Guide to adult ADHD

Looking back
In Lori's case, teacher's comments on old report cards were particularly revealing. Her Grade 3 teacher wrote: “Interpreting what has been read or instructed orally tends to need attention. Paying attention, reading carefully and asking questions when in doubt will greatly benefit Lori. Careful attention must be given in reading written assignments over.” Her Grade 6 teacher wrote: “Lori tries hard, but works too quickly at times before she has mastered a new concept.”

Lori was diagnosed with ADHD as the primary disorder, and low-grade depression and a reading disability as associated disorders. Her experience as an inattentive but not hyperactive girl, and an adult who showed symptoms of depression, illustrates why ADHD is often missed or misdiagnosed in girls and women.

“In adults, the more common presenting symptoms are not ADHD symptoms but anxiety and depression,” says Dr. Umesh Jain, who holds a PhD in psychiatry and is chair of the Canadian ADHD Resource Alliance in Toronto. “As you get older, you carry more life burden with you. That life is accumulating a lot of negative noise. Not reaching your potential and having lots of screw-ups affects your self-esteem.”

"It was like listening to a thousand radio stations going off in your head"
Prior to her ADHD diagnosis in 2002, Lori had taken the antidepressant Prozac and undergone psychotherapy for several years, but she was still depressed. “I felt dopey, like I was a zombie. I felt as if I were walking around in someone else's body watching her life go on.”

After Lori was diagnosed, and treated with Wellbutrin, an antidepressant medication that's effective for people with ADHD and secondary depression, her ability to focus and her work performance, marriage and mood improved dramatically. “It was like being reanimated,” says Lori, describing how she felt after taking Wellbutrin. “It became easier for me to concentrate. It was like listening to a thousand radio stations going off in your head and then toning that down to a hundred stations, which makes a huge difference. You're listening to a hundred at the same time, but it's less noise.”

Treatment
Successful treatment of ADHD for adults usually involves three key components: psycho-education; medication; and behavioural interventions (such as skills training, therapy or coaching), which help clients make significant lifestyle changes. Adults diagnosed with ADHD find it remarkably therapeutic to learn more about the disorder (a process called psycho-education) and understand how their own particular symptoms have prevented them from realizing their potential at different stages of life. “The most powerful resource is gaining good enough knowledge about the disorder,” says Turgay.

Medication often makes it easier for patients to act upon that self-knowledge and benefit from nondrug treatments to learn new skills, develop more effective habits, set meaningful personal goals and fulfill them.

Developing effective habits
Lori's psycho-education began at her first CH.A.D.D. meeting, where she learned about ADHD by talking to other parents of kids with the disorder. Once she was diagnosed and treated, Lori saw the problems she had experienced in school, at work and in her marriage with fresh eyes. Looking back on a letter of reprimand that she received as a bank secretary, Lori understood why the boring, repetitive nature of the job had been such a poor fit.

Lori fared much better in recent years working in a distribution warehouse, doing a wide variety of tasks. Like many people with ADHD, she is energetic and creative. By learning organizational skills and developing more effective habits, Lori was able to channel her energy and tap into ideas to succeed on the job. “I worked my way up to become a supervisor. I am much better at multitasking now. I have the ability to stay on task, and I've learned how to spend the right amount of time on each task to get it all done,” she says.

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