ADHD for Adults ADD On and Off Medicine

ADHD: Help for Adults

When it comes to ADHD, most people think of children and adolescents. But around two to three percent of adults also suffer from it. Because in about half of those affected, the symptoms do not completely disappear after childhood, but continue to lead to significant restrictions. Often ADHD is not even diagnosed until adulthood.

Symptoms - how does ADHD manifest itself in adults?

Hyperactivity, impulsiveness and inattentiveness remain the decisive symptoms of ADHD even after childhood. Most of the time, there is little outwardly visible hyperactivity, although many adults with ADHD suffer from constant inner restlessness. Adults with ADHD often have problems structuring their everyday lives and tackling tasks in an organized manner. They often seem forgetful or dodgy, for example no longer know where they left their keys and are always late for appointments. Sometimes you talk a lot and are very volatile. Sometimes they stand out for being very impulsive, often interrupting other people, and being very impatient. Up to a third of people also have difficulty controlling their emotions (emotional dysregulation). It's easy to get angry, frustrated, or irritable. This can sometimes be similar to the symptoms of borderline disorder.

Many adults who have ADHD also suffer from other problems. They are more prone to risky behavior, depression, anxiety disorders, alcohol or drug addiction.

Important: The disorder does not recur in adulthood. Symptoms that are typical of ADHD already existed in childhood. It is possible, however, that they were not recognized or classified as such at the time.

Diagnosis and therapy: who can help?

Many adults bring the diagnosis of ADHD with them from childhood. Sometimes the diagnosis is actually made in adulthood. There are specialists in psychiatry and psychotherapy as well as psychological or medical psychotherapists who have sufficient experience with ADHD and are then the right contact. Many sufferers also turn to special ADHD outpatient clinics for adults, which are often located at university hospitals. Psychotherapists who offer behavioral therapy are particularly suitable. The expert will inquire about the childhood and adolescence of the patient in order to find out whether and which symptoms that speak for ADHD were already present at that time. He will also ask about current ADHD symptoms and how they result in problems and limitations in daily life. In adults in particular, it is important to differentiate ADHD from other mental illnesses such as depression, bipolar disorder, addiction disorders, and personality disorders. At the same time, adults with ADHD almost always have at least one additional mental illness.

What does the treatment look like?

In most cases, treatment should be given. When ADHD is diagnosed in adulthood, most sufferers have suffered years of suffering. Even simple measures can help to cope better in everyday life. It helps to structure every day precisely, to plan the upcoming tasks and to write them down on a list. Larger tasks should be broken down into smaller individual steps if possible. These lists can then be worked through in the course of the day and the individual steps ticked off.

Reminder functions of cell phones, alarm clocks or notes on the front door, refrigerator or in the car remind you of important appointments. These should also be clearly recorded in a single calendar.

In the morning a look at the calendar, in the evening the creation of the task list for the next day. Fixed places for glasses, cell phones, house and car keys. Such routines support ADHD patients in everyday life. Family and relatives can also help and, for example, remind them of important appointments and tasks.

Beware of annoying distractions: those affected should create a workspace that is as quiet as possible, and avoid leaving the radio or television on in the background. If you come across a new task while you are still working on something else, you should not interrupt what you have started, but write it down for later.

Those affected often find it difficult to consistently implement these actually simple measures. The task of the expert is then to accompany the implementation, to check it and, if necessary, to change the strategy together with the patient.

In addition, behavior therapy or treatment with medication can also be considered. The psychostimulant methylphenidate and the non-stimulant atomoxetine are approved for adults. Both behavior therapy and medication have not been studied quite as well in terms of effectiveness in adults as in children. However, drugs are still very important here. Behavioral therapy alone is only recommended in very mild cases or if the medication cannot be tolerated. Both methods in combination complement each other very well.

The antidepressant bupropion can also be used in adults with depression and simultaneous ADHD. It relieves symptoms of depression and ADHD. However, it is not approved for the treatment of ADHD. Venlafaxine is often used for depression in addition to ADHD. However, it has very little effect on ADHD symptoms.

Consulting expert

Dr. med. Mathias Luderer studied medicine at the Ruprecht-Karls-Universit├Ąt Heidelberg with stays abroad in Budapest (ERASMUS scholarship) and Dublin. He did his doctorate on the outpatient treatment of alcohol addiction and completed his psychiatric-psychotherapeutic specialist training at the Central Institute for Mental Health in Mannheim with a focus on addiction medicine. Dr. Luderer is a specialist in psychiatry and psychotherapy and has been working as a senior physician at the Clinic for Psychiatry, Psychotherapy and Psychosomatics at Goethe University Frankfurt from March 1, 2018. For many years, Dr. Luderer clinically and scientifically the link between ADHD and addiction disorders.