What Does ADHD Look Like in Adults?

Ask a Doctor

My boyfriend has trouble holding down a job. I love him, but he’s disorganized, forgetful, always late, and he seems unhappy unless he’s busy with some task – usually videogames. I worry he may have an undiagnosed mental health condition. How is ADHD (attention deficit hyperactivity disorder) diagnosed? What does ADHD look like in adults?

Doctor's Response

Adult attention deficit hyperactivity disorder (ADHD) can have a negative impact on the life of the sufferer. Some commonly reported problems include the following:
  • Friendship, dating, and marital instability
  • Academic, vocational, and extracurricular (for example, in athletic, club, or volunteer activities) success below what is expected based on intelligence and education
  • Alcohol or drug abuse
  • Atypical responses to psychoactive medications
  • Antisocial personality
  • Depression, anxiety, and low self-esteem

Adult ADHD is diagnosed based on determining the presence of symptoms during childhood, establishing a long-term pattern, and demonstrating current impairment. This information can be gathered from interviewing parents, friends, siblings, and spouses or partners, as well as from screening tools, including rating scales and self-reports.

In adults, the DSM-5 requires five or more symptoms of inattention, and/or five or more symptoms of hyperactivity to make the diagnosis. In children, six or more symptoms are required; this is a recognition that there may be fewer symptoms (or they may be more subtle) in adults, but still they cause significant impairment. Many of the symptoms must have been present at or before age 12. The symptoms must cause significant impairment in at least two different settings (for example, home and work; school and home; etc.) and must not be better explained by another diagnosis.

Several screening tools, self-tests or checklists, spousal reports, and parent report questionnaires, including the Connors rating scale, the Adult ADHD Self-Report Scale Symptom Checklist, and others are available for the assessment of adults with attention deficit hyperactivity disorder (ADHD). However, the diagnostic power of these tests is still being determined, so adult ADHD is diagnosed from qualitative data more than from quantitative tests. It is generally useful (and recommended) to get a history of symptoms from others close to the individual (for example, parents, spouse or partner, siblings) to better confirm the diagnosis.
Currently, there are no blood tests, genetic tests, or imaging studies that can accurately diagnose ADHD.

For more information, please read our full medical article on adult attention deficit hyperactivity disorder.

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