Attention Deficit Disorder Symptoms In Adults

Attention Deficit Disorder Symptoms In Adults. We all occasionally find it difficult to pay attention, yet some face this struggle more than others. When the inability to focus becomes a chronic problem, it may indicate attention deficit disorder (ADD). Attention Deficit Disorder (ADD) is thought of as a childhood condition. However, most forget that children diagnosed with ADD eventually grow into adults and that many are not diagnosed by a medical professional until adulthood. How is ADD different in adults? What are the symptoms? Keep reading to learn if you or someone you know have the symptoms of ADD common in adulthood.

Attention Deficit Disorder Symptoms In Adults
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What is Attention Deficit Disorder (ADD)?

Attention deficit disorder (ADD) is a brain-based disorder characterized by inattention and impulsivity. It is similar to attention deficit hyperactivity disorder (ADHD) but without the hyperactivity. The terms are used interchangeably.

In 1994, experts categorized ADD to include a form of ADHD known as the inattentive type. Those with ADD present with inattention, as they are easily distracted and have difficulty focusing and staying on task. They do not have high energy levels and exhibit a lesser amount of impulsive behaviors.

How Many Adults Have Attention Deficit Disorder (ADD)?

Millions of children are diagnosed with ADD and/or ADHD, but how many adults suffer from the condition? It is estimated that 4.4% of the adult population in the United States have ADD. Additionally, according to the CDC, 85% of children with ADD are at risk for the disorder throughout adulthood. Males are more likely to have ADD than females. These numbers are significantly underreported, as the number of cases increases yearly.

Attention Deficit Disorder Symptoms In Adults: Inattention

Inattention is the predominant symptom of adult ADD. With inattention comes distraction and difficulty concentrating. Adults with ADD are “daydreamers”—they struggle to remain focused on the matters at hand. Whether that be a task, a work assignment, or even a conversation, their minds are constantly racing and moving on to the next thought without fully processing the ones before it. This leaves tasks uncompleted with gaps in information.

Attention Deficit Disorder Symptoms In Adults: Disorganization

Disorganization is another one of the primary symptoms of ADD in adults. Partly because responsibilities and obligations increase with age. The disorganization manifests as clutter at home or in their workspace, accidentally neglecting bills and assignments, and keeping family matters coordinated. Studies indicate “the ADHD-depression comorbidity increases illness severity and functional impairment associated with either disorder alone” (Knouse et al., 2013). Depression, a mood disorder seen in the ADD/ADHD population, compounds the disorganization seen in these patients.

Attention Deficit Disorder Symptoms In Adults: Poor Time Management

Chronic lateness is a hallmark sign of ADD. We all are occasionally late for that important meeting, a dinner date, or picking the kids up from school. However, those with ADD are habitually late because they are unable to focus on a single task and they underestimate the amount of time it will take to complete a task. While they intend to keep up with their schedule, they easily become distracted and lose track of time even when they plan.

Attention Deficit Disorder Symptoms In Adults: Impulsive Behavior

Impulsive behavior is more common in ADHD than ADD, but the latter has its share of behavioral changes. Impulsivity arises from not remaining focused enough to think about one’s actions or words. Adults with ADD speak before thinking and make decisions before weighing the consequences. For example, hastily making a large purchase. Their spontaneous behavior can lead to repercussions on their work, relationships, and personal life.

AAttention Deficit Disorder Symptoms In Adults: Hyperfocus 

Hyperfocus is an intense form of concentration. When an individual with ADD is partaking in a task or activity they enjoy, they become completely absorbed. During hyperfocus, they tend to ignore all stimuli in the environment surrounding them—failing to shift their attention to other events. While hyperfocus may initially seem like a positive symptom of the disorder, other priorities are neglected. Hyperfocus distracts from other important tasks and is detrimental to work and relationships if the individual forgets their obligations. Studies (Ozel-Kizil, et al., 2016) show hyperfocus is most common in adults.

Attention Deficit Disorder Symptoms In Adults: A Lack of Multi-Tasking Abilities

Multi-tasking is a skill of executive functioning, which are cognitive functions used to manage daily life through thinking. Adults with ADD have impairments in executive functioning. Multitasking relies on the same skills as focusing on one task. Because those with ADD are distracted, they seem to engage in multitasking activities more than those without the disorder, yet they are not more efficient in doing so. Studies from universities in Germany prove adults with ADD have a reduction in motivation and a decline in mood while multitasking. The multitasking significantly interferers with overall productivity.  

Attention Deficit Disorder Symptoms In Adults: Mood Swings

People with ADD feel emotions strongly. With such intense emotions, they find it hard to regulate their emotional reactions to situations. Mood swings of both highs and lows are not rare and present with outbursts, extreme happiness/excitement, and even aggression.

ADD is associated with depression and bipolar disorder. Statistics reveal anywhere between 9 and 35% of adults with bipolar disorder also have ADD. Physicians must practice caution to discern whether a patient has multiple disorders, as the symptoms of ADD and psychological disorders can overlap.

AAttention Deficit Disorder Symptoms In Adults: Boredom

Adults with ADD crave stimulation. They seek out tasks that sustain their attention. The brain’s executive functions perform better when interest is piqued, as they are focused on a task that sustains their attention and fuels their motivation. When they already have difficulty concentration, it is harder to focus on activities that are mundane. The connection between ADD and boredom is thought to be low activity in the prefrontal cortex of the brain, which controls stimulation and anxiety.  

Signs of boredom are:

  • Excessive eating—People with ADD may eat out of boredom when they are not hungry
  • Impulsive behavior—Engaging in reckless activities that provoke anxiety (i.e. skydiving, substance abuse)
  • Delaying Sleep—Those with ADD procrastinate going to bed until they are exhausted to avoid the time it takes to fall asleep
  • Neglecting Responsibilities—Necessary responsibilities like paying bills or chores are often ignored because they do not sustain attention

Attention Deficit Disorder Symptoms In Adults: Poor Listening Skills

Poor listening skills are a symptom of ADD in adults. Practicing active listening is a challenge because they are constantly distracted by changing stimuli in the environment such as background noise (i.e. other conversations, television, a busy classroom). They cannot optimally devote their attention to the speaker, so they tend to interrupt conversations, spontaneously switch topics, and speak out inappropriately. Due to the rapid shifting attention, spoken language comprehension is directly influenced. Listening skills are an important facet of social interactions and those with ADD have gaps in information due to poor listening, which leads to misunderstandings.

Attention Deficit Disorder Symptoms In Adults: Forgetfulness

MeMemory is also an executive function. Since ADD affects higher thinking processes like memory, forgetfulness is a symptom. The forgetfulness displayed in ADD exceeds misplacing the car keys or missing a lunch date. When it extends to work and relationships, it can be interpreted as carelessness, laziness, rudeness, or a lack of intelligence; although, that is far from the case! Forgetfulness originates from inattention.

Attention Deficit Disorder Symptoms In Adults: Low Self-Esteem

ADD impacts every facet of life—work, education, family, and friend relationships—and failures in any of those areas have consequences on self-esteem. After repeatedly suffering negative experiences from their condition, they are prone to losing confidence in themselves. Additionally, adults with ADD are more aware of their condition. They feel different and set apart from their adult peers when they have repeated negative experiences. However, research published in the journal Atten Defic Hyperact Disord suggests that low self-esteem can be improved with psychotherapy (Cook et al., 2014). 

Attention Deficit Disorder Symptoms In Adults: Easily Stressed

Managing inattention, racing thoughts, and disorganization amongst other ADD symptoms in adults are overwhelming. Those with ADD may feel hopeless as if they have little control over their lives because they cannot optimally balance due dates, responsibilities, and relationships. Consequently, ADD is associated with greater levels of stress. Stress only compounds symptoms of the condition. When someone with ADD has an increase in stress levels, their symptoms of inattention are exacerbated. Failing to address long term stress leaves them susceptible to mental disorders like depression or anxiety.

Attention Deficit Disorder Symptoms In Adults: Sleep Disorders

ADD causes sleep disturbances. The European College of Neuropsychopharmacology (2017) investigated the link between sleep and ADD—concluding that approximately 75% of adults and children with ADD have problems sleeping. This results in sleeplessness, which worsens symptoms of poor concentration, mood swings, and exectuvie functioning.

A number of sleep disorders can affect those with ADD. They include:

  • Insomnia—A sleep disorder characterized by difficulty falling and staying asleep.
  • Restless Leg Syndrome—The intense urge to move the legs while sleeping driven by an uncomfortable sensation throughout the body. It is temporarily improved by moving.
  • Delayed Sleep-Phase Disorder—A sleep disorder that delays sleep by 2 hours or more.
  • Periodic Limb Movement Disorder—Jerking of the legs during sleep.
  • Sleep Apnea—The involuntary stopping and starting of breathing while asleep. Snoring, choking sounds, and daytime drowsiness are common symptoms. ADD is a risk factor for this disorder.
Attention Deficit Disorder Symptoms In Adults
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Attention Deficit Disorder Symptoms In Adults: Procrastination

Procrastination is defined as delaying or postponing a task that needs to be completed. It’s unlikely that someone with ADD is purposely avoiding a task, but their symptoms have them caught in a cycle of procrastination. For example, they intend to finish a job assignment, yet their mind wanders. They lose focus and divert attention to stimuli they find is more interesting. Thus, they neglect the task they initially started.

Physical Health Conditions In Adults With Attention Deficit Disorder (ADD)

While ADD is a brain-based disorder affecting cognition, there is a range of mental and physical health problems related to the disorder. About 80% of patients diagnosed with ADD have a comorbid condition. Some comorbid conditions include tics and Tourette syndrome, learning disabilities, language disorders, and an autism spectrum disorder.

The most common disorders co-occurring with ADD in adulthood are:

  • Mood disorders—A mood disorder is any mental condition that disturbs mood or emotional state. Depression, bipolar disorder, and schizoaffective are a few examples of mood disorders. In ADD, depression marked by unexplained sadness, a lack of motivation, and apathy is prevalent.
  • Anxiety disorders—Anxiety is excessive fear and worry unwarranted for the situation. Social phobia, the fear of judgment in social situations, and panic disorder, intense fear causing panic attacks, are most commonly noted in ADD. Adults with ADD who also have an anxiety disorder present with more severe ADD symptoms.
  • Personality disorders—Personality disorders are a group of disorders characterized by unhealthy thought and behavioral patterns that deviate from cultural norms. Research reports over 50% of patients with ADD also have a personality disorder. Those with profound symptoms in emotional regulation with their ADD are at a higher risk of developing a personality disorder (Katzman et al., 2017).   
  • Substance Use disorders—Substance abuse disorder occurs when an individual regularly uses a substance and the use of that substance interferes with health and responsibilities. Alcohol and/or nicotine, cannabis, and cocaine use are frequently reported in ADD.

Resources

Cook J, Knight E, Hume I, Qureshi A. The self-esteem of adults diagnosed with attention-deficit/hyperactivity disorder (ADHD): a systematic review of the literature. Atten Defic Hyperact Disord. 2014;6(4):249‐268. doi:10.1007/s12402-014-0133-2

European College of Neuropsychopharmacology. (2017, September 4). Is ADHD really a sleep problem?. ScienceDaily. Retrieved June 3, 2020 from www.sciencedaily.com/releases/2017/09/170904093443.htm

Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017). Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC psychiatry17(1), 302. https://doi.org/10.1186/s12888-017-1463-3

Knouse, L. E., Zvorsky, I., & Safren, S. A. (2013). Depression in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD): The Mediating Role of Cognitive-Behavioral Factors. Cognitive therapy and research37(6), 1220–1232. https://doi.org/10.1007/s10608-013-9569-5

Ozel-Kizil ET, Kokurcan A, Aksoy UM, et al. Hyperfocusing as a dimension of adult attention deficit hyperactivity disorder. Res Dev Disabil. 2016;59:351‐358. doi:10.1016/j.ridd.2016.09.016