Adult attention deficit and hyperactive disorder (ADHD)

In a city competitive city like Hong Kong, people became more and more concern about their intellectual ability and qualifications. A psychiatric condition, called attention deficit and hyperactive disorder (ADHD), had been famed for affecting the learning abilities of the children. Therefore, it attracted the eyeballs of the parents for the past decade.
As a result, we gain more insight on this illness. Many years ago, it was thought to be a condition that only affect children, that means the condition would remit spontaneously when the patient turned into adulthood. Indeed, we seldom see any adult who jumped up and down like a monkey. Does it mean all of those attention deficit and hyperactive disorder (ADHD) children recovered? The answer is no. Although the hyperactivity gradually lessens with time, the problem of attention deficit does not cease completely when the attention deficit and hyperactive disorder (ADHD) child turns to an adult.

One of my patient told me his story. It was the time when people had no idea what attention deficit and hyperactive disorder (ADHD) was. He was noted to be a “naughty” child since young. He never sat still or concentrated at lessons. As a result, he was not a favored student of the teachers. He also disliked by his classmate for he was disturbing all the time. His school results were no good either. The headmaster of his school suggested him transfer to another school for better “adjustment”.

His parents hoped to give him a second chance and thus sent him abroad to high school in the United States. Despite all the effort he paid, his school result had not much improvement. Whatever noise happened during the lessons, he could not help looking out. He frequently committed careless mistakes and had difficulties in wrapping up the final details of the projects. It was also socially embarrassing that he kept fidgeting or squirming with his hands during gatherings and talking too much like a chatterbox. Finally, many of his classmates got admissions to their ideal universities, it seemed that only him returned to Hong Kong in disappointment.

In the end, he completed some distance learning courses and started working. He hoped things would work out finally. However, he still struggled quite a lot. He could not follow all the tedious instructions given by his supervisors and his mind drifted away halfway through their conversation. His desk was chaotic and his timetable was so packed that he found it difficult to finish all the tasks on time. His colleagues commented him to be absent-minded and disorganized. While others spending 30 minutes to finish a task, he needed almost double time to finish. Therefore, his boss didn’t give a good evaluation report on his performance.

He was not popular among his colleagues either, as he had made their projects delayed for many times before. He had a bad habit for delaying the start of anything that he need to think in detail since young. This habit was quite annoying to his work partners as he kept every one waiting all the time. It was also hard to discuss matters with him as he always interrupting other’s conversation and seemed could not follow the line of thought of others. As a result, people found it difficult to cooperate with him.

Having worked under high pressure for many years, he gradually started to have anxiety symptoms. He complained of restlessness and apprehension from time to time. On and off did he suffered from shortness of breath and palpitation. The symptoms persisted despite he was treated by his family doctor repeatedly. His sleep was superficial and had many dreams. His mood was on low side and he started to see things more negatively. His concentration and working abilities further declined. His depressed mood cast its effect to other aspects of his life that he no longer enjoyed his hobbies or social gatherings as before. He felt he was a failure and could not see his future.

His family suspected him to be suffering from depression and thus suggested him see a psychiatrist for treatment. Eventually, he came to me for an assessment.

We had a long discussion about all his problems and struggles in his earlier life. He realized that his problems did not start in recent few years, but rather budded when he was young. He was then diagnosed to be suffering from depression with underlying long standing, untreated attention deficit hyperactivity disorder(ADHD).

It is quite common for patients who suffer from attention deficit hyperactivity disorder (ADHD) remained undiagnosed throughout their childhood and into adulthood, due to lack of knowledge about this condition several decades ago. These patients might eventually develop comorbidities such as anxiety or depression, due to the hindrance caused by the attention deficit and hyperactive disorder (ADHD) in their earlier lives. In order to treat these patients successfully, the suspicion of attention deficit and hyperactive disorder (ADHD) should be high on the list. Otherwise, these patients will be hard to cure if the underlying attention deficit and hyperactive disorder (ADHD) is left untreated.

*Adopted from Employers’ Federation has initiated a Quarterly Journal (Autumn Issue 2017)