Is ADHD different in children and adults?

Attention deficit hyperactivity disorder (ADHD) is a condition that commonly starts in childhood.

According to CHADD, the medical community once thought that people outgrew the symptoms of ADHD. Now it is understood that adults also live with ADHD.

Although some researchers think childhood and adult ADHD are different conditions, the diagnostic criteria for adult ADHD mandate that symptoms must have started before age 12. Many treatment options exist for people with ADHD, including medication and cognitive behavioral therapy (CBT).

Similarities and differences

Mental health professionals think of ADHD as the same condition, whether it presents in adults or children. But some research, including a 2018 study, suggests adult ADHD and child or adolescent ADHD are different things.

According to 2017 research, ADHD can appear in adulthood. This is contrary to the current diagnostic criteria for ADHD in adults, which requires that symptoms must have been evident in childhood to receive a diagnosis after age 17.

The Centers for Disease Control and Prevention (CDC) says symptoms can look different in children and adults. Hyperactivity in children may be restlessness in adults. The pressures of adult life can also aggravate symptoms in adults. 

It’s now more widely recognized that ADHD can affect a person for their entire life. But the challenges change as a person grows up. An adult with ADHD may have trouble with the following things:

• work
• managing finances
• staying organized and motivated

Diagnosis in adulthood vs. childhood

Diagnosis of ADHD follows the criteria set out in the Diagnostic and Statistical Manual, 5th edition, text revision (DSM-5-TR) published by the American Psychiatric Association. 

Getting an ADHD diagnosis is similar for adults and children. At any age, a person must show a pattern of inattention or hyperactivity-impulsivity. 

The DSM-5-TR lists specific symptoms, of which a child must have six of either the inattention or hyperactivity-impulsivity types. An adult only needs to have five of these symptoms. 

In addition to showing symptoms, both children and adults must meet the following criteria:

• many symptoms were present before the age of 12
• many symptoms are present in two or more settings, such as at work or with friends
• symptoms interfere with a person’s ability to function
• symptoms are not explained by another medical condition

Depending on the symptoms, a healthcare professional may diagnose ADHD as:

• combined presentation (inattention and hyperactivity-impulsivity)
• predominantly inattentive presentation
• predominantly hyperactivity-impulsivity presentation

Treatments in childhood and adulthood

Treatment for adult ADHD is similar to strategies for treating childhood ADHD and may include a combination of medication and behavioral therapy. Adults may also want to get mental health support from a counselor. 

A treatment plan is carefully tailored to each person so they can manage their ADHD symptoms. In the case of children, parental and teacher involvement may be essential.

Medication

Medication for ADHD aims to improve attention span and focus. It can also help children and adults to manage frustration. 

Common medications for ADHD include stimulants, nonstimulants, and antidepressants.

Stimulants are often a first-choice medication for ADHD. They work by helping to change behavior and attention. Common stimulant medications include:

• methylphenidate (Ritalin, Concerta)
• lisdexamfetamine (Vyvanse)
• amphetamine-dextroamphetamine (Adderall)

Nonstimulants also help to increase attention span and decrease impulsivity, but they may take longer to work than stimulant medications. Common nonstimulants include:

• atomoxetine (Strattera)
• guanfacine (Intuniv)
• clonidine hydrochloride (Kapvay)

Antidepressants may be prescribed for various reasons, such as if a person has a combined diagnosis of ADHD and depression, but they are not a first-line treatment for ADHD. Examples of antidepressants include:

• bupropion (Wellbutrin)
• venlafaxine (Effexor)

It may take some time and trial and error to find the right medication to help a child or adult with ADHD.

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Behavior management

Behavior management helps children and adults to strengthen relationships. It focuses on reinforcing positive behaviors and changing behaviors that cause disruption.

For children and adolescents, some interventions include:

• parent training
• classroom behavioral interventions
• behavior-focused peer interventions
• organizational skills training
• guidance on homework organization and completion
• working through feelings of frustration
• structure, routine, and clear expectations for behavior

Adults can also benefit from some behavior management strategies, especially focusing on organizational skills. Adults may want to try these alone, or they can use the help of a professional like a therapist.

Cognitive behavioral therapy

CBT is a type of talk therapy. It focuses on practical ways to change thought and behavior patterns that influence ideal functioning. 

There are CBT programs specifically designed for adults with ADHD. They can focus on several areas of challenge, such as:

• executive functioning for time management, organization, and planning
• emotional self-regulation
• stress management
• impulse control

Many people with ADHD also have diagnoses of mental health conditions such as anxiety and depression. CBT can be an effective treatment strategy for these conditions, even if it is not CBT specifically designed for ADHD.

Summary

Adult and childhood ADHD are currently understood to be the same, but adults may manifest symptoms differently.

Adults may also need different treatment strategies to help them cope with the stress of adult life. Medication and specific talk therapy interventions like CBT can be tailored to a person’s needs.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.