ADHD and Quality of Life, Beyond Symptoms
ADHD affects approximately 4% of adults and can have a negative impact on multiple areas of an individual’s life. This includes health factors, academic and economic achievement, and interpersonal and psychological functioning. The present Diagnostic and Statistical Manual (DSM-5), does require that ADHD symptoms must negatively impact multiple domains of an individual’s life in order to qualify for the diagnosis. However, these areas and the nature of these impacts is not specifically outlined from a diagnostic stand point. As a neuropsychologist and therapist I evaluate and treat many individuals with ADHD and throughout my experiences I have learned to attend to these aspects of an individual’s life as part of both comprehensive assessment and treatment.
One of the areas affected by ADHD is that of educational and career achievement. ADHD is a childhood developmental disorder characterized by symptoms of impulsivity, hyperactivity, and inattention. As a result, academic performance as well as classroom behavior are often negatively impacted. This can result in lower academic achievement due to difficulties with tasks such as turning in homework on time or being able to sustain ones attention and focus on the teacher or the task at hand. As academic demands increase through the course of schooling, so too do the opportunities for these difficulties to interfere with academic achievement. Additionally, from a behavioral standpoint, individuals with ADHD, especially the hyperactive type are more prone to disruptive behaviors that can lead to disciplinary issues as well as interpersonal difficulties that can lead to peer rejection or isolation.
Another area of focus when considering quality of life is that of one’s overall health. ADHD has a medical and financial toll over the course of the lifespan. Between doctors appointments and medications as well as therapy there is an added cost to the diagnosis alone. When considering some of the behavioral difficulties that can arise from impulsivity and inattention, individuals with ADHD are also at risk for increased medical costs related to various accidents and injuries or the negative consequences of their decisions. Finally, one’s overall health throughout the lifespan relies on planning, reasoning, and judgment, which can all be difficult for individuals with ADHD. For example, sticking to a healthy diet, or workout routine is often more difficult when one’s brain is wired around more immediate sources of stimulation and gratification.
Finally, on a psychological and interpersonal level ADHD also can negatively impact one’s overall quality of life. Among the impulsive/hyperactive symptoms of ADHD are behaviors such as having difficulty waiting ones turn, intruding into or interrupting others, and appearing to other people as though one is not present or fully engaged in conversation. Additionally, individuals with ADHD are at increased risk for anxiety and depression for a variety of reasons. Frequently, I meet individuals whose performance at either work or school seems to fall short of their potential. Despite their best efforts they often receive negative feedback about their performances. Most commonly in children this shows up on report cards as something to the effect of “bright child, but doesn’t always seem to apply themselves.”
Overall, ADHD is a disorder whose effects on an individual’s life can be far reaching and detrimental. As a result, I advocate that when assessing and treating ADHD these factors be taken into account. There are a number of tools available to do so, most notably several Quality of Life Indicators (QoL), that are easy to administer and can provide insight and useful information to both patients and providers. Additionally, research has shown that effective treatment, both pharmacological as well as psychotherapy, can improve these various quality of life indicators. The earlier one is diagnosed and effectively treated the
greater the chances of reducing the negative impact of ADHD throughout the lifespan.
Finally, there are a number of potentially useful and beneficial aspects to ADHD. For example, individual’s with ADHD often report increased levels of creativity as well as periods of increased productivity when engaged in tasks that they find particularly interesting. When correctly harnessed and utilized these aspects of the disorder can contribute to unique talents, abilities, and accomplishments. Sometimes the challenge lies in being able to channel these abilities deliberately, which can also be improved through effective treatment.