Adult ADHD: A 21st century epidemic?

Adult ADHD: A 21st century epidemic?

The United Kingdom is experiencing dramatic increases in requests for diagnosis of attention deficit hyperactivity disorder (ADHD) in adults. But what is ADHD, and why is it suddenly becoming something the general public and medical professionals need to be aware of? In this feature, Dr. James Brown and Dr. Alex Conner provide some context.

National Teaching Fellow Dr. Conner is a reader in biomedical science communication at the College of Medical and Dental Sciences at the University of Birmingham, U.K. Dr. Brown is a reader in biomedical science at the College of Health and Life Sciences at Aston University, U.K.

ADHD is a lifelong neurodevelopmental disorder in which the brain grows differently. This leads to deficient action from the chemicals involved in pleasure and reward.

The name ADHD is a little unhelpful as those with the disorder do not have a deficit of attention, more a lack of ability to control what they pay attention to. Even the hyperactivity part isn’t always obvious, at least externally.

ADHD is commonly associated with issues with “executive function.” These are the higher thinking skills, such as planning, task management, cognitive inhibition, and working memory.

Although often seen as a “new” disorder predominantly seen in children, ADHD was first described in medical texts dating back to the 18th century. And although it is usually diagnosed during childhood, most people continue to live with ADHD for their entire adult lives.

Recently, a growing number of people are first reporting ADHD symptoms as adults, partly due to high-profile cases or the impact of social media.

In fact, somewhere around 2.8% of adults are thought to live with ADHD, with the vast majority of these being undiagnosed.

Despite this growing awareness, issues with healthcare resources, poor understanding among healthcare professionals, and stigma around the disorder mean many adults struggle to get a diagnosis.

The neurological basis for the disorder means ADHD brains often search for ways to stimulate the chemicals that have deficient action, which is why those with the disorder can experience some or all of the core traits: inattentiveness, hyperactivity, and impulsivity.

These core traits can manifest themselves in several ways, including:

  • Being unable to follow through on longer tasks or not being able to start them.
  • Being easily distracted by other tasks or thoughts.
  • Seeking out activities, sometimes including risky behaviors, that provide an immediate reward.
  • Restlessness, either externally or internally.
  • Interrupting other people without wanting to.

The symptoms of ADHD are largely similar for both adults and children, although ADHD can present differently as we age. For example, inattention is the most persistent symptom in adults, and hyperactivity is less apparent.

ADHD can be extremely debilitating if untreated. It has been associated with a higher likelihood of reduced quality of life, increased risk of substance use issues, unemployment or underemployment, accidental injuries, suicide, and premature death, among other issues.

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