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welcome back to Mayo Clinic radio I'm dr. Tom shine and I'm Tracy McCray almost everyone has heard of ADHD attention deficit hyperactivity disorder it makes people think of kids who who have trouble paying attention or who are hyperactive or impulsive maybe but it's not just a problem for kids about four to five percent of the US adults of us adults have it and that's about eight million people I identify very strongly with this topic let's just say here's the problem not many adults less than 20 percent get diagnosed or treated for it and that's unfortunate because in addition to causing trouble in your daily life your work in your relationships ADHD ADHD can cut an estimated eight years or more off of your life expectancy surprising really shocking to learn more about adult ADHD is a family medicine physician and ADHD expert dr. Bob Wilford welcome to the program dr. Wilfred it's nice to meet you it's nice to be here thank you for having me you know dr. Wilfred I would say that most people including myself are sort of surprised to know that one out of twenty adults in this country has ADHD it's not the kind of thing that you talk about when you're meeting your friends for lunch though is it and you dr. shives are a successful man I'm suspicious that perhaps ADHD doesn't show itself very commonly in in the circles in which you run and so unless it's something that we look for in seek out it's pretty easy to miss okay well do theirs everybody who has is diagnosed with ADHD as an adult have did they have it as a kid by definition so ADHD is a neurodevelopmental disorder a person who suffers from that distractibility that impulsivity was born that way it's not a behavioral choice it's not a result of their parenting it's not a result of any habits that they might have grown up with so they came out of the womb with ADHD and it's been with him 24/7 cents there are some adults who from time to time feel distractible and of course there's so many things that go on in our lives or other medical problems that sometimes we forget the name to somebody that we meet in the hallway or miss an appointment or fail to complete an obligation on time it's not always ADHD because of the way our lives are chaotic but there's certain number of kids who actually outgrow ADHD right they do not have it as an adult or no not nearly as many as was once thought really had been told to parents for a long time that Oh Johnny's having trouble in fourth grade but he'll be a great adult and he probably was but he's probably a great adult with ADHD so what happens is the hyperactivity that those kindergarten teachers are dealing with tends to fade away with time it takes a lot of energy to be hyperactive and as a guy in his 40s I don't know I can't maintain that right but impulsivity and the ups and downs of emotional dysregulation persist so I might not fidget as an adult but I might not finish the bathroom remodeling project that I started six months ago either you just learn how to kind of work around the ADHD that you have and grow up learning tricks and tips on how to get around them or you don't or your bathroom goes unfinished so it's estimated that one out of seven or one out of eight children truly outgrow the condition they are able to learn sufficient coping mechanisms that as an adult know symptom would be discoverable but that means six or seven out of those seven or eight continue to have symptoms that are discoverable in adulthood and for many of them they find ways to cope they're good at using post-it notes and Trapper Keepers or they marry someone who's a little OCD and that kind of helps them out a little bit counterbalances but but for many they don't find that way and so it won't be hard if you think of that mental rolodex you have to think of acquaintances or family members who bounced from job to job after six months at a new place just as most of us would be kind of getting into a rhythm of the workplace they're bouncing out it just didn't work out for them but if we used to think that it was 50 per 60 percent of kids who outgrow ADHD ADHD you're saying that's not true at all it's not true at all so are the symptoms the same and and why is it important for these people to get help yeah the symptoms do change the hyperactivity fades with time impulsivity emotional dysregulation persists when adults with ADHD are asked what bothers them about their pattern of thought what they say is emotional dysregulation a tendency to feel very sensitive to any possible slight from another person is enough to make what had been a great hour feel crushing for fifteen minutes and then they're better again and so sometimes a person might come into the office and say oh my girlfriend thinks I'm bipolar and it's not that it's that their emotions bounce so emotional dysregulation is is a prominent symptom in adults the other symptom we hear quite a lot is trouble sleeping because if you have ADHD you have it 24/7 even when you're asleep and so a person who feels physically tired but their thoughts are bouncing from thing to thing at night not racing it's not fast but their thoughts that seem disjointed might have ADHD at bedtime so they're awake at 2:00 in the morning wishing they could be asleep finally they're so exhausted they sleep the sleep of the Dead at 4 and 5 but then the alarm clock goes off in their racked and they can't get their shoes on and get out to meet the bus in the morning so is it I had never heard that ADHD can cut life expectancy it's striking isn't it so that data is relatively new just last fall some researchers based in Milwaukee came out with data that used life insurance claims to find that out these are researchers who had identified children with ADHD back in the 1970s and followed them till the current and a child who quote-unquote outgrew it or thought they had received treatment as a child but not into an adulthood would lose perhaps seven years of life because that that that stunting of development that loss of tips and tricks' persisted throughout adulthood a person who never got treatment whether an adult or a kid might have lost 13 years of life it is a huge impact and if you think about it part of that's because they're stressed from being unsuccessful they seek coping an alcohol or smoking or other bad choices or maybe they have diabetes later in life and you both know diabetes is picky it's a burden you have to test yourself and change doses and four times a day this and that and if you have ADHD you're not good at that kind of complexity and so caring for yourself later in life is difficult is adult ADHD a relatively easy diagnosis for you to make in the office or does it require psychological testing it would be lovely if if there were enough psychological testers in the world to allow everybody to have that kind of diagnostic evaluation unfortunately there isn't and so what most of us do is over a series of office visits ask about a person's current function there are other diseases so perhaps maybe they're not paying attention because their asthma so bad they're working to breathe we ask about their other mental health conditions ADHD is a snowball if you've been ineffective your whole life you tend to feel bad about it and so it sort of collects anxiety and depressive symptoms as well but then we also ask you to remember back in childhood remember it's a neurodevelopmental problem you had since infancy and so some symptoms should have been present in early childhood if there really wasn't then it's not ADHD the trouble arises is that many people in the 1940s and 50s and 60s didn't know about the condition and they assumed Oh Johnny's just a boy or marry sit still look pretty and and their inattention their hyperactivity wasn't named back then so it's important to find out because it can have such a major effect on your life but tell us about treatment we don't have a lot of time to go into the specifics but how successful is it surprisingly successful it's probably the easiest neuropsychiatric condition to successfully treat with medication so I believe because it's a neurodevelopmental disorder we we all need this vitamin like substance called dopamine in a certain part of our brains and there's some very inexpensive easy to use medicines that put dopamine there there are non medication ways to address the symptoms to counseling those post-it notes exercise good nutrition the things that make all of us feel better also helps a person with ADHD but there are stimulant and non-stimulant uncontrolled inexpensive medicines that well address these symptoms well that's so good to hear well it's a problem that affects some 8 million adults in the United States ADHD it's not just for kids as every Gia as we've just heard there are a lot of good reasons to find out if you might be one of those who suffers with ADHD as an adult we've been talking with an adult ADHD expert Mayo Clinic family physician dr. Bob Wilford thanks for being with us dr. Wolford thanks very much