Question from: 10/20/97

Charles H. Booras, M.D.
Co-Founder and Editor,
Jacksonville Medical Park

Answer: It's possible that you are suffering from Adult Attention Deficit Disorder (ADD). The following information was taken from the Children and Adults with Attention Deficit Disorders (CH.A.D.D.) web site. CH.A.D.D. is a nonprofit parent-based organization formed to better the lives of individuals with attention deficit disorders and those who care for them.

Until recently, it was believed that ADD symptoms largely disappeared in adolescence. It is now known that many symptoms continue into adulthood for up to 70% of individuals with ADD. Adults with ADD experience problems at work and in relationships. They may also exhibit other emotional difficulties. Medications such as psychostimulants can be an effective intervention with adults with ADD.

Background:

Attention Deficit Disorder has only recently been recognized as an adult disability. Previously, it was believed that there is a resolution of ADD symptoms in adolescence due to brain development, hormonal change, or other developmental change.

Follow-up studies documented that children with ADD continue to exhibit symptoms of the disability in adolescence and adulthood. 30-70% of children with ADD continue to have symptoms in adulthood. It has been conservatively estimated that 2-5 million adults are affected by ADD. It is now recognized that adults with ADD have similar symptoms as do children with ADD.

Many adults with ADD were never diagnosed as children. Thus, they are not aware of, nor do they understand the consequences of, their disability. Indeed, since ADD was not recognized in adults until recently, many of these adults may have been previously treated for depression, antisocial personality, or character disorders.

Diagnosing ADD in the adult requires an examination of childhood, academic and behavioral history. Symptoms are sometimes more readily recognized by a spouse than the individual with ADD. Psychoeducational and vocational testing, as well as a thorough evaluation of family relationships and interpersonal skills, can provide insight into a suitable intervention program.

ADD in adults is often undiagnosed or misdiagnosed. This can lead to low self-esteem, increased frustration and educational or vocational failure. Years of struggling with the untreated disability places these adults at risk for other problems, such as drug abuse and depression.

Most adults with ADD are restless, easily distracted, have difficulty sustaining attention and concentrating, are impulsive and impatient, have frequent mood swings and short tempers, are disorganized and fail to plan ahead.

Adults with ADD often experience career difficulties. They may lose jobs due to poor job performance, attention and organizational problems, or relationship difficulties. Other times, they may simply quit out of boredom.

On the other hand, adults who learn to adapt to their disability and to harness the energy and creativity that often accompanies ADD can thrive professionally. Many adults with ADD are successful entrepreneurs.

Education is the first strategy for intervention. Most adults with ADD have little understanding of the disability. Once they have been accurately diagnosed, they are often relieved to learn their difficulties are due to a disability, as opposed to some personal flaw.

Adults can benefit from learning to structure their environment. This may involve using an appointment book, a personal computer, or tape recorder. Other strategies include making a daily list of tasks, posting schedules and appointments throughout the home or office, learning time management skills, and setting up a self-reward system.

Psychostimulant medications can be effective with adults who have ADD. Other medications, such as antidepressants can be helpful for treating substance abuse and depression, or when phobic, panic, anxiety and/or obsessive compulsive disorders are present.

A primary goal of therapy with an adult who has ADD is to build on success. Vocational counseling designed to identify employment well suited to the individual's strengths and skills can help to ensure success.

Other intervention strategies include: scheduling regular physical exercise, maintaining a sense of humor, eliminating negative self statements, avoiding, reducing or eliminating alcohol or drug use, enlisting a friend, relative or spouse to help finish tasks and remember commitments, and to provide feedback.

Short-term psychotherapy can help the patient identify how his or her disability might be associated with a history of sub-par performance and difficulties in personal relationships.

Long-term psychotherapy can help address mood swings, stabilize relationships, and alleviate guilt and discouragement.

Editors Note:

I suggest that you visit your Primary Care Physician to develop a strategy for further evaluation, diagnosis, and treatment of your problem.

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