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ADHD in adulthood

ADHD in adulthood

ADHD (Attention-Deficit Hyperactivity Disorder) in adulthood, a condition that is little known and generally underestimated by us, has a very significant significance. It is estimated that about two million people in the United States are affected without the slightest idea. The tragic thing is that the disorder can be treated relatively well and with great success if it is recognized.

Little is known that chaos, constant mood swings, irascibility, impulsivity, inability to relate, and addictions can be the symptoms of ADHD, and they are a common thread throughout life. Unrecognized, the ADHD resembles a phantom that haunts all areas of life, can cause considerable damage and destroy relationships. Thus, a chronology of failure often develops.

There is currently no disturbance in child and adolescent psychiatry that is as controversial as ADHD (Attention-Deficit Hyperactivity Disorder). It used to be called hyperactive or hyperkinetic. While the medical specialists are largely in agreement that this is a neurotransmitter disorder of the dopamine receptor and the disorder is genetically determined to a high percentage (up to 81%), this is often still in question, especially from a pedagogical and psychological perspective as a fashion diagnosis vilified. Again and again, the charge of the psychiatrization of children is raised and those lively children should be sedated by medication. This leads to a polemic discussion, which often prevents adequate treatment, which is often associated with the sufferers with considerable suffering and the mystery why they fail again and again.

To make matters worse, that ADHD occurs very frequently. In childhood, it is the most common mental disorder and it is estimated that 5-7% of children are affected.

The previous belief that this disorder develops in adulthood has been refuted for several years, particularly through American studies. It becomes clear that 30 to 50% of children affected by ADHD show significant symptoms later in adulthood, significantly affecting their lives. However, there is usually a symptom shift, that is, the initial symptoms of childhood ADHD change.

In adulthood, not infrequently, a complex clinical picture is revealed, which can certainly cover the entire spectrum of psychiatry.

Wender Utah criteria

Based on the diagnosis of the children Wender was the "Turner-Utah criteria% laquo; and authorized by the WHO.

Attention Deficit disorder

Those affected cannot keep their headlights on for a long time. The spotlight of attention is figuratively mounted on a shaky ball joint, and at the slightest deflection, this headlight moves in the direction of the new stimulus. This leads to huge distractibility, forgetfulness, instability, and absent-mindedness, which can lead to significant school problems in children and to work disorders in adults. They forget a lot, make careless mistakes, are duped, and most of them remain so far below their potential despite their good intelligence. Significantly worse school qualifications are achieved than would have been possible with their intelligence. Sometimes not even a school degree is achieved, which significantly affects the life career. It continues to be difficult for those affected to specifically retrieve knowledge, and so they bring inconsistent benefits. It is amazing, however, that ADHD students can concentrate very well on something they are very interested in. Here they can perform at their best, and you often wonder why some things are done so brilliantly, but simple, uninteresting things are not. Here they often vary between zero-buck attitude and workaholic.

Motor hyperactivity

While the children, especially in ADHD, are still the classic fidget, are not sitting still, are wild and cannot abide by rules, the symptoms in adults are more discreet. They have learned to control themselves better, but they keep their inner restlessness; her being driven, the feeling of being under power and not being able to switch off. You only notice it by the seesaw of the feet, the fingers, which are constantly moving and playing with something and that you yourself are getting a bit restless next to them. They cannot wait, often have to walk around because they cannot sit and rest.

Dreamy, absent

There is another special form that is little known but nevertheless significant. Especially in girls, this form of ADHD, that of the inattentive type. The affected people seem dreamy, absent, uninterested. They often do not get along, tend to be unremarkable, tend to retire and resign themselves quickly. They have a high risk of depression and anxiety later in life.

Affective instability, impulsivity

By this is meant that those affected constantly go on an emotional roller coaster from "rejoicing in the sky" to "distressed to death". They live almost constantly in the extreme. On the smallest external events they react emotionally violent, often exaggerated. Since the world is just going down, because a relatively harmless remark of a fellow human being caused a deep offense, then the MP3 player does not work because you forgot to recharge the batteries and it is already flying against the wall. But when a dear friend calls, the world is alright again. These extremely fast mood changes make the affected person, but also their fellow human beings very hard.

The impulsiveness is another problem. ADHD sufferers act out of the belly with lightning speed, overshooting. "Made first, then thought ..." They often regret that they have reacted so extremely again, but they are not getting their violent feelings under control right now. It's the old "HB males", the "heat bolts," but also the people with the two faces who can be had anything when they're in a good mood, but they go completely crazy when they come under stress and mercilessly their Feelings into the world when they feel like it. I call them "mimosas armed with wooden clubs". They are hypersensitive to themselves, but not squeamish at once to strike when they feel attacked. It is an extreme emotional life, not infrequently in a state of emergency. »Black and white« and there is nothing in between. The middle is rarely found and frustrations and defeats are difficult to endure. They quickly start something exciting and at the slightest difficulty, they lose the desire. This often means that they always start new jobs or give up on relationships quickly when things get tough.

Chaos, disorganization

They can be difficult to keep order because they have no internal structure. Everything seems equally important and so they cannot throw anything away, which can also lead to a Messier existence. The chaos around them is like their inner chaos, they do not find important things in their clutter, and they have no overview in their lives. For women, these are the "chaos princesses," for men, the "scattered professors," who simply have to carry everything after them.

Difficulties in the workplace, at school and with fellow human beings

With all the problems listed above, it is understandable that there are significant problems here. Often sufferers feel bullied because of their impulsivity and mood swings, and the inconstant benefits lead to significant problems in the workplace. Not infrequently, the partners and relatives also suffer from depression and psychosomatic illnesses, because it is very stressful to deal with the daily mood swings and chaos.

It shows a fourfold increase in the divorce rate when a family member is affected by ADHD. This is aggravated by the high heritability, so that often even a parent, possibly also both parents, are additionally affected, which increases the problems. In such ADHD chaos families, it can also lead to physical conflicts in stressful situations. Single parents reach their limit very quickly

Fast fatigue and listlessness

Perseverance and self-motivation are severely limited, resulting in quick resignation and discouragement. ADHD sufferers have a huge "inner bastard," whom they find very difficult to overcome for tasks they do not care about.

This results in considerable self-doubt and a lack of self-confidence. Most biographies of the affected patients show accumulated traumatic experiences. Often the families are very problematic and the children have an early experience that they were unable to learn, were forgetful and had bad grades at school. Even if they were still hyperactive, they mostly experienced rejection from others and got into an outsider position. The previous life experience in childhood was then: "I am stupid and will be rejected". This is not a good condition for the development of a stable self-esteem

Furthermore, there are numerous comorbidities or associated disorder (concomitant disorder), which aggravate the symptoms again. This includes

  • Read permission write fault
  • Dyscalculia up to 30%
  • Tic Syndrome (Tourette) 10-20%
  • Constraints
  • High accident rate (due to ill-considered action)
  • Disruption of social behavior and oppositional behavior
  • Sleep disorders
  • Development of addiction
  • Then there is the symptom shift in adulthood.


30% of adults with ADHD suffer from anxiety and depression.

There is a high risk of subsequent addiction development. The numbers vary. Up to 50% of alcoholics have clear indications of childhood ADHD. It is often a significant abuse of nicotine, as probably excessive nicotine abuse is a kind of self-medication (as other addictions also), because nicotine also attacks the dopamine transporter and so the causative dopamine deficiency is corrected. Furthermore, all forms of addiction are increasingly showing: food addiction, buying addiction, kleptomania, addictions, etc.

Often, those affected are very indebted, because they have no overview of their finances and cannot make a plan.

Also, they tend to drive risky cars or risky sports, they are always looking for the ultimate kick and after a change. They also remain at risk of accidents as adults; it is the people who drive with 200 km / h on the bumper of the frontman because this does not make room in time.

In summary, problems can be found in the following areas:

  • Self-organization
  • Time management
  • Financial management
  • Of relationships
  • Labor organization
  • Teamwork
  • Raising children
  • Road traffic

I would not like to point out that ADHD also has many positive aspects. Those involved are original, creative people, often the uncomfortable brave masterminds, because they cannot stick to rules and question everything. There are many successful people with ADHD without disorder value, as a standard variant in terms of a "certain way of being". If these people have found the right professional niche for themselves, they are often ingenious and unbeatable in their zealous zeal and their tireless actionism. In the media or as computer professionals, we often find them as high-functioning ADHD livers, much appreciated but exhausting for their fellow human beings.

ADHD is always a phenomenon that moves between genius and madness, seamlessly from highly gifted "scattered professor" or the eloquent entertainer to a severely disturbed chaotic and failed man who breaks apart at his many failures. ADHD always becomes in need of treatment only when it comes to considerable difficulties in the area of work or relationships or even in depression and addiction. Therefore, it is necessary to offer very special therapy programs, possibly also a stimulant therapy, which has been proven for 60 years in ADHD children. This also shows new approaches to addiction therapy.

Diagnosing and knowing about ADHD is important because conventional therapies, especially psychoanalytic and revealing therapies for ADHD, are not effective. Often the patients are also so-called therapy failures because they already have an odyssey of treatments behind them. Neither antidepressants nor neuroleptics have really been able to help them with depression, tormenting restlessness, chaos and difficulty concentrating. Maybe they even worsened the condition, because the patient still has a few more construction sites, but still no overview and structure in life. What is needed is a therapy concept that is tailored to the problems and special problems of ADHD.

For this, there are behavioral programs. In the foreground here is the problem of self-organization and self-control. It is about teaching specific instructions for use and problem-solving strategies, as well as dealing with specific problems. Often it is extremely relieving for the patients that this phantom has a name, namely ADHD. ADHD patients can experience that they are not alone. The ADHD module of Freiburg also offers the great advantage that it is not taught in individual therapy, but in a group with other people with ADHD. Exchanging experiences relieves the patients, who have had many painful experiences of being different and being rejected.

It also helps immensely to reconcile with his past: "I had a hard time with ADHD and my parents too ..." And so some heavy derailments of all involved become understandable and forgivable in retrospect.

An important therapeutic pill is also the stimulant therapy, or the new agent atomoxetine (Strattera®). The drugs have a targeted effect on improving the ability to concentrate, a reduction in mood swings and depression and cause a significant reduction in impulsivity. Unfortunately, there are currently considerable problems with the reimbursement by the health insurance companies. It is a scandal that the effectiveness of children's stimulants has been proven and that children develop much better when properly recruited. Especially then, if they are at the end of the school before the final exam, then the drugs cannot be prescribed at the beginning of the majority. Many media have already dealt with these inconsistencies (including Frontal, ZDF). It is withheld from such efficacious drugs by adults, and it is an absurd argument that medication may be prescribed for up to 17 years and 364 days, but not one day longer for allegedly unproven evidence of an effect.

In adulthood, adult psychiatric disorders are manifestations that are difficult to develop without ADHD knowledge and are often mistreated. It is not enough just to treat the addiction or the depression, because that's not the entire range of ADHD can be detected, but only the tip of the iceberg, which protrudes from the water. Under the surface of the water, however, ADHD is a phantom that should be taken into account when planning therapy. Common misdiagnoses include borderline disorders or manic-depressive disorders.

ADHD is always a disorder that was already present in childhood. You have to ask for it exactly. There is no acquired ADHD. Of course, every person shows symptoms of ADHD, but it is about the fact that this complex syndrome is met in large part and throughout the course of life, resulting in significant impairment. It also seems important that mothers or parents are not at fault and that this is not a parenting error. Often, however, parents also have ADHD, and so they find it particularly difficult to give the children structure, clear and consistent to educate.

However, ADHD can be influenced by favorable factors. These include dedicated parents who are deeply involved with the disorder, can provide stability, are predictable and patient, and have resources to support the child.

Unfavorable social factors are difficult milieu, overwhelmed, impulsive parents, unemployment, and addiction in the family. Under such conditions, there may also be criminal developments.

I would be glad if you would deal with this disorder in its dimension completely underestimated disorder. It is of immense importance to patients to be able to inform themselves and to take up-to-date treatments.

 ADHD is a well-treated disorder, with even specialists, have little knowledge about it. Many wrong treatments, many failures, but also many costs could be avoided with the knowledge of it.

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