Guide to adult ADHD

Treatment makes a huge difference
Denise, an administrative assistant, is typical of most women with ADHD. As a girl, she was inattentive and dreamy in class, but not disruptive or hyperactive, so her symptoms were overlooked and she wasn't tested for the condition. “In childhood, girls with ADHD tend not to be totally disruptive and their symptoms aren't picked up,” says Hechtman. “As young adults, they may drop out of university or have difficulties at work. Because they go undiagnosed, they don't reach their full potential.”

The good news is that once diagnosed and properly treated, adults with ADHD can maximize their abilities and lead happy lives. “Adults are the most rewarding patients to work with,” says Hechtman, who directs a research clinic for adults with ADHD. “They are highly motivated, and for them, treatment makes a huge difference.”

Several differences
Adult ADHD differs from the childhood condition in several ways. The core symptoms of ADHD are inattention, hyperactivity and impulsivity. Professionals recognize three major subtypes: predominantly inattentive, predominantly hyperactive/impulsive and the combined type (a combination of the three core symptoms). In childhood, boys tend to be more hyperactive and girls more inattentive (though both genders may have the combined subtype).

As teens become adults, hyperactivity and impulsivity diminish, but problems with attention continue and may become more debilitating as the organizational demands of daily living increase. “Through the life cycle the main features of ADHD change, but by adulthood 75 per cent have the inattentive type,” says Dr. Atilla Turgay, director of the ADHD Clinic, Training and Research Institute at The Scarborough Hospital in Toronto.

Problems with attention make it hard for adults with ADHD to start a task and stick to it, or change their focus as needed. This leads to difficulties with organization and time management. For women who have to organize their families as well as themselves, and who work outside the home, too, this can be particularly difficult, says Hechtman.

Importance of diagnosis
Adult ADHD is also frequently associated with other psychiatric disorders known as comorbidities (one or more disorders coexisting with the main disorder). “About 80 to 90 per cent of adults with ADHD have comorbidities,” says
Dr. Margaret Weiss, a psychiatrist, director of the B.C. provincial ADHD program and head of an ADHD clinic at the Children's and Women's Health Centre in Vancouver.

Not being diagnosed in childhood has huge consequences for women: poor self-esteem, substance abuse and dropping out of school. “Comorbidities are prevalent in both men and women, but secondary anxiety and depression are seen more often in women. It's very frustrating and anxiety-provoking when you can't seem to do things that other people can do,” she says.

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