties appear to be equally pervasive in children with ADHD. However, as children mature, they overcome the challenges they face with behavioral issues, but cognitive obstacles still exist. Adult ADHD is thought to affect cognitive tasks such as planning, shifting attention, and other executive functions. But the influence of ADHD on prospective memory in adults is still unknown.

Anselm B. M. Fuermaier of the Department of Clinical and Developmental Neuropsychology at the University of Groningen in the Netherlands recently led a study that looked at which prospective memory deficits were present in a sample of 45 adults with ADHD. The participants, who were not on medication for ADHD, were presented with a paradigm that required they plan for, initiate action toward and execute an act in the future. Fuermaier compared the performance of the participants with ADHD to that of 45 non-ADHD adults throughout the process and found several differences.

The biggest deficit that appeared in the ADHD participants was in the area of planning. They made less detailed plans and planned less for multiple future events than the control participants. Initiation of the plan was another area in which the two groups differed significantly. Although both groups were able to recall an impending event, the ADHD participants had difficulty initiating their action plans. “Prospective memory is crucial for everyday occupational and social functioning,” said Fuermaier.  Not only is it essential in order to complete most activities related to work, family, and social interactions, it is also critical to treatment. Clients who cannot remember to attend therapy appointments or who forget to take their medications at designated times are at risk of experiencing worsening symptoms. This can result in negative outcomes such as physical illness, job loss, and relationship conflict that can ultimately increase stress. Overall, this research shows that prospective memory deficits exist in adults with ADHD and addressing this should be part of any treatment program.

Reference:
Fuermaier, A.B.M., Tucha, L., Koerts, J., Aschenbrenner, S., Westermann, C., et al. (2013). Complex prospective memory in adults with attention deficit hyperactivity disorder. PLoS ONE 8(3): e58338. doi:10.1371/journal.pone.0058338

Picture someone with attention-deficit hyperactivity. Odds are good you’re envisioning a child who can’t sit still zooming around his or her classroom, struggling with grades, and driving parents crazy. But ADHD isn’t just for children. Some kids grow out of this diagnosis or develop coping skills, but others continue to struggle as adults—some of whom were never diagnosed as children.

Children have the benefit of existing under the watchful eye of adults who can advocate for their interests. Adults, however, may struggle for years before they realize that their procrastination, difficulty concentrating, and trouble completing tasks are the result of ADHD, not a personal failing.

What Is Adult ADHD?
Adult ADHD is the same issue that children experience, but it can manifest in different forms. Children may struggle with school or making friends, but life-altering consequences from the condition in childhood are rare. In adulthood, however, failing to turn in a presentation, skipping a semester of college, or being unable to listen to a spouse can end in catastrophe. Consequently, adults who have ADHD—particularly if they’re not getting appropriate treatment—may have more dramatic difficulties than children, and often get much less sympathy.

Recognizing Symptoms
Symptoms of adult ADHD may include:

• Difficulty listening to others, trouble responding appropriately in conversation, or focusing on side details rather than the main point of a discussion.
• Procrastination and difficulty planning.
• Extreme disorganization that interferes with functioning; for example, forgetting to deposit checks or failing to bill clients.
• Trouble remaining focused on a task, even an important or fun one.
• Making careless mistakes.
• Zoning out in conversations.
• Anger.
• Restlessness and feeling unable to sit still.
• Impatience.
• Inability to tolerate boredom.
• Frequent fidgeting.
• Alternating between being excessively focused on a task—for example, reading for 12 hours—and being unable to focus on anything.

Adult ADHD and Other Mental Health Conditions
Some people with adult ADHD initially seek help for a different condition, such as depression or anxiety. The frustration ADHD can cause frequently leads to other symptoms. An adult with the issue might have trouble in his or her relationships, struggle to keep a job, have a hard time managing finances, frequently lose his or her temper, or experience low self-esteem. If the symptoms are caused by ADHD, treating depression or anxiety sometimes won’t help, which can add to the frustration.

In other cases, ADHD can co-occur with other mental health issues, and people with ADHD are more likely to be depressed than those without. If you’re experiencing symptoms of two different conditions, it’s often helpful to treat the one that’s causing you the most discomfort first. If your inability to focus is making you depressed, focus on that. But if your procrastination is a small problem and constant feelings of sadness are leaving you hopeless, it may be better to treat depression first.

Getting Help
Medication—including stimulants such as Adderall and Ritalin—and therapy can help people with ADHD, but this doesn’t mean you’ll have to be in treatment for the rest of your life. Simple lifestyle remedies such as staying meticulously organized, planning ahead, meditating, and adopting strategies for focusing can make a big difference. Seek treatment providers who specialize in ADHD. They’re more likely to understand the effects these issues can have on adults, and can recommend successful coping strategies.

References:

1. Adult ADD. (n.d.). Dr Hallowell RSS. Retrieved from http://www.drhallowell.com/add-adhd/adult-add/
2. Adults with ADHD. (n.d.). CHADD. Retrieved from http://www.chadd.org/Understanding-ADHD/Adults-with-ADHD.aspx
3. McGillivray, J., & Baker, K. (2008). Effects of Comorbid ADHD with Learning Disabilities on Anxiety, Depression, and Aggression in Adults. Journal of Attention Disorders,12(6), 525-531. doi: 10.1177/1087054708320438