Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Symptoms of attention deficit hyperactivity disorder (ADHD) in children and adolescents are predominantly external and easy to observe, such as physical hyperactivity. An exception is predominantly inattentive ADHD, formerly referred to as ADD, more common in girls. With age, a decrease in observable symptoms of ADHD seems to occur. Adults with ADHD have a longer delay before refocusing when their attention is misdirected, and they have difficulty switching tasks. The hyperactivity and impulsivity of adult ADHD are often more subtle than those symptoms types in children. For example, while hyperactivity may result in children being fidgety and frequently getting up from sitting, this symptom in adults may involve the adult getting bored easily and being unhappy about having to sit still rather than having to frequently change their position. On neuropsychological tests, these individuals often have trouble with sustained effort, planning, organization, visual tracking, and listening attentively.
ADHD is characterized by a long-term history of inattention, impulsiveness, and variable amounts of hyperactivity. Remember that all of these symptoms are normal human characteristics, so ADHD is not diagnosed solely based on the presence of these normal human behaviors. ADHD is determined by the degree of these behaviors. People with ADHD have these normal human characteristics to an excessive degree, with a poor ability to easily control them.
The Evolution of ADHD Characteristics From Childhood to Adulthood
Cannot sit still Fidgety, restless Always on the go
Inner restlessness Inability to relax Unhappy/discontent when inactive
Can't stay in line
Temper tantrums or outbursts
Snap decisions, recklessness
Switching tasks rapidly
Felling "down" when bored or "up" when excited/stimulated
Cannot finish work
Does not appear to hear
Poor time management
Misses part of conversation
Although some adults with ADHD may not meet the full criteria used to
diagnose ADHD in children, they may still experience significant
impairment in certain aspects of life. Depending on their professional
or domestic situation, these adults may need to deal with more complex
abstract issues that can be difficult depending on their degree of ADHD
severity. Consequently, a given individual's perception of his or her
own degree of impairment may vary.
Some characteristics of
adult ADHD include the following (remember these are normal human
behaviors; ADHD is diagnosed based on the presence and severity of more
than one of these characteristics):
Persistent motor hyperactivity: You may feel restless, be unable
to relax or settle down, or be discontent while active.
Attention difficulties: You may have trouble keeping your mind
on a conversation. You may be constantly aware of other things going
on around you even when you try to filter them out. You may have
difficulty reading, finishing a task, or with focus or you may experience
Affective lability: This means that you can shift from a normal
mood to depression or excitement, and these shifts can be either
reactive or spontaneous.
Disorganization or inability to complete tasks: You may be
disorganized at work, home, or school. You frequently do not
complete tasks or you switch from one task to another.
Short temper with short-lived explosive outbursts: You may lose
control for short times or be easily provoked to anger or constantly
irritable, and these problems may interfere with your personal
Impulsivity: Impulsiveness may be minor (for example, talking
before thinking, interrupting conversation, impatience) or major.
Abruptly starting or stopping relationships (for example, multiple
marriages, separations), antisocial behavior (for example,
shoplifting), and excessive involvement in pleasurable activities
without recognizing possible consequences (for example, buying
spree) are examples of major impulsivity. The bottom line is that if
you wait to do something, you experience discomfort.
Emotional overreaction: You react excessively or inappropriately
with depression, confusion, uncertainty, anxiety, or anger to
ordinary stresses. These emotional responses interfere with your
ability to solve problems.