While we tend to associate Attention Deficit Disorder (ADD) with children, it affects an estimated 1 million adult South Africans. What are the implications of an ADD diagnosis later in life?
While ADD is a common diagnosis among children today, it hasn’t always been that way. For previous generations, the kind of behaviour that would now likely lead to such a diagnosis was seen as lack of self-discipline and punished, rather than medically treated.
Before the 1990s, fewer than 5% of school-age children were thought to have the condition. That figure has more than doubled in recent years, with the Centres for Disease Control & Prevention showing that around 11% of children aged four to 17 have at some point been diagnosed with ADD. Many adult ADD-sufferers, however, slipped through
the cracks, considered rowdy or badly behaved in childhood and are only today receiving the therapy and medication needed to improve their quality of life and learning abilities. But does receiving an ADD diagnosis this far along mean it’s too late?
What causes the condition?
In her book, Adult ADD: A Guide for the Newly Diagnosed (New Harbinger), Stephanie Moulton Sarkis, PhD, explains: ‘Attention deficit disorder is a genetic and biological disorder passed on through the genes you inherit from your parents. If you have ADD, there’s a 75% chance that you inherited ADD genes from at least one of your parents. Scientists have identified several genes that are associated with [the condition]. There are also hundreds of gene variations that have been found in children with ADD. These gene variations aren’t found in other children.’
How does it differ in adults?
According to Psychcentral.com, there are distinct differences in the way the condition manifests and is expressed in children and adults. ‘In children, the symptoms may be more apparent, while adults have often found ways to cover up or make excuses for their symptoms.’ Psychcentral outlines three main components that make up the condition – hyperactivity, inattention and impulsiveness – although not everyone diagnosed with ADD has all three.
Hyperactivity in children presents as if the child is fidgety and can’t seem to sit still, in a way that’s above and beyond normal childhood restlessness. Despite the child’s best efforts, it doesn’t seem to be within their self-control to remain stationary.
For adults, this hyperactivity is experienced as general restlessness and sufferers may struggle to sit still for long periods – for instance at work or during a movie – and may show boredom with tasks once they’ve mastered them. A general feeling of constant inner restlessness is also common, as are fidgeting and difficulty responding well to frustrating scenarios.
Inattention is experienced in a similar way by both children and adults with ADD. It can present as making careless mistakes, inattention to details and an inability to finish what they’ve started. For children, this is most noticeable in schoolwork and chores; for adults, it’s evident in their work and daily activities. Both children and adult sufferers may often misplace or lose important items like phones, keys and documents.
Impulsiveness in children is often expressed as not waiting their turn during games, blurting out answers before a question is complete, skipping queues and acting before thinking of the consequences, like jumping from a high
vantage point before checking for a safe landing spot.
In adults, impulsivity may be evident in the way they interrupt others and monopolise attention during conversations,
their spending patterns and engaging in risky behaviours.
Although these symptoms are common to almost everyone some of the time, people with ADD experience them constantly and can’t control them or prevent them from happening. ‘The diagnostic criteria for ADD state that you
should also have impairment as a result of these symptoms,’ says Sarkis. ‘This means that the symptoms of ADD which you do have must make a significant difference to your quality of life. You must also have difficulty with these symptoms in at least two of the following settings: home, school/work and social settings.’
The risks of adult ADD
Sarkis outlines the following detrimental effects of adult ADD for those not receiving treatment:
- Lower socio-economic status.
- A lower level of academic achievement.
- Higher medical costs.
- Greater likelihood of engaging in highrisk behaviours (such as gambling).
- A higher rate of substance abuse.
- Increased likelihood of car accidents.
- Greater chance of unemployment.
Could you have ADD?
According to Sarkis, there are two subtypes of ADD: inattentive and hyperactive/impulsive. If you meet at least six of the nine criteria on each checklist, you may have the condition.
- Difficulty paying attention to detail; making careless mistakes
- Difficulty focusing or paying attention during tasks
- Difficulty following through on instructions and failing to finish tasks
- Avoiding tasks that require sustained mental effort
- Losing items often
- Not appearing to listen when spoken to
Hyperactive/ impulsive subtype
- A feeling of being ‘on the go’ or acting as if ‘driven by a motor’
- Fidgetiness or squirming while seated
- Difficulty waiting turns or standing in line
- Interrupting or intruding on others
- Leaving their seat when they’re expected to remain seated
- Blurting out answers before questions are completed
- Difficulty playing or engaging in leisure activities quietly
- Talking excessively
- Running around or climbing excessively
According to the Mayo Clinic, treatment for adults with ADD usually involves a combined approach of psychological counselling, medication, skills training and education. While these treatments can help sufferers manage the
condition, there isn’t a cure for ADD.
Medication for the condiiton is usually in the form of stimulants that include methylphenidate or amphetamine, like Ritalin, which can boost and balance neurotransmitters, or non-stimulant atomoxetine medication and certain antidepressants, which may take longer to work.
Psychological counselling and therapy could help you understand the condition better and equip you to:
- Gain some control over impulsivity.
- Develop more effective problem-solving skills.
- Improve organisation and time management.
- Improve your self-esteem.
- Accept and cope with past social, academic or work failures.
- Improve your personal and work relationships.
- Cope with anger and frustration.
There are also various lifestyle changes and tips that have proved helpful for adults with ADD, including:
- Keeping a notebook or electronic device handy to write down important things or ideas you need to remember.
- Making lists of tasks and prioritising them.
- Developing an organisational system to keep track of your work and activities.
- Sticking to a consistent daily routine.
- Reaching out to loved ones for support and help, and letting them know when you’re having difficulties.
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The information on this page is not intended to be a substitute for professional advice, diagnosis and treatment. Always consult your GP or a medical specialist for specific information regarding your health.