The worst part is not knowing what’s wrong. Thinking that you’re somehow lacking in character, your life beset with chronic and far-reaching failures, as you go from job to job and from relationship to relationship.

Maybe you’re not to blame. Estimates are that as many as four adults out of 100 have no idea that they suffer from Attention Deficit Hyperactivity Disorder or ADHD.

“In adult ADHD, performance is highly variable so that they can do some things very well at times, even as they struggle to cope with simple every day tasks—this can lead some to think that they are simply being lazy or not trying hard enough,” says Dr. Philip Asherson, ADHD expert and professor at the Institute of Psychiatry, King’s College London.

The condition isn’t difficult to diagnose, according to Dr. Asherson, as long as health care professionals trained to work with adults are sufficiently aware of what to look for and remain alert to the possibilities of a diagnosis more commonly associated with children.

“The disorder can be confused with personality disorder since the symptoms of ADHD start early in life, are trait-like and persistent over time; they do not fluctuate or have clear recent onset-like-anxiety or depression that tends to be episodic. Mood instability is commonly seen in adult ADHD and this can be confused with minor or atypical forms of depression.”

Adult ADHD is a continuation of a childhood-onset condition that may have gone undiagnosed.

“ADHD-like symptoms starting in adult life are more likely another condition. However it can also be the case that the structured environment in the upbringing of some children can cover up the deficits associated with ADHD particularly if the individual is bright and has mainly inattentive symptoms. In these cases, overt impairment from ADHD symptoms can emerge when they leave home or have to cope on their own, giving the impression of a later onset,” reports Dr. Asherson.

Adult symptoms tend to replicate the symptoms of childhood ADHD and typically may include impaired attentiveness, poor impulse control, inadequate listening skills and restlessness.

The disorder tends to be a family affair, with studies supporting the idea that genetic factors are mainly behind the familial aggregation of ADHD. Dr. Asherson suggests that the interaction of environmental and genetic risks is an important factor to consider as well.

“Some children will be protected from risk environments by their genes while others will be more prone to develop ADHD if they meet risk environments. The nature of the environments is not well understood, but could include exposure to toxins—alcohol /tobacco during foetal development if the mother smokes or drinks, parenting factors and small contributions from diet; however the precise environmental risks are not yet known. In terms of genes, we and others have found genetic association with dopamine system genes—the same neurotransmitter system that Ritalin and other stimulants act on.”

In approximately 30 per cent of affected adults, the long-term effects can be substantial, creating problems with mood instability, career difficulties and forming stable social relationships. Health risks include increased rates of anxiety, depression, alcohol, tobacco and drug abuse and accidental injuries. Antisocial behavior isn’t uncommon.

Weight There’s More:

A recent Canadian study suggests there may be a link between severe obesity and ADHD:

• Study involved 75 women, average age 40; average BMI of 43.1 (30.0 plus is the standard for obesity).
• 26.7 per cent of those participating were found to have ADHD—a number four times greater than in the general population.
• They presented with classic ADHD symptoms—impulsiveness, inattention, highly distractible.
• Treated with drugs such as Ritalin in combination with counseling, almost 40 per cent lost weight.

Although ADHD can’t be cured, it frequently wanes over time and many afflicted individuals develop good coping skills, learning to manage symptoms effectively.

Stimulants and other drugs are an effective form of treatment and help control symptoms in about 70 per cent of adult sufferers.

“Not everyone with adult ADHD wants or needs to be treated with drugs, but this is an essential option for some people and there are many who consider that stimulants have saved their lives, in terms of their day-to-day function at home and work,” says Dr. Asherson.

“Others need to be treated with medication to progress at school, college or work. Psychological support and advice can be very helpful.”