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[Music] millions of adults are living with attention deficit hyperactivity disorder without education and treatment ADHD can lead to chronic fatigue anxiety disorganization and issues at work and at home as a triple board-certified neuropsychologist dr. Judy Howe as a go-to expert in this field so in this series she shares that expertise and breaks down how to reach the right diagnosis find sensible treatment options and realistically achieve goals at work and at home when living with ADHD welcome back to med circle dr. Judy always wonderful to see you so great we're talking about ADHD but specifically in adults let's first define what ADHD is so attention deficit hyperactivity disorder is a condition where the individual might have a lot of attention symptoms where they have difficulty focusing or they might also at the same time have hyperactivity and impulsive it's a developmental disorder means that some symptoms have to be present in childhood although for a lot of people they're able to sort of manage until they get older and the task demands of everyday life become greater now how is this different from a dee dee so a dee dee was an older term where they talked about it in earlier versions of the DSM and a DD didn't contain the hyperactive-impulsive news features but through a lot of research they found that actually they were correlated that it's actually one part of the same syndrome although still there are people who have ADHD but inattentive type meaning that they don't really have the hyperactivity or impulsiveness symptoms then we have the individuals who are just hyperactive-impulsive not inattentive there's relatively fewer people that are like that and then we have a good number where they have the combined symptoms of both the inattention and the impulsivity and hyperactivity now what are some common misconceptions when it comes to adults who either believe they have ADHD or have received the diagnosis I feel like everybody thinks that they have ADHD and I think everybody is on the spectrum at some point at some time but if you just have inattentiveness occasionally but it doesn't actually impair your functioning and you're not that distressed about it then you're not really going to qualify for that diagnosis of ADHD adulthood ADHD is relatively at 50% of the prevalence rate as childhood ADHD so national studies have shown that ADHD in childhood is about 5% of the population in adulthood it's two and a half so roughly 50% of people recover from ADHD by the time they hit the age of 18 and then 50% go on to continue to suffer symptoms in their adulthood and I think a big misconception is that it looks the same for some reason because it doesn't in adulthood ADHD the hyperactive and impulsive features look very different as a child the child's running around the classroom getting out of their seats really being very rule not abiding you know which causes some negative attention and that's usually when the teachers are going to fight them and talk to the parents and it's all hood they may still have that restlessness but as adults we're a bit more controlled in terms of our behavior so we're not going to be running around when we know we're not supposed to but you might just feel really fidgety and so sometimes you see individuals like tapping very nervously on the desk or on the table and that may be a manifestation of an adulthood form of combined ADHD now we'll get into the diagnostic process and the criteria in the DSM for ADHD but as you alluded to earlier a lot of people think that they have ADHD because they can't sit down and read a book for more than an hour or they can't really focus when they're having a conversation when is it ADHD and when is it you're just not interested in whatever is going on exactly and I think that that is even more confusing because of the fact that right now our culture promotes a lot of inattentiveness there's so many things going to grab at our attention there's been a lot of research that shows that the more often that you're on social media the more you actually do start to show some signs I've been attentive this doesn't mean that social media causes ADHD okay but you are going to be more inattentive just the other day I was watching the news and not only are the newscasters talking there's a little ticker on the bottom that's rolling with more facts there's pop-ups in the corner and then a couple of people that I was watching the news with were also looking at the app for CNN at the same time that we were watching CNN and so yeah there's a lot of things pulling at our attention anyway so everybody experience it from time to time but when you actually have the clinical features of ADHD it's very different and in an adult there's a lot of emotional dysregulation going on to have a harder time tolerating frustration they may have a lot less patience it may be a lot harder for them to plan ahead and to organize themselves so they feel very disorganized and jumbled in their head all the time and again this is not just periodically you've got a busy day or a week this is something that's persistent that keeps coming up that actually does cut into your quality of life and possibly even impairs relationships and in fact one of the biggest complaints of adulthood ADHD is difficulty in their relationships whether it's with friends or romantic partners because if as you might imagine if you're not really attending to your partner you're constantly asking for repetition and your partner it gets very impatient with you saying you never listen to me you're ever focusing on me and so it can cause a lot of difficulties in terms of their relationships what are you finding as common co-occurring disorders with ADHD the most common co-occurring disorder with ADHD is depression so that's been something that's pretty well-established and in the literature that happens to people who have childhood ADHD as well as adulthood ADHD as a result of people underperforming in school because they're diagnosed with ADHD they start to develop anxiety as well so that's another common co-occurring issue and the anxiety is almost secondary to the ADHD oftentimes because their ADHD makes them feel incompetent and so then they start to have performance anxiety zand feelings of inadequacy that then add on to those anxiety symptoms that eventually become clinical there's also a subset of ADHD children and adults that experience substance issues and so individuals with ADHD tend to have a higher risk for substance use later they tend to try substances earlier than their peers and as adults they tend to have more difficulties with substance use I think another really important correlating factor is that adults with ADHD have a higher risk for suicidal ideation than the average population so they are more at risk for a number of different types of psychological issues and on top of that they're also oftentimes comorbid with other types of learning disabilities and again sometimes it's hard to tease out if the learning disability is really its own disorder or if the learning difficulties really come from the ADHD right it originates from the fact that they can't pay attention so they haven't been able to take in the kind of information they should have by a certain age or by a certain grade so if I'm an adult and I have been diagnosed with depression and ADHD do I treat one before the other or both at the same time I think it's always helpful to address both the same time because at that point I feel like for adults they really have seen the interplay between those two conditions you know they kind of reinforce each other the ADHD leads to more emotional dysregulation that could include mood dysregulation and that mood dysregulation makes the ADHD worse one of the symptoms of depression and not everybody has but some people do is that they have difficulty making decisions and problems concentrating so when somebody also has ADHD it's gonna be interesting to delineate where does that concentration problem come from is it part of the depression or is it part of the ADHD and maybe it doesn't really matter that much it's just that they obviously are related and probably the best way forward is to treat both at the same time know you have a private practice as well as the hundred other things that you do and part of that private practice I'm assuming you've seen adults come in with ADHD what are they struggling with with untreated ADHD so untreated HD for adults it can wreak a lot of havoc into their lives it's hard for them to stay motivated to accomplish to not get in trouble at work to hold the job in fact I have found a lot of individuals with ADHD as adults they've managed their work-life in such a way that kind of makes the ADHD less prominent so what I mean by this is a lot of adults with ADHD they become their own bosses because then no one's disciplining them they have to discipline themselves though so it could get in the way of their level of success but if they're running their own store or they're an entrepreneur and running their own company then sometimes I see adults with ADHD fielding out tasks that they're not very good at because of their ADHD conditions that there are people who can work on it for them and then they only focus on the types of tasks that they really want to do themselves but the caveat of course is that people with adulthood ADHD they don't love schedules and so they tend to have these more entrepreneurial type positions where they can wake up and start working when they want to and maybe they'll work at night too but it's kind of on their own time but that sometimes can make the ADHD worse because people with ADHD need structure and so maybe as a way of them trying to design their life around their condition sometimes they make those symptoms actually a little less easy to manage because they're not sleeping at the right time right they're up at all hours and then it cuts into their next day and the productivity and the concentration that they need yeah understood well we have a lot to talk about in this series and we'll start in our next session talking about the causes and different risk factors associated with adult ADHD subscribe below and remember this video just scratched the surface for more in depth videos on mental health topics go to med circle comm and join for free [Music] you