ADHD in Adults

According to the Centers for Disease Control, cases of Attention Deficit Hyperactivity Disorder (ADHD) are up 42 percent since the previous decade. This means that we are growing up with more and more adults knowing that they have the disorder. Today, as adults display symptoms of ADHD, it’s important to be informed about the latest psychological treatment options. While once considered solely a pediatric condition, research has shown that ADHD persists into adulthood and old age (1). In fact, approximately 60 to 70 percent of children affected by the disorder transition into adulthood with some or all of the signs and symptoms of the disorder (2). ADHD in adults has been found to influence all domains of life, including marital relationships, management of finances, health behaviors, and even driving (3). With the disease so often discussed in relation to children and adolescents, finding the right professional and educator, explicitly someone trained in ADHD in adults is key.

ADHD is divided into three subtypes (based on DSM-IV-TR criteria): 1) combined subtype: at least six inattentive and six hyperactive-impulsive symptoms present; 2) predominantly inattentive subtype: at least six inattentive symptoms, but less than six hyperactive-impulsive symptoms present; 3) predominantly hyperactive-impulsive subtype: less than six inattentive symptoms, but at least six hyperactive-impulsive symptoms present (4). In adults, it has been found that inattentive symptoms were more persisting and caused more impairment in adulthood than hyperactive-impulsive symptoms (5). However, the manifestations of ADHD in adults are generally less obvious than in children (6), which makes treating the disorder a challenge for those not explicitly trained to do so. As a result of the difficulty of diagnosing ADHD in adults, many adults are living with long-standing undiagnosed and untreated ADHD, which has been found to develop in secondary mood, anxiety, or substance use disorders (6).

After decades of treating countless adults with ADHD, Dr. Eliana Cohen and her trained staff know, without a shadow of doubt, one of the most essential facts about the disorder is that ADHD is not a “behaviour problem”, but rather ADHD is a medical disorder in which genetic, neurological, nutritional, and environmental factors imbalance the brain, causing unbalanced behaviour. Every person with ADHD has a unique pattern of deficiencies and excesses that imbalance the brain that has to be taken into account during therapy sessions.

While many adults with ADHD are treated with pharmacotherapy techniques, clinical research has shown that life-skills coaching, therapy, and/or cognitive-behavioral therapy can further improve outcomes (6). Although medications have been shown to reduce core neurobiological symptoms for many adults with ADHD, many have been found to continue to experience significant residual symptoms or cannot tolerate the medications, and thus require additional assistance in managing their disorder (7). Cognitive-behavioral therapy refers to a type of mental health treatment that focuses on all the thoughts and behaviours the individual has that occur in the “here and now” (8). Moreover, therapy with partners or family members of adults living with ADHD has been found to significantly result in these individuals having a better understanding of the impact of ADHD on the patient’s behavior and interpersonal style (9).

While psychological treatments are beneficial, a recent review of scientific literature revealed that there has been limited research on psychosocial treatments for adults with ADHD (10). Over many years, the staff of Dr. Eliana Cohen Psychology Professional Corp have been developing, studying, and refining different types of treatments that are designed to foster the development of skills to help adults with ADHD specifically. Moreover, the clinical experience the staff poses allows them to effectively deal with problems related to impulsivity, social behavior, and mood control, which are common only to a subset of adult patients with ADHD, but require a different intervention format than traditional therapy sessions. In our experience, we have found that individualized, but targeted, behavioural and cognitive interventions steadily applied by the client, with our support, can result in significant improvements in daily functioning and in all affected domains of the client’s life.

ADHD in adulthood is a valid and prevalent disorder. Adults with ADHD are not alone. They have unique abilities that they need to learn to harness. Adults with ADHD are also able to live healthy, productive lives, full of success in all areas – work, relationships, health etc. If you are concerned about ADHD in yourself or a loved one, you are advised to seek treatment with a healthcare professional.

References:

  1. Polanczyk G, Rohde LA. Epidemiology of attention-deficit/hyperactivity disorder across the lifespan. Current opinion in psychiatry. 2007 Jul 1;20(4):386-92.
  2. McGough JJ, Barkley RA. Diagnostic controversies in adult attention deficit hyperactivity disorder. Am J Psychiatry. 2004, 161: 1948-1956.
  3. Barkley RA, Murphy KR, Fischer M. ADHD in adults: What the science says. New York: Guilford Press; 2008
  4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub; 2013 May 22.
  5. Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. American journal of psychiatry. 2000 May 1;157(5):816-8.
  6. Spencer T, Biederman J, Wilens TE, Faraone SV. Adults with attention-deficit/hyperactivity disorder: a controversial diagnosis. The Journal of clinical psychiatry. 1998;59:59-68.
  7. Prince JB. Pharmacotherapy of attention-deficit hyperactivity disorder in children and adolescents: update on new stimulant preparations, atomoxetine, and novel treatments. Child and Adolescent Psychiatric Clinics of North America. 2006 Jan 31;15(1):13-50.
  8. Auclair V, Harvey PO, Lepage M. Cognitive Behavioral Therapy and the Treatment of ADHD in Adults. Sante mentale au Quebec. 2017;41(1):291-311.
  9. Rostain AL, Ramsay JL. Adults with ADHD? Try medication and psychotherapy. Curr Psychiatry. 2006, 5: 13-27.
  10. Weiss M , Safren SA , Solanto MV , Hechtman L , Rostain AL , Ramsay JR , Murray C : Research forum on psychological treatment of adults with ADHD. J Atten Disord 2008; 11:642–651