Symptoms of ADHD in adults

Hyperactive symptoms of ADHD in adults

Adults with ADHD use various coping mechanisms — whether conscious or unconscious — to help them focus in understimulating environments. These techniques are known as self-stimulatory behaviors or “stimming.” Hyperactivity, or the constant need to move the body, is one aspect of ADHD that produces some of these self-stimulatory behaviors.

Hyperactivity symptoms in adults may include:

• Fidgeting and difficulty sitting still (e.g., squirming, tapping feet, shaking legs, biting nails, twirling hair)
• Low tolerance for frustration (e.g., impatience, difficulty waiting)
• Trouble engaging in independent and quiet tasks

While hyperactivity symptoms may be thought of as solely physical reactions, someone with ADHD may experience mental and emotional symptoms as well.

Physical and emotional hyperactive symptoms associated with ADHD can have adverse effects on a person’s life. For instance, an adult with ADHD may have difficulty maintaining focus during meetings or conversations. They may also show irritability due to restlessness and deal with strained relationships due to constant activity or interruptions.

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Impulsive symptoms of ADHD in adults

In addition to hyperactivity, impulsivity — acting without thinking ahead about potential consequences — is another core symptom of ADHD. Adults with ADHD tend to make hasty decisions on the spot without regard to future impacts on work, relationships, etc.

Impulsive behaviors typical in adults with certain types of ADHD:

• Excessive talking (interrupting others in conversation, finishing another person’s sentences)
• Trouble waiting for a turn to speak and blurting out answers before being called on
• Frequently interrupting others in conversations

Impulsivity makes it difficult to delay gratification or give something up now for something better in the future. For example, an adult with ADHD may not participate in a savings or investing program because it requires the forethought to set aside funds that could otherwise be used in the present.

Adults with ADHD have a higher rate of credit card defaults, according to one study. In the study, researchers analyzed mental health data of Swedish residents between 2002 and 2015 to obtain a random population sample. They found that adults with ADHD were six times more likely to default on debt by the age of 40.

As a result of impulsive behaviors, those with untreated ADHD may also have relationship issues. It can also cause them to engage in risky behaviors, which can lead to substance abuse issues.

Emotional symptoms and ADHD in adults

While inattention, hyperactivity and impulsivity are often considered key components of ADHD, emotional symptoms of the disorder have been overlooked in diagnosis, according to an article by the American Psychological Association (APA).

However, in the last 15 years, emotional dysregulation, or the inability to control emotions, is starting to be recognized as a key component of ADHD. The APA estimates that somewhere between 30% and 70% of adults diagnosed with ADHD experience significant emotional dysregulation.

Emotional symptoms of ADHD may include:

• Racing thoughts
• Jumping from one idea to another
• Trouble relaxing or unwinding
• Intense mood swings

Adults with ADHD may find it challenging to regulate their emotions because of how their brains function. Research suggests that the part of the brain that processes emotions — the amygdala — has less processing volume in those with ADHD versus those in a control group.

Adults with ADHD also tend to have “emotional hyperarousal,” which means their thoughts and feelings are much more intense than those of someone without ADHD, according to ADDitude.

For example, emotional hyperarousal can make it difficult to accept criticism because it ultimately affects someone’s self-esteem in the long term. Those with ADHD may even experience positive emotions, like happiness or joyfulness, on a higher level, according to ADDitude.

ADHD symptoms at work and in relationships

Hyperactivity, impulsivity and emotional hyperarousal associated with ADHD can negatively impact job performance and career success. Adults with ADHD may have difficulty meeting deadlines and staying organized, according to the Attention Deficit Disorder Association (ADDA), which can create issues in the workplace.

Because people with untreated ADHD tend to act at least partially on their impulses and emotions, they also tend to change jobs more frequently than those without an ADHD diagnosis. Data published by ADDA reveals that adults with ADHD are three times more likely to quit a job impulsively.

In addition to workplace challenges, ADHD can also create relationship challenges. Impulsivity and lack of attention can lead to misunderstandings and conflicts within the relationship. Someone with ADHD may even appear to purposely neglect household responsibilities, according to the American Psychology Association, which can also lead to conflict. It can be difficult for someone without ADHD to relate to and communicate with their partner with ADHD.

Strategies for managing ADHD symptoms:

• Develop structured routines for both home and work.
• Eliminate clutter to create a calm space for your mind.
• Utilize calendars and to-do lists to prioritize tasks based on deadlines.
• Practice mindful communication by pausing before you respond.
• Talk with others in a distraction-free environment to give your full attention.

Co-occurring conditions with ADHD in adults

A majority of adults diagnosed with ADHD (about two-thirds) also have at least one co-occurring condition, according to the National Resource Center on ADHD, a program of  CHADD. Co-occurring conditions are mental health disorders someone with ADHD may have also been diagnosed with.

Often, the symptoms of ADHD can overshadow the signs of a co-occurring condition, so it’s important to talk to your doctor about all the symptoms you may be experiencing.

According to CHADD, the following are the most common co-occurring conditions in adults with ADHD:

• Mood disorders, including bipolar disorder and depression
• Anxiety
• Learning disorders, including dyslexia and speech issues
• Disruptive behavior disorders, including oppositional defiant disorder
• Tics and Tourette syndrome
• Substance abuse
• Sleep disorders

According to data published by CHADD, disruptive behavior disorders account for a majority of co-occurring conditions (around 40%). Symptoms of oppositional defiant disorder — a specific type of disruptive behavior disorder — include having a short temper, getting angry easily, being spiteful and, often, being argumentative.

Mood disorders also make up the second largest portion of conditions that co-occur with ADHD, around 38%. Close to 20% of individuals with ADHD have bipolar disorder, according to CHADD. Symptoms of bipolar disorder include frequent extreme mood swings, from very elated, energetic or hyper to feeling very sad and/or agitated.

When to seek professional help for ADHD symptoms

If you experience ADHD symptoms that interfere with your daily functioning or cause distress, it may be time to seek professional help. You’ll need a medical diagnosis before a professional can offer resources to assist you in managing your symptoms.

The process for diagnosing ADHD in adults is fairly standard, whether you visit a doctor in person or online through a telehealth platform.

1. Schedule a consultation with a licensed medical provider. Check your health insurance plan for coverage details to see if you must choose from a list of preferred providers.
2. Submit assessments and questionnaires like the Adult ADHD Self-Report Scale or other evaluations (if required before the first visit).
3. Your doctor will go over the results of the assessments during your visit. If appropriate, you may receive an ADHD diagnosis, which can be managed through medication, therapy or a combination of both.

Since most adults with ADHD also have a co-occurring condition, your doctor will also perform a full psychological exam, which may include a depression screening. Your doctor may also perform a physical exam and recommend a blood test to rule out other conditions with similar symptoms.