ADHD in Adults E-Book

Pascale De Coster

• Herausgeber: Mardaga - INT
• Kategorie: Ratgeber
• Sprache: Englisch

Seitenzahl: 223

Veröffentlichungsjahr: 2025

Beschreibung

An exclusive book on how to manage ADHD as an adult! While there are many books dealing with ADHD in children, explanations of this disorder in adults are far rarer. And yet ADHD does not disappear with age: its various symptoms continue to manifest daily and can make life complicated for adults. So, concretely, how can one work around one’s ADHD and live more serenely? Pascale De Coster provides clear and practical answers to this question. Drawing on numerous testimonies, she examines the different manifestations of ADHD and explains their impact on an adult’s personal, family, and professional life. The author offers a true toolkit: by presenting tested and approved methods, she provides many practical tools, concrete advice, and strategies that help readers understand their ADHD in order to manage it day by day. The essential tools for living better with ADHD as an adult! ABOUT THE AUTHOR Pascale De Coster is an author of children’s books and works devoted to Attention Deficit Hyperactivity Disorder (ADHD). Having ADHD herself, she has a concrete understanding of the needs of adults with ADHD and of those around them. Founder of the association “ADHD Belgium,” she has been involved for many years in helping people who face this condition. With Mardaga, she has also published ADHD – Helping My Child Reach Their Full Potential.

Leseprobe

Cover

Title page

To Adrien, André, Chris, Iris, Rose, and Sabine.

To my sons and my adorable granddaughters, Aurore and Fanny.

To my beloved husband, who supports me every day with his unconditional love and unwavering faith in me.

Foreword

I write with too many ideas rushing through my pen, words that slip away, others that get jumbled, letters that mix up, reverse themselves... and what ends up beneath my fingers is a page full of scribbles.

Ten thousand thoughts whirl around in my brain. Questions pile up by the hundreds, adding to the highway of my thoughts. My head floats in the clouds. The hours pass by, spent on everything except the urgent tasks I need to complete.

I lack focus, I lose track of where I am, I’ve lost the thread of my activities in the flood of my musings. As soon at I think it, it’s already been forgotten! Having noisy daydreams in deafening silence—that’s what mental hyperactivity feels like.

I have three sets of keys in my hands. Three seconds later, they’ve vanished—again! Once more, I can’t find them. Why have I lost so many days searching for them?

My impulsive words escape without passing through my brain. When will you finally think before you speak?

I’m an expert in the arts: the art of searching for what’s right in front of me, the art of taking detours instead of going straight to the point, the art of going in every direction except the right one, the art of complicating things when I could make them simple...

Too much, I’m too much. Too sensitive, too joyful, too sad, too overwhelming, too exhausting... too much, always too much.

What if I could finally turn my biological disorder into something that makes my life more manageable?

Pascale De Coster April 12, 1999 – one month after my ADHD diagnosis

Chapter 1ADHD: Understanding this Complex Disorder

1.1. Defining ADHD

ADHD stands for “Attention Deficit Hyperactivity Disorder,” with or without hyperactivity. As its name suggests, ADHD is a disorder,1 meaning a variation from the norm.

ADHD is a polygenic disorder, caused by a constellation of defects in thousands of genes, though its exact etiology has yet to be clarified.2 This inhibition disorder leads to diffi­culties in regulating thoughts, actions, emotions, and behaviors. It affects executive function and organization, sustained attention and vigilance, working memory, consistent effort, maintaining motivation, and planning.

As early as 1798, ADHD in children was described by ­Alexander Crichton.3 While this complex neurodevelopmental and neurobiological disorder has long been recognized in young people, its persistence in those over 18 years old has only been acknowledged since the late 20th century. Yet it affects about one in twenty-five adults.4 Most are unaware of it, and barely 10 % receive treatment. Among those, a significant proportion were diagnosed in childhood and continue to experience dysfunctions related to their syndrome in adulthood,5 or they recognize it in themselves through their child’s diagnosis.

1.2. ADHD Symptoms in Adults

Adults with ADHD primarily face issues with attention, disorganization, and difficulties in controlling impulses and emotions. Motor hyperactivity, now more subtle, is mostly experienced as discomfort in situations of inactivity or waiting.

These symptoms manifest differently from one individual to another. Moreover, they evolve and vary throughout life, more or less favorably depending on age, personality, gender, comorbidities,6 life circumstances, context, the interventions implemented, and the support provided by loved ones.

1.3. Attention Deficit

The different forms of attention are:

●Sustained attention: for example, being able to read a book without losing focus.

●Divided attention: for example, having a phone conversation while cooking.

●Selective attention: for example, working in a noisy office.

Distracted and hypersensitive to both external and internal stimuli, adults with ADHD struggle greatly to focus or maintain their attention. They overlook details and make numerous careless mistakes. Additionally, their organizational and planning difficulties make them masters of procrastination.7

These symptoms worsen in situations lacking appeal or novelty, or during monotonous, repetitive tasks. They may improve in new environments or when absorbed in particularly engaging tasks. The brain then produces chemicals that enhance concentration and alertness, allowing it to function normally. It is, in a way, “repaired” by passion.

Their faulty attention process demands extraordinary efforts of individuals with ADHD throughout their lives.

Slice of Life

“I have a filtering problem. I try to focus, but I’m constantly distracted by a fly buzzing, footsteps in the hallway, an incoming email, the phone ringing... My colleagues manage to work by blocking out distractions, but I can’t. They call it attention deficit, but I feel like it’s the opposite for me. I’m too attentive to everything, all the time.”

Ingrid, 42 years old

Slice of Life

“I find it very hard to stay focused during work meetings or family meals. Lost in thought, absent, distracted, I daydream and get lost in my many thoughts. I don’t hear what people say to me, or I forget it. When something doesn’t interest me, it’s even worse—I’m completely incapable of listening or even pretending to listen.”

Cyril, 54 years old

Slice of Life

“I spend my life making careless mistakes. I read instructions or manuals too quickly, or I read while thinking about something else. As a result, I understand the words but fail to grasp the main idea. Reading a book under these conditions is really hard! Writing isn’t any better. I forget letters, words, or make tons of spelling mistakes.”

Chloé, 33 years old

Slice of Life

“Every day, I forget, misplace, or lose my keys, glasses, umbrella, coat, bank card, car... Yesterday, it was my car. I was thinking about something else while parking, and then I couldn’t find it. I spend my life looking for things.”

Maxime, 26 years old

Slice of Life

“Since starting university, I’ve been asked to manage my schedule and prioritize between what’s important and what’s not to make the right choices. But I’m incapable of setting priorities.

I act and live in a disorderly way. My dorm looks like a pigsty. I want to tidy it up, but I don’t know where to start. My work is sloppy because I get bogged down in details or jump from one thing to another without finishing anything. Unable to manage time, I systematically underestimate how long things will take, whether it’s studying or getting somewhere. How do people get organized?”

Clémence, 22 years old

Slice of Life

“I go around in circles, not knowing what to do even though there’s so much to tackle... I scatter myself. I don’t know where to start. I don’t know how to start. I’m afraid of not being good enough, so I keep putting things off. And all those ‘little things’ end up becoming huge obstacles.”

Lucas, 19 years old

Slice of Life

“I can’t focus on multiple things at once. If I’m interrupted while doing something, I lose my train of thought. And then it can take me hours to get it back. I can’t listen and take notes at the same time or hear instructions while concentrating on an exercise. My studies are a daily nightmare!”

Leila, 20 years old

1.4. Motor Hyperactivity

As people age, hyperactivity changes in “quality.” It shifts from visible, physical activity to a more subtle, internal restlessness. This is often interpreted as nervousness, impatience, or boredom.

Slice of Life

“I’ve learned to cope with my irresistible need to move. I channel it by doing a lot of sports. However, waiting in line or for my turn is still really hard.”

Robin, 43 years old

Slice of Life

“I’m fidgety; I don’t like sitting still. Long meals, meetings, movies, or shows are pure torture for me.

If I can’t avoid them, I fidget discreetly. I shift positions, sway, squirm in my chair, move my legs, fiddle with my pen, tap on the table...”

Marianne, 32 years old

Slice of Life

“I’m constantly on the go. I have two different jobs, participate in tons of activities, have a huge circle of friends, and love meeting new people. I’m always doing at least two things at once: exercising while on the phone, cooking while watching TV, talking to the kids while working... When I’m on the computer, I always have a multitude of windows open.

I know this behavior annoys those around me, but I can’t function any other way.”

Lucie, 46 years old

1.5. Intellectual Hyperactivity

Intellectual hyperactivity is characterized by a rapid pace of thought. Ideas race at a frantic speed, impossible to control.

Slice of Life

“I talk the way I think, which is all the time and very, very fast. Just yesterday, during a family gathering, my brother asked when I was finally going to shut up. I can’t help it. If I don’t say everything that crosses my mind, I feel like my brain will explode. At night, with my mind buzzing from hyperactive thoughts, I really struggle to go to bed, let alone fall asleep.”

Guillaume, 30 years old

Slice of Life

“My mind is restless. I think too much, all the time. My brain is like a volcano, always bubbling. I live in a constant mental whirlwind.

I jump from one thought to another, one idea to another, one worry to another, unable to control the frantic pace of my brain. As a result, by imagining the worst and worse than even that, I’ve become terribly anxious.”

Laurence, 31 years old

Slice of Life

“I’m constantly thinking about the past or the future. I regret my choices. I imagine what would have happened if I’d acted differently. Or I think about what will happen if my son fails his studies, if my wife gets hit by a car, if I get fired, if the airline goes on strike the day we leave for vacation. I’m so consumed by my thoughts that I can no longer enjoy the present moment.”

Timothée, 38 years old

1.6. Impulsivity

Impulsivity is characterized by difficulties in inhibiting8 actions, gestures, words, thoughts, and emotions. Enthusiastic, passionate, and overly spontaneous, adults with ADHD act without thinking about the consequences of their actions. While they feel regret and suffer repercussions, they learn little or nothing from their mistakes.

Slice of Life

“I act quickly and without thinking. I get excited too fast, can’t resist temptation, and persist in my mistakes. I always choose immediate rewards without considering the future. This has led me to make bad decisions with heavy consequences, including bankruptcy. I deeply regret them.”

Victor, 46 years old

Waiting is emotionally challenging for adults with ADHD. Impatient, they frequently interrupt others during activities, work, or conversations.

Slice of Life

“I say whatever comes to mind without considering the timing or relevance of my remarks. When I have something to share, I do it immediately, even if it means interrupting. I’m too afraid of forgetting what I wanted to say.

I have an opinion on everything, even on things I don’t know about or that don’t concern me. I’m aware of the inappropriate comments I make and regret them afterward, yet I can’t stop myself from doing it again.

People constantly tell me I’m exhausting.”

Charlotte, 49 years old

Extremely sensitive, they struggle to manage their emotions. They are easily frustrated, moody, quick to anger, and prone to losing their temper.

Slice of Life

“Emotionally, I’m completely unstable. I overreact to different stress factors. As a result, I switch from good to bad moods, from joy to sadness, in the blink of an eye...

Hot-tempered, often touchy, quick to anger, easily irritable, stressed—it takes so little, just a word, to hurt me or make me snap.”

Christelle, 42 years old

They struggle to follow rules, particularly traffic laws. Their impulsivity annoys others and causes frequent conflicts, leading to job changes, unstable relationships, and often to tense family dynamics.

Slice of Life

“Whenever I’m bored, upset, frustrated, or dissatisfied, I quit my job. I’ve lost count of how many times I’ve changed jobs. As a result, at 40 years old, despite my degrees, I’m still working as a basic employee. As for my love life... it’s better not to talk about it.”

Thomas, 40 years old

1. The term “disorder” is used when the patient or their loved ones experience distress, or when significant impairments in social, academic, professional, or family functioning are evident. Therefore, ADHD is not diagnosed when “everything is fine.”

2. Diane Purper Conference, September 14, 2018, ADHD Care Pathway.

3. Palmer, E.D. & Finger, S. (2003). One of the earliest descriptions of ADHD (inattention subtype): Dr. Alexander Crichton and “mental restlessness” (1798). Child Psychology and Psychiatry Review, 6, 66-73.

4. https://www.ncbi.nlm.nih.gov/pubmed/18688774.

5. Two-thirds of affected children continue to experience issues related to this syndrome in adulthood. Source: Adler LA: “Familial transmission of ADHD and psychoactive substance use disorders” American Journal of Psychiatry, 165, 2008, 11-12.

6. Comorbidity refers to the presence of additional disorders alongside the primary one. Distinct disorders coexist within the same individual.

7. Pathological tendency to delay, to put off action until later.

8. To restrain, block, or paralyze.

Chapter 2Who Makes the Diagnosis and How?

Slice of Life

“My name is Antoine. I’m 30 years old. A friend of mine, who has ADHD, told me a few weeks ago, after I confided in her, that she recognized many of the symptoms of her ‘illness’ in me (I don’t know what to call it). At first, I laughed. I didn’t take her seriously. Later, out of curiosity, I looked up what ADHD was. Many explanations, testimonies, and outside opinions surprised me. I also took several online tests, and each time, the results were striking. Since these aren’t expert opinions, I didn’t take them too seriously... but I thought about it. I’ve never been truly hyperactive. Yet inside, my brain is constantly buzzing. Endless ideas, sometimes trivial, sometimes pushing me to create, and sometimes, on the contrary, very negative, dark, and destructive.

When I was a child, I often received remarks from teachers, notes in my report card saying I never listened. That I was always daydreaming. My parents said the same. I couldn’t focus on my homework for long. My parents had to force me to start and stay with me constantly to ensure I finished. Otherwise, I’d do all sorts of other things, or just stare out the window or into space. A sound, a movement, anything would distract me. Or I’d just daydream. Yet, when it came to activities I enjoyed, like sports or playing, I was very focused.

My behavior didn’t ultimately worry anyone: though I was never brilliant in school, through sheer determination, retakes in secondary school, and teacher remarks, I managed to pass in the end.

Things got harder later, and they’re getting worse. I wanted to study psychology at university. I liked the courses, but I couldn’t learn them. There were so many other things I could do (I’m passionate about so many things), so many distractions. Even locked in my room without a TV, computer, or anything, just looking out the window was enough to imagine countless other activities... So I repeated, started over, failed, and gave up. I went to work. Without a degree, I couldn’t find anything truly interesting, and I only lasted a year. I went back to study social work. The same problems arose: no concentration during classes or when trying to study. Fortunately, the material was much less extensive than at university. Eventually, with patience, perseverance, and the help of my loved ones, I earned the diploma. I sincerely thought the hardest part was behind me. But that was far from the truth.

I quickly found a job as a social worker in public housing. A full-time, permanent contract. I was proud of myself. Unfortunately, there was so much to learn—my colleagues explained and re-explained things—meetings with clients, home visits, budget guidance... I mixed everything up, got discouraged, discouraged those working with me, and even those I was supposed to help. I wrote everything down to stay focused and not forget, but then I’d lose the papers, the documents. When it came to updating files, writing reports, sending letters, scheduling home visits, unable to organize myself despite all my efforts, I did things in total disorder, bit by bit, distracted by everything, overwhelmed by the amount of work. In the end, after a year, the director called me in and informed me of my dismissal.

I took it relatively well, thinking it was an opportunity for a fresh start. Two months later, I had another job. This time, as an educator in a school. Supervision wasn’t a problem. But when it came to managing files, it was chaos again. I stayed for 4 months. At another school, they kept me for 6 months. Each time, it was at the end of my contract, but they preferred to hire someone else for the next school year.

Today, I’m unemployed, and I’m afraid it will all happen again. Each time, my confidence and self-esteem take a hit. I’m afraid I’ll never succeed.

Meanwhile, I’m never idle. I’m particularly active in the arts (drawing, painting, music...) because it’s the only field where I can express myself. But I get bored quickly, too quickly, with everything. I’ve enrolled in academies, sports clubs, but I always quit after a few months. Even in my romantic relationships, I can’t keep anyone for more than a few years, sometimes just a few months. I don’t really know why. I feel like no one understands me, and truly alone.

I also lack motivation and can’t make decisions. For as long as I can remember, I’ve been a stressed, anxious person. I regularly have panic attacks. An incessant flow of ideas pounds in my head, often morbid, infinitely sad, terrifying thoughts. I’ve seen psychologists, psychiatrists. I was diagnosed with depression, generalized anxiety disorder, and prescribed medication. Yet, nothing really changes. Yes, I feel sad, down, anxious, but today, I sincerely believe the problem isn’t just that. Or not only that.

I have so many questions. I have no idea if I have ADHD. I’d like a professional opinion. But I don’t know who to turn to. Could all these symptoms simply be due to this ‘disorder’? Who should I see? Who can help me?

I want to stop feeling guilty about my life, my behavior, my journey. I want to stop feeling responsible for these failures, for disappointing my loved ones. I’m trying to get through it, to rise above it all, but it’s really not easy.”

Antoine, 30 years old

An ADHD diagnosis can be made at any point in life.

2.1. Who Diagnoses ADHD?

ADHD is a heterogeneous syndrome that manifests differently in each person. Only a specialist doctor (psychiatrist or neurologist) is qualified to make a differential diagnosis of ADHD.

This differential diagnosis determines whether the symptoms are indeed caused by ADHD or if they stem from other causes with similar signs. It also establishes whether ADHD is standalone or associated with comorbidities.

2.2. How is the Diagnosis Made?

The diagnosis of ADHD is based exclusively on a thorough clinical evaluation. This includes a medical history9 that covers the patient’s academic and professional journey, as well as their romantic, social, and family history. It notes their medical, personal, and family background and checks for the presence of the disorder at different stages of life.

Adults with ADHD often struggle with self-observation, so additional sources like questionnaires10 (completed by both the patient and their loved ones), old report cards, medical reports, etc., provide complementary collateral information.

Social and professional success does not automatically rule out an ADHD diagnosis. Adults with this disorder often develop numerous compensatory mechanisms, allowing them to adapt. Despite their apparent success, these adults often function at a suboptimal level due to their various symptoms.

Possible physical exams, biological tests, or imaging studies help rule out certain conditions like hyperthyroidism,11 epilepsy,12 neurofibromatosis,13 intolerances, allergies, nutritional deficiencies, or hearing and vision impairments, which can cause symptoms similar to ADHD.

Neuropsychological tests (psychomotor, attention, memory, language, intellectual ability, etc.) refine the diagnosis. These tests do not confirm a diagnosis. In fact, some individuals with ADHD develop effective compensatory strategies during these evaluations. However, they provide an inventory of cognitive and executive abilities, indicating the priorities to consider during treatment.

In adults, symptoms of inattention, hyperactivity, and impulsivity are often masked by complaints of anxiety-depression, addiction issues, tics, mood or sleep disorders, etc. When one of these diagnoses is made, it’s important to check whether ADHD is a comorbidity.

The doctor then assesses whether the core symptoms typical of ADHD (as described in the DSM-514) are sufficiently present and severe enough to impact both the patient’s quality of life and that of their loved ones.

Slice of Life

“I faced enormous difficulties during my schooling and always felt stupid. Later, in the working world, thinking I was good for nothing, I drifted from one uninteresting job to another. I went to see a psychiatrist to get antidepressants. He saw me several times. Then he asked me to bring my old report cards and had me, my husband, and my parents fill out various questionnaires.

In the end, I was diagnosed with ADHD. I’m neither slow nor stupid. I just have a significant attention deficit. This diagnosis and the subsequent treatment changed my outlook on life. For the first time in my life, I feel capable of moving forward.”

Clémentine, 43 years old

2.3. Diagnostic Criteria for ADHD in the DSM-5

The DSM-5 identifies three types of ADHD: the inattentive type, where inattention is predominant; the hyperactive-impulsive type, where motor agitation and impulsivity dominate; and the combined type, which involves varying degrees of attention difficulties, motor hyperactivity, and impulsivity.

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

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

Note: The symptoms are not solely a manifestation of defiant, provocative, or hostile behavior, nor are they the result of failure to understand tasks or instructions. In older adolescents and adults (age 17 and above), at least five symptoms are required.

Examples

(a) Often fails to pay attention to details or makes careless mistakes in schoolwork, at work, or in other activities.

Ignores or does not notice details, works inaccurately, misreads a question, writes without checking, hands in incomplete work…

(b) Often has difficulty sustaining attention in tasks or play activities.

Has trouble concentrating while reading long texts, during conversations, or in lectures…

(c) Often seems not to listen when spoken to.

Seems distracted, “daydreaming,” appears to have their mind 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.

Starts tasks but quickly gets distracted and is easily sidetracked, loses track of an ongoing activity, becomes scattered while working, abandons tasks before completing them…

(e) Often has difficulty organizing tasks and activities.

Finds it hard to manage tasks that involve multiple steps, has trouble keeping belongings and papers in order, works in a messy way, is disorganized, manages time poorly, cannot meet deadlines, struggles with sequential tasks, and has difficulty maintaining an organizational system…

(f) Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.

Puts off writing reports, filling out forms, doing calculations, or completing any other kind of “paperwork” until the last moment…

(g) Often loses things necessary for tasks or activities.

School materials, pencils, books, tools, wallet, keys, documents, glasses, mobile phone, planner…

(h) Is often easily distracted by external or internal stimuli.

Easily distracted by noises, conversations, visual stimuli, electronic messages (texts, social media).

Has difficulty not getting lost in their own thoughts.

(i) Is often forgetful in daily activities.

Forgets household tasks, shopping; forgets to return phone calls, pay bills, show up for…

(2) Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least six months, to a degree that is inappropriate and inconsistent with developmental level, and that has a negative impact on social, academic, or occupational ­activities.

Note: The symptoms are not solely the manifestation of defiant, provocative, or hostile behavior, nor the result of failure to understand tasks or instructions. In older adolescents and adults (age 17 and above), at least five symptoms are required.

Examples

(a) Often fidgets with hands or feet, or squirms in their seat.

Taps fingers, plays with a lock of hair, fiddles with a pen, moves feet, rocks in their seat…

(b) Often leaves their seat in situations where remaining seated is expected.

Gets up in class, in the office, or in other situations where they are expected to stay in place.

(c) Often runs about or climbs in situations where it is inappropriate.

(Note: in adolescents or adults, this may be limited to a subjective feeling of motor restlessness.)

Moves excessively when it is not appropriate. This need to run or climb transforms, with age, into an inner sense of restlessness or uncomfortable agitation.

(d) Often has difficulty playing or engaging in leisure activities quietly.

Needs to be moving. Has difficulty tolerating calm or passive activities.

(e) Is often “on the go” or acts as if “driven by a motor.”

Shows clear discomfort when required to remain still for long periods, such as at school, in a restaurant, at the cinema, or in a meeting. Appears constantly in a hurry, restless, impatient…

(f) Often talks excessively.

Speaks excessively or in a tone that may be loud or bothersome.

(g) Often blurts out an answer before a question has been completed.

Finishes others’ sentences, cannot wait for their turn in conversation, responds before the question is finished, interrupts…

(h) Often has difficulty waiting their turn.

Is extremely impatient in lines or in traffic.

(i) Often interrupts or intrudes on others.

Intrudes into conversations, games, or activities; takes or uses others’ belongings without asking for or receiving permission…

B. Several symptoms of inattention and/or hyperactivity-­impulsivity were present before age 12.

C. There is evidence of some level of functional impairment related to the symptoms in two or more different settings (for example, at work, at home, with friends or family) and in various activities.

It is important to document the presence of symptoms in at least two areas of life, such as daily life, school or work, or interpersonal relationships with family or friends.

D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or another psychotic disorder, and are not better explained by another mental disorder (for example, mood disorder,* anxiety disorder, dissociative disorder, or personality disorder).

*Mood disorders are more commonly known as affective disorders.

Slice of Life

“It’s never too late to seek help. I was diagnosed with ADHD at the age of 59!”