ADHD/ADS news from adult diagnostics
ADHD/ADD News from adult diagnostics!
The internet is now full of ADHD/ADD posts and personal experiences on Insta, Facebook, TIKTOK and Co. - there are coaches, books and mottos. The fact that there is a lot of talk about the brain metabolism disorder is really great and now it is not only seen as neurodiverse by some brain researchers or sociologists, but also by many other places and those affected.
In this blog post, I will focus on the topic of ADHD/ADD in adulthood. I would like to take a closer look at how the diagnosis is made in adults and what differences there are compared to the child version.
It is important to note that diagnosing ADHD/ADD in adulthood is challenging and should not be taken lightly. It is not a fashionable symptom that can simply be attributed to a supposed "clumsy" or "chatty person". Differentiating it from other mental disorders is complex, and only a few specialists in Germany carry out specific diagnostics in adulthood.
ADHD (Attention Deficit Hyperactivity Disorder) can manifest itself in adults in a variety of ways. Symptoms are similar to those seen in children and adolescents, but may change throughout adulthood. Here are the core symptoms of ADHD in adults:
Hyperactivity and inner restlessness : While children often show physical restlessness, adults tend to show inner restlessness . They feel the need to move, but often cannot sit still. They avoid situations that require them to sit for long periods of time. Many sufferers tap their feet or drum their fingers to relieve their restlessness.
Attention disorders : Problems with attention are a central feature of ADHD in adults. They are easily distracted and have difficulty focusing on a task or conversation partner. They are often overwhelmed by environmental stimuli and have difficulty distinguishing between important and unimportant things. Reading texts often requires several passes.
Impulsivity : Many adults with ADHD have difficulty controlling impulses. They often act spontaneously without thinking about the consequences. Impulsive behavior can manifest itself in various areas of life.
In order to diagnose ADHD in adulthood, the symptoms must have been present in childhood and currently cause impairment in at least two different areas of life (e.g. in the family environment and at work). There are various subtypes of ADHD, which are differentiated according to the predominant symptoms .
Diagnosis
Diagnosing ADHD in adults requires a careful examination and evaluation by a specialist. Here are some steps and methods to help in making the diagnosis:
Anamnesis (exploration) :
A detailed conversation with the person concerned is the priority.
Current problems, stresses and symptoms are asked about.
The life story and the development of problems up to the present are recorded. Partners, parents or other acquaintances can provide helpful information.
Questionnaires and tests :
Various questionnaires can be used:
ADHS-DC : ADHS Diagnostic Checklist
ADHS-E : ADHS screening for adults
ADHS-SB : ADHS Self-Assessment Scale
CAARS-O : Conners Adult Attention and Behavior Scales (external assessment)
CAARS-S : Conners Adult Attention and Behavior Scales (self-report)
WE : Wender-Reimherr Interview
Other specialized questionnaires can also be used.
Clinical opinion :
The doctor evaluates the information collected and makes a diagnosis.
Other possible causes for the symptoms are also ruled out.
Treatment methods:
Treating ADHD in adults may involve a combination of different approaches. Here are some common treatment methods:
Medications:
Stimulants such as methylphenidate (e.g. Ritalin) or amphetamine (e.g. Adderall) are often prescribed to improve attention and impulsivity.
Non-stimulant medications such as atomoxetine (Strattera) may also be used, especially if stimulants are not well tolerated.
The correct medication and dosage should be agreed individually with a specialist.
2. Behavioral therapy :
Cognitive behavioral therapy (CBT) can help change negative thought patterns and develop coping strategies.
Mindfulness training can improve self-regulation and reduce stress.
3. Neurofeedback
combined brainwave training - neurofeedback with the possibility of direct transfer (brain jogging, sports, etc.)
4. Structure and routines :
A structured daily routine can help control symptoms.
Organizational tools such as calendars, reminders and to-do lists are useful.
5. Lifestyle changes :
Exercise and regular physical activity can alleviate symptoms.
Food intolerances?
A healthy diet and sufficient sleep are important.
5. Support from self-help groups and therapists :
Exchanging ideas with other affected people can be helpful.
A therapist can provide individual strategies to help manage ADHD symptoms.
Dopamine
the fascinating neurotransmitter, plays a crucial role in the central nervous system and influences our behavior, emotions and cognitive functions. Let's take a closer look at the connections between dopamine deficiency and excess in the context of ADHD/ADD :
Dopamine deficiency in ADHD/ADD :
In people with ADHD/ADD, dopamine is not available in sufficient quantities where it is needed – namely in the brain.
A dopamine deficiency leads to impaired signal transmission and impairs the interaction in the attention and motivation systems.
Executive functions, such as the ability for self-regulation and impulse control, are affected .
Neurobiology in the synaptic cleft :
Our journey begins in a nerve cell (neuron) , the basic element of the nervous system.
Signal transmission between neurons occurs via neurotransmitters in the synaptic cleft .
Dopamine is one such neurotransmitter that processes information between nerve cells and conveys positive feelings of happiness .
Process in the synaptic cleft :
In the presynapse, dopamine is stored in vesicles and released by electrical signals.
In the synaptic cleft, dopamine docks onto receptors in the postsynapse .
In people with ADHD, a higher number of dopamine transporters are found at the presynapse.
Overall, it appears that dopamine plays a key role in ADHD/ADD.
Here are some strategies to improve dopamine imbalance in ADHD:
Nutrition and nutritional supplements :
Make sure you eat a balanced diet rich in tyrosine . Tyrosine is an amino acid needed for dopamine synthesis .
Foods such as fish, eggs, legumes, nuts and bananas contain tyrosine.
Movement and sport :
Regular physical activity promotes the release of dopamine.
Aerobic exercise such as running, swimming or cycling can be particularly helpful.
Stress management and mindfulness :
Stress negatively affects the dopamine system. Practice meditation and mindfulness to reduce stress .
Sleep and rest :
Getting enough sleep is important to correct dopamine imbalance.
Maintain a regular bedtime and create a relaxing sleeping environment.
Avoid stimulants and caffeine :
People with ADHD are often prone to addictive behavior. Stimulants such as coffee or energy drinks can worsen the dopamine imbalance . .
Vitamin and mineral supply:
The differential diagnosis
in ADHD is crucial to exclude other disorders with similar symptoms. Here are some important aspects of the differential diagnosis:
Acute stress reactions :
Sometimes the symptoms of ADHD resemble a healthy stress response to stressful situations. It is important to distinguish these temporary reactions from ADHD.
Unrecognized giftedness or mental retardation :
Gifted people may exhibit behaviors similar to ADHD, such as impatience, easily distracted, and impulsiveness.
Mental retardation can also lead to concentration problems.
Primary organic disorders :
Sleep disorders, post-concussion syndromes, deficiencies (e.g. vitamin D, B12, zinc, iron), migraines, thyroid problems and other organic causes should be ruled out.
Restless Legs Syndrome (RLS) :
RLS can cause symptoms similar to ADHD.
Substance abuse and addiction :
Alcohol, illegal drugs and nicotine can cause ADHD-like symptoms.
Mental disorders :
Anxiety disorders, affective disorders, autism spectrum disorders (ASD) and borderline personality disorder (BPD) can exhibit similar symptoms.
Prenatal alcohol damage (FAS) :
FAS can lead to behavioral problems similar to ADHD.
Seizure disorders (epilepsy) :
Epilepsy can overlap with ADHD symptoms.
The differential diagnosis is complex and requires an individual assessment by a specialist.
ADHD and comorbidities
ADHD in adults can often be accompanied by comorbidities . These associated disorders or comorbidities often occur together with ADHD. Here are some of the most common comorbidities:
Anxiety and depression :
Up to 50% of adults with ADHD develop an anxiety disorder and/or depression during their lifetime.
It is important to treat both the anxiety and depression as well as the ADHD.
Obsessive compulsive disorder :
When obsessive thoughts or compulsive actions occur, ADHD is often overlooked because those affected are often extremely precise and perfectionistic.
However, it is not a contradiction that compulsion and chaos can exist side by side in ADHD.
Other comorbidities :
The following diseases are well researched in childhood:
Dyslexia (up to 30% of cases)
Dyscalculia (up to 30% of cases)
Tic syndrome (Tourette) (10 - 20 %)
Autism spectrum disorder (in 10-15% of cases)
Compulsions
Disturbance of social conduct and oppositional behavior
sleep disorders
Symptom change in adulthood :
In adulthood, a so-called symptom change occurs, in which the symptoms change over the course of life.
Often only the so-called concomitant diseases are identified, and the underlying ADHD is not recognized.
Research projects :
There are ongoing national research projects addressing ADHD:
ADOPT : Affective Dysregulation in Childhood - Optimizing Prevention and Treatment (Coordination Prof. Dr. Manfred Döpfner, University of Cologne)
ESCAlife : Evidence-based Stepped Care of ADHD along the life span (coordination Prof. Dr. Tobias Banaschewski, Central Institute of Mental Health, Mannheim)
ADHD/ADD News from adult diagnostics!
Great post!
Very interesting!👍