For Adult ADHD

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a diagnosis of ADHD must include:

A. A pattern of inattention and/or hyperactivity/impulsivity that interferes with functioning or development as characterized by (1) or and/or (2):

1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:

   a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).

   b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).

   c. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).

   d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).

   e. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).

   f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).

   g. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, cell phones).

   h. Is often easily distracted by extraneous stimuli (e.g., unrelated thoughts).

   i. Is often forgetful in daily activities (e.g., doing chores, running errands; returning calls, paying bills, keeping appointments).

2. Hyperactivity and Impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and negatively impacts directly on social and academic/occupational activities:

   a. Often fidgets with or taps hands or feet or squirms in seat.

   b. Often leaves seat in situations when remaining seated is expected (e.g., leaves their place in the classroom, in the workplace).

   c. Often runs about or climbs in situations where it is inappropriate (NOTE: in adults, may be limited to feeling restless).

   d. Often unable to play or engage in leisure activities quietly.

   e. Is often "on the go," acting as if "driven by a motor" (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).

   f. Often talks excessively.

   g. Often blurts out an answer before a question has been completed (e.g., completes people's sentences; cannot wait for turn in conversation).

   h. Often has difficulty waiting their turn (e.g., waiting in line).

   i. Often interrupts or intrudes on others.

B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.

C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).

D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).

It is estimated that between 1% and 5% of adults in the United States have ADHD.

Cognitive components (thoughts and beliefs) can worsen ADHD symptoms. For example, a person who is facing something they find overwhelming might shift their attention elsewhere or think things like, "I can't do this," "I don't want to do this," or "I will do this later."

Behavioral components are the things people do that can make ADHD symptoms worse. The actual behaviors can include avoiding what you should be doing or keeping or not keeping an organizational system.

Core neuropsychiatric impairments, starting in childhood, prevent effective coping. By definition, adults with ADHD have been struggling with this disorder since childhood. Because of these symptoms, adults with ADHD often have sustained underachievement or other experiences that they might label as "failures." In turn, this history of failures can result in people with ADHD developing overly negative beliefs about themselves, as well as negative, maladaptive thinking when approaching tasks. Therefore, the negative thoughts and beliefs that ensue can add to avoidance or distractibility. Thus, people with ADHD shift attention even more when confronted with tasks or problems that they may find difficult or tedious, and related behavioral symptoms can also get worse, resulting in a vicious cycle.