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Adult Attention Deficit and Hyperactivity Disorder
26/01/2020
Adult Attention Deficit and Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is a chronic neuropsychiatric disorder that begins in childhood and can spread to an entire life. Heredity, genetic and brain imaging studies on their biological origins have contributed significantly to our understanding of this disorder. Although it is a well-defined psychiatric disorder, both social-cultural objections and additional psychiatric comorbidity related to ADHD diagnosis remain a poorly understood disorder. In addition, the transition of different symptoms of the disease to the fore in certain periods may confuse parents, trainers and even physicians.

Prevalence
The prevalence of ADHD in the community is reported to be approximately 8% in childhood, 6% in adolescence and 4% in adulthood. Attention deficit, hyperactivity and impulsive behaviors that already exist in childhood become noticeable at first by starting school. Children who cannot sit in the classroom, have intense problems with their friends in games and who are late in reading activities can be noticed relatively quickly and directed to get medical help. In other words, when the leading symptoms are hyperactivity, there is an earlier treatment application compared to the situations where the symptoms related to carelessness are leading. Nevertheless, the number of seeking treatment and reaching effective treatments is quite low considering the extent of the disorder.

The decrease in the incidence with the advancement of age actually indicates a decrease in symptoms of discomfort. Often the symptoms did not disappear completely. Due to the addition of the characteristics of the period, the presence of the disorder especially in adolescents leads to the ceiling of risky health behaviors and permanent damage forward. However, it can be said that the well-known excessive mobility and the consequences of impulsive behaviors tend to decrease over time. However, despite this declining trend, individuals with ADHD are unable to start a job, inefficiency and bad time management at work, not being able to finish most of them despite a large number of jobs, not being able to sit down during a meeting, not being able to cope with stress and anger attacks, the tendency to say the first thing to mind, bad driver. problems and intense problems related to the management of marriage and responsibilities often arise or go away. When dealing with this disorder in adults, unlike childhood, the complexity of adult life should be considered and the change in symptoms should be considered with age.

Girls at risk ..!
In various studies, the male: female ratio was reported between 2: 1 and 6: 1, while it was equal in adults (1: 1). There may be several explanations for this change in gender ratios that occur with age. One of them is that in adulthood, especially the attention deficit symptoms cause the problem and the gender ratio is equalized by the predominance of the attention deficit symptoms in women. Another possibility is that the relatives of the children refer to the complaints of the adults themselves and express their complaints. Carelessness mostly disturbs the individual, and other devastating symptoms mostly disturb the environment and complain more about boys. Contrary to men who manifest their symptoms, girls often tend to internalize negative feedback, apologize, try to adapt, take blame and not fight. By working harder to meet expectations and coping with their disability, they can be successful students until high school. However, the fact that the disorder is quieter and the inability to perform the necessary interventions in a problem area that can be intervened causes serious damage to women's life, especially their academic development.


Concomitant diagnoses, other accompanying mental disorders

Psychiatric comorbidities frequently pointed out by studies conducted with children and adults include: Oppositional defiant disorder, Conduct disorder, Anxiety disorders (Panic disorder, Obsessive-Compulsive disorder, Teak disorder), Mood disorders (Depression, Dysthymia, Bipolar), Learning disorders and Alcohol mental illnesses called substance use disorders. Accompanying other mental disorders can sometimes lead to concealing ADHD symptoms, remaining stuck, or causing disruptions in the other while treating a disorder with medications.
 
Treatment
Unlike children, psychiatric comorbidity and the complexity of adult life, which is almost a rule in adulthood, require more comprehensive treatment approaches in adult ADHD treatment. Drug treatments for ADHD, the neurobiological basis, form the basis of a holistic treatment approach. Medicines should be planned by considering medical and psychological comorbidities in adults. Then it is time to add problem-oriented, structured cognitive behavioral psychotherapies to treatment.

In adulthood, ADHD strongly influences a person's behavior, emotions, relationships, and how he evaluates himself. The primary determinant of self-esteem and shame in adulthood is how one evaluates himself in childhood and adolescence. Adult ADHD cases have basic neuropsychiatric disorders that have started since childhood and hampered effective coping skills. Specific symptoms such as distraction, inability to organize, difficulty in maintaining assigned tasks, and impulsivity can prevent individuals with ADHD from learning or using effective coping skills. Due to the lack of effective coping skills, most people with this disorder have had recurring failures or have had experiences that they might call defeat. These failure stories can lead one to develop negative thoughts about themselves. They can also develop dysfunctional thoughts about the tasks they undertake. These resulting negative thoughts and beliefs may increase existing avoidance behaviors or vulnerability. As a result of these thoughts and beliefs, when individuals face a task or problem, their attention may shift more and associated behavioral symptoms may worsen. Those who have this disorder in treatment often provide significant benefits from structured cognitive behavioral psychotherapies focused on organizational and planning difficulties, distraction, losing-avoidance behavior, communication difficulties, and anxiety-depression-anger symptoms.

Result
The diagnosis of ADHD should be considered in all adults with lifelong carelessness, impulsivity, or hyperactivity. Attention Deficit Hyperactivity Disorder is one of the important problems of the society and health services in terms of negative effects reflected on interpersonal relations, school and business world. ADHD affects not only patients, but also their environment, families, and parents, whether in childhood or adulthood. Smoking and substance abuse, legal problems, poor peer relationships, loss of self-confidence, low school and work success, and psychiatric comorbidities are observed in adolescents and young adults who are under threat in terms of risky health behaviors. Accompanying other mental disorders, which is almost a rule in the adulthood, in other words, the presence of psychiatric comorbidity and the complexity of adult life, require more comprehensive treatment approaches in the treatment of adult ADHD. It is very important to plan the treatment with drugs considering the comorbidity and to add cognitive behavioral psychotherapies that are structured in a problem-oriented manner. People who have had difficulties with ADHD since childhood; they both exhibit similar symptoms during adulthood, and sometimes carry reflections of the damage they have received during childhood, even if the symptoms subsided. It is important that this discomfort, which persists when not treated, is properly diagnosed and treated properly. In order to prevent preventable losses, when the discomfort is noticed, an effective treatment should be started quickly and carefully using all treatment options. To achieve this, those with ADHD symptoms should first apply to a psychiatrist and individuals with ADHD complaints should be directed to a psychiatrist. 


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