Comparing Childhood & Adult ADHD
Attention deficit hyperactivity disorder, or ADHD, may have its roots in genetics. In fact, according to Mental Health America, 30-40 percent of children who have ADHD have a relative who also has ADHD. That means many kids living with the disorder could turn to their parents for support, guidance, or advice.
But are the symptoms a child with ADHD has the same as the symptoms an adult might have? Are the treatments the same? Chances are, the adult and the child may have the very same disorder with very different symptoms and different treatment needs. They may be able to support one another, but the disease is very different in these two population groups.
ADHD in Children
Children with ADHD have a classic suite of symptoms that involve:
These children may struggle in school, simply because they cannot bear to be stuck in a classroom at the same desk for hours on end. Their brains and bodies cannot handle that long form of attention. These kids need to move.
In addition, per research published in the Archives of Disease in Childhood, children with ADHD struggle with relationships. When these children are very young, their parents may notice few invitations for play dates and parties. These kids may be taunted at school for their differences. They may become resistant to the mere idea of getting help, simply because they fear it will result in more bullying. These children are pretty isolated, and they tend to do poorly, both academically and socially.
ADHD in Adults
An adult with ADHD may be able to sit in a desk and seem to conform with the demands of a focused job. But this adult may:
- Miss deadlines
- Work hard on one part of a project while ignoring others
- Chat excessively
- Seem unable to reach true potential
An overview in Psychology Today suggests that many adults with ADHD are considered the “life of the party.” These people are overwhelmingly successful in social encounters, and they often find it easy to both make friends and retain friends. Their relationships may be superficial, but they exist.
Also, adults with ADHD may be desperate for help. They may find that they want to do better at work but can’t seem to do so. Or they may find that they cannot maintain an intimate relationship, and they want to do so. Unlike children with ADHD, adults may be actively looking for a solution to problems that may have plagued them all of their lives.
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Help for ADHD
While adults and children may have very different ADHD symptoms, they both face very real risks without treatment. Research from the Centers for Disease Control and Prevention suggests that 30-60 percent of people with ADHD have comorbid conditions, including addiction, depression, or anxiety.
Also, ADHD can cause loss of work, loss of financial security, and loss of meaningful and close relationships. It leads to a difficult life. Treatment can help.
Medications paired with therapy are commonly used as a treatment plan for ADHD. The medications help to soothe haywire electrical impulses that cause unusual ADHD behavior, while the therapy helps people to develop lives that protect them from negativity and impulsivity. With this approach, people can get better — whether they are children or adults.
Frequently Asked Questions
People who have attention deficit hyperactivity disorder (ADHD) struggle with a condition that is likely to affect them for their entire life. While this can be detrimental if the person does not receive an appropriate diagnosis and treatment plan as soon as possible, many people who have ADHD can live normal lives, with appropriate medication and therapy.
What are the causes of ADHD?
ADHD develops due to a combination of genetics, family history, and environment. Essentially, people with ADHD have brains that respond differently to neurotransmitters, including dopamine, serotonin, and norepinephrine. Dopamine in particular may play a role in the condition, since it is partially responsible for regulating sleep, attention, learning, mood, and movement.
This condition, according to the World Health Organization (WHO) develops in about 3-4 percent of the population; about 4.5 percent of the population in the United States has ADHD. Between 60 and 90 percent of adults who had ADHD as children continue to struggle with this condition into adulthood.
The only cause of adult ADHD is developing the condition as a child, although it may not be diagnosed until the person grows up and begins struggling with worsening symptoms of the disorder. Adults who have ADHD, especially if it has not been appropriately treated in childhood, struggle at work, school, and in relationships due to the inability to focus. Many adults with undiagnosed ADHD suffer low self-esteem and mood disorders like depression and anxiety.
In children, genetics, family history, and environment collide to lead to the development of ADHD. A child whose parent has ADHD has a 50 percent chance of also developing the condition; a child whose sibling has ADHD has a more than 30 percent chance of developing ADHD.
Other environmental factors that can trigger the development of ADHD include:
- The mother drinking or smoking during pregnancy
- Low birth weight
- Difficult pregnancy
- Brain injury, especially to the frontal lobe
- Exposure to chemicals, including lead, pesticides, and potentially some food additives
Contrary to popular belief, a diet high in sugar, lack of exercise, or overexposure to television or video games does not trigger ADHD in children or adults. While these are not part of a healthy lifestyle, they are not linked to ADHD.
Is ADD the same as ADHD?
Yes, attention deficit disorder and attention deficit hyperactivity disorder are now combined into the same condition. At one time, ADD and ADHD were separate disorders, with the difference based on the person’s level of kinetic hyperactivity and impulsivity. Originally, ADD was only the person’s inability to pay attention, while ADHD included poor impulse control and extreme physical energy. However, the DSM-5 combined these conditions, as they were very difficult to differentiate and diagnose separately. Additionally, the treatment plan – medication and psychotherapy – is the same.
What types of therapy can treat ADHD?
The Centers for Disease Control and Prevention (CDC) notes that there are three basic types of therapy used to treat ADHD, both in childhood and adulthood. These are:
- Medication, typically Adderall or a similar stimulant drug
- Changes to school, work, and/or home environment
- Behavioral therapy
The American Academy of Pediatricians (AAP) recommends a combination of prescription medication and behavioral therapy as the best treatment to reduce the long-term impact of ADHD. The overseeing physician will monitor their patient to ensure medication is helping, and adjust dose or type of medication as needed. Behavioral therapy helps the person understand their condition and how it will impact their life; this, in turn, allows the therapist to help their client develop coping mechanisms so symptoms like inattention, physical energy, and impulsivity can be managed.
Therapy is also important for parents of children with ADHD, and it can be useful for spouses or loved ones of adults with ADHD. Therapy helps those around the person with ADHD to understand and cope with the condition.
Is ADHD overdiagnosed?
As more children are diagnosed with ADHD – up to 9.5 percent in 2007, from 6.9 percent in 1997 – there is a growing concern about misdiagnosis or an epidemic of overdiagnosis. One point of concern is the pathologizing of normal childhood development; another is the widening definition with the release of the DSM-5. Parents and teachers could place greater pressure on clinicians to diagnose normal behaviors that are not detrimental to the child but disruptive to the home or school environment. Environmental pressure on a child to perform well at many complex tasks, such as schoolwork or afterschool activities, could lead to behavioral issues that are misdiagnosed as ADHD.
Part of the concern about misdiagnosing ADHD, especially in children, involves the powerful stimulant drugs used to treat the disorder. In affected individuals, Adderall, Ritalin, and similar stimulant medications improve attention to tasks; while medication alone is not an effective treatment, the substances do help alleviate some of the more intense symptoms of the condition. In children who do not have ADHD, however, strong stimulant medications could lead to brain damage, increased behavioral problems, and addiction, co-occurring disorders, or polydrug abuse problems later in life.
ADHD may be overdiagnosed in younger children, or children who have other behavioral issues, but it is hard to know how significantly the condition is misdiagnosed. However, if impulse control, intense physical energy, and inability to concentrate negatively impact a person’s daily life, ADHD could be the root cause. Regardless of the ultimate diagnosis, it is important to seek help for the symptoms before they lead to other problems, like depression or anxiety.
Does ADHD increase the risk of substance abuse?
Many people express concern that treating ADHD with stimulant medications increases the risk of those people developing an addiction to their prescriptions; the assumption is that people who are exposed to other drugs like opioids or benzodiazepines are at an increased risk of suffering an addiction to these potent compounds, so stimulant prescription medications must be similar. While there are people who struggle with addiction to Ritalin or Adderall, these individuals typically do not have ADHD. People with the condition, according to several studies, are not likely to develop an addiction to their stimulant prescriptions because of how these medications affect their brain function.
However, there is a link between ADHD and substance abuse problems. Typically, this involves adolescents and adults who have undiagnosed or undertreated ADHD, and abuse substances to sleep, improve their mood, or for other, similar reasons. One study found that only 30 percent of participants used intoxicating substances specifically to get high; the other 70 percent struggled with substance abuse specifically to self-medicate symptoms of ADHD. However, this was true for people who had not received an appropriate diagnosis in childhood or appropriate, timely treatment.
Adolescents and adults with undiagnosed ADHD, or who receive a diagnosis of ADHD later in life, are three times more likely to become addicted to nicotine, twice as likely to develop an alcohol use disorder, 1.5 times more likely to struggle with addiction to marijuana, and 2.5 times more likely to suffer a substance use disorder in general, according to a 2011 meta-analysis. However, taking stimulant medications to treat ADHD is not associated with a greater risk of substance abuse; it is people who do not receive treatment for ADHD who are more at risk of addiction and substance abuse problems.
Are ADHD medications addictive?
Medications like Ritalin and Adderall do have addictive properties, but not for people with ADHD. Stimulants increase the amount of dopamine in the brain. Higher levels of this neurotransmitter in the brain are linked to elevated mood, better attention, and increased pleasure. For people who struggle with ADHD, the increase in dopamine gives them the ability to pay attention to tasks without physical, emotional, or behavioral distractions. In people who do not have ADHD, the increase in dopamine is more than their brain is used to, so they feel euphoric, or “high.”
Additionally, people who struggle with addiction to ADHD medications are not likely to have a physician overseeing their use of the drug. People who have been diagnosed with ADHD have a psychiatrist or physician who monitors their medication and adjusts the dose as needed. People who abuse prescription medications, including Adderall or Ritalin, are likely to take higher doses for recreational purposes. These drugs are also associated with increased focus and reduced appetite, so they are frequently abused by adolescents or young adults who need to study hard at the last minute or who have an eating disorder.