Attention deficit hyperactivity disorder is a neurodevelopmental disorder. It affects
three main domains. Attention, hyperactivity and impulsivity. So people who have ADHD have
difficulties in paying attention and focusing and concentrating. They tend to be hyperactive
and they tend to be over impulsive. In children, the hyperactivity and impulsivity often more
prominent than inattention, but in adult life, inattention is often the most prominent feature.
Although, quite often you get a combination of all three. In addition, people with ADHD
often have mood swings and also excessive anxiety and depression. So the most of the
people I see with ADHD have additional psychiatric comorbidities which are often the result of
ADHD. So, they will be excessively anxious or more prone to depression than other people
and indeed they may present anxiety and depression rather than overt signs of ADHD. People who
have ADHD struggle in work, and in relationships. They have difficulties in motivating themselves
and have difficulties in completing tasks. There are specific difficulties in managing
big projects as they find it very difficult to plan ahead which means that to help people
of ADHD, big projects have to be broken down into smaller tasks.
Adults are commonly diagnosed of ADHD. ADHD is a neurodevelopmental disorder. It starts
in childhood. However, the condition is not often picked up until adult life. There are
various reasons for this. One reason may be that there was reduce awareness of ADHD in
the past and people did not think of making a diagnosis. Another reason that childhoods
can often be highly structured. Schools are highly structured environments and children
are given specific tasks to complete and little is left-- and quite often little is left to
the initiative. Parents also provide structured home environment. When that structure disappears,
ADHD often becomes overt in a way that may not have been earlier on. There are also huge
benefits in diagnosing ADHD in adult life. People that I see have most of the working
lives ahead of them and most of the social life ahead of them. And diagnosing ADHD in
any age can make can make huge changes to people's lives. I've diagnosed ADHD in people
in the 50s and 60s and they have had great benefits from this. It is therefore never
too late to diagnose ADHD and people can always benefit from appropriate treatment and guidance.
The reason for diagnosing ADHD, it helps people become more self-aware and understand the
difficulty that they've been struggling with. The diagnosis itself even without treatment
can improve self-esteem and help with anxiety and depression.
People with ADHD are easily distracted. They find it very difficult to focus on anything.
The mind tends to wander a lot of the time. So, for example somebody with ADHD who was
sitting in front of a computer to perform a particular task, but would be distracted
by it by emails, messages and other websites and will not complete the task they are asked
to do. Another area of difficulty with ADHD is procrastination. Difficult tasks are put
off and people who've ADHD find is very difficult to split a task into its components. This
means that they tend to put things off until the last minute before a deadline. Quite often,
they'll miss the deadline, but can also mean that the work is of poor quality than otherwise
would have been, because it's done too quickly. People who have ADHD tend to lose and misplace
things. So they forget to take things with them, but they'll also forget where they've
put them. So the patients of ADHD will often complain of losing mobile phones, credit cards
and misplacing their glasses. Another area of difficulty with patients who have ADHD
is that they get bored easily. They find it very difficult to queue. They'll go to the
supermarket and the queues are everywhere. They may abandon the trolley and not finish
the shopping. This can also result in people having difficulties with speeding and having
excessive penalty points on the driving licences. NICE guidelines on treating attention deficit
hyperactivity disorder suggests that the first step is making environmental adjustments.
Once that has been done, I recommend treatment with medication. The medications for ADHD
all increased dopamine levels in the frontal lobe of the brain and restore the dopamine
levels to what they would have been in somebody without ADHD. This means that people who have
ADHD, once on medication, can have improved concentration, improve motivation and are
much better at completing their tasks. Medications commonly used are methyphenidate. The brand
name of which is Ritalin and Dextroamphetamine. I tend to use long-acting medications. Which
means that people do not need to take medication several times a day. These medications are
taken in the morning and can act for between eight to ten hours subsequently. They help
people get through the day and function and complete their tasks. This can lead to dramatic
transformations in people's lives. People can manage exams much better and also improve
interpersonal relationships and have an improved performance at work. These medications are
highly effective. The positive response in between seventy to eighty percent of patients.
They also have very few adverse effects. The other factor to bear in mind is that these
medications are not addictive. Patients do not on the whole develop a tolerance and once
a dose of medication is established, people can continue taking those in the long term.