The same symptoms that apply to children with AD/HD also apply to adults; however, the symptoms may be manifested in a number of ways. Diagnosis is further complicated by the overlap between the symptoms of adult ADHD and the symptoms of other common psychiatric conditions such as depression and substance abuse.

The primary symptoms of AD/HD are inattention, impulsivity and hyperactivity. The adult versions of these symptoms often have severe consequences. Inattentive children are reprimanded for daydreaming in class. Inattentive adults neglect their spouses, forget directions, and crash their automobiles. Impulsive children often make bad choices. Impulsive parents also make bad decisions. Consequently, they may face huge credit card bills, marital strain and other negative consequences. Hyperactive children are always moving. Hyperactive adults may feel restless and are drawn to high-risk behaviors. Other behaviors that are common to children who have AD/HD are also seen in adults with the disorder. Children with AD/HD will procrastinate, turning in homework late, if at all. Their work is often sloppy. Procrastination in adults results in paperwork and work-related projects being completed late or not at all. Bills go unpaid not because there is no money, but because the adult simply never gets around to mailing in the payment.

Other common symptoms include not living up to one's potential, hypersensitivity to stimuli, emotional reactivity, and poor short term memory. Any one of these behaviors presents a problem for an adult. Taken as a group, they represent a potentially disabling condition.

Consider the following challenges:

1. How can the parent who procrastinates, help his AD/HD child learn strategies for getting homework and other school projects finished in a timely fashion?
2. How can the disorganized parent help his child learn organizing skills to keep materials and possessions tidy and at hand?

3. How can the hyperactive, restless parent find a way to emotionally connect with a child who may prefer quiet activities?

4. How can the daydreaming parent listen and be attentive to her child's needs?

5. How can the overly emotional, short-fused parent stay calm when his child needs a steady, calm parent to help her self-regulate her own volatile unpredictable moods?

6. How does the hypersensitive parent handle the onslaught of activity and noise of a busy household? Untreated, the parent facing such challenges could easily become depressed, anxious, angry, or an explosive combination of all three, setting up a vicious cycle wrought with guilt and poor self-esteem. These parents often question why they can't do a better job raising their child. Invariably, the child loses out too, because his or her emotional and sometimes physical needs are not being met.

Treatment for Adults
Adults with AD/HD respond well to treatment. Appropriate management of adult patients with AD/HD is multimodal and should include psychoeducation, counseling, supportive problem-directed therapy, behavioral intervention, coaching, and cognitive remediation. Couples or family therapy may be indicated to help the parent learn better parenting strategies for raising the AD/HD child. (Wender)

Stimulant medications are the first line of treatment for adults with AD/HD. Stimulant use among patients with a history of substance abuse should be closely monitored to ensure that no abuse occurs. Approximately 70% of adults who have been treated with stimulant medication show a reduction of symptoms. The antidepressant medication Bupropion has also been shown to be effective in treating adults with AD/HD. (Kuperman) Atomoxetine, a non-stimulant medication which is a highly selective inhibitor of the norepinephrine transporter, appears to be an efficacious treatment for adult AD/HD. Its lack of abuse potential may be an advantage for many patients. (Michelson)

Once effective treatment is in place, adults with AD/HD usually do quite well. Paired with the other interventions, medication can provide the parent with the tools he or she needs to improve the quality of life for the family.

Conclusion
Because AD/HD is a genetic disorder, screening the parent of the AD/HD patient is imperative as part of the overall medical/psychological management of the child. Appropriate and effective treatments are available to both child and parent and should be considered for both in order for families to live successful, healthy lives.

References Barbaresi, W., Katusic, S., Colligan, R., Pankratz, V., Weaver, A., Weber, K,. Mrazek, D., Jacobsen, S. "How Common Is Attention-Deficit/Hyperactivity Disorder? Incidence in a Population-Based Birth Cohort in Rochester, Minnesota" Archives of Pediatrics and Adolescent Medicine, Vol. 156 No. 3, March 2002 Barkley, R. "International Consensus Statement on AD/HD" January 2002 Barkley, R. Taking charge of ADHD. NY: Guilford Press. 1995 Kuperman S, Perry PJ, Gaffney GR, Lund BC, Bever-Stille KA, Arndt S, Holman TL, Moser DJ, Paulsen JS. "Bupropion SR vs. methylphenidate vs. placebo for attention deficit hyperactivity disorder in adults." Annals of Clinical Psychiatry 2001 Sep; 13(3):129-34 Michelson D, Adler L, Spencer T, Reimherr FW, West SA, Allen AJ, Kelsey D, Wernicke J, Dietrich A, Milton D. "Atomoxetine in adults with ADHD: two randomized, placebo-controlled studies." Biol Psychiatry 2003 Jan 15; 53(2):112-20 Pary R, Lewis S, Matuschka PR, Rudzinskiy P, Safi M, Lippmann S. "Attention deficit disorder in adults." Annals of Clinical Psychiatry 2002 Jun; 14(2):105-11 Searight HR, Burke JM, Rottnek F., "Adult ADHD: evaluation and treatment in family medicine." American Family Physician 2000 Nov 1; 62(9):2077-86, 2091-2 Wender PH, Wolf LE, Wasserstein J. Adults with ADHD. An overview. Annals of the New York Academy of Science 2001 Jun;931:1-16 Zeigler, Chris. Teaching Teens with ADD and ADHD, Dendy, November 2000 2003

By Terry Matlen MSW, ACSW
Terry is a psychotherapist and consultant in Birmingham, Michigan specializing in AD/HD in adults. She is the author of "Survival Tips for Women with AD/HD".

Terry is the director of www.addconsults.com, an online AD/HD eClinic and www.myADDstore.com . She serves on the board of directors of the Attention Deficit Disorder Association (ADDA).  A popular presenter at local and national conferences, Terry has a passion for raising awareness of the special challenges for women with AD/HD and the unique issues parents face when both they and their children have AD/HD.

She can be reached via her website at www.addconsults.com

E-mail Terry

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Keywords and misspellings:  ADD ADHD AD-HD hyperactivity simptoms hypersensity hipersensitivy