ADHD in Adults: How to Recognize It and What to Do

“ADHD is a neurodevelopmental disorder, likely characterized by a dysfunction of the dopaminergic and noradrenergic systems, which disrupts the brain circuits involved in regulating attention, impulsivity, and planning ability.

It commonly appears in childhood with marked difficulty in maintaining attention during prolonged tasks: affected children may easily get distracted by irrelevant stimuli, struggle to complete schoolwork, and show excessive restlessness in their movements. This hyperactivity is often a strategy to self-regulate attention, seeking new external stimuli to maintain cognitive activation,” explains Dr. Dieci.

Additionally, ADHD has a genetic and biological component. If first-degree relatives have ADHD, there is a higher likelihood of developing the disorder.

Severe and Mild Forms

“It’s important to specify that ADHD is not a binary condition, meaning present or absent, but rather it exists along a continuum of severity. In severe cases, the inability to maintain attention and control impulsivity deeply compromises school and social performance. Conversely, there are milder (subclinical) forms that may not significantly interfere with daily life,” adds Dieci.

“As individuals reach adulthood, the disorder often tends to lessen, but in some cases, inattention persists, making it difficult to manage time and daily responsibilities effectively.”

Studies show that childhood ADHD is a risk factor for the development of psychiatric disorders in adulthood, including bipolar disorder, antisocial personality disorder, and other mood disorders. Although in most cases ADHD manifests during childhood and continues into adulthood, some individuals may experience symptoms that emerge later in life, in a form of late-onset ADHD.

In adults, the most common form is the predominantly inattentive type, with symptoms that may include:

• Difficulty maintaining focus on prolonged tasks (e.g., reading a book, attending meetings, completing a project);
• Easily distracted by irrelevant environmental stimuli;
• Problems managing time and planning daily activities;
• Difficulty completing tasks once started;
• Tendency to lose personal items;
• Feeling mentally overwhelmed.

“Many adult patients, even though they have average or above-average intelligence, report persistent difficulties with reading books, organizing daily activities, and maintaining focus,” continues Dieci.

If someone suspects they have ADHD, the first step is to consult a specialist, such as a psychiatrist or neuropsychiatrist, for a thorough evaluation. It is important to avoid self-diagnosis and rely on professionals experienced in recognizing the symptoms and distinguishing them from other psychiatric or neurocognitive conditions. The diagnosis of ADHD is clinical, based on collecting the patient's history and structured interviews.

“A critical aspect is the risk of overdiagnosis and overtreatment: the threshold for initiating pharmacological treatment is a debated issue within the scientific community. Therefore, a thorough and prolonged evaluation over time is essential before deciding whether a patient actually needs pharmacological treatment.”

ADHD can be managed through several approaches:

• Pharmacological treatment: In Italy, two medications based on amphetamines and methylphenidate are approved, which work by increasing dopamine and norepinephrine levels in the brain. These medications can improve concentration and reduce impulsivity but must be prescribed carefully after an accurate diagnosis.
• Cognitive-behavioral therapy: Helps develop strategies to improve organization, time management, and emotional regulation.
• Rehabilitative and behavioral interventions: Attention training techniques and psychoeducational support can be useful for managing daily difficulties.
• Lifestyle modifications: A balanced diet, regular physical exercise, and mindfulness techniques can help regulate attention better.

“It’s worth noting that in many individuals, ADHD tends to decrease with age, and some patients no longer require therapy in later life,” says Dieci.

As shown by the experiences of famous individuals such as actors Jim Carrey and Emma Watson, ADHD is not an insurmountable obstacle. With proper diagnosis and treatment, it can be effectively managed, allowing individuals to lead a fulfilling and satisfying life.