In the last 10-15 years we have become increasingly aware of Attention Deficit Hyperactivity Disorder (ADHD), a condition where we recognise symptoms such as difficulties in attention or focus, hyperactivity and impulsivity. Naturally, these symptoms tend to be noticed at an early age but they become more evident when a child’s circumstances change such as starting school. Therefore, most of the cases are diagnosed when children are 6 to 12 years old. Children treated for ADHD show in general a marked improvement, it is widely accepted that the symptoms of ADHD usually improve with age, but this is quite a misleading concept. In my experience symptoms do not improve: they become simply masked. In the process of growth, undiagnosed ADHD children become undiagnosed adults who are able to develop coping mechanisms to address the ADHD symptoms, provided they are offered the right circumstances and support. In my clinical practice I come across patients who have found the right “niche” where their hyperactivity and impulsivity are useful (workaholics for example) or the right support to manage the inattention (a good secretary, a supportive team, etc). However, this is not always the case and undiagnosed ADHD children become frustrated adults: feeling that the achievements do not truly reflect their intelligence and abilities which is usually a very painful experience.
In most of the cases, whether successful or less, adults experience what I tend to describe as “the tipping point”: a moment when either the “coping mechanisms” are not effective anymore or the level of frustration becomes unbearable. Encouraged by family, friends or partners they finally seek help providing them an increased awareness of adult ADHD. These adults then discover that they might suffer from this condition and seek assessment and treatment. In these cases, the changes are usually quite dramatic and the drama stems from the fact that when responding to treatment, the usual comment is that their “personality” has changed: used to be seen under a certain light – impulsive, short tempered, lack of patience, hyperactive, ec – they present now as almost “different” individuals.
The symptoms of attention deficit hyperactivity disorder (ADHD) can be grouped into 2 types of behavioural problems: inattentiveness, and hyperactivity/ impulsiveness. Therefore we talk about ADHD predominantly inattentive, predominantly hyperactive/impulsive or mixed. Most people with ADHD have problems that fall within the mixed type, but this is not always the case. ADHD can present itself in the form of inattentiveness without hyperactivity or impulsiveness, in these cases is known as ADD Attention Deficit Disorder. Since ADHD is a developmental disorder, it cannot develop in adults without it first appearing during childhood. The symptoms of ADHD in adults are sometimes more difficult to define but they tend to be a continuation of those present during childhood and adolescence.
During early age the main presenting symptoms of inattentiveness are: having a short attention span and being easily distracted making careless mistakes – for example, children in school may appear forgetful, seem unable to listen, or they may flit between tasks unable to stick to one activity, they may also appear forgetful. The main signs of hyperactivity and impulsiveness are: being unable to sit still, especially in calm or quiet surroundings constantly fidgeting being unable to concentrate on tasks excessive physical movement excessive talking being unable to wait their turn acting without thinking interrupting conversations little or no sense of danger.
By the age of 25, an estimated “15% of people diagnosed with ADHD as children still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives.” In general we agree that the way in which inattentiveness, hyperactivity and impulsiveness present and affect adults can be very different from the way they affect children. For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressures of adult life increase. Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms.
In general it is accepted that the symptoms in adult ADHD are:
- Inattentiveness
- Hyperactivity
- Impulsiveness
- Lack of Patience
- Carelessness
- Lack of Attention to Detail
- Often Starting New Tasks Before Completing Old Ones
- Poor Organisational Skills
- Inability to Focus or Prioritise
- Continually Losing or Misplacing Things
- Forgetfulness
- Restlessness and Edginess
- Difficulty Keeping Quiet
- Speaking Out of Turn & Interrupting Others
- Mood Swings, & a Quick Temper
- Inability to Deal with Stress
- Extreme Impatience
Further to this, the behavioural problems associated with ADHD can also cause problems such as difficulties with relationships and social interaction, increased chance of issues such as sleep & anxiety disorders.
Treatment:
ADHD can be treated with specific medications and the response is usually very good. As with any other medication, the response is individual and side effects need to be considered. In addition, there are other therapies such as Cognitive Behavioural which prove to be effective too. In my practice I assess in depth the clinical presentation with a set of tests and having reached a diagnosis, I discuss with the patient the different therapeutic options which include, in addition to medication and therapy, integrative medicine. The Integrative Medicine approach addresses the effect that minerals and vitamins as well as the microbiome (the bacteria we have in our guts) have on the wellbeing of the individual and aims to correct possible deficiencies and/or imbalances.
If you would like to find out more about Dr P Jeczmeins ADHD clinics and advise, read more here & ask for a free consultation to discuss your experience, and how holistic therapy could help.
