Adult attention deficit hyperactivity disorder can destroy relationships, sabotage careers and cause havoc – yet most people remain untreated because it’s one of the most misdiagnosed disorders. Could adult ADHD be at the root of your problems?
By Joan van Zyl and Danél Blaauw for You Pulse Magazine
When a psychologist told Cape Town systems programmer Daniël du Toit* (50) 10 years ago that he had ADHD, he refused to believe her. Daniël had been hopping from one psychologist to another for 20 years in a bid to find out why neither his life nor his career showed any progress.
“I noticed at school something wasn’t right,” he says. “I did well in primary school but afterwards my marks would take a dive whenever I was in a stressful situation, for instance when I moved on to high school.”
At university Daniël really came unstuck. Even though he was a bright student, he just couldn’t settle down to study. “I would jump up and make tea, come back and read a sentence then find something else to do,” he explains.
He nearly dropped out of university a few times due to excessive exam stress. He even sought advice from the campus cousellor, to no avail. Eventually it took this gifted man four years to complete his three-year degree.
After university he worked in the field of personnel management where he did well until he was promoted and was given a series of new responsibilities. It made him so anxious he couldn’t tolerate the job any longer. After a few sessions with a career advisor and a psychologist he decided to try computer programming.
“Most people finished the programming exam long before 5 pm but I sat there until 9 pm,” he recalls. Daniël enjoyed the new job but his supervisor often complained about his slow working pace. “I would drift off or get sidetracked by an unimportant part of the task and spend all my time on that.”
Once again he looked for help and saw various psychologists, one of whom finally identified the problem as adult ADHD. Even though he didn’t want to believe her, he followed her advice and went to see Peter Collis, a Cape Town clinical psychologist who specialises in ADHD.
“Peter told me to write down everything that bothered me,” Daniël says. “When I returned with the list he ticked them all off: every single one was a symptom of ADHD. More than 20 years after first seeking help I was eventually diagnosed. It was an incredible relief, a real ‘aha’ moment.”
Although Daniël admits it’s occasionally still a battle he now successfully manages his condition with the help of medication, adjustments to his lifestyle and occasional therapy sessions with Collis or a psychiatrist.
An Idols' story
Popular Idols finalist Graeme Watkins (27) and his fiancée, Kim Coppen (24), have had a relatively easier journey with ADHD. Both were very young when diagnosed with the condition and so they were able to develop their own coping skills from childhood. But school was still challenging for both of them. They were often bullied by other children and called stupid.
Kim says ADHD runs in her family. Mom Margie, father Trevor and brothers Neil and Greg all have the condition. Kim’s parents chose to put her on Ritalin until Grade 12 (she now manages without it) while Graeme’s parents decided not to give their son medication for ADHD.
After leaving school Graeme started theatre training – and life improved. He has a passion for music and drama and says people with ADHD focus well on things they enjoy a lot. Graeme is hyperactive. While we talk he fidgets in his seat, his eyes wander and his foot taps gently on the floor. Like many adult ADHD sufferers he’s an almost obsessive perfectionist. In this way he ensures his ADHD doesn’t hamper the quality of his work.
He still doesn’t take medication but tries to manage his condition with a strict low- GI diet and daily exercise at the gym to get rid of excess energy. At best a relationship with an ADHD sufferer is a challenge. So it’s impressive how this couple has made their relationship work for seven years.
People with ADHD are inclined to overreact emotionally, Kim says. “That’s why we’re really careful about what we say to each other. When we argue we know how far we can go.”
For them even sleeping arrangements are a challenge. Like some people with ADHD Kim is sensitive to light. Graeme has a sleeping disorder (also typical of people with ADHD) and can’t fall asleep without watching TV.
The solution: Kim sleeps with an eye mask and earplugs while Graeme watches DVDs on his laptop. Every night he puts on the same DVD – Die Hard 4. If it’s a movie he hasn’t seen before, he’ll watch it to the end and easily stay up all night.
Graeme and Kim know they are very fortunate to have been diagnosed as children. Why? Because if ADHD is not diagnosed and follows you undetected into adulthood it can be devastating. In fact the life of an adult with ADHD can be a chaotic battlefield with careers and relationships the most significant casualties.
The reason, psychologist Peter Collis says, is impaired control in your life and actions.
There are three main symptoms:
- Impaired concentration – you can’t focus and often forget things.
- Impulsiveness – you react without thinking and your emotions govern your reason.
- Hyperactivity – you can’t sit still and must keep moving. If you have to sit still you fidget, squirm and tap your foot. All three symptoms are not necessarily present. Daniël and Kim, for example, have attention deficit without hyperactivity, the form of ADHD that’s sometimes called ADD.
How do you know it’s ADHD?
The good news is adult ADHD can be effectively treated. But doctors often miss the condition, says Dr David Benn, a child psychiatrist at the ADDNovaClinic in Johannesburg. They see only the ADHD complications such as depression and anxiety and not the underlying problem.
Formal diagnostic criteria are currently being prepared for adult ADHD, but in the meantime you can take a look at the list of symptoms below. Remember we all exhibit these symptoms from time to time and to be diagnosed with adult ADHD you have to show symptoms continual and over a long period of time. It must disrupt your day-to-day life, Collis says. Also, you can’t develop ADHD as an adult. It’s something you carry with you from childhood, Dr Benn adds.
• Do you easily feel emotionally overwhelmed?
ADHD sufferers are like tortoises born without a shell, Collis says. The tiniest thing can provoke an excessive emotional reaction. It’s as if the emotion takes over your entire being and you can’t see it in perspective. Sufferers also have little emotional and social intelligence and struggle to read the emotional messages of others.
• Do you struggle with relationships?
Because someone with ADHD is so impulsive you quickly lose your temper, don’t listen to others, blurt out responses and don’t communicate well, Collis says. It’s bad news for your personal relationships. People who are diagnosed with ADHD when they’re older often have a divorce or two behind them. They often end relationships impulsively or start affairs.
• Do you suffer from depression or anxiety?
Most adults with ADHD suffer from one or more additional conditions too, particularly anxiety and depression. Other conditions often associated with ADHD include bipolar disorder, sleeping disorders, obsessive-compulsive disorder and drug abuse. It’s no wonder then that doctors so easily misdiagnose adult ADHD. If you complain about depression your doctor is going to treat you for that and probably miss the underlying ADHD.
• Is your working life a mess?
If you have adult ADHD you’re probably late for work most of the time, terrible with time management, you procrastinate and get tangled up in unimportant detail. As a result your performance is dramatically impaired and your productivity is often very low because you work so slowly and may try to compensate by being a perfectionist.
• Do you abuse alcohol and drugs?
Many people with ADHD abuse drugs, prescription medication or alcohol, Dr Benn says. It’s often a form of self-medication because substance abuse provides the stimulation they desperately seek or help them cope with depression and anxiety. Among the criticisms levelled at Ritalin is the theory that it can turn one into a drug addict. But the latest research shows the opposite is true: the risk of becoming an addict is far greater if your ADHD goes untreated than if you’re treated with medication at an early stage.
• Do you get bored quickly?
Most people don’t enjoy mundane chores, but people with ADHD have an active aversion to such tasks, Collis says. That’s why the home of someone with ADHD is often messy and untidy. But give them a task that stimulates them and they’ll focus on it with no effort at all. Boredom and ADHD don’t go together well. Sufferers are starters, not finishers. They often begin a new project or even career but don’t see it through.
• Do you get a lot of speeding tickets or cause car accidents?
Hyperactive people love speed and often drive too fast. People with attention deficit struggle to concentrate on driving and the road.
• Do you become stressed out when multifunctioning is required?
Often people with ADHD function very well at work – until they are promoted. Then they fall apart because they can’t keep all the balls in the air. The same can happen with parents. A mother with ADHD can possibly handle her first child well but when the second arrives a breakdown threatens.
• Does someone in your family have ADHD?
ADHD runs in families. If you have it chances are high that one or more of your siblings also suffer from it. Many adults realise they have ADHD only when their kids are diagnosed.
* Not his real name