October is ADHD awareness month and in honor of that, I thought I’d highlight adult ADHD.
1. ADHD is highly heritable.
ADHD is highly heritable. In fact, it’s about as heritable as height. In numbers terms, if you have a parent with ADHD , you are EIGHT times more likely to have ADHD than if your parent did not have it. Of course, this also means if you’ve got a child with ADHD there’s a strong likelihood that either Mom or Dad also has it, even if it has never been diagnosed.
2. If you have ADHD, you aren’t typical
Have you heard of the term “neurotypical?” This is the term used to distinguish people who don’t have neurodevelopmental conditions like autism. The term being used for ASD is neurodiverse. And it might surprise you to know if you have ADHD, you are also in the neurodiverse category. ADHD brains have some differences from neurotypical brains. Specifically, the frontal lobes, basal ganglia, cerebellum, and anterior cingulate cortex are 3 – 5% smaller in people with ADHD than neurotypical people of the same age. These brain structures are also significantly less active.
3. Having ADHD leaves a person unusually vulnerable to substance abuse.
ADHD brains often crave pleasure and excitement. One of the big neurotransmitters involved with pleasure and excitement is dopamine. Dopamine is in short supply in ADHD brains and clears more quickly than in neurotypical people. This translates to highs that are less high and highs that are shorter.
People with ADHD have much higher rates of job changes, legal problems, and financial problems. And, finally, a majority of people with ADHD have difficulty with sleep. All three of these issues can make substance use seem very attractive and after a certain point, the use has become abuse. People with ADHD are at greater risk than neurotypical people to become alcoholics.
4. ADD is no longer a diagnosis.
ADD (attention deficit disorder) has officially become ADHD (attention deficit and hyperactivity disorder). But this doesn’t mean everyone is hyperactive. ADHD is now considered to have three “presentations”: predominantly hyperactive, predominantly inattentive, or a combined type.
5. Most kids with ADHD don’t “outgrow” it.
About 2/3 of kids who are diagnosed with ADHD will still meet the criteria for a diagnosis of ADHD as adults. This translates into about 5% of adults having ADHD. Of course, it looks a little different in adults. Most adults aren’t bouncing off the furniture; their hyperactivity may look like constant fidgeting or tapping of fingers or a bouncing knee. It can also be an internal feeling (like restlessness) that isn’t apparent to onlookers.
6. ADHD brains have delayed development.
You might recall that at the beginning I referred to ADHD as a neurodevelopmental disorder. ADHD’s effect on the brain is such that the development of the cortex in ADHD brains is about 3 years behind that of neurotypical people of the same chronological age. People with ADHD eventually catch up, but remember the brain is not done developing until the mid 20’s, whether you have ADHD or not.
7. Why getting a diagnosis as an adult matters.
Adults with ADHD complete fewer years of education, have higher rates of unemployment and underemployment, have higher rates of arrest, more driving accidents and tickets, and relationship difficulties like higher rates of separation and divorce. Almost 1 in 5 adults with ADHD will have a substance or alcohol use disorder, 51% will have anxiety, and 32% will have depression. And people with ADHD are estimated to earn between $9,000 and $15,000 less per year than their neurotypical peers. These are some grim statistics. Being diagnosed with ADHD as an adult gives you legal protections under the Americans with Disabilities Act at work and school. You may be able to get accommodations (such as a cubicle rather than an open work space which could be very distracting for someone with ADHD) or extended time for tests. Medications can be tried to see what help they can provide. And, importantly, once you become aware of your particular struggles as a result of ADHD, you can begin to learn how to address them. In short, at least some of the problems with ADHD can be minimized or ameliorated so that they don’t lead to unemployment, legal troubles, etc.
8. There is proven, effective psychotherapy for ADHD
Talk therapy cannot cure you of ADHD. But therapy CAN equip you with tools and techniques that will help you shore up your particular ADHD weaknesses. I’m a therapist who not only has a child with ADHD, I’m the parent with ADHD herself. As you might imagine, living with ADHD myself, I have an interest in ADHD. I am happy to work with adults to help them find their best solutions for living with ADHD.
9. You have choices in medications.
There are many options now and not all medications are stimulants like Adderall. I have ADHD and I cannot tolerate the stimulants, much to my disappointment. Instead, I now use a nonstimulant that originally was, of all things, a blood pressure medicine that has been tweaked a bit. I can’t compare it to stimulants directly, but I can tell you the general consensus is that the nonstimulant medications are probably less effective. However, in my own case, less effective still beats not having any help at all! In some cases, you can combine a nonstimulant medication like I use with a lower dose of a stimulant medication. And you may already be treating your ADHD with stimulants without even knowing it: both nicotine and caffeine are stimulants. Finally, the prescription used to treat depression, Welbutrin, may be helpful since it works to increase the shortage in dopamine. If you are interested in getting some medication for ADHD, I advise you to see a psychiatrist rather than your family doctor. A psychiatrist will have much greater knowledge and be able to approach treating your particular needs with more nuance.
ADHD is a real condition. It’s not a matter of simply trying harder or getting organized. It is an issue with a biological basis. But there is help, even if it can’t be cured.