What Is Attention Deficit Hyperactivity Disorder In Adults? Things You Should Know

This is a five hundred years old story of a genius artist. This great artist failed to complete many projects. He used to spend so much time planning the project that he could not focus on the work which needed to be done to start and complete the job. This lack of perseverance was present from his childhood and continued into his adulthood. After working hard as an assistant for many years, he was commissioned to do his first independent work and was paid in advance. He was excited but could not complete it. His paintings were the work of a genius but noblemen were hesitant to commission him for their desired work due to his unorganized way of functioning and lack of focus which would result in unending procrastination.

A contemporary writer observed how he worked while he painted a now famous art piece, "He would take up his brush and give one or two touches to one of the figures and suddenly give up and go away again". His procrastination was so severe that many of his paintings were incomplete even after 20 years of starting them and many times, other artists were called to complete them. The Pope of that time exclaimed, "Alas! this man will never do anything, for he begins by thinking of the end of the work, before the beginning". He would constantly be on the go, keeping himself occupied with doing something but always jumping from task to task. He would sleep very little, and work continuously with short naps. His rival colleague also insulted him in front of everyone over an unfinished bronze horse.

Who was this genius artist? He was Leonarda Da Vinci, the contemporary writer described his way of functioning while painting The Last Supper and his rival colleague was none other than Michelangelo.

Attention Deficit Hyperactivity Disorder (ADHD)

We can never be sure if Leonardo Da Vinci had ADHD or not as that diagnosis didn't exist in his time but it is important to know about ADHD as it is undiagnosed in many people. ADHD stands for Attention Deficit Hyperactivity Disorder. It is a condition which starts in childhood, usually gets better with age but can last in adulthood also. ADHD in childhood can cause problems in education, learning and behaviour. ADHD in childhood can cause problems with attention (which becomes a major obstacle in their studies), Hyperactivity (children who are overactive, and can’t sit for long) and Impulsivity (behavioural problems). ADHD can have three presentations i.e. predominantly inattentive, predominantly hyperactive or combined. ADHD is linked to inefficient information processing in the Prefrontal Cortex of the brain. The prefrontal cortex has many functions which include cognition and executive function i.e it plays an important role in intelligence, planning, decision-making, self-regulation, self-control etc. As these qualities are very important in a child’s education, ADHD symptoms should not be ignored. ADHD in adulthood can cause impairment in a person’s employment, economic aspects and social functioning.

Adults with ADHD can have problems with organization, planning, getting easily bored, difficulties in attention to paperwork and other reading, procrastination, poor time management and impulsive decision-making. They can also have problems with interpersonal skills like poor follow-through on commitments, poor listening skills, and difficulty with intimate relationships. They can have major problems with the organization of work as well as finances, leaving jobs or relationships even if they are going well. A general impatience in their day-to-day, as well as long-term life, could be present which can become a major impediment to their success and happiness.

What is not Adult Attention Deficit Hyperactivity Disorder (ADHD)?

Many of us can have some of the symptoms mentioned above at some point of time in our life. But that is not adult ADHD. ADHD starts before the age of 12 and is a pervasive pattern which doesn’t appear and disappears at different times. Some of the symptoms of ADHD can be present in other psychological disorders. One has to also understand that some people could be more active than the average population or some people could be more impulsive in nature. Just having these qualities doesn’t make that person suffer from ADHD. To make the diagnosis of ADHD, one must have significant difficulties in some aspects of his/ her life such as work, education or relationships and these difficulties must be present since childhood. If a person has significant impairment but symptoms have appeared or have significantly worsened during some phase of adult life, clinical depression or other psychological conditions should be ruled out first. Depression can have cognitive symptoms which are similar to symptoms of the Inattentive type ADHD. Impulsivity could be integral to some Personality types. So if you observe some of the symptoms of ADHD, a thorough assessment is required.

ADHD management

Medications play an important role in ADHD treatment. However, only medications could be insufficient in the majority of the cases. Sometimes, adults find innovative ways to deal with their ADHD symptoms like Richard Branson delegates most of his work and so can manage around 400 companies. In well-adjusted people or people with less severe symptoms, medication can be avoided. In such people, learning skills of better planning, organization, managing distractibility, reducing procrastination and some behaviour therapy for anger, frustration management and communication skills can be enough. I will try to give some techniques to deal with these problems in the next articles.

Dr Chinmay Kulkarni is a psychiatrist practising in Mumbai. He believes that mental health is an ignored topic in India and millions of Indians are suffering in silence because of this. The views expressed are the author’s own.