ADHD in adults

Coping more easily with everyday life

Cannot concentrate and poorly organised? This may be caused by a psychosomatic illness. People with ADHD are easily distracted, can rarely concentrate on a task over a longer period of time, often do not complete activities once they have started and are often disorganised. Time and again this leads to conflicts in all areas of life and thus often to additional psychological illnesses.

At Schoen Clinic we are specialised in the treatment of ADHD in adults. With effective therapy methods we help you to better self-management.

Causes & symptoms

How does ADHD manifest itself in adults?

It is only in recent years that ADHD has been perceived as a disease of adulthood. It is assumed that in about 60 percent of affected children the disorder does not stop at the age of 18. However, the nature and expression of the symptoms change in adulthood: For example, the motoric urge to move in children can give way to a constant restlessness in adults. Reduced attention with disorganisation, "postponement-itis" or mood swings, on the other hand, can become more relevant.

Whether ADHD needs to be treated always depends on the individual level of suffering of the affected person. Knowing about these interrelationships is already helping some people.

Causes: How does ADHD develop?

The causes of ADHD are not yet fully understood. However, it has been proven that the disorder is due to genetic and environmental factors.

Genetic influences

In ADHD, a pronounced family incidence can be observed. If a member of one’s nuclear family has ADHD, the risk for the other members is increased up to fivefold. Many parents only find an explanation to their own problems when their child attracts attention at school.

ADHD also has a negative effect on neuronal systems, especially certain messenger substances. If their balance and function is disturbed, this can not only have far-reaching effects in the areas of concentration, memory and perception, but also in the ability to regulate feelings and control impulses. This often results in a lack of control and impairment of self-organisation.

Environmental influences

External risk factors include pregnancy and birth complications, low birth weight, infections and toxins such as alcohol or nicotine abuse, and diseases of the central nervous system. Serious neglect in early childhood can affect the degree of severity and stability of symptoms and can contribute to aggressive, oppressive and delinquent behaviour.

ADHD - Symptoms: frequent signs of ADHD in adults

Attention Deficit Hyperactivity Disorder (ADHD) is characterised by three core symptoms:

  • Attention Deficit Disorder
    Tasks in which one has to concentrate for a longer period of time are poorly mastered, especially when the task seems uninteresting and arouses little curiosity. Boredom, abortion of the task and fatigue quickly occur. Since sensory impressions cannot be filtered or ordered well, those affected can quickly get distracted. Every detail seems equally important, so you loses yourself in details. In general, those affected tend to get bogged down, postpone things or not finish them. They work inefficiently and slowly. Appointments and agreements are forgotten or things are lost or misplaced. This leads to frustration and anger. This can result in general exhaustion, disinterest, irritability and loss of drive. There is however also the phenomenon of “hyper focussing”, in which people with ADHS delve into a topic of interest to them and forget about everything around them.
  • Hyperactivity
    Those affected are restless, fidgety, restless, internally tense and feel driven. Constant talking, restlessness, fiddling with things are noticeable. They often try to balance their hyperactivity through (excessive) sport. In adults, the motoric restlessness is often not as pronounced as in children, it then turns more inwards and is perceived as tension, drive and thoughts racing through the mind. The desire to change activities with a lot of freedom of movement is great. Many suffer from violent emotions.
  • Impulsivity and emotional liability
    Impulsive people are prone to taking ill-considered actions and making decisions without thinking about the longer-term consequences. In doing so they often damage themselves and others. They strive for immediate reward or satisfaction of needs. People with ADHD are impatient and quickly get irritable in many everyday situations. They often have an unrestrained flow of speech and frequently interrupt their counterpart. Sudden mood swings with outbursts of rage over trivial things alternate with hard to comprehend enthusiasm and euphoria. Those affected are unable to necessarily distance themselves from many things. The generally reduced tolerance of stress and frustration can only be partially compensated with considerable effort.
Not all three ADHD symptoms occur to the same extent in every affected person. Three subtypes can be distinguished:

  • Combined type
    All three core symptoms in relatively uniform expression
  • Predominantly inattentive type
    Inattentiveness and disorganisation in the foreground
  • Impulsivity and hyperactivity rather low or non-existent - Predominantly hyperactive-impulsive type
    Impulsivity and hyperactivity still dominant in adulthood - inattentiveness in everyday life not really a problem.

Accompanying disorders in ADHD

There can be family, partnership or school/professional problems: People with ADHD repeat classes more frequently at school, drop out of education, change jobs often and are more often unemployed. In relation to what they could potentially achieve through their intellectual capacity, they usually fall short of their potential. Partnerships also break down more often. They often relocate, burning all bridges. Abuse of alcohol, drugs or nicotine, delinquency or falling into debt are also typical of ADHD. Basic beliefs are "I am somehow different from other people" or "I cannot do anything, my life is a disaster". In combination with the feeling of perplexity and helplessness this then often results in serious self-esteem disorders. Psychological stress such as sleep disorders, eating disorders, burnout syndrome, compulsions as well as personality disorders develop. Among the most frequent concomitant diseases are depression (40%), anxiety disorders (30%) and substance-related disorders (30%).

Diagnostics

Diagnosis: No small matter

The diagnosis of ADHD in adults is quite extensive and time-consuming.
It is crucial for the central symptoms to have existed before the age of 12 and that difficulties already arose during primary school. Your symptoms are then checked to see if they meet the criteria of the globally recognised ICD-10 classification system. Other illnesses are also detected or excluded

An extensive conversation with you will give the experienced specialist or psychotherapist good information about your illness. Specific tests support the diagnosis, but always require a final clinical evaluation.

Test psychological diagnostics

Supplementary diagnostics with the ADHD self-assessment questionnaire (ADHS-SB) helps to determine the current state of expression as well as the degree of stress you are under through ADHD. The structured clinical Wender-Reimherr-Interview (WRI) can also be used for this purpose. Here you will find questions on organisation, emotional stability, excitability and stress tolerance. Based your answers, we can adequately assess your symptoms in everyday life.
The Conners’ Adult Scales (CAARS) can assess the impairments of distractibility, impulsiveness, and motor agitation and lead to an overall ADHD index that reflects the extent of the symptoms.