ANNOUNCER: Attention deficit hyperactivity disorder, or ADHD, was originally considered a childhood disorder.
But in most cases, ADHD persists into adulthood.
LENARD ADLER, MD: Adult ADHD is a very common and quite impairing disorder. Recent studies show that about 4.4% of the adult population in the United States has ADHD. That means about 8 million individuals.
ANNOUNCER: There can be serious consequences associated with undiagnosed or untreated adult ADHD.
LENARD ADLER, MD: If individuals are worried that they might have ADHD, it's important to go in and get a diagnosis. The consequences of missing the diagnosis are significant. We know that untreated adults with ADHD are more likely to be divorced and separated, to be underemployed, change jobs more frequently or be unemployed, more likely to abuse substances, smoke cigarettes, and have more driving accidents.
ANNOUNCER: Most adults do not experience the same level of hyperactivity that is found in children.
But there are other symptoms that can be common in adults.
WILLIAM D. DODSON, MD: Adults will present with three large groups of symptoms. The first one is work inefficiency. They will start on a project, get distracted, then realize that they're distracted, have to come back, find their place. The second big area of impairment is going to be in emotional lability. People with ADHD generally will say that that's the biggest area of impairment for them, is that they feel very vulnerable to the perception that someone is disapproving of them, has withdrawn their approval and respect. The third major area that impairs people with ADHD is impulsivity. People with ADHD find out what they're thinking and are going to say and do the same way that everybody else does. It's out there, and they're constantly going, "Oh, I wish I had that back."
ANNOUNCER: And adults often suffer from additional medical conditions that can mask ADHD symptoms.
DAVID W. GOODMAN, MD: In ADHD we often find that about 70% of the adults with ADHD have or have had another psychiatric condition. Those conditions include clinical depression, bipolar disorder, anxiety disorders and substance and alcohol abuse.
DR. DAVID FEIFEL: Oftentimes the second condition in an adult is driven by the ADHD that if -- if the ADHD isn't recognized, it can be a very frustrating experience for both the physician and the patient who are trying to deal with the comorbid or second condition, because it doesn't respond very well, because the ADHD is lurking behind it and continues to generate it.
ANNOUNCER: An accurate diagnosis of ADHD requires a thorough medical and psychological evaluation.
DR. DAVID FEIFEL: There's no test, neither a brain scan or a computer test, that will in and of itself diagnose ADHD. At the core of it, the diagnosis is a good interview with somebody who's experienced with what ADHD, you know, is all about and can differentiate symptoms that fall into the category of ADHD from those that might belong to something else.
ANNOUNCER: Treatment usually includes counseling, so patients can be better organized managing their daily tasks.
DAVID W. GOODMAN, MD: We talk about managing this person's behavior during the day. Audio cues like alarms and clocks help orient them to time. Visual cues help them remember how to do things and when to do things.
ANNOUNCER: In addition to behavioral modification, most patients are prescribed stimulants.
DAVID W. GOODMAN, MD: The stimulant medications that are indicated for adult ADHD are Adderall XR, and Focalin XR. The most common prescribed long-acting stimulant medication for adults is Adderall XR.The term stimulant comes from the fact that if I give these medications to a person without ADHD, they get activated. They get hyper. But ADHD brains are different, so that when we give these medications to them, it calms them down. It reduces their distraction. It slows their thinking so that they can stay on one thought at a time, and also they say they're less fidgety and more calm.
ANNOUNCER: Most patients can feel almost immediate results while taking stimulant medications.
WILLIAM D. DODSON, MD: They are immediately effective as soon as they reach the brain. It's not like antidepressants, where you have to putz around for three weeks to see if they're going to do anything. These medications, you'll see all the benefits, all the side effects in just one hour. So consequently, you can fine-tune the medication very aggressively.
ANNOUNCER: Stimulants are not addictive, and doctors say that they are unlikely to be abused by people with ADHD.
DAVID W. GOODMAN, MD: There's a perception that stimulant medications are abusable and desirable, that people are out there seeking them all the time. My experience with my patients is getting them to take it consistently. If they're so desirable, how is it my ADHD patients only fill eight prescriptions a year when they ought to be filling 12? So in fact, they're forgetting to take their medicine.
ANNOUNCER: A diagnosis of ADHD and adherence to treatment can make a world of difference to adults with the disorder.
WILLIAM D. DODSON, MD: I've never met a person who said, "Boy, I'm glad I waited until I was 40 to start on medication." Just about everybody says, you know, "My life would have been so different if I'd started on medication and got treatment as early as possible." You're not doing anybody a favor by waiting to initiate treatment.
But in most cases, ADHD persists into adulthood.
LENARD ADLER, MD: Adult ADHD is a very common and quite impairing disorder. Recent studies show that about 4.4% of the adult population in the United States has ADHD. That means about 8 million individuals.
ANNOUNCER: There can be serious consequences associated with undiagnosed or untreated adult ADHD.
LENARD ADLER, MD: If individuals are worried that they might have ADHD, it's important to go in and get a diagnosis. The consequences of missing the diagnosis are significant. We know that untreated adults with ADHD are more likely to be divorced and separated, to be underemployed, change jobs more frequently or be unemployed, more likely to abuse substances, smoke cigarettes, and have more driving accidents.
ANNOUNCER: Most adults do not experience the same level of hyperactivity that is found in children.
But there are other symptoms that can be common in adults.
WILLIAM D. DODSON, MD: Adults will present with three large groups of symptoms. The first one is work inefficiency. They will start on a project, get distracted, then realize that they're distracted, have to come back, find their place. The second big area of impairment is going to be in emotional lability. People with ADHD generally will say that that's the biggest area of impairment for them, is that they feel very vulnerable to the perception that someone is disapproving of them, has withdrawn their approval and respect. The third major area that impairs people with ADHD is impulsivity. People with ADHD find out what they're thinking and are going to say and do the same way that everybody else does. It's out there, and they're constantly going, "Oh, I wish I had that back."
ANNOUNCER: And adults often suffer from additional medical conditions that can mask ADHD symptoms.
DAVID W. GOODMAN, MD: In ADHD we often find that about 70% of the adults with ADHD have or have had another psychiatric condition. Those conditions include clinical depression, bipolar disorder, anxiety disorders and substance and alcohol abuse.
DR. DAVID FEIFEL: Oftentimes the second condition in an adult is driven by the ADHD that if -- if the ADHD isn't recognized, it can be a very frustrating experience for both the physician and the patient who are trying to deal with the comorbid or second condition, because it doesn't respond very well, because the ADHD is lurking behind it and continues to generate it.
ANNOUNCER: An accurate diagnosis of ADHD requires a thorough medical and psychological evaluation.
DR. DAVID FEIFEL: There's no test, neither a brain scan or a computer test, that will in and of itself diagnose ADHD. At the core of it, the diagnosis is a good interview with somebody who's experienced with what ADHD, you know, is all about and can differentiate symptoms that fall into the category of ADHD from those that might belong to something else.
ANNOUNCER: Treatment usually includes counseling, so patients can be better organized managing their daily tasks.
DAVID W. GOODMAN, MD: We talk about managing this person's behavior during the day. Audio cues like alarms and clocks help orient them to time. Visual cues help them remember how to do things and when to do things.
ANNOUNCER: In addition to behavioral modification, most patients are prescribed stimulants.
DAVID W. GOODMAN, MD: The stimulant medications that are indicated for adult ADHD are Adderall XR, and Focalin XR. The most common prescribed long-acting stimulant medication for adults is Adderall XR.The term stimulant comes from the fact that if I give these medications to a person without ADHD, they get activated. They get hyper. But ADHD brains are different, so that when we give these medications to them, it calms them down. It reduces their distraction. It slows their thinking so that they can stay on one thought at a time, and also they say they're less fidgety and more calm.
ANNOUNCER: Most patients can feel almost immediate results while taking stimulant medications.
WILLIAM D. DODSON, MD: They are immediately effective as soon as they reach the brain. It's not like antidepressants, where you have to putz around for three weeks to see if they're going to do anything. These medications, you'll see all the benefits, all the side effects in just one hour. So consequently, you can fine-tune the medication very aggressively.
ANNOUNCER: Stimulants are not addictive, and doctors say that they are unlikely to be abused by people with ADHD.
DAVID W. GOODMAN, MD: There's a perception that stimulant medications are abusable and desirable, that people are out there seeking them all the time. My experience with my patients is getting them to take it consistently. If they're so desirable, how is it my ADHD patients only fill eight prescriptions a year when they ought to be filling 12? So in fact, they're forgetting to take their medicine.
ANNOUNCER: A diagnosis of ADHD and adherence to treatment can make a world of difference to adults with the disorder.
WILLIAM D. DODSON, MD: I've never met a person who said, "Boy, I'm glad I waited until I was 40 to start on medication." Just about everybody says, you know, "My life would have been so different if I'd started on medication and got treatment as early as possible." You're not doing anybody a favor by waiting to initiate treatment.