The Difficulty of Diagnosing ADHD Later in Life
During the 1940s, 1950s and 196, ADHD was rarely diagnosed in children. Now, adults born during that period are seeking ADHD testing because they are experiencing what they believe are symptoms of the condition. However, It can be challenging to evaluate older adults for ADHD because the normal aging process mimics some classic ADHD symptoms. And, on the flip side, ADHD symptoms, overlap with some signals of mild cognitive impairment.
Getting an ADHD Diagnosis in Adulthood
ADHD occurs in approximately 5% of the adult population and includes cardinal symptoms of hyperactivity, inattention, and impulsivity that may be difficult to identify with routine clinical methods. Continuous performance tests are objective measures of inattention and impulsivity that, combined with objective measures of motor activity, can help confirm identification of ADHD among adults.The consistent marker for ADHD in adults however is the longevity of symptoms. ADHD does not begin in adulthood – those who have it are born with it, and it remains with them for life.
According to the DSM-IV, there are three subtypes of ADHD.
- ADHD, Predominantly Inattentive Subtype – This subtype is diagnosed if symptoms of inattention have persisted for at least 6 months and are age inappropriate.
- ADHD, Predominantly Hyperactive-Impulsive Subtype – This subtype is diagnosed if there are some symptoms of hyperactivity-impulsivity along with fewer symptoms of inattention.
- ADHD, Combined Subtype – When both symptom of inattention and hyperactivity-impulsivity are present, the subject may be diagnosed as having the Combined Type of ADHD
So what can you use to determine if you should seek a diagnosis of ADHD? While there is no single test for ADHD, there are some behavioral indicators that may point to having the condition: For example, if you:
- Bounce from job to job
- Find it hard to finish daily tasks like house chores or paying bills
- Forget things you need to do
- Get upset easily
- Perform unevenly on your job
- Have relationship problems
- Get stressed about not meeting responsibilities
- Often feel frustrated or guilty
Potential Differences for Men and Women
Diagnosing ADHD in women can be more difficult due to the effects of menopause on estrogen. According to Patricia Quinn, M.D., a developmental pediatrician and founder of ADDvance, for ADHD women and girls. “If you lower estrogen, you lower dopamine and norepinephrine, which, in turn, lowers cognitive function. That holds true for all women. For ADHD women, lower estrogen means their symptoms get worse. They aren’t just imagining it; it’s a biological fact.” Separating
Many women are diagnosed with ADHD in their late 30s or 40s during perimenopause when diminishing estrogen brings ADHD symptoms to the fore. The stress that women may undergo during this time due to the demands of caring for family, maintaining a career and perhaps suffering from unrelated health issues, can overwhelm an ADHD brain that no longer has the same amount of estrogen to help it cope.
Men also go through hormonal changes as they age, but not to the same degree. However, decreases in testosterone can lead to mood swings, sleep disturbances, and cognitive decline.
Getting Help with Adult ADHD
If you have ADHD, you many want to consult a team of professionals
- A neurologist or psychiatrist to help monitor your health and prescribe medication.
- A therapist or life coach to help you make positive changes in your day-to-day life.
- Family members who, with a better understanding, can help you mitigate some of the negative aspects of ADHD.