Do you: Cut the tags out of your
clothes? Relive (and regret) past conversations? Have episodes of burnout and
fatigue? Zone out while someone is talking? Become hyper-focused while working
on a project? Take on dozens of hobbies? Daydream? Forget things?
اضافة اعلان
According to TikTok, you might have
attention deficit hyperactivity disorder. Videos about the psychiatric condition
are all over the social media app, with the #adhd hashtag receiving more than
17 billion views to date.
Many feature young people describing their
specific (and sometimes surprising) symptoms, such as sensitivity to small
sensory annoyances (such as clothing tags) or ADHD paralysis, a type of extreme
procrastination. After viewing these videos, many people who were not diagnosed
with ADHD as children may question whether they would qualify as adults.
As with most psychiatric conditions, ADHD
symptoms can range in type and severity. And many of them “are behaviors
everyone experiences at some point or another”, said Joel Nigg, a professor of
psychiatry at Oregon Health & Science University. The key to diagnosing the
condition, however, requires “determining that it’s serious, it’s extreme” and
it is interfering with people’s lives, he said. It is also critical that the
symptoms have been present since childhood.
Those nuances can be lost on social media,
experts say. In fact, one study published this year found that more than half
of the ADHD videos on TikTok were misleading. If a video (or article) has you
thinking you may have undiagnosed ADHD, here is what to consider.
Why is ADHD often undiagnosed in adults?About 4 percent of adults in the US have
enough symptoms to qualify for ADHD, but only an estimated 1 in 10 of them is
diagnosed and treated. For comparison, roughly 9 percent of children in the US
have been diagnosed with the condition, and three-quarters have received
medication or behavioral therapy for it.
“With adults, it’s oftentimes not necessarily hyperactivity or impulsivity, it’s more executive functioning issues… it’s more subtle.”
One reason for the lack of diagnoses in
adults is that when people think of ADHD, they often imagine a boy who cannot
sit still and is disruptive in class, said Dr Deepti Anbarasan, a clinical
associate professor of psychiatry at the New York University Grossman School of
Medicine. But those stereotypical hyperactive symptoms are present in just 5
percent of adult cases, she said.
Instead, symptoms such as forgetfulness,
trouble focusing, organization problems, and procrastination — what experts
call inattentive ADHD (as opposed to hyperactive ADHD) — are more common in
adults. “With adults, it’s oftentimes not necessarily hyperactivity or
impulsivity, it’s more executive functioning issues,” Anbarasan said. “It’s
more subtle.”
ADHD may also be misdiagnosed as another
psychiatric condition. For example, it is common for people with ADHD to have
problems with emotion regulation; people can be quick to anger or have dramatic
mood swings. Excessive worry and anxiety can also occur, sometimes because of
the ADHD symptoms themselves. As a result, many adults may have been diagnosed
with depression or anxiety when the root problem is actually ADHD.
How do you diagnose adult ADHD?There are three main questions a
psychiatrist will go over with you to help determine whether you have normal
inattention or forgetfulness or ADHD: How many symptoms do you have? Have you
had them since childhood? And do they affect two or more parts of your life?
The last two are particularly helpful in
determining whether someone will be diagnosed, said Craig Surman, a
psychiatrist who runs the Adult ADHD Research Program at Massachusetts General
Hospital. Once those have been established, he said, “you really winnow out a
number of people”.
A person must have five out of nine
symptoms listed in the official psychiatry diagnostic manual to qualify for
inattentive ADHD. These symptoms loosely fall into three categories: problems
with productivity or performance (procrastinating at work or failing to finish
chores); memory (frequently losing your phone or keys or forgetting to pick up
milk on your way home); and organization of objects and time (having a
cluttered house or always running late).
These symptoms must negatively affect two
or more parts of life, such as work, home, and relationships. If your house is
a mess, but you are successful at work and your personal life is rich and
fulfilling, you probably would not qualify for a diagnosis.
The symptoms also must have been present
since before you were 12 years old. In the eyes of most clinicians, ADHD is a
neurodevelopmental disorder, meaning it started when the child (and their
brain) was young. This can be the most difficult to determine because people
might have received assistance or compensated for their symptoms without
realizing it. For example, a parent may have provided them with daily reminders
to finish homework that helped get them through school.
Boys are roughly twice as likely to be diagnosed with ADHD in childhood as girls are because, even at young ages, girls’ symptoms tend to be more inattentive than hyperactive in nature.
“They’ve had the disorder probably for most
of their lives, but they’ve learned how to cope with it in various ways,”
Anbarasan said. “They’ll be people who write everything down or they follow a
structure very well and they put a lot of time and effort into organizing
themselves.” Many people do not recognize something is wrong until the demands
and responsibilities of adulthood add up and the systems they have been using
begin to fail.
This can be especially true for women. Boys
are roughly twice as likely to be diagnosed with ADHD in childhood as girls are
because, even at young ages, girls’ symptoms tend to be more inattentive than
hyperactive in nature. As a result, girls with ADHD might struggle a bit in
school or be seen as quiet daydreamers, but evade diagnosis because they are not
noticeably disruptive in class or at home.
What options are available if you are
diagnosed?The good news is that ADHD is fairly easy
to treat. Stimulant medications such as Ritalin or Adderall are effective at
helping people harness their attention. Another class of drugs, called alpha-2
agonists, were originally developed to treat high blood pressure but are also
sometimes prescribed for ADHD. These medications can help people focus without
many of the unpleasant side effects of stimulants, such as trouble sleeping or
decreased appetite.
Non-pharmaceutical treatments, such as
behavioral coaching and therapy, can also be useful. These techniques help
people understand how ADHD affects their daily lives and gives them strategies
to cope.
Regardless of your recommended treatment
plan, it is important to take ADHD seriously. Untreated, people with the
condition have a higher risk of early death, both from accidents and suicide.
They are also more likely to have problems with their finances, legal issues,
substance use, unsafe sexual behavior, and unsafe driving. But with effective
treatment, those risks are dramatically reduced.
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