what symptoms and what treatment in adults? Answers from a neuropsychologist

DIAGNOSIS – In the collective imagination, it is often associated with the image of turbulent and noisy children, unable to stay still. However, this is an erroneous idea of ​​what ADHD (attention deficit disorder, with or without hyperactivity) is. It is certainly detected mainly in children, but can also persist into adulthood.

The prevalence of this neurodevelopmental disorder is estimated at 2.8% of those over 18 years old by the High Authority for Health (HAS). “15% of children with ADHD continue to present clinical characteristics that meet diagnostic criteria at age 25”specifies the health authority in a note dating from 2021.

What are the symptoms of ADHD in adults? How to make a diagnosis and for what treatment? Answers from Laura Geati, neuropsychologist based in Paris.

Le HuffPost. What are the most common symptoms of ADHD in adults?

Laura Geati. As in children, ADHD has a neurobiological origin in adults: patients who suffer from it do not produce enough dopamine, a hormone that helps maintain the level of motivation and gives the feeling that we are doing. something pleasant in the moment.

It is mainly attention deficit problems at work that raise concerns. We can list four main categories. First, the difficulty with sustained attention: an adult suffering from ADHD will have a tendency to procrastinate in their tasks, to be distracted because it is difficult for them to ignore external stimuli. Then, the short-term memory deficit, which is called working memory, and which results in forgetfulness or difficulty remembering conversations and appointments. ADHD adults also have difficulty planning daily activities, struggle to complete tasks they have started, and have poor awareness of time. Finally, we must note the frequent loss of objects.

Can ADHD manifest in adults in subtle ways, without apparent hyperactivity?

There are several types of ADHD: with a predominance of impulsivity and/or hyperactivity and a combined form. Hyperactivity also manifests itself in adulthood, but in a different form than in children. The adult has an intellectual maturity which allows him to inhibit certain traits that we can observe in childhood, such as movements, cries, etc.

In adults, hyperactivity manifests itself mainly in the form of executive disorders listed above, but also in the form of internal nervousness and impulsivity. To avoid this, ADHD adults develop avoidance strategies, in order to avoid situations where they have to remain still such as classes, meetings, queues, etc. This requires a lot of effort and therefore energy. . Finally, hyperactivity can also take the form of a lack of inhibition: they frequently cut themselves off and put themselves forward in order to escape this internal agitation. This can cause relationship problems with those around them, who criticize them for behaving immaturely.

How is ADHD diagnosed in adults?

The diagnosis is multidisciplinary. If ADHD is suspected, for example in the event of concentration problems, an adult can consult a psychiatrist or neurologist, who will then redirect to a neuropsychologist to carry out a complete assessment. This assessment includes an anamnesis, that is to say a review of the repercussions of the disorders on daily life, and the administration of tests, which are used to assess the level of attention and to indicate what type of ADHD the patient has. present. Personally, I also take an IQ test because studies have shown the link between high intellectual potential and ADHD.

Are there many adults diagnosed late with ADHD?

Yes. Until recently, this disorder was little known to the general public and therefore less well diagnosed. Adults suffering from ADHD were criticized during their childhood for being in the mood, for being too agitated or turbulent… These adults often felt different during their childhood, felt a lot of guilt for not being able to be more efficient or not to control their impulsiveness. This may have caused them suffering, manifested by low self-esteem, anxiety disorders, depression or professional burnout. Doing a neuropsychological assessment allows them to understand themselves, act on their symptoms and regain self-confidence.

What is the treatment for ADHD in adults?

Treatment combines psychotherapy and, if necessary, drug treatment. In France, there are four authorized medications, which increase dopamine levels for 8 to 12 hours: Ritalin, Concerta, Quasym and Medikinet. Except in the most severe forms, drug treatment is not recommended as first-line treatment. But it will allow adults who benefit from it to concentrate better on their tasks because it temporarily inhibits the symptoms. These medications are not addictive and can be stopped temporarily, for example during vacations or outside school periods.

As for psychotherapy, it includes two components: first cognitive remediation, to give patients behavioral strategies and thus reduce the impact of ADHD on their daily lives. But it is also essential to support them psychologically to understand how this disorder could have cluttered their lives and work on their lack of self-esteem.

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