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ADD & ADHD
ADD in Adults

What is ADD or ADHD? We hear about it all the time -in the news, from teachers and other parents - but what is it and how does it affect kids who have it? What do I do if my child is diagnosed with ADD?  The whole family needs to learn how to deal effectively with the diagnosis. Is medication or behavioral therapy the best approach?

You don’t outgrow AD/HD.  That is why AD/HD (also known as ADD) is being diagnosed in adults in their 20’s, 30’s, and even in grandparents in their 60’s. Many AD/HD adults say that they weren’t aware of the disorder until they had a child who was diagnosed. After seeing AD/HD in their children, these adults gradually realized that they had the same signs and symptoms.

AD/HD does not affect all people the same way. Some with AD/HD have learning disorders, while others do not. Some AD/HD people are intellectually gifted, others have average or below average IQ. Some come from supportive homes, others come from dysfunctional families. These factors affect the impact of AD/HD on the life of the individual.

Why Seek Treatment
Many AD/HD adults have learned survival skills to help cloak their AD/HD.  They hide their cluttered desks behind closed office doors; they learn to look attentive even when they have no idea what has just been said. However, these coping skills only go so far. Frustration becomes more apparent as the gap between ability and actual performance grows.

Research on AD/HD adults illustrates the scope of the problem. Twenty-five percent of AD/HD participants in the study did not graduate from high school versus 1% of the participants who did not have AD/HD. Only 15% of AD/HD participants had completed a bachelor's degree compared to more than half of the Non-AD/HD group having completed a bachelor's degree or higher.

There are many reasons why these AD/HD adults finally realize they should seek treatment. They begin to feel unable to cope, as the responsibilities of marriage, parenting, mortgage payments etc. begin to pile on. This frustration may lead to self-medication with drugs or alcohol, which lead to more problems of their own. Jobs and relationships suffer as a result and an overall sense of failure begins to take over.

Breaking this cycle of failure and frustration is the primary goal of treatment for the AD/HD adult. Clinical experience shows AD/HD adults benefit from a multi-modal treatment - combining medications and psychosocial interventions.

Diagnosing ADD
A thorough evaluation is necessary in making an accurate diagnosis and should include gathering information from a variety of sources. A review of the person’s medical, academic and family history is essential. Depression, anxiety and other emotional disorders are tested through a comprehensive psychological screening. Intellectual and achievement testing is used to help screen for and then assess learning problems, and areas of strength and weakness.

To assess whether a person has ADD or ADHD, specialists consider several questions:

  • Do your behaviors and feelings show that you have problems with attention and hyperactivity? (Your doctor might ask you questions about your past, your life now and your relationships. You may write down answers on forms.)
  • Have you had these problems for a long time, ever since you were a child?
  • Do you have a hard time keeping your temper or staying in a good mood? Have you had these kinds of problems since you were a young child? Do these problems happen to you both at work and at home? Do family members and friends see that you have problems in these areas?
  • Do you have any physical or mental health problems that might affect your behavior? Your doctor may give you a physical exam and tests to see if you have medical problems that are like ADHD.

Treatment Options
Doctors generally use the same medications for adult AD/HD as they do in children. Psychostimulants such as Ritalin, Adderall, Dexedrine and Concerta are usually the most effective and safe medications. Stimulants may not be appropriate due to a history of abuse, a patient’s high blood pressure or heart disease. For some of these patients, doctors may prefer antidepressants.

Medication will not automatically overcome self-defeating habits and behaviors.  In order to do that, it is helpful to seek the guidance of a psychotherapist. Psychotherapy is especially helpful for AD/HD patients with conditions such as depression and anxiety. It can also help adults deal with the frustration and anger they feel because their AD/HD was never addressed in childhood. In addition, psychotherapists can help improve social skills and ability to deal with AD/HD-unfriendly situations.

In individual counseling, a therapist can help the adult with ADD learn to feel better about his or herself. They do this by helping the person recognize that having a disability does not reflect who they are as a person. Over time the therapist can help people with ADD identify and build on their strengths, cope with daily problems, and learn to control their attention and aggression.

In therapy a patient talks with the therapist about their upsetting thoughts and feelings, explore self-defeating patterns of behavior, and learn alternative ways to handle their emotions. Cognitive-behavioral therapy helps people work on immediate issues by supporting them directly in changing their behavior.

Where to Call Next for Help
Dr. Kathy Marshack can help you. If you live in the Portland, Oregon or Vancouver, Washington area (or can drive to these locations) please call to set up your first appointment.  See Therapy FAQs for more information. Please give us a call at (360) 256-0448 or (503) 222-6678 or email us at info@kmarshack.com.

Read more information on parenting children with AD/HD.