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Including forgetfulness, procrastination, chronic restlessness and lack of following through
You’re late to everything. If you don’t put an event in your calendar, you completely forget about it. And those tasks at work you’ve been putting off? They’re piling up fast, but you do your best work the night before a project is due so everything is fine.
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These may seem like personality traits you’ve acquired over the years. After all, you are who you are! Never change.
But, if these traits are causing disruption to your relationships and leading to other problems that include disorganization, anxiety or burnout, they may actually be symptoms of adult attention-deficit/hyperactivity disorder (ADHD).
ADHD symptoms in adults are more subtle and harder to catch than symptoms of ADHD in kids. Pediatric behavioral health specialist Michael Manos, PhD, explains how to spot and manage symptoms of adult ADHD and when to know how these symptoms are in fact a problem you should address.
Look at your life and look at your choices: if you’ve left a wave of what Dr. Manos calls “incompletions” in your path — failed projects, incomplete homework, missed dates and forgotten anniversaries — you may very well be dealing with ADHD.
“Adults with ADHD tend to leave things partially done and incomplete,” says Dr. Manos. “Those incompletions are the central functional characteristic that is problematic for an adult with ADHD.”
Diagnosing ADHD is a 3-step process. When diagnosing an adult for ADHD, a doctor looks for:
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“You do not have a disorder unless you have dysfunction,” says Dr. Manos. “Sometimes, if people have had dire circumstances in their life — like if they can’t pay rent, they’re unable to send a child to the school they want to go to, or if someone in the family has died or experienced some sort of trauma — when people have concerns like that, those concerns can be preoccupying their attention, make them forgetful, make them irritable or experience other symptoms of ADHD.”
An estimated 2.5% of adults worldwide have ADHD and 4.4% of adults in the U.S. have ADHD. More than half of those who have ADHD also have other behavioral health and mood disorder diagnoses like depression or anxiety. And according to one 2019 study, adult ADHD diagnoses are growing four times faster than childhood diagnoses.
“When adult ADHD is not attended to, with either therapy or medicine, it results in the adult leaving a trail of incompletions in their path, and leaving things incomplete can cause some people to get anxious or depressed,“ says Dr. Manos. “Many times, adults with ADHD can be diagnosed with a depressive disorder or anxiety disorder because of that very thing.”
For this reason, it’s important to get the diagnosis for adult ADHD correct and identify any underlying causes to provide the best course of treatment. When diagnosing ADHD, doctors look at 18 different symptoms — nine inattentive symptoms and nine hyperactivity symptoms.
For a child to be diagnosed with ADHD, they need to present six of the following symptoms in at least two different settings or environments (like at home and at school). For adults, they only need to present five or more of the following in any environment.
There are two kinds of attention at play here:
We all use these two forms of attention to various degrees, but when our ability to direct, hold and maintain our attention is hindered or interrupted, it can cause the nine symptoms listed below.
“People with ADHD have impaired directed attention,” says Dr. Manos. “They’re not able to easily use effortful attention. Instead, they avoid it and they engage in automatic attention tasks instead.”
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This may seem like a no-brainer, but if you ever feel just a little left-of-center on recalling specific details to get things accomplished, this is a sign of ADHD. Maybe your spouse told you they left the spare key for the back door in the top right drawer of your nightstand, but you look in the top left drawer instead. Or maybe you’re putting together a presentation but left out some key points because you were moving too quickly. At the end of the day, you could use some help focusing a bit more on what’s happening around you.
It’s easy for you to bounce around from one task to the next, maybe for no other reason than you have a lot going on. I mean, you’ve always claimed you’re really good at multitasking. But if you have six projects, assignments or activities that are all 40% complete, and you’re feeling the pressure to just get one thing — anything — finished, this might be a problem for you.
When someone is speaking to you directly, you have a glazed-over look in your eyes. It’s not that you’re intentionally ignoring them, but maybe a thought popped into your head that reminded you of a funny story, and suddenly your mind is somewhere else waiting for an opportunity to share your thoughts. If you’ve ever been told you don’t listen to specifics or that you seem inattentive during conversations, this could be your ADHD rearing its head.
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Deadlines, birthdays, anniversaries — the important details about these events not only slip your mind, but you have trouble following through on promises you’ve made and on completing actual tasks. And when other people call you out, it may be hard to explain just how things went south on your decision-making abilities. After all, you really did have the best intentions.
“You may very well intend to do it and you just don’t,” says Dr. Manos. “You avoid it instead.”
You can be disorganized in a variety of ways. Maybe you don’t put your dishes in the right cabinet, or you throw your bright green sweatshirts into the laundry basket that’s meant for only your white clothes. Someone could take a look at your space and think it’s cluttered, or you have a hard time finding the things you need at any given point. Either way you look at it, your system of organization gets in the way when it becomes a barrier to finishing tasks on time and making you feel successful.
Ahh, those late nights writing a paper the day before it’s due bring back fond memories, don’t they? While your days of putting everything off until the last minute in high school are long over, procrastination can perk up in all sorts of other ways in your adult life.
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They may not even be noticeable to you at first. You put off responding to text messages, calling people back or making a Facebook calendar event for that upcoming Friendsgiving you’re hosting. Maybe you hit the snooze on your alarm clock one too many times, and instead of getting out of bed and getting ready for work, you put those activities off in exchange for a few more minutes of sleep.
“Procrastination is the avoidance of having to use effortful attention,” says Dr. Manos. “It’s easier for adults with ADHD to put off things they don’t want to do in exchange for the things that require less effort.”
You can never find your car keys and leave behind your phone whenever exiting a room only to forget you ever left it there in the first place. As scattered as you are, it’s easy for you to set something down, even an assignment or project, and then forget where you left it.
Like a dog running after a shiny new toy, you are easily drawn from one thing to another. You can be in the middle of a conversation and then something will happen outside of the window that catches all of your attention. Or, maybe you look at your phone in the middle of a meeting and suddenly 30 minutes have passed by and you haven’t been paying any attention at all. This can cause serious anxiety if you’re so distracted it becomes obvious to others you aren’t 100% present.
Dates, cooking timers, important reminders — you name it, your mind throws it to the wind. If you ever catch yourself telling the same story two or three times without any recollection of telling it before, that’s not so terrible. But if you forget important details that have been told to you by a close friend, family member, boss or significant other, you might come off as ignorant or unable to be attentive to their needs.
“Everybody is inattentive at some point or another in their life. Everybody tends to lose or misplace something,” says Dr. Manos. “It’s not that adults with ADHD do these things that make them have ADHD. It’s that adults with ADHD do these things so much that it poses a problem for them.”
Hyperactivity in children is easier to catch than hyperactivity in adults. When a hyperactive child is in a controlled environment like a classroom, they may be openly disruptive, restless and anxious. But adults who have ADHD might just always appear hurried or overwhelmed by too many tasks because over time they’ve taken on too many things on at once.
“The manifestation of these hyperactive behaviors are certainly different in adults,” says Dr. Manos.
Here’s how:
If you have a hard time focusing in a meeting because you’re doodling, note-taking, or fumbling with your phone, this can be considered fidgeting. Biting your nails or tapping your feet can also be a sign of fidgeting.
Coupled with your ability to be easily distracted, maybe you have a hard time sitting at your desk all day so you schedule several breaks to walk away from your work area and then find yourself caught up in other tasks and conversations. This isn’t inherently an issue, unless these periods of getting up and walking around are disrupting your ability to complete tasks.
Fidgeting, getting up and walking around: these are all signs of chronic restlessness. And it’s not just that you feel restless during the hours you should be productive; you also feel restless when you should be at rest. Do you ever just get out of bed or put off bedtime because you feel like you should be doing something, and in reality it could all wait until the morning? If your restlessness is interrupting your ability to sleep, work or be productive, you may struggle with ADHD.
If you can’t sit still, you may have trouble participating in solo experiences like reading a book, meditating or watching a full feature-length film without getting distracted or disrupting the activity. You may also have difficulty falling asleep unless there’s some music or film playing in the background to occupy your racing thoughts.
“Sometimes people can’t even sit and watch a movie even if the movie is engaging,” says Dr. Manos.
You’re the high-energy, go-get-’em type. You’re a master multitasker and you never seem to slow down for anything or anyone. Every minute of your day is filled with some sort of activity, and when you’re working to complete one thing, you actually distract yourself with other things along the way.
“If you are one of those people who are constantly on the go, constantly getting stuff done, and you’re hyperfocusing in different areas, it might not be a problem. People who are hyperactive get a lot done,” says Dr. Manos. “But often, adults with ADHD tend to take on more than they actually can complete. Instead of completing everything, they tend to avoid the additional tasks that they might have accrued for themselves and they leave things incomplete along the way.”
You ever hear that phrase, ‘It’s mind over matter’? That’s especially true when you have a thought you just can’t hold back. Your impulsivity tends to take over when telling a story, or sometimes you feel the need to over-share details about what you’re thinking simply because you just have to get it out of your system.
You’re quick to get to the point and are almost impulsive when having a conversation. You may not necessarily intend to override someone else while they speak, but your mind is moving faster than your mouth. When that happens, you tend to pick up the pace and keep things moving more toward your speed, however unintentionally.
Whether it’s the checkout line at the grocery store or it’s backed-up traffic on the highway: you’re impatient in long lines, quickly irritable and everyone needs to move out of your way. This is in large part fueled by chronic restlessness that builds up when things around you start to slow down.
When you’re hyperactive, your mind and body may be moving so fast that other people’s boundaries may not be front-of-mind right away. Maybe you barge into rooms without knocking, you interject in conversations when your opinion isn’t needed or maybe you feel the need to always get the last word in when having an argument. These impulsive actions may easily seem like part of your personality, but they could also be signs of ADHD if they’re causing issues with your relationships.
Similar to other mood disorders, there are common triggers that can set off symptoms that coincide with ADHD impulses, like:
Like other mood disorders, if your inattentiveness or hyperactivity is disrupting your way of life and causing harm to your relationships, your healthcare provider can work with you on a variety of treatments. Most often, cognitive behavioral therapy paired with prescription medication can be the best course of action to helping you manage your systems and improve your focus. Your doctor may also advise an ADHD coach who can work with you to set up structures and coping mechanisms to help manage your symptoms.
“The point is that an adult with ADHD must often have an external organizational system like calendars, reminders, timers and a network of people to help keep them on track,” says Dr. Manos. “If they don’t, then they’re relying on what they keep in their heads to assist them and that information is at times highly inaccessible.”
Being forthright about your diagnosis can also be helpful in some relationships — after all, it’s sometimes easier to understand and relate to someone who says they’ll be late to an event because they establish a clear and honest expectation than to create an upset due to an unfulfilled expectation from the start.
“Whenever possible, you want to try and clean up your incompletions by doing the tasks you set out to finish, changing the angle of the task if you can’t complete them or canceling the task completely,” says Dr. Manos. “It really comes down to setting up proper and predictable expectations for yourself and other people.”
To hear more about ADHD from Dr. Manos, listen to the Health Essentials Podcast episode, “ADHD and Kids.” New episodes of the Health Essentials Podcast publish every Wednesday.
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