Understanding and Managing Adult ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD) is often associated with childhood, but it can persist into adulthood, impacting various aspects of life. In Singapore, with its fast-paced and demanding environment, adults with ADHD may face unique challenges. This blog post aims to raise awareness about adult ADHD, its symptoms, and the importance of seeking professional help. 

 

Understanding ADHD in Adulthood 

ADHD is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. While these traits may be present in everyone to some extent, individuals with ADHD experience them to a degree that significantly impairs their daily functioning. In adults, ADHD can manifest as difficulty focusing, disorganization, restlessness, impulsiveness, and emotional dysregulation. 

 

Unmasking ADHD Symptoms in Adults 

ADHD symptoms in adults can be subtle and easily mistaken for other conditions or personality traits. Here are some common signs: 

  • Inattention: Difficulty sustaining focus, easily distracted, forgetfulness, procrastination, poor organizational skills. 
  • Hyperactivity: Restlessness, fidgeting, difficulty relaxing, excessive talking, interrupting others. 
  • Impulsivity: Acting without thinking, difficulty waiting their turn, interrupting conversations, making impulsive decisions. 
  • Emotional dysregulation: Mood swings, irritability, difficulty managing emotions, low frustration tolerance. 
  • Executive function challenges: Problems with planning, prioritizing, time management, and self-regulation. 

 

Recognizing ADHD: When to Seek Professional Help 

If you suspect you or someone you know may have ADHD, it’s essential to seek a professional assessment. A diagnosis typically involves a comprehensive evaluation, including: 

  • Clinical interview: A detailed discussion about symptoms, medical history, and family history. 
  • Psychological testing: Standardized questionnaires and tests to assess attention, impulsivity, and executive function. 
  • Behavioural observation: Observing behaviours and interactions to identify ADHD-related patterns. 

 

Why Early Diagnosis Matters: 

  1. Improved Quality of Life: Proper diagnosis and treatment can significantly improve quality of life by reducing symptoms and enhancing daily functioning. 
  2. Reduced Risk of Comorbidities: ADHD often co-occurs with other mental health conditions like anxiety and depression. Early intervention can help prevent or manage these comorbidities. 
  3. Enhanced Relationships and Career Success: Managing ADHD symptoms can lead to improved relationships, increased productivity, and greater career success. 
  4. Increased Self-Awareness: Understanding your ADHD can help you develop coping strategies and self-management skills. 
  5. Reduced Stigma: Seeking help for ADHD can challenge the stigma surrounding mental health and encourage self-acceptance. 

 

 

Creating a Supportive Environment at Promises 

At Promises Healthcare, we understand the challenges faced by adults with ADHD. Our team of experienced psychiatrists and therapists provides comprehensive assessments and personalized treatment plans. We offer a range of evidence-based therapies, medication management, and support groups to help you manage your ADHD and achieve your full potential. 

We believe in creating a supportive and non-judgmental environment where you can feel comfortable discussing your concerns and working towards a fulfilling life. Contact Promises today for a confidential consultation and take the first step towards managing your ADHD effectively. 

Dealing with ADHD Effectively

 

In this episode of the Health Check podcast, Dr. Winslow reveals that he suffers from attention-deficit hyperactivity disorder. No-one would begrudge you your raised eyebrows, least of all him. After all, it is precisely his duty to educate you about ADHD.

Dr. Winslow joined journalists Joyce Teo and Ernest Luis at The Straits Times’ podcast studio, where the duo court the expertise of medical professionals to inform and enlighten. Armed with myriad perspectives, Dr. Winslow availed his own brain to help demystify ADHD.

It wasn’t until Dr. Winslow began to see the parallels between his childhood behaviour and those of his clients with ADHD, that he realised he too had the disorder. It didn’t seem to bother him too much – he laughs at being chided by his son’s teachers for his pride in his son’s ability “to pass exams exactly the same way” as he did, without paying attention in class.

Dr. Winslow says that in the brains of people with ADHD, communication between cells is difficult – that’s how they are more likely to lose focus, become distracted, or give in to impulses. Singapore’s regimented education system doesn’t help either. Students with ADHD face real disadvantages, in their inability to sit through lessons, and in the way educators see those who refuse to (or simply can’t) pay attention for long stretches.

Dr. Winslow recalls being forced to run laps around the school as a child by his teachers, who had hoped to wear his indefatigable energy down into submission in time for class. He admits that it worked surprisingly well. ADHD can be managed, as he would learn.

It is unfair to say that ADHD is “not a real disorder”, and that one merely needs to “concentrate on overcoming it”. That just doesn’t make sense. ADHD is a medical condition that can be tackled with correct tools and the right will. Dr Winslow says it’s possible to address the few big symptom groups (Hyperactivity, Impulsiveness, and Difficulty with Distractibility) with practical advice in the right contexts. For example, you might teach your always-tardy child about time management with to-do lists.

Dr. Winslow says parents should try and come to terms with their child’s ADHD, or risk more worrisome aspects spilling over into adulthood. Adult ADHD often comes packaged with low self-esteem, where inability to complete tasks due to inattention becomes internalised as laziness in a self-defeating cycle.

Overcoming ADHD is easy, says Dr. Winslow, when you understand this maxim: “The more you understand the complications brought by your limitations, the more you can do to manage your symptoms.” It’s an expansion of the classic “knowledge is power”.

Once you begin to appreciate the ADHD brain for its quirks, advantages become more apparent. The meandering thoughts of people with ADHD often help them develop novel solutions to problems – “thinking outside the box”.

The doctor’s recommendations? Don’t panic, try to understand ADHD, and don’t forget the fish oils!

Listen to the Health Check podcast over at The Straits Times website, or search for it on your favourite podcast platform.

Psychological Testing: What You Should Know

Psychological evaluation is often helpful in understanding the strengths and challenges an individual may have in their cognitive, behavioural, learning and socio-emotional functioning.

At Promises Healthcare, we believe that “one size fits all” is not an approach that is applicable to the treatment of psychological disorders and challenges. We provide tailored recommendations for parents, teachers, and therapists so that interventions and accommodations allow each child to reach their potential.

IQ and academic testings can provide important information about a child’s cognitive strengths and weaknesses, academic needs, and preferred learning style. These can assist parents and children in making educational choices and implementing strategies to ensure that the child’s learning is appropriately supported.

Specific reasons for testing include:

  • Learning difficulties or delays (e.g. difficulties with spelling, writing, maths and/or reading)
  • Giftedness
  • Underachievement
  • Emotional and/or behavioural problems presenting in the classroom and/or at home
  • Admission to special educational programs
  • Increasing understanding of a child’s learning style
  • Concerns regarding possible attentional difficulties

What is IQ testing?

Intelligence testing is a method used by psychologists to measure a child’s intellectual capabilities. Intellectual assessment is a good indicator of a child’s potential. We use the Wechsler Intelligence Scale for Children, fifth edition (WISC- V). This is an individually administered instrument for assessing the cognitive ability of children aged 6 years to 16 years.

The WISC V is one of the most reliable and valid IQ testing instruments available and is the most widely used measure of IQ. The WISC V provided scores that represent intellectual functioning in four specified cognitive domains: Verbal Comprehension, Perceptual Reasoning, Processing Speed and Working memory.  During the testing session, a child is asked to solve problems and puzzles and to answer a range of questions. Generally, most children enjoy the testing session as it is an engaging process involving novel and fun tasks. Should parents have worries about their child’s emotional wellbeing during the assessment, raise it with us and, we can explore a workable collaborative plan to support you and your child during the testing process.

What is Academic Testing?

Academic Testing provided an overview of a child’s current performance across a range of academic domains. We use the Wechsler Individual Achievement Test (WIAT-III) with subtests including:

  • Oral Expression
  • Listening Comprehension
  • Written Expression
  • Spelling
  • Pseudoword Decoding
  • Word Reading
  • Reading Comprehension
  • Numerical Operations
  • Maths Reasoning

The assessment provides a rich source of information about a child’s achievement skills. Information obtained can then be utilized for intervention decisions.

The Assessment Process

The assessment is conducted in several stages:

  • An initial assessment with parent(s) is an integral part of our assessment procedure.
  • A time is set to administer the WISC 5 and the WIAT-III and other relevant tests. Usually, you may have to set aside about two or more sessions for approximately 6 to 12 hrs (excluding initial consult session) for testing, depending on the capacity and the needs of the child/person. Spacing out testing over several days can help some children overcome fatigue and stress.
  • A comprehensive written report will be prepared after all the testings are completed, based on the outcome of the assessment and testing process. The report will highlight relative areas of strengths and difficulties, with recommendations for home and school settings.
  • A feedback session will be provided to parents after the completion of the report. During this session, parents can be given an opportunity to clarify and discuss any concerns regarding the report.

Fees for assessments

  • The Psychologist conducting the tests will inform parents of the charges involved during the initial consultation session, based on the needs of the child/person and the different tests required.

Payment Plans

  • Payment plans are available for our testing procedures. Clients may choose to pay the full amount for testing at the end of the initial consultation or they may elect to pay in two payments. Like most of the private practices, reports will not be released prior to receipt of full payment.

Referrals/ For Information

Please do not hesitate to speak to our friendly reception staff at (+65) 6397 7309 if you wish to make an initial appointment. Alternatively, should you wish to clarify matters with me personally, you can leave your name and contact details with the reception at clinic@promises.com.sg

How ADHD therapy can help manage stress and work performance in Singapore.

Have you met Michael recently? He’s the bright, young, dynamic person at our office… I always thought of him as the person who’s the life of the party, and he genuinely seems to care for his colleagues… Aah, yes, the same person who unfortunately missed out a promotion this year… I heard his boss say that he definitely had the potential,  but it wasn’t showing up in his work. He would initiate tasks with enthusiasm but would lose interest quickly; turned up late for meetings, or even forgot about them, and frequently misplaced important files as his table was often cluttered.

Does this seem familiar? Do you recognise similar signs in yourself or someone else you know? These issues might be due to something known as Executive functioning deficits or disorder (EFD). Though symptoms start in early childhood,  the challenges might have been seen as the individual’s behaviour problems and not as a syndrome. Even as adults, many of those with EFD aren’t aware they have it — they just know that even everyday tasks can be challenging.

What is EFD?

Executive functions are the set of higher-order mental skills that allow us to analyse, plan, organise,  make suitable decisions, manage time, focus attention and execute the plan. No matter how smart or talented one is, not much will get done well without these key capabilities. The human brain comprises of two systems: the automatic and the executive.  While the automatic system guides 80 to 90% of our activities every single day, the executive system guides the remaining 10 to 20% and requires purposeful, regulatory effort.1

What causes EFD? 

Experts don’t know exactly what causes this and a 2008 study found that differences in these skills are “almost entirely genetic in origin due to differences in brain chemicals” 2

People who have executive functioning deficits might have problems with many of these functions:

  • starting, organising, planning, or completing tasks on deadline.
  • multitasking
  • listening  or paying attention
  • remembering tasks or details
  • problem-solving
  • time management
  • decision making
  • controlling emotions or impulses
  • prioritising

But it is important to note that EFD is not associated with low IQ.

Almost everyone has some symptoms similar to EFD at some point in their lives but It isn’t EFD if the difficulties being faced are recent or occurred only occasionally or intermittently in the past. If you’re curious to know if you do have EFD, you could take the test given below.

https://www.additudemag.com/executive-function-deficit-adhd-symptoms-test-for-adults/

Even if you’re not sure if EFD is indeed the cause of the problems experienced, or, if you do not want to give it a label, you could still use the tips/ strategies given below to enhance your general skills and productivity at work.

One surprising way found to improve executive function in adults is aerobic exercise. Many research journals have published that regular aerobic exercise in older adults can boost the executive functions that typically deteriorate with age, including the ability to pay focused attention, to switch among tasks, and to hold multiple items in working memory.3

If you think that the feeling of the constant deluge at the office is largely the result of so many things clamouring for attention at once, a tool like Stephen Covey’s Quadrants can be used. Each quadrant (Q) has a different property and is designed to help prioritise tasks and responsibilities. These  are:

  • Q 1 – Urgent and important
  • Q 2 –  Not urgent but important
  • Q 3 – Urgent but not important
  • Q 4 – Not urgent and not important

Another useful technique is the Pomodoro technique of time management developed by Francesco Cirillo in the late 1980s. It uses a timer to break down work into 25-minute intervals, separated by 5-minute breaks. This method not only helps you remove distractions and enhance focus on your task, but it also factors in time to take a short breather.

Those who are tech-savvy can find these as smartphone apps. Other technology tools that can help are File-sharing software like Dropbox to keep notes handy,  digital sticky notes or reminders, and password manager software to keep track of passwords. Those who are not  comfortable with technology can compensate for working memory deficits by making information external — using cards, signs, symbols, sticky notes, lists, journals, clocks and timers.4

Other simple  workable strategies are:

  •  Break large tasks into smaller individual tasks and put them into a linear order or flow chart. This helps provide clarity and allows you to monitor your progress
  • Keep a routine
  • Know yourself and get your best work done according to your own biorhythms
  • Give it a positive twist – make the activity a ‘want to do’ instead of ‘should do’.

Games can help to improve executive function skills. Games like Checkers, Monopoly, and Clue use planning, sustained attention, response inhibition, working memory and metacognition. Games like Zelda and SimCity help with problem-solving and goal-directed persistence. Managing  fantasy sports teams also use executive skills like task initiation and time management while having fun.4

Positive emotions reduce the impact of stressful events on the self and help build resilience. They make us more flexible, allowing us to be more open to options of problem-solving. Studies show that people feel and do their best when they have at least three times as many positive emotions as negative emotions.5 It is, therefore, most important that you periodically reward yourself when you have met the goals you have set.  Equally important is positive self-talk which is a powerful tool for increasing your self-confidence and strengthening your resolve to make these healthy new habits a part of your personal and working life.

 When to seek help?

Diagnosis of EFD can be difficult because certain symptoms are similar to those caused by other conditions, such as ADHD, LD, depression, anxiety, mood disorders or OCD. If any of the symptoms listed above continually disrupt your life, talk to a mental health professional. There is a variety of strategies recommended by experts to help strengthen the areas of weakness that EFD creates. Treatment options could be medications and therapy such as occupational or speech therapy, Cognitive behavioural therapy (CBT).


References:

https://www.additudemag.com/working-memory-powers-executive-function/

https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/executive-functioning-issues/executive-functioning-issues-possible-causes

3https://www.pbs.org/wgbh/nova/article/the-science-of-smart-surprising-way-to-improve-executive-function/

4https://www.additudemag.com/executive-function-treatment/?src=embed_link

https://kidshealth.org/en/teens/power-positive.html

https://www.medicalnewstoday.com/articles/325402#summary

https://www.additudemag.com/executive-function-disorder-adhd-explained/?src=test

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