Attention-deficit/hyperactivity disorder (ADHD) is a common mental disorder that typically affects children. Its most common symptoms include inattention, hyperactivity, and impulsivity, which can impact those diagnosed with it emotionally, socially, and academically. In the US, approximately one in nine children between the ages of 3 and 17 are diagnosed with ADHD.
In the 2000s, adult ADHD was recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Before that, ADHD was widely believed to be a childhood condition that rarely transcended adulthood. Two decades after its inclusion in the DSM, adult ADHD has reached staggering numbers. In 2023, US adults diagnosed with ADHD reached 15.5 million — and more than half of this number were first diagnosed in adulthood.
Adult ADHD’s prevalence necessitates the need for healthcare professionals to better understand what it is and how it presents to help patients who may need further medical assessment and testing, as well as provide better patient care. This article tackles how nurses can recognize adult ADHD symptoms in patients and how it differs from childhood ADHD.
How Adult ADHD Presents Differently Than Childhood ADHD
ADHD looks different in adults than in children. In this section, we discuss the most common differences between childhood ADHD and adult ADHD.
ADHD Presentation in Adults vs Children: What Nursing Professionals Must Know
Childhood ADHD symptoms include:
- Excessive talking, humming, and fidgeting
- Difficulty with social interactions. Some children with ADHD exhibit specific play behaviors such as being bossy, intrusive, annoying, easily frustrated, and inattentive
- Difficulty following and remembering multi-step instructions
- Difficulty with self-control behaviors, such as interrupting peers or teachers in class
- Distracted and forgetful
- Excessive daydreaming or zoning out
- Difficulty with time perception
Adult ADHD symptoms include:
- Disorganization
- Procrastination
- Difficulty with prioritizing and decision-making
- Difficulty focusing
- Physical and mental restlessness
- Difficulty deferring gratification
- Compulsive/impulsive buying
- Struggling with attention to detail
- Having mood swings and fluctuating between inattentiveness and being hyper-focused
- Difficulty multitasking or transitioning from one task to another
Key Adult ADHD Symptoms Nurses Should Look For
ADHD is often difficult to diagnose in adults due to its symptoms appearing in other potential mental and physical illnesses that adults may have. Nurses who directly communicate with patients and see ADHD signs and symptoms can help them get the appropriate medical evaluation and assessment they need.
Here are some adult ADHD symptoms nurses should look for when interacting with patients:
- They seem overwhelmed when they’re asked to follow multiple or complex instructions, such as instructing them how and when to take medication. For example, telling a patient with ADHD to “take this antibiotic for seven days, three times per day, after meals. Finish the entire prescription regardless of whether you start feeling better,” may be difficult for them to follow because it has multiple steps and requires specific sequencing.
- They often have rescheduled or missed medical appointments.
- They’re inattentive during medical visits and appear to zone out during long or complex explanations. They ask you to repeat questions or instructions multiple times.
- They’re easily distracted by noise, another patient or healthcare professional in the room, or even their own thoughts.
- They tend to forget previous diagnoses and the names of the medications they take. They also forget to mention specific and sometimes important symptoms or events relevant to their condition.
- They interrupt you when you’re speaking or change the topic of conversation often.
- They show signs of restlessness such as fidgeting, squirming in their seat, playing with their clothes or phone, or getting up to pace around the room.
When you observe these behaviors in patients, be respectful and non-judgmental. If you encounter patients who are having trouble following long or complex instructions, break them down into simple sentences and write them down to ensure that patients will be able to follow them without difficulty. Document your objective observations and your patient’s concerns without labeling them, and notify the patient’s primary care physician or mental health clinician so they can make an evidence-based assessment of whether further evaluation is appropriate.
