Understanding Adult ADD/ADHD

Understanding Adult ADD / ADHD

Most people have some concept of hyperactive children but few people have a sound understanding of the full presentation of Attention Deficit / Hyperactive Disorder.  In fact, fewer people have an awareness or understanding about the presentation of ADD and ADHD in adults. The intention of this article is to offer an introduction to adult ADD/ADHD.

Core Symptoms of Adult ADD / ADHD

It’s helpful to begin this introduction by exploring the core symptoms of adult ADD / ADHD. The core symptoms are:  1) Inattention and 2) Distractibility.

Attention vs. Inattention
Attention and Distractibility is often misunderstood in that people frequently believe that if an adult or child is able to focus on something he or she favors, then ADD/ADHD is not the problem.In truth, if the ADHD child or adult finds a task, subject or issue] a) interesting, b) new or novel, (e.g., that new book, project or hobby) or c) an enjoyable challenge – then focus and attention will be much stronger on the continuum. In contrast, if something is a) not interesting, b) boring or lacking novelty, or c) an overwhelming challenging – then  attention and focus will be much weaker on the continuum. I’ll go into this more deeply in future articles but take a moment and consider how this relates to your abilities to focus and attend or not.

Distractibility
Two of our more popular distractions are auditory and visual distractions. The auditory distractions are those sounds and noises that tend to challenge our focus and attention. The visual distractions are those things that catch our eye – a movement or visual object that captures our interest and attention. However, the greatest distraction that many of us struggle with is the stimulation of our own mind. Think about it. How often do you find yourself daydreaming or thinking about this or that when you’ve found yourself bored by what is happening in the moment? Obviously, it’s more complicated than this, but this summary will do for now.

The Temperament of  ADD / ADHD Adults
This issue will present what are typically the symptoms of Impulsivity and Hyperactivity. I prefer to reference the work of Thomas Phelan, PhD, who has reframed these symptoms within his definition of the Temperament of the ADD and ADHD adult. The severity of temperament symptoms will of course, vary from one ADD/ADHD adult to another. I prefer to consider the symptoms aligned along a continuum from low to high.

The Temperament of the ‘ADHD Hyperactive’ adult:
The symptoms of this individual are as follows:
 
Restlessness – The physical hyperactivity of children presents as physical/mental restlessness. This may include a shaking/pulsating leg movement, tapping fingers, shifting in the chair and/or general physical restlessness. However, I have also found what I have defined as a “restlessness of spirit”. This is a restlessness and inability to simply “BE” in the moment without wandering physically or mentally.
It may also present as restlessness and boredom with job, tasks or relationships. This can also lead to impulsive decisions and behaviors.
Impatience – Most ADHD adults can easily identify with the feeling of impatience. We dislike lines, we’re impatient with waiting; even the drive-thru of the fast food restaurant is not fast enough. Communication with others may be frustrating; for example, they don’t get to the point of a conversation fast enough.
Irritability – As the impatience grows, it is quickly followed by an underlying yet distinct feeling of irritability. Unlike rage and anger that may be destructive and visible, irritability often remains beneath the surface yet often visible to others.
Impulsivity – In ADHD adults, impulsivity commonly presents as verbal interruptions, inappropriate or untimely comments,  impulsive touching or movements. As stated above this may include the impulsive decision to quit a job or questionable impulsive behaviors. Unfortunately, one of the most common problems for ADHD adults is that of impulsive spending and credit card debt.

The Results of the ‘ADHD’ Temperament
Again referring to the continuum, the results or impact of the ADHD Temperament can be challenging and troubling to the  life of the ADHD adult and to those close to him/her. Results = Core symptoms (Distractibility & Inattention) + ADHD Temperament (Restlessness, Impatience, Irritability, Impulsivity).
Non-compliance – For example, when the ADHD adult is non-compliant with what he/she agreed to do, other people are likely to ‘make-up’ or conclude that [based on the above temperament] the ADHD adult didn’t want to comply, that the non-compliance was intentional. “He would have done it if he’d wanted to”.
Socially – A fair number of ADHD adults may begin to feel socially rejected secondary to the impact on others of their ADHD temperament of impatience, irritability and/or impulsivity. At first the behavior is acceptable but may become overwhelming or disappointing to others after a time.
Disorganization – is very common to ADHD adults. We often find it difficult to organize our home, worksite, and thoughts.  In addition, our social life and relationships may also be challenged.


The Temperament of the ‘Non-Hyperactive’ ADD Adult:
In contrast, let’s now review the temperament of the ADD adult without hyperactive symptoms. The symptoms differ dramatically. Most importantly, these ADD adults lack the Restlessness, Impatience, Irritability and Impulsive symptoms of the hyperactive adult. 
Results of the ADD (Non-hyperactive) Temperament
Non-compliance
– is perceived by others as ‘unintentional’, as innocent forgetfulness. “Oh, she forgot but I’m sure she get that project in soon”. Socially – These adults appear normal. Their temperament does not stand out and they fit in the norm quite well.
Disorganization – is relatively pervasive throughout their lives and challenging, much like the ADHD adult.

The Underactive adult:
In some cases, the ADD adult lacking the hyperactive temperament can be perceived as lethargic or underactive. This means that he/she may be challenged by or perceived as having low motivation or poor at initiating tasks while possibly doing better once the project is started. The results for this adult may at times be more similar to the ADHD adult.

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