Attention deficit and hyperactivity disorder (ADHD) is one of the most common childhood and adolescent neuropsychiatric disorders. It was once perceived as a neurodevelopmental disorder meaning it was first diagnosed in childhood and would resolve by adolescence or early adulthood but it is now recognised as lifespan neurodevelopmental disorder and its manifestations in adults are widely recognised. Multiple studies have concluded that majority of school age children diagnosed with ADHD continues to have clinically significant symptoms and impairments into young adulthood. Both children and adults suffer significantly with psychiatric comorbidities and neurocognitive deficits, but adults have more functional impairment.
Adult ADHD has a prevalence of around 4.4 % and yet remains under-recognised and untreated. It has high prevalence of secondary comorbid mental illness like mood disorder, substance use disorder, learning disabilities, poor interpersonal relationships, academic and occupational impairments. As a consequence these may lead to unemployement, financial troubles, troubles with the law, unstable relationships, poor self image, poor physical and mental health and road traffic accidents. They also have higher rates of divorce and separation, affecting the quality of life of the individual.
All these negative consequences warrants for identification and treatment of the illness.
Common symptoms of adult ADHD includes carelessness, inaccurate work, difficulty in sustaining focus on boring work, troubles with extensive reading, difficulty in retaining information, problems with following direction or finishing tasks, procrastinating, missing deadlines, misplacing things, easily distracted by surrounding noises, fidgety or restlessness, louder than normal, finishes others sentences or answering before question is completed, difficulty in waiting, interrupts others in conversations.
If these symptoms are present on occasions and do not have significant impact on your life minor modifications in lifestyle may help but in case they starts disrupting life of an individual a professional help should be sort. Diagnosing adult ADHD may be difficult as it may appear like other mental illness like mood disorder (mania, depression), anxiety.
Medications/pharmacotherapy remains the cornerstone of the treatment which includes stimulant and non stimulants. Stimulants are the most commonly used medications although, due to risk of abuse or illicit diversion of these medications clinicians feel reluctant in prescribing these medications. Strong evidence has been found for Cognitive behaviour therapy (both in individual and group settings). Other approaches such as ADHD coaching, yoga, mindfulness training, cognitive remediation programs, neurofeedback etc have also been found helpful. Personalised management plan according to the needs of the patient are best, for eg couples therapy for individuals suffering from marital or relationship discord. Education planning, consideration of academic and occupation accommodations are of utmost importance as part of the treatment which would involve occupational counselling and vocational training rather than insisting on a long term (3-4 years college/course).
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