Monday, November 2, 2009

Is it Adult ADHD or Just Impulsivity?

The diagnosis of AD(H)D in children includes short attention span, impulsivity, and often, hyperactivity. In adults, the hyperactivity often takes the form of restlessness or fidgeting. AD(H)D adults also have issues of time management, remembering important things, organizing their environment and procrastinating until the eleventh hour. I know because I have AD(H)D and have had it lifelong.

In my coaching and clinical experience I have come across several individuals who think they have AD(H)D because they are often impulsive. For example, they may meet someone on the Web without thinking ahead of the dangers, or interrupt an ongoing conversation, or engage in impulsive buying. However they do not exhibit the spectrum of behaviors associated with AD(H)D. They are organized non-procrastinators, good at time management, not restless or fidgety or lacking in focused attention. In other words, they do not fit in to the category of ADD or AD(H)D.

Why does this distinction matter? Most importantly it matters for treatment considerations. Stimulant therapy is usually recommended for AD(H)D. Will it help people who are just impulsive? That’s a tough call, because it may help, since it is well known that a proportion of non-ADDers can benefit from stimulant medication. So if it helps impulsive adults, it does not mean they are ADD or AD(H)D, since they have not met the other criteria for the syndrome.

Cognitive- behavior modification is very useful for both impulsive people and ADDers. In general, it helps people with a variety of disorders, so it may be a better approach for impulsive people than stimulant medication.

Are you sure you have ADD or AD(H)D, or are you just impulsive?

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