From College of the Redwoods
Disability News for 04/14/2008 - Adults with ADHD
By Trish Blair
Apr 14, 2008, 13:41
ADULT ADHD
ADHD is one of those conditions that cause a great deal of consternation and disagreement both in the diagnosis and the treatment. When the discussion switches to adult ADHD, the level of consternation increases. ADHD is a condition that is largely thought of as a childhood and adolescent disorder. However, in the late 1960’s and early 1970’s the concept of adult ADHD came to the fore. In 1994 Hallowell and Ratey published “Driven to Distraction”, and the idea of ADHD in adulthood as a unique and diagnosable disorder began to emerge.
Over the past few decades, the attitude toward adult ADHD has become one of greater acceptance; however, there are still significant barriers to the diagnosis and treatment of the condition. There are several reasons for this.
• No Diagnostic Criteria
The DSM-IV does not recognize “adult ADHD” as a clinical entity. Therefore, there are no specific criteria that can be used to make a diagnosis, other than the criteria that is used for children and adolescents.
• Physician Training
While there are no specific diagnostic criteria to be used for diagnosis, there are some scales which are commonly used. Many physicians are not familiar with these tools, or where to find them. Therefore, the diagnosis process remains somewhat unclear for many physicians.
• Disbelief
There is still a belief out there that ADHD is not a real thing. The problems are related to the child’s behavior, parental discipline of the child etc. Some people feel that ADHD is no more than an excuse for children who do not want to attend to the teacher or knuckle down to school work. There are also those who believe that the problems are outgrown, and they do not continue into adulthood. This makes the diagnosis more difficult.
• Patient Embarrassment
No one wants to admit that they have a problem. This is also so the case with adult ADHD. While for some it is a relief to think that there is actually “something wrong”, others find it embarrassing to think that they have a problem that is generally associated with children. Therefore, they do not always seek out assistance or diagnosis.
• Reluctance to treat with controlled substances
There may be a reluctance by both the medical service provider and the patient themselves to commit to pharmacological treatment. The idea of taking stimulants is unacceptable for some people. For the service provider, there is concern for a variety of reasons to prescribe them. Firstly, there is the issue of abuse. Secondly, it is not at all unheard of for a patient to sell their medication on the street.
• Comorbidity
There are many disorders that have the same or very similar symptoms to adult ADHD. Trying to sort out what is truly ADHD and what is another disorder is difficult. It becomes more difficult with ADHD is present along with another condition. It is thought that anxiety may be present in as many as 50% of adults with ADHD. Other disorders that are commonly present with ADHD in adults include:
• Oppositional Defiant Disorder
• Conduct Disorder
• Depression
• Bipolar Disorder
• Learning Disabilities
• Movement Disorders
• Substance Abuse
Quotation of the Week
“The greatest gift you can give another is the purity of your attention."
Richard Moss
Comments? Trish-blair@redwoods.edu
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