Adult ADHD: No one-size-fits-all approach
A psychiatrist at Mediclinic Sandton explains that ADHD in adults can cause their lives to be chaotic, often resulting in a great deal of personal anguish. As such, an accurate diagnosis and choosing a treatment method that suits the patient’s needs is paramount.
‘Attention deficit hyperactivity disorder (ADHD) is characterised by three core symptoms, namely inattention, hyperactivity and impulsivity. It is considered to be a neurodevelopmental disorder and starts in childhood, although the diagnosis may only be made in adulthood. It is a strongly inherited illness, and parents often recognise the symptoms in themselves if their child is diagnosed,’ says psychiatrist at Mediclinic Sandton with a special interest in the disorder, Dr Rykie Liebenberg.
‘Another way to understand this dysfunction of the brain is to see it as a poor executive functioning of the brain, in other words, the CEO of the company is out of the office, gone fishing,’ she adds.
‘The inattentive type of the disorder is often present in women with ADHD and may not include the element of hyperactivity. The inattention can be divided into the inability to focus attention and the inability to sustain attention. Practically, this means symptoms like procrastination, distractibility, last minute meeting of deadlines or missing deadlines habitually, poor time management, inability to prioritise and forgetting items all the time,’ says Dr Liebenberg.
If the hyperactivity element is prominent, people fidget, cannot sit still for long, may be workaholics or even do extreme sports.
Impulsivity may show in poor decision making about work, relationships, driving and substances. Practically, it may translate into:
- poor management of personal finances and administration
- a higher chance of divorce
- less likely to be promoted
- difficulty with interpersonal relationships
- possible substance abuse or other addiction issues such as internet addiction or gambling
- reckless driving
Associated symptoms include mood swings and temper outbursts, sleep disturbances (mostly owl timing and the inability to get up in the morning). The appetite can also be disturbed, with binge eating and obesity a problem especially in women with ADHD, according to Dr Liebenberg.
Treatment is possible, wide ranging and effective
The management of ADHD includes medication, therapy for the individual and the family, skills training regarding time management, study skills as well as lifestyle changes.
‘Medication can be a stimulant formulation, methylphenidate, in either long-acting or short-acting form, or non-stimulant medication such as atomoxetine as well as some antidepressants.
‘Cognitive behaviour therapy is very useful and family therapy helps to educate everybody about coping mechanisms and life skills needed to live with and support someone with ADHD,’ she says.
‘Lifestyle changes like exercise, reducing the use of substances such as alcohol, good sleeping habits, good eating habits and creating structure in the sufferer’s life can also help the person to cope better,’ explains Dr Liebenberg.
See the right expert
It is advised in the new South African guidelines for Adult ADHD that the first diagnosis is made by a professional who has a special interest and training in this condition. The Society of Psychiatrists has a special interest group, busy with training and building up a network of interested professionals.
For free help and assistance, call the South Africa Depression and Anxiety Group’s ADHD line on 0800 55 44 33.
SCHOEMAN, Renata; LIEBENBERG, Rykie. The South African Society of Psychiatrists/Psychiatry Management Group management guidelines for adult attention-deficit/hyperactivity disorder. South African Journal of Psychiatry, [S.l.], v. 23, p. 14 pages, apr. 2017. ISSN 2078-6786. Available at: <https://www.sajp.org.za/index.php/sajp/article/view/1060>. Date accessed: 12 july 2017. doi:http://dx.doi.org/10.4102/sajpsychiatry.v23i0.1060.