The reality is many adults who have ADHD are diagnosed only when they seek help for their own children. “I was sitting in the paediatrician’s office and had this déjà vu kind of experience while he was examining my child. It was almost as if the paediatrician was talking about me. I thought, well, I was like that when I was a child.”
Adults with ADHD are often very creative, vibrant and emotionally sensitive; they can read environments really well.
A high-protein, low-carbohydrate diet that contains lots of fresh vegetables can stabilise energy levels and concentration.
Deficiency in B group vitamins, particularly B6, is also very common in ADHD sufferers.
Research shows that choosing organic food is a good option for people with ADHD.
Jason stared glumly at the résumé clutched tightly in his hand. He’d held five jobs in the past four years and had been asked to leave each one because he struggled to meet deadlines. As he was called in for his latest job interview, he repeated an all-too-familiar mantra to himself: stay calm, stay alert. For most people, the day-to-day responsibilities of juggling work, family and social schedules can seem demanding. For adults with ADHD, like Jason, it can be overwhelming.
ADHD, or attention deficit hyperactivity disorder, is a medical condition that involves inattention, impulsive behaviours and hyperactivity. Sufferers may experience one, two or all three of the behavioural symptoms in varying degrees. Broad-based studies show that 3.5 per cent of adults across the globe have ADHD but there may be many that remain undiagnosed. For those who do fall through the cracks, without adequate treatment, the future can look bleak.
ADHD can tear apart relationships, cripple careers, and wreak havoc on the self-esteem of the sufferer. “Adults with ADHD may have a limited attention span and be restless and easily bored,” says Mark Brandtman, educational consultant and ADHD coach and mentor.
As a consequence, their actions affect their daily lives. Establishing and maintaining meaningful relationships in adulthood can be tough for ADHD sufferers. They may have trouble with intimacy, self-esteem and mood swings. They can have trouble sitting still and may seem overly anxious and frustrated with things that wouldn’t normally upset people.
There are many misconceptions associated with ADHD. One is that it’s something associated with childhood and that kids will simply grow out of it, says Associate Professor Julian Trollor, Director Department of Developmental Disability Neuropsychiatry at the University of NSW. “Research shows around 15 to 20 per cent of children with ADHD will still have full-blown ADHD when they reach adulthood and a further 30 to 40 per cent will carry forward some disabling symptoms of ADHD but not have the full-blown disorder,” he says.
It’s also important to understand that you can’t get ADHD as an adult, so if you are diagnosed with the condition as an adult, you’ve had it since childhood.
What causes ADHD
The answer to what causes ADHD is quite complex, according to experts. It is related to brain function and chemical imbalance, but that is only one theory, says Dr Caroline Stevenson, clincial psychologist and ADHD specialist.
“It can be anything that causes mild brain impairment, such as being premature, exposure to lead or smoking during pregnancy — all these can contribute to the expression of ADHD. Basically, it centres around impairment in the frontal lobes of the brain. If you put them under a brain scan there is less blood flow to that area, and the frontal lobes can also be minutely smaller in size,” she says.
There is also a genetic influence, says Trollor. If one parent has ADHD there is a strong risk that other family members will also have the condition. However, Trollor is quick to point out that genetic vulnerability is only part of the final equation.
“As with most complex conditions it’s not a matter of one gene that is causing the condition — multiple genes conferring the risk then interact with environmental influences that help to shape development of a child,” he says.
As a condition, ADHD is not only misunderstood, it’s also frequently misdiagnosed by health professionals. It’s a costly oversight for those who have ADHD, says forensic psychologist, Dr Alison Haigh. “Patients are presenting to their GPs, psychiatrists, counsellors or psychologists with a gamut of problems ranging from relationship difficulties, to depression, anxiety, drug and alcohol, and gambling problems. The ADHD is underlying these disorders but is being missed by the clinicians,” she says.
The reality is many adults who have ADHD are diagnosed only when they seek help for their own children. Educational consultant Mark Brandtman has ADHD. He only discovered it when he took his child to a paediatrician to discuss some concerns he had about his child. “I was sitting in the paediatrician’s office and had this déjà vu kind of experience while he was examining my child. It was almost as if the paediatrician was talking about me. I thought, well, I was like that when I was a child,” he says.
Living your life as an adult with ADHD isn’t easy and, even when a diagnosis is confirmed, the road ahead can be tough. “A diagnosis in childhood is overwhelming but in adulthood it’s a life lost for many. They wonder what their lives would have been like, how different their journey would have been, so there is often a lot of grieving,” says Brandtman.
Nothing new
A common fallacy about ADHD is that it is a condition of the 20th century. It is not a new phenomenon. English paediatrician George Still described it back in 1902, though he called it “defective moral control”. The name has changed but there still remains a stigma associated with ADHD. Even when adults with ADHD are diagnosed, few will disclose it to friends and co-workers for fear of social ridicule and alienation.
Talk to some experts and they’ll tell you mainstream media have fuelled the problem. Disturbing and violent images are often played out in the media, according to Dr Haigh. “You will see current affairs TV shows portraying children with ADHD running into walls red-faced and screaming,” she says.
Not all children and adults with ADHD show hyperactive behaviour. Dr Haigh, herself an ADHD sufferer, was not diagnosed until age 27. “I was a good little girl at school. I always got straight As,” she says. “It wasn’t until I got to high school, with less structure and teenage hormones kicking in, that my anxiety really surfaced — but even then I was good at hiding it,” she says.
Even with the challenges associated with ADHD, it’s not all gloom and doom. “If I could wave a magic wand and take it all away, I wouldn’t,” says Dr Haigh. “Adults with ADHD are often very creative, vibrant and emotionally sensitive; they can read environments really well. We can think laterally and we aren’t afraid to take risks.”
People with ADHD can carve out successful careers — they just need to find employment that suits their needs. Many are often at the helm of multinational organisations, according to Dr Haigh. “These CEOs surround themselves with people who are good at attention to detail and organising, (but) they are the visionaries — they can see the bigger picture.”
The symptoms of ADHD can mirror the frustrations each and every one of us encounters from time to time. Most people will misplace a wallet, fidget or interrupt a conversation on occasion. It all comes down to how the behaviours impact on your life, the severity of the episodes and how long it’s been happening, says Brandtman. “It’s all about degree and frequency,” he says. “Most people will lose car keys but if you do it often and have a meltdown every time you do, there could be a problem,” he says.
Treating ADHD
ADHD cannot be cured but it can be effectively managed with an individual treatment plan. There is a broad range of treatment options. Evidence-based research shows the best form of treatment is a multimodal or holistic approach, according to the experts.
A treatment plan could involve seeing a psychiatrist and possibly being given medication to help to correct the imbalances in brain chemistry. This may help those with ADHD to think clearly and reduce hyperactivity, distractedness and impulsive behaviour. Some doctors may also suggest cognitive behaviour therapy to learn different coping systems, and or relationships counselling.
Cccess to treatment can be a challenge. “It can be difficult for psychiatrists to prescribe medication; the medication itself is not on the PBS list, and it’s expensive,” says Dr Haigh.
Due to the cost factor, undergoing treatment can place an enormous strain on many families’ budgets. “We had a gentleman phone into our helpline and tell us that he, his wife and two children had all been diagnosed,” says Dr Haigh. “The family budget could only stretch to paying for treatment for two family members. He asked us how he was meant to choose who gets treatment.”
If you do have ADHD, one of the most important things you can do is find out as much as you can about the condition. Educate yourself and your family. Join an ADHD support group; it can help to talk with others about how they manage their condition, says Dr Stevenson.
“Joining a support group helps to normalise it. Most people with ADHD tend to feel like they are lazy, stupid or crazy,” she says. “At the same timem having other people there who are going through the same thing takes away that.” Joining support groups and exchanging ideas on what helps to manage the condition can also be helpful for ADHD sufferers.
A holistic approach
Get organised by using a diary and having a wall planner. Play music when you are doing tasks that might be boring to you. Many adults with ADHD tend to procrastinate, so do things with others to help motivate you and make you accountable. According to Dr Stevenson, seeking guidance in anger management, stress management and exercise such as tai chi may also help.
A regular exercise regimen can also help to burn off extra energy. ADHD adults and children can feel like they have boundless energy; working that off through vigorous exercise can help with staying focused. The benefits of exercise will last for a few days.
“If you think you might have ADHD, the first thing you need to do is see your GP. Then ask for a referral to a psychiatrist who specialises in ADHD,” says Dr Stevenson.
An anti-ADHD diet
Dietary additions and supplements are important components of holistically managing your ADHD. Working to cut down or eliminate consumption of some foods and adding others to your diet can help to reduce symptoms. A high-protein, low-carbohydrate diet that contains lots of fresh vegetables can stabilise energy levels and concentration.
“Some of the symptoms of ADHD, such as mood changes, difficulty concentrating and forgetfulness, are quite similar to those of an omega-3 deficiency,” says Katherine Maslen, herbalist and naturopath from Wellness One in Brisbane. “Research has shown a deficiency in omega-3 can exacerbate the symptoms of ADHD,” she says. Foods rich in omega-3 fatty acids commonly are oily fish such as salmon, tuna, mackerel, sardines and herring. You can also take supplements — around 3000 milligrams a day is the recommended amount, according to Maslen.
Deficiency in B group vitamins, particularly B6, is also very common in ADHD sufferers. “In this case, supplementation can be of benefit as it helps to balance the brain chemistry,” she says. Ensuring you have adequate zinc and magnesium is also critical in managing your condition.
“Both zinc and magnesium have a role in calming the nervous system and it’s been shown that ADHD sufferers can respond quite well, particularly if they have the more hyperactive tendencies,” Maslen says.
Research also shows that choosing organic food is a good option for people with ADHD. Studies by Canadian Researcher, Maryse F. Bouchard, from the University of Montreal in Quebec, have shown a strong causal link between use of pesticides and symptoms of ADHD. So go organic where possible.
Excess heavy metals in your system may also aggravate your symptoms, says Maslen. “Get your levels checked by a naturopath — if they are too high, dietary intervention and nutritional supplements will help to speed up detoxification,” she says.
To help manage your ADHD, eat a healthy diet, including lots of fruits, vegetables and whole grains,” advises Maslen. You also need to eat proteins such as lean meat, low-fat cheese and eggs. Adequate protein is an important dietary component as it helps form building blocks for neurotransmitters in the brain.
Just as there are foods you should be adding to your diet, there are also those you should avoid. Consumption of highly refined sugary foods can throw your blood sugar levels into a cycle of peaks and crashes — exactly what you need at avoid if you suffer from ADHD.
Avoid processed white flour, white rice, soft drinks and refined sugary foods such as icecream and chocolate. You should also stay away from saturated fats and margarines. “Artificial colourings, sweeteners and flavourings in foods have also been linked to increased hyperactivity in those with ADHD,” says Maslen.
With dietary intervention, those with ADHD are likely to experience many positive changes in their psychological wellbeing.
Types of adult ADHD
Predominantly inattentive ADHD: The most passive of the three types. Inattention is the main symptom. The person can often be thought of as a daydreamer. Impulsivity and hyperactivity may show but to a lesser degree.
Predominantly impulsive/hyperactive ADHD: Symptoms are mainly hyperactivity and impulsive behaviours. Short attention span or inattention may also be present but are not as obvious.
Combined ADHD: Inattention, hyperactivity and impulsivity are all exhibited — each at about the same level.
New guidelines
One of the issues with ADHD is the lack of evidence-based information that can help those with ADHD understand and manage the condition. The good news for those with ADHD is that a document outlining assessment and diagnosis, information, sources and treatments will soon be released to clinical practitioners. The new guide to clinical practice will improve diagnosis and treatment outcomes for those with ADHD.
For more information checkout www.add.org.au and www.livingwithadhd.com.au/adults/default.aspx
Carrol Baker is a freelance journalist based in the lush tropical Sunshine Coast hinterland. She writes for lifestyle and health magazines across Australia and loves climbing mountains, trekking and exploring the great outdoors with her young family.
