High Functioning Autism and ADHD

Howie Mandel, Michael Phelps, Solange Knowles, Ty Pennington, James Carville, Christopher Knight, Richard Branson, and thousands of other adults struggle with ADHD.

aspergers and adhd

According to one study, high functioning autism and adhd occur in up to 1/3 of children. Therefore, it follows that many autistic adults struggle with ADHD.

Attention Deficit Disorder Explained

Attention Deficit Hyperactivity Disorder presents in a pattern of behavior present in multiple settings (e.g., school, home, work), that significantly interferes in social, educational or work settings.

Attention Deficit Disorder can be characterized by either inattention primarily inattention, or by both inattention and hyperactivity/impulsivity.

Here are some examples of behaviors –

Symptoms of Hyperactivity

  • Feeling like one is driven by a motor
  • Restless
  • Cannot sit still
  • Always on the go

Symptoms of Poor Attention

  • Easily distracted
  • Difficulty organizing
  • Becoming bored easily
  • Difficulty switching from one task to another
  • Difficulty planning
  • Difficulty concentrating
  • Can’t do boring or unattractive tasks

Symptoms of Impulsivity

  • Interrupting often
  • Answering questions before a person finishes asking them
  • Blurting out inappropriate comments
  • Acting before thinking
  • Doing things you later regret
  • Having difficulty waiting

In DSM-IV, ADHD could not be diagnosed as a separate condition if a person had autism spectrum disorder. However, this is not the case for DSM-V.

However, a clinician needs be sure that ADHD symptoms do not occur only during the course of –

  • schizophrenia or another psychotic disorder
  • or that the symptoms are not better explained by another mental disorder, such as
    • depressive or bipolar disorder
    • anxiety disorder
    • dissociative disorder
    • personality disorder
    • or substance intoxication or withdrawal

Twenty years of research conclusively show that a significant number of people diagnosed with ADHD as children continue to experience the disorder as adults.

Here’s a video that better explains ADHD –

 

Diagnosis of Adult ADHD

Information from this section is adapted from the Mayo Clinic.

ADHD in adulthood has been a controversial diagnosis. Psychiatric diagnoses, in general, are hard to validate. With physical diagnoses, a doctor can perform a blood test, do an x-ray or biopsy, or even take a person’s temperature to confirm a diagnosis. However, with psychiatric diagnoses, doctors must diagnose these conditions based on the patient’s report of symptoms, their own observation of the person, and the observations of others.

Who can diagnose ADHD?

Psychiatrist

As per Wikipedia, a psychiatrist is a physician who specializes in psychiatry. A psychiatrist specializes in the diagnosis and treatment of mental disorders. Psychiatrists are medical doctors who must evaluate patients to determine whether or not their symptoms are the result of a physical illness, a combination of physical and mental, or a strictly psychiatric one. In order to do this, they may employ the psychiatric examination itself, a physical exam, brain imaging (computerized tomography or CT/CAT scan), magnetic resonance imaging (MRI), and positron emission tomography (PET) scanning), and blood laboratories. Psychiatrists prescribe medicine, and may also use psychotherapy, although the vast majority do medical management and refer to a psychologist or another specialized therapist for weekly to bi-monthly psychotherapy.

Psychologists

According to Wikipedia, A psychologist evaluates, diagnoses, treats, and studies behavior and mental processes.[1] Some psychologists, such as clinical and counseling psychologists, provide mental health care, and some psychologists, such as social ororganizational psychologists conduct research and provide consultation services.

Family Doctors

Neurologists

Only Psychiatrists and Psychologists, and licensed master’s level clinical counselors or clinical social workers are likely to provide ongoing counseling.

The healthcare professional will rule out other possible causes for the ADHD – e.g., mental health disorders (anxiety disorders, mood disorders, adjustment disorders, learning and language deficits, psychotic disorders); other health problems – thyroid disorder, lead poisoning, low blood sugar (hypoglycemia); or alcohol or drug abuse and certain medications can cause ADHD-like symptoms.

The doctor may evaluate signs and symptoms from childhood. S/he may ask for old school records and for information from teachers, parents, and anyone else who knew you when you were young. Doctor may also ask to talk to your spouse, parent, close friend, or someone else who knows you well.

See also – 5 Easy Steps to Diagnosing Adult ADHD

Here’s an Adult ADD Quiz you can take to find out whether you should seek a more formal diagnosis from a healthcare professional.

You may want to also have your spouse, a parent, or a close friend take it as if they were you (based on their observations of you), and compare the results.

The Effects of ADHD

The way we think and believe can worsen ADHD symptoms.

Behavior components are things that people do that can make ADHD symptoms worse. For example, avoiding tasks or not keeping an organizational system makes leads to disorganization and procrastination.

Here’s a cognitive behavioral model of adult ADHD from Mastering Your Adult ADHD.

high functioning autism and adhdCore neuropsychiatric impairments, starting in childhood, prevent effective coping. Whether diagnosed in childhood or not, adults have been suffering with ADHD symptoms many years. Distractibility, disorganization, difficulty following through on tasks, and impulsivity can prevent people with ADHD from learning or using effective coping skills.

Lack of effective coping can lead to underachievement and failures. Because of this, people with ADHD have sustained underachievement, or things that they might label as ‘failures.’

Underachievement and failures can lead to negative thoughts and beliefs. Growing up with failures can result in developing overly negative beliefs about oneself. Consequently, when a person approaches a task, s/he may habitually engage in negative, maladapting thinking, that adds to avoidance or distractibility.

Negative thoughts and beliefs can lead to mood problems and make avoidance worse. Thus avoidance and distractibility gets worse instead of better.

Treatment of ADHD

ADHD Meds often serve to lay the foundation upon which a house of skills is built. Without them can seem like trying to roof your house during a hurricane. -Brian R. King

Medications are the first-line treatment approach for adult ADHD, and they are the most extensively studied.

A psychiatrist will first try stimulants, tricyclic antidepressants, monamine oxidase inhibitors (antidepressants), and atypical antidepressants.

Medications can reduce many of the core symptoms of ADHD: attention problems, high activity, and impulsivity.

However, up to 20 to 50 percent of people either don’t see a reduction of their symptoms, or they cannot tolerate these medications. Even if they do respond to medication, they tend to see only a 50% reduction in their symptoms [Mastering Your Adult ADHD, pg 8}.

Cognitive Behavior Therapy

As seen from the diagram above, attention deficit disorder can lead to under achievement, unemployment or underemployment, economic problems, and relationship difficulties. Medications don’t teach specific strategies and skills to cope with ADHD.

Cognitive behavior therapy is a psychotherapeutic approach which is time-limited, goal oriented, and will help you work ways to improve your organization and planning; reduce distractibility; think differently about yourself and your ADHD; overcome procrastination,; and prevent relapse.

If you’re interested in both diagnosis and treatment for adult ADHD, call the phone number on the back of your healthcare insurance card for behavioral or mental health. Ask to be referred to either a psychiatrist or psychologist who specializes in diagnosing and treating ADHD.

Educate Yourself About ADD/ADHD

ADDitude

There are many attention deficit disorder websites out there, but I have been thoroughly impressed with ADDitude, the online add/adhd magazine. This site has attention deficit information about ADHD symptoms, medication, treatment, diagnosis, and parenting ADD children from the experts at ADDitude magazine

Books About Attention Deficit Disorder

You Mean I’m Not Lazy, Stupid or Crazy?!: The Classic Self-Help Book for Adults with Attention Deficit Disorder, by Kate Kelly

Here’s a book summary from Amazon:

With over a quarter million copies in print, You Mean I’m Not Lazy, Stupid or Crazy?! is one of the bestselling books on attention deficit disorder (ADD) ever written. There is a great deal of literature about children with ADD. But what do you do if you have ADD and aren’t a child anymore? This indispensable reference — the first of its kind written for adults with ADD by adults with ADD — focuses on the experiences of adults, offering updated information, practical how-tos and moral support to help readers deal with ADD. It also explains the diagnostic process that distinguishes ADD symptoms from normal lapses in memory, lack of concentration or impulsive behavior. Here’s what’s new:

  • The new medications and their effectiveness
  • The effects of ADD on human sexuality
  • The differences between male and female ADD — including falling estrogen levels and its impact on cognitive function
  • The power of meditation
  • How to move forward with coaching

And the book still includes advice about:

  • Achieving balance by analyzing one’s strengths and weaknesses
  • Getting along in groups, at work and in intimate and family relationships — including how to decrease discord and chaos
  • Learning the mechanics and methods for getting organized and improving memory
  • Seeking professional help, including therapy and medication

Mastering Your Adult ADHD: A Cognitive-Behavioral Treatment Program, by Steven A. Safren, Susan Sprich, Carol A. Perlman, and Michael W. Otto

This program was developed by a group of psychologists at Massachusetts General Hospital and Harvard Medical School after treating adults with ADHD in their clinic, using cognitive-behavioral therapy. The authors conducted a randomized, controlled trial, studying patients who had been treated with medications but still having significant problems. Half of the patients received no treatment beyond medications; the other half took medications and also went through the cognitive-behavioral strategies listed in the workbook. An independent assessor who did not know whether the patients had treatment or not evaluated their symptoms. According to the assessments, patients who went through the program experienced about a 50% decrease in symptoms. Those who did not had negligible changes.

If you are working with a cognitive behavior therapist, encourage her or him to purchase the therapist version of this workbook [Mastering Your Adult ADHD: A Cognitive-Behavioral Treatment Program Therapist Guide (Treatments That Work)]. Then work together through the material.

References Cited

DSM V fact sheet

Aspergers Adults Symptoms and Signs Explained

Mastering Your Adult ADHD.

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