Adults With ADHD, Underdiagnosis And Treatment

Adults with ADHD, underdiagnosis and treatment

Attention deficit hyperactivity disorder (hereinafter ADHD) is a neurodevelopmental disorder characterized by attention problems, hyperactivity and impulsive behaviors, generating in the patient a psychosocial deterioration that affects at least two environments of their daily life (work, family , studies…).

The disorder usually presents in developmental stages located in childhood (around 7 years of age) although some juvenile patients can develop it even much earlier. Given the impact that children and adolescents have on their psychosocial functioning in the family and academic spheres, currently the tendency for ADHD diagnosis in our country is high, reaching prevalence figures of up to 7% (Catalá-López et al. , 2013), somewhat higher than the 5% figure declared by the American Psychological Association (APA, 2013). On the contrary, the adult population with ADHD seems to suffer a tendency towards underdiagnosis, reaching 2.5%, a figure much lower than that declared for children and adolescents.

This problem has caused ADHD to be routinely treated as a child-adolescent neurodevelopmental disorder so child and adolescent psychologists are in charge of applying appropriate treatments in collaboration with psychiatrists, in the case of children and adolescents.

For its part, the underdiagnosed adult population even with suspicions of possible ADHD, usually doubts this diagnosis (not made in previous years), suffering from self-esteem problems, poor emotional management and comorbidity with various psychological disorders, including anxiety-depressive disorders, substance addiction disorders and certain personality disorders (First, 2015).

What exactly is ADHD?

ADHD is a psychological disorder characterized by three types of presentation:

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ADHD in childhood

As mentioned above, ADHD causes various problems related to the person’s functioning in living environments.

During the school stage, children and adolescents are described as forgetful, distracted, impulsive, irritable or active, causing harm to their own academic performance as well as to the rest of their classmates. In the same sense, families claim to have various psychosocial problems in their relationship with their children, including the appearance of other related disorders, such as oppositional defiant disorder, intermittent explosive disorder or various behavioral disorders.

ADHD in adulthood

In the adult population, symptoms are usually associated with a decrease in hyperactivity over the years, while attention deficit remains relatively stable. Many adults with ADHD complain of not having been detected in earlier stages, thus enhancing a feeling of low self-esteem due to negative self-talk focused on blaming oneself for one’s forgetfulness, forgetfulness, and dysfunctional behavior. Likewise, it is common for adults to have a marked perfectionism (high need for control, associated with a low tolerance for frustration) reinforced over time as a measure of compensation for the mistakes they believe they have made in their personal or professional life.

For its part, it is common to see cases in consultation of adults with ADHD associated with addiction disorders, especially to alcohol and various substances, in order to promote dissociation from reality and a decrease in the cognitive speed of their mind. Also impulsive behaviors (buying clothes, sporadic sex…) can occur in cases with high hyperactivity. Another common step in consultation is that the adult with ADHD has anxiety-depressive symptoms, often associated with a possible disorder of the same nature. The high level of blame as well as the negative self-talk already mentioned, together with a high level of frustration for not achieving certain vital goals, causes the adult with ADHD to easily generate these symptoms.

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The tendency to underdiagnose adults with ADHD

Treatments in the adult population with ADHD:

There are some treatments with proven effectiveness associated with therapeutic improvement and an increase in the emotional well-being of adults with ADHD: