Many people with attention deficit hyperactivity disorder (ADHD) may not be diagnosed until adulthood. Adult symptoms may be a little different from those of childhood.
It’s important to know what to look for, so people can get support to help them better understand themselves and realize their full potential.
People, including some clinicians, may not be aware of adult ADHD and how symptoms can change as a person develops and grows. We aim to change that through the development of a Australian ADHD Guidelinewhich is evidence-based and now open for feedback.
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ADHD is a neurodevelopmental disorder that affects executive functions of the brain, such as the ability to focus and sustain attention, plan and organize, and exercise self-control.
It affects approximately 6 to 10% of children and is the most common neurodevelopmental condition in children. Yet many people with ADHD are not diagnosed in childhood, for a variety of reasons. Some may have grown up in an environment that suited them well, so the symptoms were not obvious.
For example, they may have been interested and motivated in academic matters, which allowed them to focus and maintain their attention on schoolwork. They may have a high intellectual capacity, which may mean that a minimum of independent study is necessary to succeed in school subjects. They may have only had ADHD Inattentive Symptoms – such as daydreaming or difficulty performing tasks – which may be less noticeable than hyperactive-impulsive symptoms.
Symptoms of ADHD in childhood can include difficulty focusing attention. This can show up as not understanding or remembering teacher instructions, forgetting homework or losing things like school sweaters, and being disorganized with a messy room or office at school.
Children with symptoms of hyperactivity-impulsivity may have difficulty sitting still during class or when eating dinner at home, be loud and talkative, disturb or interrupt others, and have trouble waiting their turn .
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4 Ways Adult ADHD Can Look Different
In adulthood, symptoms may still be present, but they may be more internalized and less obvious. Here are some ways ADHD symptoms in adults can present that are slightly different from those in childhood:
1. No time to stop
Rather than climbing on things and being overtly hyper, adults may have an inner feeling of restlessness. They may find it difficult to relax and have a constantly busy mind. They may feel driven to always do something and try to be constantly productive. It can mean that even on vacation there is an inability to relax and the person has to be busy doing activities.
2. Organized, then a bit overwhelmed
Rather than always being disorganized, adults may experience periods when they are highly organized to overcompensate for their ADHD symptoms, followed by periods when they feel overwhelmed and unable to get things done. This period of overwhelm, which can last a few days, may be due to the extra effort that must be organized when you have ADHD.
3. Severe procrastination
This can lead to failure in college subjects and difficulty performing work-related tasks. Procrastination can impact the completion of household chores and fall behind in the general administration of life, such as paying important bills. Postponing things to an extreme degree—so that an impending deadline results in a last-minute, “break-in,” “all-night” effort—is common in ADHD.
4. A bad sense of time
In adults, this can lead to a constant underestimation of how long things will take, leading to frequent delays. A person may disregard the coffee stop and traffic in their calculations.
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Many of us experience occasional moments when we feel or act in the ways described above. When multiple instances of these occur and cause significant negative impacts in different areas of life – such as our ability to study, work, socialize, take care of the home – or cause a negative self-image, it may be time to consider the possibility of ADHD.
Recently, there has been greater public awareness of ADHD in adults, including on social media and websites with people describing their lived experience. This has increased demand for adult ADHD assessment and treatment services and has highlighted a significant gap in healthcare delivery in Australia.
There are simply not enough ADHD clinicians, no public services for adults with ADHD, and no uniform standards of care for ADHD. This creates long waiting lists for diagnosis and treatment.
It is crucial to receive the right diagnosis, the right treatment and the right support. Evidence-based treatment for ADHD in adults may include lifestyle changes and environmental modifications, medications, and psychological treatments, such as cognitive behavioral therapy. The right treatment for ADHD yields better results, including improvements in life expectancyreduced accidentsand reduced substance use disorders.
A major barrier to effective care for people with ADHD has been the lack of an Australian guideline for clinicians that outlines evidence-based best practice in diagnosis, treatment and support.
the Australian Association of ADHD Professionals has developed a practice guide for the identification, diagnosis and support of children, adolescents and adults with ADHD. The public can now comment and contribute to the draft guideline.
Public consultation is important to ensure that the Australian guideline addresses issues relevant to people with lived experience of ADHD and those involved in diagnosing and supporting people with ADHD. It is hoped that these guidelines can help people identify their ADHD as early as possible and receive the support they need to reach their potential.