There is much confusion about ADHD – many are unsure it even exists, and some consider it an excuse for bad behavior, procrastination, disorganization and missing deadlines. Until recently, the diagnostic criteria for the disorder did not include older adolescents and adults. The American Academy of Pediatrics changed the ages for diagnosis of ADHD from ages 6 – 12 to ages 4 – 18 (and above) in late 2011.
College students and adults in the workforce who were not diagnosed when younger often find themselves struggling in adulthood. Many who were previously treated have stopped taking ADHD medication, hoping to outgrow the symptoms after puberty, as doctors once believed. They are often surprised when they begin to have similar problems as adults. Frequently these adults need to be officially diagnosed (again) and treated for adult ADHD to keep their jobs or save their grades.
Russell Barkley and others have reported 65-80% of kids with ADHD continue to have symptoms as adults. Sadly, only 10% or so receive treatment; gratefully, that seems to be changing. More recent research on adult ADHD supports the diagnosis, hence the change in diagnostic criteria. Without treatment the outcome is bleak for many adolescents and adults.
ADHD and Employment
The ADHD Awareness Coalition, spearheaded by CHADD, ADHD Coaches Organization (ACO), ADDitude magazine and Attention Deficit Disorder Association (ADDA), conducted a non-scientific survey last year and found disheartening results. Over 2,000 adults participated in the survey. 60 percent said they had lost a job due to ADHD symptoms. “More than 36 percent reported having 4 or more jobs in the past 10 years, and 6.5 percent responded they have had 10 or more jobs within the past 10 years.”
Clearly, finding the right job and career path to fit your specific needs is critical to success. Ask for accommodations; sometimes even minor changes can make the difference between success and failure in college or the workplace. As one who was too ashamed to ask for ‘special treatment’ (allegedly, because I didn’t want anyone else to ‘think’ I had problems), I can tell you it’s best to address your denial and come to terms with reality sooner, rather than later.
Coming to Terms with Invisible Conditions
Coming to terms with any kind of disability or difference is an adjustment. It requires honesty, courage and letting go of who you thought you were. Counseling may be helpful to work through the grief and other issues related to the adjustment period. It took over 50 years for me to accept that my ADHD is truly disabling without the right support and accommodations.
I have chronicled the ‘most’ major event that triggered my coming to terms with ADHD in a free ebook if you are interested in more details. There are also links to information about the legal protection, accommodations, advocacy and other relevant information in the article Adult ADHD and Self Advocacy:10 Tips for Facing Giants.
How Do I know if I have ADHD?
Not everyone who is easily distracted, disorganized or disruptive has ADHD. Likewise, many adults who have ADHD are undiagnosed or misdiagnosed. I was treated for anxiety for two years before my therapist realized that I had ADHD in the early 90s. Numerous confounding variables make it difficult to diagnose this disorder, ie., over half of adults with ADHD also have anxiety, depression and sleep disorders.
Here are some red flags and nuances to look for:
- ADHD is genetic. There is up to an 80% chance that children will have the disorder if a parent has ADHD. Many adults don’t realize they have ADHD until a child in the family is diagnosed.
- ADHD begins in childhood unless the symptoms are caused by a head injury or other environmental factor. In most cases, you are born with ADHD or not. Some believe that many babies who are oxygen deprived at birth and/or born with forceps may develop learning disabilities, ADHD or other mental health problems. The same is true for many babies who are exposed to alcohol or other drugs (including tobacco) before birth, and toxins such as lead paint after birth. Head injuries can result from abuse, accidents such as falling and other seemingly minor insults to the brain. All of these and other environmental factors are believed to cause brain damage, which often shows up as problems with learning, attention or mental health, though it may go undetected until a child enters school.
- ADHD is a misnomer. People assume that an attention deficit means that people are unable to focus at all. Most people with ADHD can be very focused or ‘hyper-focused’ on things they find stimulating, ie., video games, movies, music, reading, typing, etc. When someone is hyper-focused, he or she appears to block out almost everything around them and have difficulty transitioning from one task to another.
When not stimulated externally, the pre-frontal cortex of the ADHD brain is seeking stimulation. It is believed that the neurons are not firing fast enough, hence the need for external stimulation. I heard two different doctors describe ADHD as caused by a ‘sleepy brain’ that literally causes people to shift and move around to stay awake. The brain can be stimulated by medication, exercise, mindfulness or other meditation, fidgeting, chewing gum, knitting or crocheting, playing an instrument (particularly drums) or other stimulating activity. Different things work for different people.
- There are three types of ADHD – Hyperactive (the more obvious kind), Inattentive (dreamy, disorganized, procrastination, seemingly unmotivated and often mistaken for laziness by outsiders) and Combined, a combination of hyperactivity and inattention. Since these manifest very differently, identifying the less obvious Inattentive Type can be difficult. Those who have symptoms of both (me!) seem to bounce from one to the other. Hyperactivity is more easily recognized in children. In adults, it appears more as restlessness, impatience, fidgeting or wiggling.
- Keep in mind, ADHD symptoms may be mild, moderate or severe. The severely hyperactive person, who is always late, harried and in a hurry every day looks very different from a mildly or moderately hyperactive person, who bounces his/her foot or taps her fingers all day. An mildly inattentive person who can’t seem to start on projects or find her address book, presents differently from the severely inattentive one who can’t see over the piles on her desk, forgets to pick up the kids from school and sends email to the wrong person at work.
- A diagnosis of ADHD doesn’t mean you have all of the symptoms. It is also important to realize that many of the symptoms are present in everyone to some degree. The determining factors for diagnosis have to do with age of onset, level of impairment in daily life (work/school, relationships, etc.) and the cluster of symptoms that are not related to another medical or mental health condition. There is a lot of overlap between symptoms of ADHD and anxiety, Bi-Polar Disorder, so finding the right diagnosis is critical to finding the right treatment.
If you aren’t sure, but some of these challenges resonate with you, ask your medical provider or see a mental health practitioner for an assessment (preferably the latter). College counseling centers deal with these issues a lot. Don’t wait until your papers are late and grades are dropping to ask for help. Transitions, like going away to college, add stress to an already difficult situation. The change in structure and support may exacerbate ADHD.
LuAnn Pierce is a licensed clinical social worker and writer/blogger. She previously served as Teen Editor for selfhelpmagazine.com. LuAnn has published online articles for multiple publications. Additionally, she has published materials for non-profits such as the National MS Society, including several books (Growing up Sane: In Uncertain Times – 1997) and curricula (The Rest of the Story: Psychosocial Skills for Youth Develop – out of print). She works with dailyrx.com (1-800-THERAPIST) as a contributing expert and writes two blogsites. LuAnn has a small private therapy practice in Denver.