Windber Medical Center

WIN 2014

Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.

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6 Adults with inattentive ADHD often fell through the cracks as children, says Dr. Barbara Sumbatian, who is a child psychiatrist affiliated with Holy Spirit Health System, Camp Hill, Pa. "This may be particularly true in women, whose ADHD often is overlooked until adulthood when they begin having trouble juggling multiple roles," says Dr. Sumbatian. But any type of ADHD can become a serious issue for adults, who may not be able to successfully hold down a job or maintain a relationship with a spouse. "Adults with ADHD can often have low self-esteem and low levels of job satisfaction," says Dr. Sumbatian. "They may have trouble with their ability to balance their lives between things they enjoy and things they are not as interested in but that are important." GETTING A DIAGNOSIS Even when an adult is having serious problems with organization or attention, no one should assume that ADHD is responsible, says Amber Stirlen, a clinical psychologist who is affiliated with NorthBay HealthCare Group, Fairfield, Calif. "For every five adult ADHD referrals I've been given, maybe one actually has ADHD—and has always had it, but it went undiagnosed," says Stirlen. "The others are relationship issues or other life issues. All of these things can have symptoms that overlap with ADHD, but they are not ADHD." The process of diagnosing ADHD starts with a careful clinical exam and history, and includes testing and various types of screenings. The final ADHD diagnosis should always be made by a psychologist or mental health provider, says Stirlen. But she adds that she sees a disturbing number of adults who just assume they have the disorder and abuse their children's ADHD stimulant medication to cope with it. "It's important to get a proper diagnosis," says Stirlen. "If you start taking stimulant medication and it helps you, that doesn't mean you have ADHD. We can't do a backward diagnosis." 1. Concentration problems 2. Diffculty organizing or completing tasks on time 3. Restlessness 4. Impulsivity 5. Mood swings 6. Little tolerance for frustration Behavioral modification may include implementing: • Strategies for creating a stable daily routine • Tools to aid in time management • Visual cue systems for better social interaction • Extended timeframes for projects • Techniques for splitting big projects into smaller jobs • Vocational rehab to find a suitable job • Appropriate accommodations for work or school "We even talk about things like learning mindfulness and being in the moment," says Dr. Fritschle. "There are many tools to help people take a step back and avoid becoming overwhelmed and distracted." If medication is recommended, a stimulant such as methylphenidate (Ritalin and other brands), dextroamphetamine (Dexedrine) or dextroamphetamine-amphetamine (Adderall XR) may be prescribed. Other effective drugs include atomoxetine (Strattera) and antidepressants. Dr. Fritschle also advocates maintaining a healthy lifestyle, with exercise and a well-balanced diet. However, there's no proof that any specific diet helps treat the disorder, she says. "We can't make blanket statements about diet, although there has been some evidence that taking an omega-3 fatty acid supplement and removing red dye from the diet may be helpful," she says. "However, for individual people, you can have differences in how you react to anything." The good news, says Dr. Fritschle, is that hyperactivity tends to diminish with age, along with many other symptoms of ADHD. "Not everyone will outgrow ADHD, although some do," says Dr. Fritschle. "But symptoms often improve or become more subtle in adults." • w w w. s p i r i t o f w o m e n . c o m W I N T E R 2 014 SPI RIT O F WOM EN SHUTTERSTOCK TREATMENT OPTIONS As with almost any condition, most therapists begin with the least-invasive treatment possible, depending on how much the ADHD symptoms are interfering with someone's life. "There are a couple of ways to treat ADHD, usually with a combination of behavioral modification and therapy," says Dr. Fritschle. "I like to start with behavioral modification, because even if medication is ultimately needed, that usually results in less medication being necessary." SYMPTOMS of adult ADHD 21

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