Gooseberry ognevka (photo): signs of infection and struggle

A Visual Guide to ADHD in Adults

ADHD Affects Adults, Too

Attention deficit hyperactivity disorder is not limited to children — 30% to 70% of kids with ADHD continue having symptoms when they grow up. In addition, people who were never diagnosed as kids may develop more obvious symptoms in adulthood, causing trouble on the job or in relationships. Many adults don’t realize they have ADHD, leaving them mystified about why their goals seem to slip out of reach.

Signs of Adult ADHD: Running Late

ADHD in adults follows a slightly different pattern than in children. Adults may be chronically late for work or important events. Adults may realize that their tardiness is undermining their goals, but they just can’t seem to be on time.

Signs of Adult ADHD: Risky Driving

One of the hallmarks of ADHD is difficulty keeping your mind on the task at hand. That spells trouble for teens and adults when they’re behind the wheel of a vehicle. Studies show that people with ADHD are more likely to speed, have accidents, and lose their drivers’ licenses.

Signs of Adult ADHD: Distraction

Adults with ADHD may have trouble prioritizing, starting, and finishing tasks. They tend to be disorganized, restless, and easily distracted. Some people with ADHD have trouble concentrating while reading. The inability to stay focused and follow through on tasks can derail careers, ambitions, and relationships.

Signs of Adult ADHD: Outbursts

Adults with ADHD may have problems with self-control. This can lead to:

  • Difficulty controlling anger
  • Impulsive behaviors
  • Blurting out rude or insulting thoughts

Signs of Adult ADHD: Hyperfocus

Some adults with ADHD can focus intently on things they enjoy or find interesting — the ability to hyperfocus. But they struggle to pay attention to tasks that bore them. The trouble is that many tasks necessary for success in everyday life are dull, from making a grocery list to filing documents at work. People with ADHD tend to put off boring tasks in favor of more enjoyable activities.

Multitasking or ADHD?

It may seem like everyone has ADHD these days, as we respond to text messages, email, calls, and fast-paced work environments. While all of this can be distracting, most people manage to focus on important responsibilities. In people with ADHD, distractions interfere with the completion of vital tasks at home and at work.

ADHD or Something Else?

If you are often restless and have trouble concentrating, don’t jump to the conclusion that you have ADHD. These symptoms are also common in other conditions. Poor concentration is a classic sign of depression. Restlessness or anxiety could indicate an overactive thyroid or anxiety disorder. Your health care provider will investigate whether these conditions could be causing your symptoms instead of — or in addition to — ADHD.

What Causes ADHD?

In people with ADHD, brain chemicals called neurotransmitters are less active in areas of the brain that control attention. Researchers don’t know exactly what causes this chemical imbalance, but they think genes may play a role, because ADHD often runs in families. Studies have also linked ADHD to prenatal exposure to cigarettes and alcohol.

An Evolutionary Advantage?

One genetic variation that causes ADHD-like traits is more common in the world’s nomadic peoples. Researchers think that traits such as impulsive behavior, novelty-seeking, and unpredictability might help nomads track down food and other resources. So the same qualities that make it challenging to excel at a desk job may have been an advantage to nomadic ancestors.

Diagnosing ADHD in Adults

Many adults don’t learn that they have ADHD until they get help for another problem, such as anxiety or depression. Discussing poor habits, troubles at work, or marital conflicts often reveals that ADHD is at fault. To confirm the diagnosis, the disorder must have been present during childhood, even if it was never diagnosed. Old report cards or talking with relatives can document childhood problems, such as poor focus and hyperactivity.

Testing for ADHD

During an evaluation for ADHD, some mental health professionals use neuropsychological tests. These can include timed, computer-based tests that measure attention and problem-solving skills. Neuropsychological testing is not needed to make a diagnosis, but it can shed light on how ADHD affects a person’s daily life. It can also uncover coexisting conditions, such as learning disabilities.

Complications of Adult ADHD

Coping with the symptoms of adult ADHD can be frustrating in itself. At the same time, many adults with ADHD struggle with depression, anxiety, or obsessive compulsive disorder. They’re also more likely to smoke or abuse drugs. People with ADHD can limit these problems by seeking proper treatment.

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Medications for ADHD

The most common medicines for ADHD are stimulants. It may seem ironic that people who are restless or hyperactive get help from stimulants. These drugs may sharpen concentration and curb distractibility by fine-tuning brain circuits that affect attention. If stimulants don’t help enough, your doctor may prescribe an antidepressant to stabilize mood or a В selective norepinephrine reuptake inhibitor, such as atomoxetine, which can help control impulsive behaviors.

How Effective Are ADHD Drugs?

There have been far fewer studies of ADHD drugs in adults than in children, but the research to date is promising. Studies have shown adults taking stimulants have fewer ADHD symptoms — and some people may feel they can concentrate better within about 30 minutes.

Counseling for ADHD

Most adults with ADHD improve when they start medication, but they may continue to struggle with poor habits and low self-esteem. Counseling for ADHD focuses on getting organized, setting helpful routines, repairing relationships, and improving social skills. There is evidence that cognitive-behavioral therapy is particularly helpful in managing problems of daily life that are associated with ADHD.

Adult ADHD on the Job

Holding down a job can be tough for people with ADHD. They often have trouble breaking down tasks and following directions, staying organized, and making deadlines. They’re also prone to tardiness and careless mistakes. In one national survey, only half of adults with ADHD were employed full time, compared to 72% of adults without the disorder. People with ADHD also tend to earn less than their peers.

Careers for Adults with ADHD

There’s not much research yet into the careers where people with ADHD are likely to thrive. But ADHD expert Russell A. Barkely, MD, says his patients have excelled in sales, acting, the military, photography, athletic coaching, and many trade professions. A person with ADHD can pursue almost any career that interests them.

Job Coaching for ADHD

People with ADHD may be able to boost their job performance with coaching or mentoring. The mentor will help with organization skills, such as taking notes, keeping a daily planner and prioritizing a to-do list. A quiet workspace with few distractions may help. ADHD is a disability under the Americans with Disabilities Act. This means employers must make adjustments to support a worker’s needs.

Adult ADHD and Marriage

ADHD can sabotage marriage and other relationships. The condition makes it difficult to remember social commitments, birthdays, or anniversaries, finish household chores, and pay bills on time. Adults with ADHD may lose their tempers easily or engage in reckless behavior. This leads to higher rates of separation and divorce.

Life Coaching for ADHD

Like having a mentor in the workplace, some people with ADHD benefit from having a coach for everyday life. Coaching is generally a supplement to more formal psychological counseling. The mentor helps the patient put newly learned skills into practice in real-life situations, whether organizing the home or planning a trip.

Organizational Skills for ADHD

Smart phone «organizer» apps can be especially useful for people with ADHD. Use an app to create a new to-do list every night, and you’ll always have it with you on your phone. Keep your list organized by using four categories: calls, emails, tasks, and errands. Other apps can help you keep your schedule up to date, so you won’t miss important events.

Diet Tips for Adults with ADHD

Some experts believe foods that provide quality brain fuel could reduce symptoms of ADHD. High-protein foods, including nuts, meat, beans, and eggs, may improve concentration. Replacing simple carbs with complex carbs, like whole-grain pasta or brown rice, can help ward off mood swings and stabilize energy levels.

Does Sugar Worsen ADHD?

The idea that sugar makes people hyperactive is popular, but there is no evidence that sweets cause ADHD or make its symptoms worse. Research in children indicates switching to a sugar substitute, such as aspartame, does not reduce symptoms of ADHD.

Outlook for Adults With ADHD

Adults with ADHD don’t outgrow the condition, but many learn to manage it successfully. Long-term treatment can reduce problems at home and at work, bringing patients closer to their families and their professional goals.

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Cleveland Clinic: «ADHD in Adults.»
Reimer, B. Journal of Traffic Injury Prevention, September 2007.
National Resource Center on ADHD: «Diagnosis of ADHD in Adults.»
Hormone Health Network: «Thyroid Problems.»
Williams, N. The Lancet, October 2010.
National Institute of Mental Health: «Attention Deficit Hyperactivity Disorder.»
U.S. National Library of Medicine: «Drug Class Review: Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder.»
Medline Plus: «Atomoxetine.»
National Collaborating Centre for Mental Health (UK): » Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults.»
Biederman, J. Journal of Clinical Psychiatry, April 2006.В
The New York Times, February 2011.
CDC: «Symptoms of ADHD.»
American Medical Association: «New Analysis Cites Economic Impact of ADHD,» Sept, 2004.
Kessler, R. The American Journal of Psychiatry, April 2006.
Searight, H. American Family Physician, November 2000.
Nancy Ratey, EdM, author, The Disorganized Mind: Coaching Your ADHD Brain to Take Control of Your Time, Tasks, and Talents.
National Resource Center on ADHD: «Complementary and Alternative Treatments.»
Eisenberg, T. BMC Evolutionary Biology, MarchВ 2008.В

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Reviewed by Smitha Bhandari, MD on June 19, 2018

This tool does not provide medical advice. See additional information.

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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10 Signs You May Have Kidney Disease

More than 26 million American adults are living with kidney disease. Most don’t know it — Over 90 percent of people with signs of kidney disease are unaware of it. March is National Kidney Month, and one of the best ways to observe this health awareness month is by getting tested if you’re at risk for kidney disease. Major risk factors include high blood pressure, diabetes, a family history of kidney failure and being age 60 or older.

While the only way to know for sure if you have kidney disease is to get tested, there are a number of physical signs. Sometimes people attribute these physical symptoms of kidney disease to other conditions. This is because those with kidney disease tend not to experience symptoms until the very late stages, when the kidneys are failing or when there are large amounts of protein in the urine.

Here are 10 possible signs you may have kidney disease:

  1. You’re more tired, have less energy or are having trouble concentrating. A severe decrease in kidney function can lead to a buildup of toxins and impurities in the blood. This can cause you to feel tired, weak and can make it hard to concentrate. Another complication of kidney disease is anemia, which can also cause weakness and fatigue.

You’re having trouble sleeping. When the kidneys aren’t filtering properly, toxins stay in the blood rather than leaving the body through the urine. This can make it difficult to sleep. There is also a link between obesity and chronic kidney disease, and sleep apnea is more common in those with chronic kidney disease.

You have dry and itchy skin. Healthy kidneys do many important jobs. They remove wastes and extra fluid from your body, help make red blood cells, keep bones strong and work to maintain the right amount of minerals in your blood. Dry and itchy skin can be a sign of the mineral and bone disease that often accompanies advanced kidney disease, when the kidneys are no longer able to keep the right balance of minerals and nutrients in the blood.

You feel the need to urinate more often. If you feel the need to urinate more often, especially at night, this can be a sign of kidney disease. When the kidneys’ filters are damaged, it can cause an increase in the urge to urinate. Frequent urination can also be a sign of a urinary infection or enlarged prostate in men.

You see blood in your urine. Healthy kidneys typically keep blood cells in the body when filtering wastes from the blood to create urine. However, when the kidneys have been damaged, these blood cells can start to «leak» out into the urine. In addition to signaling kidney disease, blood in the urine can be indicative of tumors, kidney stones or an infection.

Your urine is foamy. Excessive bubbles in the urine — especially ones that require you to flush several times before they go away — indicate protein in the urine. This foam may look like the foam you see when scrambling eggs, as the common protein found in urine, albumin, is the same protein as in eggs.

You’re experiencing persistent puffiness around your eyes. Protein in the urine is an early sign that the kidneys’ filters have been damaged, allowing protein to leak into the urine. This puffiness around your eyes can be due to the fact that your kidneys are leaking a large amount of protein in the urine, rather than keeping it in the body.

Your ankles and feet are swollen. Decreased kidney function can lead to sodium retention, causing swelling in your feet and ankles. Swelling in the lower extremities can also be a sign of heart disease, liver disease and chronic leg vein problems.

You have a poor appetite. This is a very general symptom, but a buildup of toxins resulting from reduced kidney function can be one of the causes.

Penile, Urethral, Testes & Scrotum Infections

What are epididymitis and orchitis?

The infections that strike within the scrotum usually involve the epididymis and/or testicles. The epididymis is a slender, convoluted (tightly coiled) structure lying on the backside of each testicle. It serves as a reservoir where sperm mature. When the epidiymis or testicle gets infected with bacteria or viruses, it is referred to as epididymitis or orchitis respectively.

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Infections within the scrotum are readily treatable if diagnosed quickly. If left undiagnosed and untreated, the infections can advance to severe consequences. The specialists at the Glickman Urological and Kidney Institute are experts at treating all urological infections including all sexually transmitted diseases.

Epididymitis is an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm. Males of any age can get epididymitis and it impacts less than 1 of every 1,000 males each year. In certain cases, a testicle also may experience additional infection and inflammation as a result of epididymitis. That inflammation is called epididymo-orchitis.

Orchitis (as previously mentioned) may be caused by epididymitis. However it can also be a primary infection. Orchitis is an infection of the testicle. Orchitis is caused by a bacterial infection or mumps. About 30% of boys with mumps will develop orchitis. Bacterial infections that may cause orchitis include sexually transmitted infections (STIs) such as chlamydia or gonorrhea. Orchitis may impact fertility.

What causes epididymitis and orchitis?

A number of bacteria and viruses cause the infections in the scrotum. A substantial percentage of epididymis/orchitis is caused by sexually transmitted infections (STIs) such as chlamydia and gonorrhea. Chlamydia is responsible for about half or more of epididymis cases in men 35 or younger. Gonorrhea is the second most common cause. Bacteria that commonly cause orchitis include Escherichia coli (E.coli), Staphylococcus (Staph), and Streptococcus (Strep).

Chronic orchitis may be due to tuberculosis (TB), syphilis, or a condition known as non-specific granulomatous change. This is a change that describes the granulated tissue that forms during healing as a result of injury, inflammation or infection. In young prepubertal boys and in men 35 and older, epididymis is often caused by coliform bacteria, a germ normally found in the intestines. Tuberculosis epididymo-orchitis is usually associated with renal (kidney) tuberculosis. Some of the more rare viral causes of orchitis include Coxsackie virus, infectious mononucleosis, varicella and echovirus.

The prevalence of chlamydia and gonorrhea in the United States is an excellent reason to use protection when engaging in sexual activity.

What are the symptoms of epididymitis and orchitis?

Symptoms include scrotal swelling (enlarged testicles), a tender or heavy feeling in the testicle that is affected, fever, discharge from the penis, and pain with urination, during intercourse, or with ejaculation. Additional symptoms include groin pain, blood in the semen, and a lump in the testicles.

Important: Acute testicular pain and/or swelling may result from testicular torsion – a twisted testicle. This is an emergency medical situation and immediate care should be sought from the nearest medical facility or emergency room.

Further, many men who are concerned about pain or unusual symptoms struggle to ask their doctors about their overall penis health.

How are epididymitis and orchitis diagnosed?

Diagnosis includes a physical examination, laboratory testing, and often imaging studies. The physical examination will include palpation (feeling) of the scrotum to localize the source of pain, identify swelling of the affected testicle, and to detect any suspicious lumps. The exterior of the scrotum will be examined for any appearance of infection. A rectal examination is conducted as some cases of epididymis/orchitis have been related to prostatitis.

Laboratory tests include urinalysis and a urine culture. This test involves putting a small sample of urine in a growth medium to identify the bacteria that may grow. Determining the species of bacteria that are present will help the treating physician choose an appropriate therapy. There will also be a urethral smear, a procedure in which a sample of fluid is acquired by inserting a small swab in the urethra. The sample is used to culture bacteria.

The imaging study is usually sonography. Sonography bounces sound waves off of tissues and structures and uses the echoes to form an image, a sonogram. If an infection is present, the sonogram may show increased blood flow to the infected area. Sonography is also used to rule out testicular torsion.

How are epididymitis and orchitis treated?

Broad-spectrum antibiotics are used to treat these infections. They are called “broad-spectrum” because they destroy a range of bacteria. Analgesics (medication to treat pain but not cause anesthesia) are prescribed to help control pain that may be associated with the infections. Bed rest, elevation of the scrotum and ice packs are recommended for comfort. The pain should resolve within 3 to 4 days.

Patients diagnosed with STIs (chlamydia or gonorrhea) should have their sexual partners tested and treated if necessary. They should also take an HIV test. The patient returns after 3 to 7 days of treatment for lab testing to insure that the infection has been eradicated. Unfortunately there are no effective medications for viral infections as yet.

Most cases of orchitis and epididymitis will resolve without complications but a percentage of patients may need hospitalization. These are those with intractable pain; those with nausea or vomiting that inhibit oral medications; those with evidence of an abscess; those who fail to improve after 72 hours of outpatient treatment, and those who are immunocompromised with significant symptoms.

If you have pain in your scrotum, please seek medical attention. Your Cleveland Clinic doctor can help treat epidiymitis and orchitis.

How are epididymitis and orchitis prevented?

No known method of preventing epididymitis or orchritis exist. However using precautions while engaging in sexual activity can reduce the risk of gonorrhea and chlamydia; which are known to cause epididymitis and orchitis. This includes using condoms as a contraceptive measure.

However, orchitis and epididymis are readily treatable infections if diagnosed quickly but if left undiagnosed and untreated, the infections can advance to severe consequences. If any symptoms are experienced, please consult a Cleveland Clinic urologist immediately for an examination.

Reviewed by a Cleveland Clinic medical professional.

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