adhdAttention, please!

It’s not just kids who have ADHD – more adults are being diagnosed than ever before. Could you be one of them?

Your house is always cluttered and you can’t seem to remember where you put things. You’re constantly running late and missing deadlines. You often feel restless and have a hard time sitting still. Sound familiar? Then you just might be one of the 8 million adults with attention deficit hyperactivity disorder (ADHD, formerly ADD).

Many people have trouble getting organized and difficulty focusing from time to time; it veers into ADHD territory when these problems are so persistent and severe that they affect your ability to function at home as well as at work. People with (untreated) ADHD make an average of $10,000 less than others in the same job, tend to get fired and quit jobs at a higher rate, and are more likely to get divorced, says Steven Kurtz, PhD, senior director of the ADHD and Disruptive Behaviors Disorders Center at the Child Mind Institute in New York City.

 

FIGURING OUT THE SYMPTOMS

ADHD always first crops up in childhood. Since the condition wasn’t well known decades ago, you may have had it even if you weren’t diagnosed. (Teachers’ comments on old report cards may provide some insight.) “We believe that certain parts of the brain aren’t getting enough dopamine and norepinephrine, which leads to problems with focus and impulse control,” says Tanya Froehlich, MD, assistant professor at the Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center. Family history also plays a part, and several genes have been linked to ADHD, says Stephanie Sarkis, PhD, author of Adult ADD: A Guide for the Newly Diagnosed.

Although many kids with ADHD outgrow it – hyperactivity in particular tends to lessen around puberty – about half still have symptoms into adulthood. And various life changes, such as starting a new job or having a baby, may cause the condition to worsen.

If you often have trouble finishing projects, remembering appointments and concentrating when people are talking to you, ADHD is a possibility. But sometimes there are more subtle signs. For example:

  • Impulsive shopping People with ADHD have problems controlling their impulses, so you might spend well beyond your means on a regular basis and get into financial trouble.
  • Social-skill issues If you have ADHD, you’re more apt to interrupt others in conversation and blurt out whatever’s on your mind. “Many people do this occasionally, but when you have ADHD it happens consistently and it starts to affect relationships,” says Dr. Sarkis.
  • Never getting anything done on time Maybe you procrastinate until the last minute, have trouble finishing assignments or find yourself starting tasks but never completing them. “With ADHD, the brain has trouble getting motivated to do things it doesn’t want to do,” says Dr. Sarkis.


If you think you might have adult ADHD, it’s worth talking to a mental health professional such as a psychiatrist or psychologist (find one at add.org or chadd.org).

THE RIGHT TREATMENT

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Treatment for adults (and kids) generally involves a combination of medication  and cognitive behavioral therapy. “Studies show that this works better than either option alone,” says Dr. Sarkis.

What’s covered in therapy depends on how severe your case is and whether or not you also have a related condition like depression or anxiety. But it often involves learning to replace negative thoughts with positive “self-talk.” (For example, when you have a deadline looming, telling yourself “I can do it” instead of “I’ll never finish.”) A therapist will also work with you on time management and other organizational techniques to help you function more productively, says Dr. Sarkis.

There are several ADHD medications, including stimulants such as Ritalin and Adderall, which affect neurotransmitters in your brain. “There’s about a 65% chance that you’ll get better on the first one you try. If not, you may need to switch to another option,” says Lenard Adler, MD, an ADHD specialist and psychiatrist at NYU Langone Medical Center in New York City.

Studies have shown that these drugs can have side effects like insomnia and agitation, but they’re generally very safe for adults as well as kids. However, they tend to raise blood pressure, so if you have any heart problems (or family history of them), you may have to be monitored more closely than usual while you’re taking them, says Dr. Adler.

THE DIET LINK

Most experts say there’s no good evidence that what kids eat affects ADHD, but a review of 35 years of studies published in Clinical Pediatrics revealed that some kids do get better when they stop eating certain foods. But it’s unclear who might fall into that group, says Laura J. Stevens, an assistant professor at Purdue University who led the review.

Potentially problematic ingredients include artificial food dyes and preservatives; dairy; chocolate; wheat, rye and barley; eggs; processed meats; citrus; legumes; soy; corn and corn oil/syrup. If medication and therapy hasn’t worked, cut out all of these for two weeks, then reintroduce each one by one to seekids if there’s a noticeable change (often within hours), says Stevens. If so, that food should be eliminated; if not, your child can return to eating it.

If you opt to try this controversial approach, make sure that your child gets the nutrients he needs during those restrictive two weeks, which might involve taking vitamins. (Talk to your pediatrician.)

Something Dr. Froehlich suggests trying first: omega-3 fatty acids. Serve fatty fish, like salmon, three times a week or give your child  a supplement.

Is ADHD overdiagnosed in kids?
Probably not. The percentage of children diagnosed with ADHD rose nearly 22% between 2003 and 2007, according to the Centers for Disease Control and Prevention, but that’s simply because we’ve gotten better at recognizing the symptoms, says Dr. Kurtz. What’s more, he and other experts believe the condition is still underdiagnosed, because studies show that there are many kids who meet the ADHD criteria but aren’t being treated. Girls in particular tend to fall through the cracks.

“They’re more apt to have problems focusing, but they’re often not hyperactive, so they don’t get red-flagged by teachers,” says Dr. Froehlich.

It’s true that misdiagnoses do happen, but this probably isn’t as rampant as parents fear, says Dr. Froehlich. Crucial to getting the right help is seeing a specialist for a full mental-health workup. “The doctor should ask many questions over several hours and be just as invested in determining that it’s not ADHD as in concluding that it is,” says Dr. Kurtz.