If you drive by Lisa Greenberg’s house, you might see her car doors swung wide open, but the car empty and no one in sight. Her house keys may still dangle in the front door lock. The amount of clutter and disorganization inside the house might strike you as out of control. And when Greenberg is overwhelmed, the delivery truck makes frequent stops at her door because she tends to shop compulsively to cope with stress.
“I really want to be organized, but I don’t know how to do it,” says Greenberg, a married mother of two. “I’m always losing things, leaving things out, leaving things undone. It’s a frustration for everyone.”
Greenberg’s forgetfulness, distractedness, impulsive behavior and disorganization are hallmarks of attention deficit hyperactivity disorder (ADHD), a condition most commonly associated with childhood but whose effects continue into adulthood. Like many adults with the disorder, Greenberg still experiences extreme distractibility that affects her everyday life.
Because you can’t “get” ADHD—it is a genetic neurobiochemical disorder—in order to be diagnosed as an adult, you must have exhibited symptoms as a child. But, as Ari Tuckman, Psy.D., author of More Attention, Less Deficit, points out: “If you’re older than about 30 to 35, it’s very unlikely that you would have been diagnosed as a kid simply because we didn’t know that much about it then.”
Instead, he says, “other explanations were used. ‘He just needs to try harder,’ ‘She is just not that motivated,’ and, ‘He is just a bad kid.’ The symptoms were there, they just weren’t labeled with ADHD."
Greenberg, 46, says she fits that bill. “I was the student who lost everything but crammed at the last minute and then did very well,” she says. “I was the one who missed the bus to school, the kid with the very messy room, the one who always lost her notebook.”
Her ability to hyperfocus on things that interested her helped her to attain an Ivy League degree, though. Once Greenberg entered the career world, bosses were often completely frustrated by her apparent disorganization and perpetually messy desk. “But I was able to pull the rabbit out of the hat,” Greenberg says. “That’s a very (ADHD) feature. We can do some pretty amazing things. But we don’t think traditionally.”
Many adults only learn they have ADHD when their children start exhibiting symptoms. This is not surprising. ADHD is caused by signaling problems in the brain and has a strong genetic component.
“If you find a kid with ADHD, you’ve got a 50/50 chance that one of those parents has ADHD,” says Dr. Tuckman. “So, I call this a two-for-one diagnosis. The kid gets diagnosed, and one of the parents says, ‘Huh. I was just like that.’”
ADHD has actually been around for awhile, says Patricia Quinn, M.D., (www.ADDvance.com) director of the National Center for Girls and Women with ADHD. It was first identified in the medical literature in 1902 and appeared in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders II in 1968. At the time, it was described as “hyperkinetic reaction of childhood” and clinicians believed kids outgrew its symptoms. But that’s not so, says Dr. Quinn.
An estimated 4 percent of adults have ADHD, according to a 2006 study in the American Journal of Psychiatry. The disorder is found worldwide, says Dr. Quinn. “The numbers or ratios are about the same everywhere, so it’s not just a uniquely American condition,” she says.
While the exact cause is unknown, environmental factors may combine with genetic ones to increase the odds of developing ADHD. For example, a 2010 study in the journal Pediatrics showed that children with the greatest concentration of pesticides in their urine were more likely to be diagnosed with ADHD. Still, there isn’t enough scientific data yet to point to an exact cause.
The symptoms of ADHD show up differently depending on your age. In childhood, the condition is characterized by hyperactivity, poor concentration and the inability to focus. During the teen years, when the prefrontal cortex (or “CEO” part of the brain) starts developing, organizational issues are likely to crop up. This can later lead to job performance problems, such as missing deadlines, “zoning out” in staff meetings and having a hard time making decisions.
“For example, you wouldn’t expect an 8-year-old to be organized, but you would definitely expect a 28-year-old to be able to get to work on time,” Dr. Quinn says. “We see these executive functioning skills being deficient in adults with ADHD.”
Undiagnosed ADHD Can Put Strain on a Marriage
Aside from the two-for-one parent-child diagnosis, Dr. Tuckman says marriage counseling often leads to an ADHD diagnosis. The non-ADHD spouse usually seeks help because she feels like she’s shouldering the brunt of the responsibility of running the household. Or she might simply be fed up with feeling as if her spouse never listens when she talks and is constantly cutting her off mid-sentence—common ADHD traits.
“So you wind up with an imbalance and the [non-ADHD] partner becomes increasingly frustrated, and probably then increasingly critical,” says Dr. Tuckman. “And a partner with ADHD, especially if it’s undiagnosed and untreated, feels increasingly bad about dropping the ball, but also increasingly angry about always being on the receiving end of this criticism.”
Women react to their ADHD symptoms differently than men, says Dr. Quinn. Men are more likely to lash out and blame outside factors for their failings: “The bus was late,” rather than “I missed the bus.” But women internalize and are more likely to blame themselves, which leads to anxiety and depression.
“I always say that a woman with ADHD is the true ‘Desperate Housewife',” says Dr. Quinn. “They are overwhelmed by day-to-day activities that everybody else seems to be able to do: Getting the laundry done, getting all the kids out in the morning. They have to stay up very late at night to get things done. They may be very messy. They won’t let anyone in their house. And if you don’t invite anyone over, then no one knows the struggle you’re having.”
Adult ADHD Can Be Treated
The same stimulant medications used to help children focus can help adults with ADHD, too, says Dr. Quinn. They work by activating the part of the brain that tells us to stop and think before we do something. “The medication helps you pay attention, but it doesn’t teach you a new behavior,” she says.
For that, she tells her ADHD patients to hire a professional organizer and life coach who can help you set goals and give you accountability in meeting them. Regular exercise and getting outside can also help improve focus and reduce hyperactivity. Dr. Quinn also suggests making sure you’re well-rested, because sleep deprivation can make it harder to focus.
ADHD is never “cured,” though about 40 percent of patients’ symptoms are either not severe enough to cause problems or they’ve developed effective coping mechanisms, says Dr. Quinn. These coping skills are sometimes learned during behavioral therapy, but often people simply figure out ways around their disorder—hiring a secretary to keep them on schedule, or as Greenberg does, pasting notes on the wall because a visual cue helps them remember things. But if your symptoms meet the ADHD diagnostic criteria—persistent (existing since childhood), pervasive (affecting several areas of your life) and impairing your relationships or career, then treatment could really help you.
A version of this story originally appeared on iVillage.