Attention Deficit Hyperactivity Disorder, ADHD for short, has long since outgrown its infancy. But regardless of whether you grew up with it or only received the diagnosis as an adult: the therapy is always based on several pillars.
Just a quirk, a case of character weakness, or is it an illness? Anyone who is constantly late, constantly misplaces or forgets things and finds it difficult to stay on task often finds little understanding from the other person. You just have to put in a little more effort, after all, others can do it too, it’s not uncommon to say. Accusations, self-reproaches and self-doubt are often faithful companions in everyday life when things are not going the way you or others would like them to be. One possible cause of this is attention-deficit/hyperactivity disorder. For a long time it was considered a “childhood disease” that grows out over the years. Today we know that this is a mistake. Around 50 to 80 percent of those affected in childhood still suffer from symptoms as adults, around a third still show the full picture of the disorder. For some, the symptoms also change. The hyperactivity often decreases over the years, but there is often a persistent inner restlessness. In some cases, people with ADHD don’t even realize they have a disease until they are adults. This can come as a shock, but many of those affected also report great relief: finally knowing what is going on, understanding previous failures and finding possible starting points for therapy or help in everyday life.
What exactly is behind the symptoms of ADHD is not yet known down to the last detail. However, it is known that an imbalance in the messenger substances plays an important role. First up is dopamine, which in ADHD is present in too low concentrations or is broken down too quickly. This is where drugs come into play. They increase the availability of this messenger substance. Serotonin and norepinephrine also play a role. A hereditary predisposition is considered to be certain: ADHD for one or both parents increases the probability that their children can also be affected. In addition, experts discuss the influence of environmental factors. It also happens that adults become aware of their own ADHD after their child has been diagnosed.
It is therefore important to investigate a suspicion: unrecognized and untreated ADHD in adulthood can increase the risk of further diseases. These include anxiety and depression, but also addictions. These include not only so-called substance addictions, but also non-substantive addictions such as compulsive shopping or gambling. Difficult to control impulses plays an important role, often also the search for the “kick”. A preference for risky sports is more common among ADHD sufferers. It is also important to rule out other diseases as the cause of the symptoms.
Exceptionally individual
ADHD covers a wide range of different characteristics. This is also reflected in the therapy options and in the decisions to make use of them. Some adults with minor or moderate impairments have already found strategies for themselves in everyday life to cope with the special features that arise for them as a result of ADHD. These include structures that simplify processes in daily life and make them clearer so that less is lost or forgotten, such as to-do lists or daily planning. Some have found jobs or fields of activity in which their physical and mental urge to move is particularly in demand. If the illness is severe or cannot be brought under control, the support of a behavioral therapist can help to better understand problems, find solutions and thus tame the sometimes chaotic life. This is usually done as part of an outpatient therapy with regular appointments. In these, individual goals are defined and small steps taken to achieve them.
Another pillar in ADHD therapy consists of medication. Unlike ten years ago, there are now approved drugs for the treatment of ADHD for adults too. Depending on the severity of the disease, possible accompanying circumstances – such as an existing addiction – and previous illnesses, various active ingredients are now available. Some of them are subject to the Narcotics Act. This and the fact that they improve hyperactivity and anxiety sometimes lead to the misunderstanding that they are sedatives. The opposite is the case. Methylphenidate, the most commonly used drug, belongs to the group of stimulants. In people without ADHD it has a stimulating effect, in ADHD sufferers it regulates the imbalance of the messenger substances in the brain, increases alertness and at the same time has a calming effect. Doctors determine the right dose and the ideal time to take it for each patient individually. Some active ingredients come in both rapid-release forms, which act quickly, and sustained-release forms, which take effect more slowly and last longer. In this way, the therapy can be further adjusted.
ADHD Symptoms
Even if the diagnosis is first made in adulthood: ADHD begins in childhood. The focus is on three core symptoms: inattention, impulsiveness and/or motor restlessness (hyperactivity). For a diagnosis, the symptoms must last at least six months, occur in different areas of life and impair social life and performance. This is the definition of the guideline ADHD in children, adolescents and adults. Guidelines summarize the state of medical knowledge and give recommendations for diagnostics and therapy based on current medical research.