The aging process is often riddled with complaints of reduced focus and concentration. How can this be such a concern in the life of so many individuals? As an adult psychiatrist, I am given brain problems to solve. Sometimes it seems that the brain just gets overloaded with the demands of modern day life. Today there is little down time to have your brain in idle. However, being greatly distracted by the multiple requirements of 21st century life does not necessarily indicate that one has Adult Attention Deficit Disorder(ADD). The following is a commentary on the exponential growth of the ADD diagnosis.
First, Attention Deficit Disorder is a valid and recognizable problem in some adults. Most individuals with ADD have mild symptoms and do not need treatment. Mild symptoms are defined as distraction, inattention, and hyperactivity problems that are noticeable but do not impede daily life functioning. Adults are smart. They find external memory systems or external brains that work for them. Planners, cell phones and live calls, and post-it notes are survival tools for many. Do they have an illness that requires treatment? Probably not. Most adults easily compensate for their distraction problems by using their executive brain functioning. This ability of adults to compensate often requires clinicians to be highly skilled in order to diagnose an underlying ADD condition. The ADD may be the culprit behind their depression and anxiety problems.
When the distraction problem is at the next level of severity, the diagnosis is simplified. Here the individual’s attention span is obviously limited during conversation. Frequent distraction by environmental cues and an inability to sit still for any length of time are also reported.
At this level of functioning, attention challenges impact upon the person’s daily world. Reports of hours spent finding misplaced items, lost ATM cards, bills going unpaid on time, tons of paper piles, and missed or late appointments all cause ongoing out of control problems.
Hearing such complaints, I have to assess whether the problem is acute or chronic. The individual history will determine the possibility of current stressful situations explaining the distraction. Acute life issues with family, money, and health can distract one from being totally focused. Yet some individuals have a long standing history of lack of attention. These adults have found techniques such as post-its and written lists for maintaining focus. It is hard to maintain attention if you have problems on your mind. Focus and concentration problems that develop suddenly and without a reason need to be checked out medically. Depression, diabetes, thyroid issues, and medication effects are conditions that can impact concentration.
Severe distraction and concentration problems are readily recognizable. Struggling throughout the day, missing project deadlines, getting speeding tickets for driving in zone, and spacing out most of the time make life challenging and overwhelming. The continued pain of living out of control often fuels a phone call to a health professional. Yet making the ADD diagnosis for an adult is often tricky. Why? People with ADD can hyper focus on things that are of interest and excel at them. The common myth is that an ADD individual cannot excel in life. Most forget that adults adapt to their situations. If you are disorganized, you may be unconsciously attracted to a spouse, receptionist, or business partner who is able to take care of the boring and uninteresting tasks. The ADD person is often the creative big picture person; the problem is in completing the boring details.
In summary, the Attention Deficit Disorder diagnosis in adults is often missed. The condition can be masked by underlying problems with mood such as anxiety and depression. Current treatment options depend upon the severity of illness. Most often, patients respond by just obtaining a correct diagnosis which allows them to limit daily tasks and responsibilities.
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