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What is adult ADHD? Is adult attention deficit disorder the same as the condition commonly associated with children and adolescents? The medical and mental health community has long recognized this chronic biochemical disorder in children; recognition and diagnosis of adult ADD has steadily increased in recent years.The terminology and labels used to represent the group of childhood issues characterized by the condition have changed multiple times over the decades, but most medical and mental health practitioners use and recognize the termsattention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD).

What is ADHD in Adults?

Health care professionals began formally recognizing adult ADD/ADHD sometime around 1990. Research indicates that attention deficit hyperactivity disorder continues into adulthood in approximately 60 percent of children diagnosed with the condition. Experts estimate that approximately 4.5 percent of adults suffer from ADHD. Adult ADD symptoms resemble those of childhood ADD, but the intensity of symptoms, particularly hyperactivity, may diminish over time. A history of problems attributed to ADHD in childhood is required for clinicians to diagnose adults with ADD. However, if impairment exists in multiple environments, such as academic, relational, and professional, the individual need not meet the full Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) criteria for ADD diagnosis in childhood.

Symptom Presentation in the ADHD Adult – Overview

Typically, ADHD adults first speak to their primary care physicians about a variety of attention-related complaints, including difficulty with organization, time management, task prioritization, task persistence, and simply beginning a task. Adult attention deficit disorder causes problems in relationships, work environments, and other social settings due to varying levels of impulsive behaviors and a low tolerance for frustration.

Adults with ADD have dealt with the condition and its impact on their quality of life since childhood, but often only receive a diagnosis and ADHD treatment as adults. Symptoms may occur in varying levels, but they are always present and never occur episodically. Frequently, the ADHD adult has co-existing psychiatric disorders, such as bipolar disorder, depression, antisocial personality disorder, or learning impairments. Often these adults have developed unhealthy coping mechanisms, such as alcohol or substance abuse, in an attempt to self-medicate their symptoms.

Prior to publication of the new DSM-V, the DSM-IV criteria required that adult report that symptoms, causing impaired quality of life, were present before 7 years of age (even if the adult was never diagnosed as a child). The new DSM-V revision states that symptoms must have been present prior to 12 years of age with no requirement that they created impairment at that time. By increasing age of onset and taking away the impairment requirement, adults can more easily get the help they need.

Treatment Overview for Adult ADD

As in children with the disorder, ADHD drugs called stimulant medications represent the front line treatment protocol for the ADHD adult. These greatly improve the cognitive and behavioral symptoms associated with the condition in the majority of adults. For adults with a potential for substance abuse, a non-stimulant drug such as Strattera has shown moderate efficacy in some adults, but stimulants still demonstrate the highest degree of efficacy in bringing significant relief to ADHD adults.

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Second generation antidepressants and CBT have evidence bases of benefits and harms in major depressive disorder. This meta-analysis concluded available evidence suggests no difference in treatment effects of second generation antidepressants and CBT, either alone or in combination, although small numbers may preclude detection of small but clinically meaningful differences.

HR Amick et al (2015) Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis BMJ 2015;351:h6019

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Binge eating tied to other mental health problems, obesity to physical symptoms in study patients.

MONDAY, July 29, 2013 (HealthDay News) — Bipolar disorder develops differently in obese people and among those who binge eat, a new study finds.

Up to 4 percent of Americans have bipolar disorder, a serious mental illness that causes extreme mood swings. Just less than 10 percent of people with bipolar disorder are binge eaters, which the authors of the new study said is a higher rate than in the general population.

This study found that bipolar patients who binge eat are more likely to have other mental health problems, such as suicidal thoughts, psychosis, anxiety disorders and substance abuse.

Obese bipolar patients who do not binge eat are more likely to have serious physical conditions such as arthritis, diabetes, high blood pressure and heart disease.

More women than men with bipolar disorder were binge eaters or obese, according to the study, which was published online recently in the Journal of Affective Disorders.

“The illness is more complicated, and then by definition how you would conceptualize how best to individualize treatment is more complicated,” study co-author Dr. Mark Frye, a psychiatrist and chairman of the psychiatry/psychology department at the Mayo Clinic in Rochester, Minn., said in a Mayo news release.

“It really underscores the importance of trying to stabilize mood, because we know when people are symptomatic of their bipolar illness their binge frequency is likely to increase,” Frye said. “We want to work with treatments that can be helpful but not have weight gain as a significant side effect.”

The investigators plan further research to determine whether there is a genetic link between binge eating and bipolar disease.

“Patients with bipolar disorder and binge eating disorder appear to represent a more severely ill population of bipolar patients,” study co-author Dr. Susan McElroy, chief research officer at the Lindner Center of HOPE, in Cincinnati, said in the news release.

“Identification of this subgroup of patients will help determine the underlying causes of bipolar disorder and lead to more effective and personalized treatments,” McElroy said.