Adult ADHD concealed by depression and panic disorder, posing treatment difficulties

Although adults experience attention deficit hyperactivity disorder (ADHD) much like children, there are certain challenges associated with diagnosing and initiating early treatment for adult ADHD patients compared to children.

“ADHD in adults differs somewhat from ADHD in children due to its involvement in complex social situations over an extended duration, accompanied by heightened stressors, and distinct outward symptoms. Consequently, there are instances where it may be misconstrued as depression or anxiety,” explained Professor Bae Seung-min, a psychiatrist at Gachon University Gil Medical Center, appearing on the “Gil Hospital TV” YouTube channel. 

Presently, there exist two prevailing viewpoints on adult ADHD. One posits that it persists from childhood, while the other asserts that it emerges anew during adulthood and wasn’t present during childhood.

ADHD is classified as a neurodevelopmental disorder, resulting from congenital brain structural abnormalities, Bae said.

“It’s noteworthy that in many clinical settings, there is a notable trend of individuals having ADHD during childhood, often going undetected, and subsequently being diagnosed in adulthood. Consequently, the prevailing perspective leans towards ADHD in adulthood being a continuation of the condition from childhood,” he said.

The prevalence of ADHD in children is conservatively estimated to range between 3-7 percent. Remarkably, a substantial proportion of these children, ranging from at least 50 percent to as high as 80 percent, continue to exhibit symptoms as they transition into adolescence and adulthood. 

“Considering this, there are a significant number of adults with ADHD,” and it’s worth noting that co-occurring disorders like social anxiety disorder, panic disorder, and depression are more prevalent, further contributing to the underdiagnosis of ADHD,” Bae said.

A delayed diagnosis of ADHD can result in prolonged periods of stress and the emergence of additional severe mental illnesses. 

Bae shared that in clinical practice, he encountered instances where individuals attempt to cope with their challenges through addictive behaviors like alcohol, which can exacerbate their struggles with addiction.

In adulthood, the presentation of ADHD symptoms undergoes a transformation, occasionally leading to a misconception that these changes indicate improvement. 

According to Bae, hyperactivity symptoms tend to diminish with age. Due to this natural progression, many would not pursue treatment for their children because they think their children’s symptoms would improve as they mature. 

In essence, a reduction in hyperactivity should not automatically be interpreted as a sign of improvement in ADHD. 

Moreover, adults grappling with ADHD are at a heightened risk of encountering difficulties compared to children, primarily due to the increased social responsibilities that come with adulthood.

In adulthood, one’s social role undergoes a transformation from childhood, causing seemingly minor mishaps or mistakes in activities like driving, work, or business to carry more significant consequences. Furthermore, maintaining deep and consistent interpersonal relationships becomes challenging due to frequent encounters with trivial issues. Essentially, adult ADHD symptoms can manifest in unique difficulties compared to childhood, impacting various life domains and potentially reducing overall quality of life.

Treating adult ADHD poses unique challenges. According to Bae, “Addressing adult ADHD can be more challenging than treating children with the condition because the adult brain is more mature, making it harder to observe the long-term effects of medication.” 

Nevertheless, consulting with your healthcare provider regarding your profession, work routine, and any coexisting conditions can facilitate the customization of medication or treatment to align with your specific requirements and circumstances, he said.

To minimize mistakes, consider maintaining a journal, utilizing smartphone scheduling apps with alarms to provide frequent reminders for crucial appointments, and establishing support systems to aid in your efforts to stay organized and on top of your tasks.

Bae suggests that for enhanced effectiveness, it is essential to closely assess the symptoms and their severity in adults with ADHD, as well as their influence on their present personal and professional lives. Techniques such as skill training and cognitive behavioral therapy can then be tailored to address these specific needs.