ADHD in adults: causes, characteristics and diagnosis

What is Attention Deficit Hyperactivity Disorder?

The "Attention Deficit Hyperactivity Disorder" (ADHD) is a neurobiological disorder; a developmental disorder that affects the executive functions of the human brain and is often associated with other comorbid disorders (which occur simultaneously). The main symptoms are: hyperactivity, impulsivity and lack of concentration.

ADHD is chronic. That is, it begins to manifest itself in childhood and accompanies the person throughout their entire life. Despite this, if it is possible to treat the symptoms pharmacologically and take a treatment that helps reduce the negative effects to have a full and satisfying life.

How does ADHD manifest itself in adults?

It is important to be clear that ADHD is not a behavior disorder or a learning disability. Rather, ADHD is a developmental deficit in the brain's self-management system. Therefore, when we speak of “attention deficit” it is not that the person with ADHD cannot or does not want to maintain attention, but rather that their brain cannot resist the urge to pay attention to anything else that enters their visual field. auditory or mental at any time, regardless of your own wishes or goals.

This deficit in brain function causes the adult with ADHD to experience impatience, disorganization, forgetfulness, poor time management, and mood swings. The consequences are, mainly, poor academic and work performance, the inability to define priorities in daily life, unstable interpersonal relationships and generates a great impact on mental health. 

Types of ADHD

ADHD is a disorder that varies in terms of symptomatic intensity and impact on the functioning of different areas of life.

According to the DSM-V there are 3 presentations of ADHD:

  1. Predominant presentation with inattention: difficulty in sustaining attention and finishing tasks, poor time management, forgetfulness.
  1. Predominantly hyperactive / impulsive presentation: feeling of internal restlessness, excessive talking, impulsive decision making.
  1. Combined presentation: mixed symptoms of inattention and hyperactivity / impulsivity

Causes of ADHD

Regarding the causes of ADHD, studies indicate that the main cause is genetic and therefore hereditary. According to Barkley (1997), the children of a parent with ADHD have a 50% chance of experiencing the same difficulties. The genes affected in this disorder are related to the functioning of dopamine, the neurotransmitter responsible for our sensation of pleasure, which influences our mood, our behavior and is essential to regulate our metabolism.

Other studies link ADHD to some environmental factors such as lead contamination, low birth weight, and tobacco and alcohol use by the mother during pregnancy. 

Executive Functions and ADHD

In his research, Dr. Russell Barkley concluded that ADHD is related to an alteration in the so-called “Executive Functions” (FFEE). Executive functions are mental self-control faculties that allow us to maintain an action over time, solve problems and persist until we reach a goal. These mental activities play a key role in regulating our behavior to better adapt to our environment and achieve our goals.

The 5 main Executive Functions are:

  • Behavioral inhibition: avoiding the urge to do something or stopping what we are doing to allow another function to take control of our actions.
  • Non-verbal working memory: retain images that serve as mental maps to guide our actions and remember the sequence of steps that are necessary to reach our goal. It is also related to the subjective way we perceive time.
  • Verbal working memory: using the inner voice to guide our actions, self-impose rules and question the way we solve a problem.
  • Control of motivation and emotions: The ability to contain our emotional reactions and moderate them based on our well-being and our long-term goals.
  • Planning and problem solving: being able to manipulate and rearrange the information in our minds to find novel solutions and overcome new obstacles

Adults with ADHD have difficulty activating and putting these executive functions to use. For example, it is common for them to do things like become easily distracted, beat around the bush when talking, leave tasks unfinished, have excessive emotional reactions, become very frustrated with seemingly simple tasks, or make impulsive decisions.

Impact of ADHD on adult life

ADHD can be understood as if it were an Iceberg, in which hyperactivity, impulsivity and inattention are the visible point that hides many other characteristics of the disorder underneath, as much or more important than the previous ones. These traits are often confused with bad character, personality defects (laziness, carelessness, negligence) or lack of morals, when in fact they are part of the functioning of ADHD.  

Different studies have been carried out with the aim of showing the repercussions that ADHD can have in different areas of daily life. The work has focused primarily on six areas: academic performance, job adaptation, interpersonal relationships, sexual behavior, crime and traffic accidents.

Studies show that adults with ADHD are more likely to have:

  • Poor academic achievement.
  • Frequent labor difficulties (Layoffs, unemployment, etc.).
  • Relationship and daily management problems with children.
  • Risky sex.
  • High frequency of criminal and antisocial behavior.
  • Irresponsibility in driving cars.
  • High risk of accidents.
  • Bad anger management.
  • Substance abuse, addictions, and problem use in general.

Diagnosis and treatment of ADHD in adults

According to statistics, approximately 10 million adults have ADHD in the world and there is growing evidence of the impact it has on individuals, families and society.

Currently, ADHD is underdiagnosed, especially in adults. Reasons such as: the changes in the manifestation of symptoms over the years, the different ways that individuals find to compensate for their deficits and the severe comorbidity that usually camouflages their presence, make this disorder difficult to diagnose. Generally, the most outstanding features in adults are: mood disturbances, difficulties in organizing oneself, and frequent forgetfulness and forgetfulness. 

Treatment for ADHD in adults is structured around four components:

  1. Pharmacological treatment appropriate to the specific needs of the patient.
  2. Provide tools so that the patient can compensate and reduce the consequences of the deficit of executive functions.
  3. Inclusion of the family network to understand the scope of the disorder and build a support system.
  4. Promote new habits and healthy behaviors of sleep, physical exercise and social interaction.

In this section you can read more about the diagnosis and treatment of ADHD.

Each person can manifest different symptoms and intensities. This depends on factors, such as education and life experiences. It is for this reason that reaching a diagnosis and starting treatment according to the individual needs of each patient can help them achieve better long-term performance, greater emotional stability and greater general well-being.


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