Dr Zana Marovic, Phd

Clinical Psychologist, Johannesburg

ADD/ADHD in Adults

Adult ADD/ADHD, as in children, is characterized by excessive inattentiveness, impulsiveness and hyperactivity. While in children, hyperactivity is often displayed as constant squirming and moving, in adults it may be more of a constant feeling of restlessness and agitation. Extreme procrastination, disorganization, trouble making deadlines, and impulsive behavior is common. While most of us have challenges in these areas, someone with adult ADD/ADHD has these problems constantly, in good times and in bad, and often to the despair of loved ones.

Signs and symptoms of adult ADD/ADHD

The causes of adult ADD/ADHD, as with children, are still unknown. ADD/ADHD is thought to occur at least in part due to abnormal functioning of neurotransmitters, the chemical messengers of the brain. Risk factors for adult ADD/ADHD include a childhood diagnosis of ADD/ADHD or suspicious behaviors, a family history of ADD/ADHD behaviors, or issues in pregnancy such as smoking or drinking; low birth weight and premature birth also are risk factors.

While the final diagnosis comes from evaluation from a skilled professional, hallmarks of adult ADD/ADHD include similar childhood symptoms and persistent adult symptoms that interfere with work and relationships, even through the ups and downs of life.

Childhood ADD/ADHD symptoms

Even if you were not formally diagnosed, if you had ADD/ADHD as a child, you are at risk of having ADD/ADHD as an adult. A child with ADD/ADHD might be someone who persistently can’t sit still, who never seems to listen, who doesn’t follow instructions no matter how clearly you present them, or blurts out inappropriate comments at inappropriate times.

Inattention symptoms

In adults, symptoms of inattention, especially those of concentration and organization, often become more dominant than in children.

  • Concentration – Adults with ADD/ADHD have trouble with concentration to an extreme degree. They have trouble following conversations, “zoning out” without realizing it. Finishing tasks might feel impossible, and person with ADD/ADHD might have several tasks started at once without the ability to continue. They might easily get distracted or forgetful, leading to errors or incomplete work.
  • Organization – Keeping things organized at home and work might be an enormous challenge. Home and/or work space might be unusually cluttered and messy. ADD/ADHD adults might underestimate the time it takes to complete tasks or have trouble with procrastination, making completing large projects very difficult. Adults with ADD/ADHD often also continually forget or lose things.
Hyperactivity symptoms

While hyperactivity may conjure up an image of a child bouncing around and screaming, in adults it looks different. Adult with ADD/ADHD may find oneself easily bored, irritated and experience mood swings. He/she may be restless and full of nervous energy, not able to sit and relax. Quiet activities might feel impossible and there is a need to talk incessantly.

Impulsivity symptoms

ADD/ADHD adult may have trouble controlling impulses, which can range from relating to others to daily decisions.

  • Decision making – He/she might have a pattern of making sudden decisions “on a whim” or have trouble listening to others.
  • Relating to others – ADD/ADHD adult might have trouble following a conversation, interrupting others, answering before a question has been asked, or blurting out things you regret later.


Effects of adult ADD/ADHD

Left untreated, ADD/ADHD can disrupt everything from your career to your relationships and financial stability. While most of us sometimes have challenges in these areas, the persistent chaos and disorganization of ADD/ADHD can make managing the problems worse and worse. Some key areas of disruption might include:

  • Health – Impulsivity and trouble with organization can lead to problems with health, such as compulsive eating or reaching for unhealthy foods, a reinforcing cycle of alcohol and drug abuse, or trouble making appointments or forgetting medication for a chronic condition.
  • Work and finances – Difficulty concentrating, completing tasks, listening, and relating to others can lead to trouble at work. Managing finances may also be a concern: struggling to pay bills, losing of paperwork, missing deadlines, or debt due to impulsive spendig.
  • Relationships – Adults with ADD/ADHD might wonder why loved ones are constantly naging him/her to tidy up and get organized. They have tendency to create constant drama in their relationships or change partners due to feeling bored and looking for constant stimulation.


Positives aspects of adult ADD/ADHD

While much is still being learned about ADD/ADHD and its effects, there can also be positive traits associated with this condition. Impulsivity, boundless energy and the tendency to switch tracks constantly may manifest itself as creativity, flexibility, the ability to rapidly adapt to new information or tremendous drive and commitment. One trait common to ADD/ADHD is hyperfocus, the ability to focus intensely and exclusively on one specific problem to the exclusion of all else, which can lead to creative breakthroughs if harnessed. The key is moderating the negative symptoms while keeping the positives. Luckily, there are many different treatment approaches to adult ADD/ADHD.


Tips for management of ADD/ADHD

Learn as much as you can about adult ADD/ADHD and treatment options

The more you know, the better you’ll be at assisting your own recovery. Adult ADD/ADHD can be a challenge to diagnose, as there is no simple test for it. Many symptoms of ADD/ADHD overlap with other conditions, such as depression, emotional trauma, or anxiety disorders such as obsessive compulsive disorder. Additionally, it is not uncommon for someone with ADD/ADHD to have another condition such as depression, anxiety and bipolar disorder. To ensure you have the best treatment plan, make sure that you get a diagnosis from a qualified professional with experience in diagnosing ADD/ADHD.

Practice some basic organizational skills

Adults with ADD/ADHD might be so overwhelmed with the thought of organizing work and home that even the smallest step seems hopeless. However, building short, effective habits goes a long way towards staying organized.

Here are some simple steps to get started:

  • Keep it in one place – Use one organizer for all of your appointments and commitments. It’s easy to lose post it notes or pieces of paper. Keep a short daily to-do list and update it nightly. Start with less, not more, as you build your confidence, and give yourself extra time.
  • For big tasks, start small – Start with small amounts of time, even 5 to 15 minutes, to a task, and stop when the time is up. You will probably be pleasantly surprised in how much you can accomplish in smaller chunks, and it will be easier to continue your momentum.
  • Realize it takes time to develop good habits – You might be quick to frustration and feel that you are not getting anywhere. But with time and patience, good organizational habits will help you focus more on what is important to you. It is worth the effort!
Yoga, stress and ADD/ADHD

Under stress, most of us tend to become even more unorganized, forgetful and cranky. With ADD/ADHD, where mood swings, anxiety and trouble with organization is already a challenge, decreasing stress will increase productivity and help minimize symptoms. Managing stress includes maintaining a healthy work life balance and relaxation techniques such as meditation, yoga or deep breathing. Recent studies indicate the effectiveness of yoga as a complimentary tool in addition to primary medication, in management of ADD/ADHD. When introduced and practiced under daily basis, yoga provides a large number of health benefits. In combination with physical activity and self-awareness is, yoga helps to create a balance between the mind and body, focuses mind and calms anxiety which are common issues in those with ADHD.

Work on your social skills

People with ADD/ADHD are notorious for thinking before they speak, talking too much, and not appearing to listen to others. However, social skills can be improved with practice, such as:

  • Active listening – If someone else is talking, practice focusing exclusively on what s/he is saying instead of what you are going to say. Before responding, briefly summarize what the person said.
  • Pausing before you speak – If you tend to blurt out things without thinking, you might want to practice stopping yourself before making a comment. If you still feel that the comment is important after five or ten minutes, then it is probably worth repeating. However, you might find that the comment was inappropriate, or you have thought of a better way of wording it.
  • Looking for social cues – Practice hearing the ebb and flow of conversation. There are natural pauses and voice intonations that signal the end of a thought, for example. Cues that someone is finished with a conversation might include fidgeting, looking at a watch or turning towards the door. The better you understand these social cues, the more effective you will be in communication.
Seek support

It’s important to have people you can turn to for help and encouragement. A good support network of people can help you get through both good times and bad. An ADD/ADHD support group or therapist can be a helpful place to practice social skills like not interrupting or getting feedback on how you respond to people. However, it’s also important to build other social connections as well. Make sure that you spend time with people you enjoy, such as loved ones, friends, neighbors and colleagues. Volunteering or joining special interest groups is a great way to meet new people with common interests as well.

Make healthy choices

You might have trouble getting to sleep or keep irregular hours trying to get things finished. Impulsivity might lead to unhealthy eating choices. Regular sleep, healthy eating, and exercising habits can help ground you:

  • Sleep – Simple changes to daytime habits, such as avoiding caffeine late in the day or napping, go a long way towards a good night’s sleep. Try to go to bed at the same time every night and do a quiet, calming activity that you enjoy. Make sure your sleeping area is comfortable and quiet.
  • Healthy Eating – Eat a wide variety of foods, and try to incorporate fruits, vegetables, whole grains and legumes into your diet. Use caution with sugary foods, foods high in refined grains, caffeine, and alcohol. If impulsivity is a problem, make sure you only have foods that are healthy within reach, such as carrot sticks instead of chips.
  • Exercising – Exercise is easier to fit into your routine than you think. If working out for 30 minutes seems like too much, several 10 minute bursts each day can be just as effective. Some simple ideas for 10-minute activities include climbing the stairs instead of using the elevator, parking a few blocks from your office and walking to work, or doing ten minutes of jumping jacks during your favorite television show at night.

Treatment Options for ADD/ADHD

There are many effective treatments available that can help people with ADD/ADHD. For example, coaching or professional organizing may be useful if you need tools and support for getting an unorganized life back under control. Therapy can help you put the rest of your life in context and uncover other roadblocks to recovery. A support group helps to both learn more about the disorder and practice social skills.

Medications for treating ADD/ADHD

Some of the medications used to treat adults include stimulants such as Ritalin; research is also being done with the use of antidepressants. However, medications should be approached with caution, as they have side effects and additionally, stimulant medications do have a potential for abuse. If you are considering medication, it’s especially important to have an accurate diagnosis from a qualified professional. You may also want to try self-help and professional help such as cognitive-behavioral techniques to see if that is all you need.

Links and Resources

Attention Deficit and Hyperactivity Support Group of Southern Africa