Attention Deficit has
only recently been recognized as an adult disability. Previously,
it was believed that there is a resolution of ADD symptoms in adolescence
due to brain development, hormonal change, or other developmental
change.
Follow up studies documented
that children with ADD continue to exhibit symptoms of the disability
in adolescence and adulthood. 30-70% of children with ADD continue
to have symptoms in adulthood. It is now recognized that adults
with ADD have similar symptoms as do children with ADD.
Many adults with ADD
were never diagnosed as children. Thus, they are not aware of, nor
do they understand the consequences of their disability. Indeed,
since ADD was not recognized in adults until recently, many of the
adults have been previously treated for depression, antisocial personality,
or character disorders.
Diagnosing ADD in the
adult requires an examination of childhood, academic and behavioral
history. Symptoms are sometimes more readily recognized by a spouse
than the individual with ADD.
ADD in adults is often
undiagnosed or misdiagnosed. This can lead to low self-esteem, increased
frustration and educational or vocational failure. These individuals
are more at risk for other problems, including drug abuse, and depression.
Most adults with ADD
are restless, easily distracted, have difficulty sustaining attention
and concentrating, are impulsive and impatient, have frequent mood-swings
and short-tempers, are disorganized and fail to plan ahead. Adults
with ADD often experience career difficulties, they may lose jobs
due to poor performance, attention, and organizational problems,
or relationship difficulties. Other times, they may simply quit
out of boredom.
On the other hand, adults
who learn to adapt to their disability and to harness the energy
and creativity that often accompanies ADD can thrive professionally.
Many adults with ADD are successful entrepreneurs.
Education is the first
strategy for intervention. Most adults with ADD have little understanding
of the disability. Once they have been accurately diagnosed, they
are often relieved to learn their difficulties are due to a disability,
as opposed to some personal flaw.
Adults can benefit from
learning to structure their environment. This may involve using
an appointment book, a personal computer, or tape recorder. Other
strategies include making a daily list of tasks, posting schedules
and appointments throughout the home or office, learning time management
skills, and setting up a self-reward system.
Psychostimulant medications
can be effective with adults who have ADD. Other medications, such
as anti-depressants can be helpful for treating substance abuse
and depression, or when phobic, anxiety, and/or obsessive compulsive
disorders (OCD) are present.
A primary goal of therapy
with an adult who has ADD is to build on success. Vocational counseling
designed to identify employment well suited to the individuals strengths
and skills can help to ensure success. Other intervention strategies
include:
- Scheduling regular physical exercise
- Maintaining a sense of humor
- Eliminating negative self statements
- Avoiding, reducing, or eliminating alcohol or drug use
- Enlisting a friend, relative or spouse to help finish tasks
and remember commitments, and to provide feedback.
Short-term psychotherapy
can help the patient identify how his/her disability might be associated
with a history of sub-par performance and difficulties in personal
relationships
Long-term psychotherapy
can help address mood-swings, stabilize relationships, and alleviate
guilt and discouragement.
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