Hi, I'm Dr. Tracey Marks, a psychiatrist,
and I make mental health education videos.
I talked in a previous video
about how more people than we originally thought
have carry over ADHD symptoms into adulthood.
Attention deficit hyperactivity disorder,
also called ADHD for short,
is a neurodevelopmental brain disorder,
characterized by inattention, hyperactivity,
and impulsivity.
Some people have a combination
of the hyperactivity/impulsivity with inattention,
but some are only inattentive,
and some are only hyperactive impulsive.
Some people will say ADD for short
to mean that you are only inattentive
and you don't have hyperactivity.
But the actual terminology is ADHD, inattentive type.
Our current understanding is that ADHD starts in childhood,
but some research has questioned whether or not
there's an adult onset version
of people who did not have it in childhood.
That issue is still debated, and the conventional thinking
is that the problem starts in childhood,
whether or not you receive a diagnosis.
You may demonstrate some of the problems,
but never see a professional for help because after all,
your parents have to take you to be evaluated,
and there's still a lot of people
who just think it's a disciplinary problem,
especially in the hyperactive kids
or you may just be seen as slow or not a good student.
Even if a parent recognizes
that their child may have this problem,
many don't want their children taking medication.
And therefore, may still not take you to see a professional
and be diagnosed.
So all of this to say the requirement for the disorder
is that you had symptoms in childhood,
but not that you had an official diagnosis
from a professional.
Sometimes the problems that you had as a child can go away,
and you can show different problems as an adult
as part of your original ADHD.
That is your symptoms can shift and look different.
Here's how the core symptoms can look different
between children and adults.
First, let's look at hyperactivity.
In children, this tends to look like fidgeting,
not being able to sit through something
like a meal or class, running inside the house
even though there's nowhere special they're trying to go.
Adults tend to manifest hyperactivity more internally
than externally.
So you stop running inside the house,
but you may feel internally restless,
making you need to fidget or get up.
Can you sit through a two-hour movie
without needing to take a break?
You can also talk excessively.
Fast, reckless driving
can also be a hyperactive manifestation of ADHD.
Next, impulsivity.
When you're a child, you tend to blurt out answers
to things before someone's finished speaking.
And what you say may be a premature answer
to what someone asked, or it could be completely unrelated.
You just speak when you have something to say
and it doesn't matter what's going on around you.
That behavior tones down a little in adults,
but you still interrupt people,
especially when you think you've got the gist
of what they're saying.
The hyperactivity and the impulsivity in adults
may take more of a tone of impatience
and being sensitive to low stimulation.
No one likes to be bored,
but the person with ADHD can become irritable, distressed,
or depressed when they're bored for too long.
And impulsivity in adults
tends to have more serious consequences
like ending relationships on a whim
or leaving a job without having a future plan.
An attention can look similar between children and adults
when it comes to paying attention to what people are saying
or having trouble remembering what you read
and being easily distracted.
Inattention in adults can also manifest as memory problems
because if you don't pay attention long enough
to encode the information, you won't be able to recall it.
Poor attention to detail
and poor planning can lead to disorganization
that you can see in both children and adults.
But here are two features that tend to be more of an issue
with adults than children.
The first is executive dysfunction.
Executive dysfunction
is not part of the diagnostic criteria for ADHD,
but it is seen in people with ADHD and some other disorders.
Executive dysfunction is trouble with organization,
planning, time management, working memory,
which is the information that you can keep in your mind
for easy retrieval.
If you're a technology person,
working memory would be your RAM memory.
I talk in more detail about executive dysfunction
and how it affects you in this video.
Another adult feature is emotional dysregulation.
It's a relatively new concept called deficient,
emotional self-regulation.
It's the inability to control strong emotions
and process them appropriately.
Think of it as emotional impulsivity.
Symptoms of this include low frustration tolerance,
temper outbursts, and sudden mood shifts.
When something distressing happens,
in order to regulate your emotions,
you need to be able to suppress inappropriate reactions,
refocus your attention away from the emotional trigger,
and then channel it towards efforts
that advance your best interests.
So can you see how,
if you struggle with things like distraction,
organization, and impulsivity,
how you could also have trouble managing your emotions?
Some of the things that you can see with this
are being quick to be upset,
overreacting with raw unfiltered emotions,
and being easily angered or resentful over trivial matters,
or at least others would see them as trivial
or inconsequential.
What can you do if you have ADHD or believe you have it
and have a lot of emotion regulation problems?
If you have not been diagnosed with anything,
you should see a psychiatrist
or therapist for an evaluation.
Although deficient emotional regulation
is not part of the diagnostic criteria for ADHD,
it is an associated feature that can possibly respond
to stimulant medication, but not entirely.
Stimulants help certain aspects of ADHD
by increasing dopamine in parts of the brain
that control your attention and executive function.
If you improve these functions,
you can improve your emotional regulation in theory,
but we don't fully understand the cause
of the dysregulation,
and therefore can't say that the medications that we have
adequately target these associated features.
So an alternative option is to take a holistic approach
by using mindfulness exercises, daily meditation,
regular exercise, and eating cleanly.
On top of these basic interventions,
you could also add seeing a therapist
for cognitive behavior therapy or CBT.
Dialectical behavior therapy is a type of CBT
that has four modules.
One of which is distress tolerance,
and another is emotion regulation.
Watch this video where I talk more about distress tolerance
and give you a mindfulness acceptance template
that you can apply to your own situation.
Thanks for watching.
See you next time.