Symptoms
The main symptom, as the name ADS suggests, is the attention deficit disorder that has existed since childhood. This refers to a lack of concentration in which those affected lack perseverance in thinking tasks. They are also easily distracted, appear disorganized and inattentive.
They often perform less well at school or at work and are less successful in many areas of their lives because they have difficulties in planning and structured action. Their restraint and introversion lead to problems in their social environment. They find it more difficult to make friends because their attention deficit disorder also hinders them in listening to and learning social norms.
In contrast to the hyperactive subtypes, ADHD patients can suffer from hypoactivity, i.e. underactivity. Typical here are a slow working pace and excessive demands in everyday professional and social life. This also leads to rapid exhaustion.
Patients seem introverted, quiet and may be socially isolated. However, these symptoms are much less noticeable than in the hyperactive ADHD type. Many therefore only learn about their disease as adults or are not diagnosed at all.
The only thing they have in common with other ADHD types is inattention. Although this is usually less conspicuous than in typical ADHD, it can still massively affect the patient. Frequent examples are lack of concentration and distraction, carelessness and forgetfulness, poor organisation, problems completing tasks and many more.
ADHD patients are less able to follow instructions, quickly lose interest and shy away from tasks that require a high level of concentration. Adults are usually unaware of the disease, show compensation strategies and the typical symptoms are easy to overlook compared to children. Many ADD patients also have psychological problems.
These can be caused by the ADHD itself, such as mood swings or irritability, but also by the experiences that the adult has gained from his or her illness since childhood. These include fear of failure, depression, anxiety disorders and the like. ADS is therefore a risk factor for many other psychiatric diseases in adults and should be treated.
Treatment/Therapy
ADS is treated by a combination of different treatment approaches. Doctors, psychologists and many other professional groups are involved, but the patient must also play an active role. ADS cannot be cured.
In most cases, however, the therapy enables a normal life. Depending on the severity of the symptoms and the individual factors of the person affected, a variety of therapy options are available, from behavioural therapy to medication. Each patient responds differently, so an individual therapy plan must be drawn up for each patient to help them cope.
Many patients already benefit from simple approaches such as sufficient sleep, exercise, regular daily routines, etc. which make it easier for them to organise their everyday life. Techniques for organising thoughts such as meditation can also help.
Psychologists and psychiatrists also offer psychotherapy and behavioural training to help patients give up compulsive compensation strategies and learn how to deal with their illness. The aim of these therapies is to promote the patient’s potential and to develop social skills. This includes reducing concentration problems and increasing the patient’s self-esteem and self-management, thus making it easier for them to control and organize their everyday life.
This enables those affected to compensate for their ADHD-related weaknesses and avoid associated problems. For more pronounced forms of ADHD, pharmacotherapy, i.e. medication, may be considered. In this case, so-called stimulants, especially methylphenidate (trade name Ritalin,see below), are used.
Since side effects can occur with any medication, consistent monitoring of the therapy and, if necessary, dose adjustments by an experienced doctor are necessary. The greatest therapeutic success is achieved by a combination of the above mentioned therapies. If the disease has a high genetic factor, i.e. if many family members suffer from similar symptoms, the same drugs are often effective for them.
Compared to children, adults with ADHD can participate in the treatment much better and the therapy is successful in most cases. In many cases, conservative psychotherapy is not sufficient and combination with a drug that increases signal transmission in the brain via messenger substances is indicated. This is supposed to increase cognitive performance and thus the ability to concentrate.
In most patients, a significant improvement in symptoms is achieved as a result. They are also well tolerated and can be used in the long term. However, these drugs are relatives of the so-called amphetamines, which have a certain risk of addiction.
In ADHD patients without hyperactivity, the same drugs are used as in typical ADHD, but the effect is somewhat weaker. A lower dosage is usually sufficient for them. The drug of choice is the so-called methylphenidate, which is marketed under the name Ritalin ®or Medikinet.
It blocks the reuptake of the messenger substances and increases the activation of the nerve cells in the brain. Side effects include stomach problems and headaches. Other preparations such as Attentin and Elvanse also come from the amphetamine family and have similar mechanisms of action and tolerability.