Joel P. Sussman, M.D. FAAP
Clinical Director; Palmetto Associates for Scholastic Success (P.A.S.S.)
245 Business Park Boulevard                  Columbia, SC 29203           Phone:  (803) 462-1234


Adult A.D.D.

ADHD Undiagnosed In Adults
It has only been since 1989 that ADHD in adults was recognized. Previously, ADHD was thought to be primarily a disorder of hyperactive little boys. Then, non-hyperactive children (girls more than boys) were recognized as having problems. Still, the majority of those diagnosed were diagnosed with behavior problems. Most of the behavior problems tend to settle down as children become teenagers. Because the problems were no longer obvious, it was thought that ADHD was a disorder that was outgrown as the child grew. It was not appreciated that a person could have a hyperactive brain which did not allow him to concentrate on one thing at a time. 

Adult Males With Undiagnosed ADHD - At Work
What happens to the children with ADHD when they grow up and have not been diagnosed with ADHD? Let’s first discuss the boys who have become men. Some of them are outstandingly successful. Many of them are entrepreneurs and self employed businessmen. They don’t tend to climb the corporate ladder. They are more maverick in their personalities and don’t do well doing things the way others would want them to. They are very creative, and in many businesses, creativity is not appreciated. Many of them are extremely good in the area of sales. Their natural ability to talk about a lot of topics makes them successful in interacting with people. Their problems are not being able to keep up with the details. They must learn to surround themselves with detail oriented individuals.  This allows them to do what they do best---sell their products or have visions of how their business will be more productive. If they learn how to hire the right detail people and how to delegate to these people, they do fine at work.

Adult Males with Undiagnoised ADHD - At Home
However, when they get home from work, they often have nothing left over for their family. They often fall into two general behavior patterns. They either tend to be very short tempered or aloof.  The first type are the yellers---exploding whenever anything goes a bit out of kilter. The second type retires into himself and is often unavailable to his wife and to his children. Both types are mentally exhausted from a long day at work and, although they are terrific during their work day, they are less than terrific for the ones that they love the most. 

Drowning In Disorganization

Details that are taken care of by their subordinates at work don’t get accomplished at home.  The lost keys, cell phones and wallets are a source of constant frustration. Getting out of the house in the morning often entails several trips back and forth from the house to the car and back again. The undiagnosed ADHD husband often forgets what his wife has told him to do, creating constant friction. If he does work in a business not his own, he will be inefficient and not be able to get his work done in a timely manner and not be able to stay focused at meetings. These failings will put him at risk of losing his job and financial security. 

Adult Women with Undiagnosed ADHD
What of the woman with ADHD? Men come for help because either their wives or their bosses tell them to get help---OR ELSE! Women come in for help because they almost always say they feel “…so overwhelmed…” They tend to be at the extremes - they either look like fashion models and appear to have it all together, or they are clearly a mess.  The women who look perfect often see themselves as close to coming apart. They may be very successful in their careers and their house may be immaculate, but they do all this at the price of great anxiety. They have what could be thought of as the Chicken Little Syndrome. They worry that at any time, the “…sky may fall down….” That is the reason they feel they have to make everything in their life as perfect as possible. The feelings they generate will frequently cause them to be on anti-anxiety medicines and anti-depressants. While these may be indicated, they often can be discontinued once the diagnosis is made correctly. 

Those who do not have these perfectionist defenses will look more obvious in having ADHD symptoms. They are often sloppy in their appearance, their houses are disaster areas and, if they have children with ADHD, they find keeping up with these high maintenance kids nearly impossible. Their self-esteem is extremely low and they feel that they have no self-worth. They are “laundry challenged” and, unless they have a lot of hired help, keeping up with the household chores is exceedingly difficult. As far as balancing a checkbook, forget it. As many of them have said, they need a very efficient “wife” to help them stay stable. 

ADHD Women and Other Issues
Both types of ADHD women often have sexual issues. While they are trying to get in the mood, they are thinking of shopping lists, what to make for supper and a thousand other topics unrelated to the activity they are supposed to be concentrating on. These same problems probably befuddle ADHD men as well; however, men would rarely admit to the problem.

hile medicine may help both ADHD men and women, making the diagnosis correctly is the most important step in the treatment of this disorder. At that point all of the co-morbidities must be assessed and other modes of treatment considered. Only by looking at the totality of the problems can the most effective help be found.
















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