The disorder from Attention deficit and hyperactivity (ADHD) is one of the most frequent neurosviluppo disorders and it is estimated that 2-6 % of school-age children affects.
The symptoms are clear and defined and include agitation, impulsiveness, difficulty waiting for one’s turn, struggles to concentrate and strong distractability.
While thehyperactivity tends to disappear with advancing age, the aspects of inattention And impulsiveness often persist in adolescence and adulthood.
But how does the ADHD in adult presents? Why is it so underestimated?
How is it possible to evaluate it and what can we do to help who is affected?
To understand what we are talking about, you need to do an overview of ADHD in childhood.
ADHD: What is it?
The deficiency disorder of attention and hyperactivity (ADHD) It is a childhood disorder that compromises the normal development of the child.
The child with ADHD has difficulties of attention and concentration, cannot control impulsiveness and is very very very active on a motor level (hyperactivity).
Attentive symptoms
- He cannot pay attention to details or make errors of distraction in school tasks, at work, or in other activities
- Has difficulty maintaining attention on homework or game activities
- It doesn’t seem to listen to when you talk to him directly
- Does not follow the instructions and does not complete school tasks
- It has difficulty organizing itself in tasks and activities
- Avoid, test aversion, or is reluctant to engage in tasks that require protracted mental effort (such as homework or home)
- He loses the objects necessary for homework or activities (e.g. toys, school homework, pencils, books, or tools)
- It is easily distracted by foreign stimuli
- Is careless in daily activities
Symptoms of hyperactivity
- Moves with restlessness or feet with restlessness or wags on the chair
- Leave your place to sit in class or in other situations where you expect it to remain sitting
- Scroll and jumps everywhere in an excessive way in situations where this is out of place
- He has difficulty playing or dedicating himself to amusements in a quiet way
- It is often “under pressure” or acts as if it were “motorized”
- Talk too much
Symptoms of impulsiveness
- Often “shoot” the answers before the questions have been completed
- Has difficulty waiting for its turn
- Often he interrupts others or is intrusive towards them (e.g., intrude into conversations or games)
To complete the diagnosis it is also necessary that the symptoms are presented before 12 years In two or more contexts (home, school, recreational activities).
The symptoms must then interfere or reduce the quality of social and school life and must not be exclusively present during the course of other psychiatric disorders.
Etiology of the ADHD: What do we know?
The origins of the ADHD are still partially unknown but we know it is a disorder, neurobiological with a strong Genetic component: It is a picture already present at birth that emerges in development.
Through neuroimaging tools, for example, it has been highlighted that some brain areas are smaller, there is less blood flow or consume less oxygen.
Alterations have also been found at the gene level and the familiarity for the disorder is now undoubtedly (if a parent is suffering from ADHD the probability of diagnosis in the child increases eight times).
ADHD in adults: symptoms and operation
The life of an adult subject with ADHD can be considerably compromised, in each possible area.
There chronic care It manifests itself in different forms and comes to cause social, working and personal problems. The simple “forgetting things or distracting themselves continuously”, if as a child it is compensated by the parental figures, for an adult it can be a terribly disabling factor.
At the working level, the discomfort caused to forget orders, poor, meetings and appointments is understood.
Not least is the damage to social life: aspects like “Forget the keys to the house“,”Do not pay bills“,”be unable to put priority to things“, “Do driving errors or take fines“… these and many others are the problems with which these subjects fight every day. The difficulty in planning and chaos in thoughts are on the agenda.
The inattention also compromises the ability of organize activities and sometimes being able to make an appointment or follow the instructions To carry out a task they become epic challenges, bringing these subjects to procrastinate to infinity.
The typical events
Hyperactivity And impulsiveness They manifest themselves in physical agitation, in the difficulty in sitting and primarily in doing things without thinking about the consequences. There is no “time” to think, just one thing is required or displayed … it has already been done!
At the verbal level they are people logorroicwhich speak above the others and often do not filter what must be said according to the context, often being offensive, too explicit cynics (there is no time to filter!).
The adult with ADHD (especially if never diagnosed) unfortunately develops very little social skills, And his private life is often unbalanced and disastrous. Also the constant feeling of “boredom“He worsens the situation and blows up the subjects from one action to another, from one job to another, from one relationship to another.
Level workingin addition to the problems of attention often, the subjects with ADHD tire easily, discuss with colleagues or owners, are fired or in any case prefer the formula “many short -lived works”. They are subjects who work at a level much lower than their potential.
The problems of daily life often aggravate the mood (depressive symptoms), appeal to the use of substances and increase the rate of crime and judicial problems.
The excess of layoffs, of separations and divorces and frequent and constant economic problems also lead to a significant increase in thoughts and suicidal conduct.
The problem of diagnosis
Already in childhood without specific tools the diagnosis of ADHD is complex: discriminating a lively child from a hyperactive is difficult. Often until the school age it is impossible to make a real diagnosis, although the emotional consequences are already very present.
If we transport the problem in adulthood it becomes even more unimaginable to discriminate a physiological agitation and/or poor concentration with a more successful and structured picture of suffering and discomfort.
The physiognomy of adults with ADHD is known and confuses a lot
“Not being able to stay in the queue”, “forgetting things”, “being distracted” are aspects that many of us unite. One of the possible causes of the underestimation of this disorder lies in the fact that these symptoms they are considered strokes of one’s character and therefore are not brought to attention to our doctors.
Yet as we have seen the ADHD is not a phenomenon nor light or passenger.
High comoribility Psychiatric represents both an obstacle to diagnosis and perhaps one of the few “means” to make it: if discriminating the symptoms of other disorders from those of the ADHD is often impossible, many subjects are found the ADHD lasted the treatment of other disorders.
A 2006 study highlights that on a sample of subjects suffering from psychiatric diseases evaluated also for the ADHD, the disorder was present from 6.5% to 25.4%. The most associated paintings seem to be the dependence on substancesThe District disordertheagoraphobia and the bipolar disorder.
Little compliant patients, who partially adhere to the treatment, forget the tasks, are impulsive or are excessively dissatisfied by the poor improvement of their symptoms could be followed with a different treatment if they are also framed in the diagnostic profile of the ADHD.
The case of substances dependence
Irritability, restlessness, poor concentration, they are just some of the symptoms that unite an adult affected by ADHD by an adult who suffered from a Substance use disorder – DUS. Recent studies tell us that 15% of adults with ADHD have a comorbidity with the DUS. Conversely, 23% of those who are dependent on substances are also affected by ADHD.
There are many hypotheses on the causes of this strong association and genetic and environmental factors have explored: if on the one hand those who have been exposed to substances during pregnancy are more likely to have the ADHD, on the other many subjects approach the drugs precisely because of that device difficult to manage or of the boredom difficult to tolerate.
Evaluation tools: Diva 2.0
One of the most used interviews to diagnose ADHD in adults is the Diva 2.0.
The peculiarity of this tool lies in the fact that the same questions are asked simultaneously to the subject, to a family member who reports for childhood and, even better, to a person who can confirm the symptoms in adulthood.
As for childhood, for adults, the diagnosis is differentiated depending on the prevailing compromise area and three subtypes are identified: subtype “Impreted”, Subtype “Hyperactive-impulsive”, Subtype “Combined”.
Treatment
The treatment of ADHD is both pharmacological and psychological and the combined approach seems to be the most effective.
Although 25/50% of adults treated with the pharmacotherapy Monsters a considerable improvement in symptoms, psychological well -being does not always improve due to some skills (skills) never learned.
Cognitive behavioral psychotherapy (CBT) It seems effective to help patients with ADHD develop important skills that are most commonly learned in growth but that ADHD makes insidious.
Through techniques such as psychoeducation, patients are helped to learn to optimize the organization of time and develop organizational skills and develop skills of problem solving.
We work on the increase in self -esteem and on negative thoughts related to relational or working failure.
The interventions for the emotional regulation And to increase social skills (social skill training) in order to improve relationships with others (family, friends, colleagues).
It is important not to neglect the work with i family members For adults as well as for children. Those who live with a subject suffering from ADHD must be helped to understand and face the situations that are created daily in order not to suffer every moment in a stressful way.
Bibliography
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- Naya, N., Tsuji, T., Nishigaki, N., Sakai, C., Chen, Y., Jung, S., & Kosaka, H. (2021). The Burden of Undiagnoseed Adults with Attation-Deposito/Hyperactivity Disorder Symptoms in Japan: A cross-selectional study. Cureus.
- Pallucchini, A., Carli, M., Maremma, A., Scarselli, M., Perugi, G., & Maremma, I. (2021). Influense of Substance Use Disorder in Treatment Retection of Adult-Attention-Deposit/Hyperacative Disorder Patient. A 5-Yaars Follow-up Stduy. Journal of Clinical Medicine.
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