Attention deficit hyperactivity disorder (ADHD) in adults: how can it be recognised and treated?

What is adult ADHD? 

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects adults as well as children. While in children the signs are often visible (motor hyperactivity, restlessness in class), in adults the symptoms may be more discreet, such as difficulties in organising themselves, managing time or maintaining attention.

Adult ADHD is often misunderstood and widely under-diagnosed. Many people mistakenly believe that it disappears with age, but it often persists into adulthood, even though some symptoms may improve. This disorder is not linked to a lack of willpower or motivation: it is a neurological condition that can have a major impact on daily life, relationships and work.

About 3-4% of adults in the UK suffer from ADHD, according to ADHD UK. 

What are the symptoms of ADHD in adults? 

Adult ADHD manifests itself through a series of symptoms that can profoundly disrupt daily life.

Persistent lack of attention

Adults with ADHD often find it difficult to stay focused on even a short task. They can easily lose focus, forget appointments or lose track in meetings. This affects productivity, leads to mistakes and can fuel a sense of failure.

Impulsivity that is hard to control

Decisions are often taken in a hurry, without thinking through the consequences. This can result in impulsive purchases, inappropriate speech or behaviour that is considered ‘too direct’. These reactions can damage relationships and professional stability.

Constant inner restlessness

In adults, ADHD is often expressed by internal tension rather than visible hyperactivity. It is difficult to settle down, relax or ‘put the brain to rest’. This mental overwork can lead to stress, anxiety and sleep problems.

Chronic lack of organisation and procrastination 

Adults with ADHD often feel overwhelmed by simple tasks. Managing priorities, meeting deadlines and planning are often complicated. The tendency to procrastinate increases mental workload and anxiety.

Emotional hypersensitivity 

Emotions are experienced in an amplified way: rapid frustration, irritability, sadness or excessive excitement. This emotional instability complicates social interaction and can undermine self-esteem in the long term.

Adult ADHD is frequently associated with other disorders, including anxiety, depression, sleep disorders and low self-esteem. These co-morbidities are common.

Why is ADHD often diagnosed late in adults? 

Attention deficit hyperactivity disorder (ADHD) in adults is still often misunderstood or misdiagnosed, which explains why many people are not diagnosed until adulthood.

There are several reasons for this delay. Many unknowingly develop strategies to compensate for their difficulties, such as using reminders or avoiding complex situations, which can mask the symptoms.

ADHD also shares common signs with other disorders such as anxiety, depression or burn-out, making it more difficult to identify.

In addition, the lack of training in adult ADHD among some healthcare professionals can lead to errors or delays in diagnosis.

Finally, the stigma attached to mental disorders in adulthood often leads the people concerned to play down their difficulties or not to seek help.

How is ADHD diagnosed in an adult? 

The diagnosis of ADHD in adults may seem complex, but it is essential for access to appropriate treatment. It is recommended to see a healthcare professional as soon as persistent difficulties in managing everyday life appear. These may include attention problems, marked impulsivity, frequent lack of organisation, constant inner agitation, or unusual irritability and frustration.

The diagnosis must be made by a trained professional, such as a psychiatrist, neuropsychologist or specialised psychologist, who is able to distinguish ADHD from other disorders with similar symptoms, such as anxiety or depression.

The diagnostic assessment is based on an in-depth clinical interview to retrace the history of symptoms and measure their impact. It also relies on standardised questionnaires and specific tests, used as part of an overall analysis conducted by a qualified professional.

There are a number of different questionnaires and tests available:

Questionnaires:

• ASRS (Adult ADHD Self-Report Scale) : validated by the WHO, widely used by general practitioners and psychologists.  
• CAARS (Conners' Adult ADHD Rating Scales) : a very comprehensive tool, used in clinical settings (particularly by psychiatrists and neuropsychologists).
• Brown ADD Scales : focuses on executive functions; used by some professionals as an additional test.
• WURS (Wender Utah Rating Scale) : used to trace childhood symptoms, which is essential for making a diagnosis of ADHD according to the DSM-5 criteria.
• DIVA-5 (Diagnostic Interview for ADHD in Adults) : a recognised semi-structured interview, used by specialists trained in adult ADHD.

Neuropsychological tests:

• TOVA (Test of Variables of Attention) : a recognised computerised test.
• CPT-3 (Continuous Performance Test) : a variant of TOVA, also used to assess sustained attention and inhibition.
• Stroop Test : this is a classic neuropsychological test which measures cognitive inhibition.
• Trail Making Test (TMT) : tests to measure mental flexibility and attention. 
• WAIS-IV (Wechsler Adult Intelligence Scale) : certain subtests, tests designed to assess a specific aspect of an overall test, are used in ADHD assessments.

The results obtained using these tools help to confirm or refute the diagnosis of ADHD, and to distinguish this disorder from similar conditions. Once the diagnosis has been established, a personalised treatment plan can be worked out for the patient.

What treatments are available for an adult ADHD ? 

The treatment of attention deficit hyperactivity disorder (ADHD) in adults is based on a combination of medication, therapy and psychological support.

Medication 

Methylphenidate is a common treatment for adults with ADHD. Marketed under names such as Ritalin®, Concerta®, Equasym® or Medikinet®, it works by increasing dopamine and noradrenaline in the brain, thereby improving attention and reducing impulsivity. When methylphenidate is ineffective or poorly tolerated, non-stimulant alternatives such as atomoxetine (Strattera®) may be prescribed.

Cognitive and behavioural therapy (CBT) 

Cognitive behavioural therapy (CBT) is recommended to help adults with ADHD develop coping strategies. They aim to change negative thinking patterns and problem behaviours, focusing on time management, organisation, problem solving and emotional regulation.

Coaching and psychological education 

Specialised coaching and psychological education can be a complement for medication and therapy. Coaching helps individuals identify their goals, draw up action plans and develop specific skills to manage the day-to-day challenges associated with ADHD, while psychological education provides information about ADHD, its symptoms and its impact, enabling patients and their families to better understand the disorder and actively participate in the treatment process.

Such multidisciplinary approach implies the collaboration of different healthcare professionals such as psychiatrists, psychologists, coaches and specialist educators.

Some tips for a better life with ADHD 

There are some tips that can help adults with ADHD manage their symptoms more effectively and improve their quality of life:

• Manage your time effectively: use methods such as the Pomodoro technique (25 min work, 5 min break) to improve concentration. Plan your days with fixed time slots and set realistic goals to avoid overload.
  
• Get organised using the right tools: diaries, to-do lists, smartphone reminders, etc. These tools can give structure to your day. Creating simple, regular routines helps reduce forgetfulness and increase stability.
  
• Create a distraction-free environment: establish a calm, uncluttered workspace. Use noise-cancelling headphones or soft music to improve concentration. Avoid visual or digital distractions.
  
• Learn to say no: protect your time and energy by setting clear limits. Refusing certain requests is not a failure, it is a gesture of self-preservation.
  
• Get support: talk about your ADHD to people you trust. Join support groups or see trained professionals for personalised advice and long-term support. 

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