Popular Science Moment | Diagnosing Adult ADHD, Good News and Bad News.

After half an hour, you need to meet up with a friend and are just starting to put on makeup, you decide—
You had a paper arranged a month ago that is due in three days, you decide—
Late at night, suddenly craving fried chicken, preferably from the one near the stairs at the basement of the mall, you decide—
Faced with these situations, some people choose to analyze the pros and cons and make decisive decisions;
But there are also some people who cannot control their emotions with reason.
Always running late or on the way to running late;
Brain bursts, always having a short-lived enthusiasm;
Accompanied by some daily incidents of losing things.
“Procrastination” and “Forgetfulness” seem inadequate to describe it, more and more adults, either voluntarily or involuntarily, are diagnosed with “ADHD” after entering society.
ADHD, short for “Attention-Deficit/Hyperactivity Disorder,” commonly known as “hyperactivity,” is a common neurodevelopmental disorder that affects patients’ attention, memory, decision-making abilities, leading to issues like lack of concentration, hyperactivity, impulsivity, and emotional problems.
When ADHD is mentioned, the image of a mischievous boy is most clear, always fidgety, with scattered attention, sensitive and impulsive, hardly staying quiet for even a second.
However, these symptoms commonly seen in children not necessarily vanish on their own or entirely in adulthood, with about half of the people carrying these symptoms into adulthood.
As per the analysis published in the Journal of Global Health in 2021, the international adult ADHD prevalence ranges from 2.58% to 6.76%.
Those who slack off at work, postpone dates endlessly, exhibit symptoms of hyperactivity disorder… can finally breathe a sigh of relief: it’s not about their character, it’s all about ADHD causing trouble.
ADHD is primarily categorized into three types: inattentive type, hyperactive-impulsive type, and a combined type of both.
Based on this, a doctor in Japan coined a vivid name, “Doraemon-Nobita Syndrome,” where Nobita’s scatterbrained nature and procrastination represent the former, while the irritable and impulsive behavior of Takeshi represents the latter.
The above manifestations may not comprehensively summarize the various impacts of ADHD; for instance, compared to boys, girls with ADHD predominantly display attention deficit issues, while hyperactive/impulsive behavior isn’t prominent. This causes many girls’ academic difficulties to be wrongly attributed to being “dull” or “unfocused” until they grow up.
Caught between “act immediately” and “it’s fine to procrastinate”;
Disappointment and hope, optimism and pessimism, separated only by a thin line.
While most people can relate to one or more of the given behaviors, only a tiny fraction have the opportunity, awareness, and means to correctly link these symptoms to ADHD.
ADHD seems to be exclusive to children, forever separated from the adult world.
In the context of an East Asian emphasis on postnatal education, admitting to having ADHD symptoms is not easy.
People are quick to accept labels like “weirdo” or “person with issues,” what about ADHD? Isn’t it only diagnosed in children?
According to blogger @青衫Aspie’s “ADHD National Diagnosis Guide,” there are a total of 73 hospitals in China that can diagnose adult ADHD, covering 23 provinces and regions including Hong Kong, Macau, and Taiwan.
Most of these hospitals’ registration departments are named “Child Psychiatry” and operate on weekdays.
The tendrils pruned in childhood grow wildly during adulthood, with complexities that cannot simply be summed up as “feeling pressured.”
Current research leans towards genetic and neurobiological factors influencing ADHD, categorizing it as a neurodevelopmental disorder with a heritability rate of about 70%, with approximately half of the parents of ADHD patients showing clear ADHD symptoms.
Hence, for some individuals, it’s almost a destined battle.
In fact, there are distinct differences between the ADHD brain and a normal brain. Neurons in the brain transmit information via synaptic neurotransmitters, with three elements related to neurotransmitters believed to influence ADHD-related behavior.
Norepinephrine, plays a crucial role in controlling impulsivity;
Dopamine, forms the basis for mood swings, attention, and motivation;
Serotonin, stimulates the brain’s reward center.
Of these, dopamine secretion abnormalities have garnered wide attention from scientists. A decrease in the brain’s dopamine transmission ability may lead to a state of “hypofrontality,” while excessive secretion can easily manifest as hyperactive behavior.
During executive tasks, the ADHD brain exhibits different activation patterns, resulting in uncontrollable impulses, restlessness, or a pursuit of novelty.
MRI scans of the brain show that the cortical layers of the ADHD population are thinner than those of individuals without ADHD, particularly noticeable in the prefrontal cortex responsible for reasoning, planning, emotions, and problem-solving.
Studies indicate that in children with ADHD, the development of the frontal cortex lags significantly behind that of their peers, ultimately causing issues like lack of focus, hyperactivity, and impulsivity.
Beyond chemical and structural differences, scientists have utilized functional magnetic resonance imaging (fMRI) to analyze brain blood flow patterns, which revealed significantly lower blood flows in the frontal, parietal, and striatal regions of ADHD patients than in those without ADHD when undergoing short-term memory, attention, or other cognitive tests, indicating that the brain cannot function smoothly and efficiently.
Neuroscientific research has provided insights into some of the causes of ADHD, making the path towards improving treatments evidence-based and enabling diagnosis regardless of age.
Searching for ADHD on social platforms, the word most mentioned by diagnosed young individuals is “enlightenment.”
Enlightenment comes from finally having a name for long-unexplained behavior patterns, learning difficulties, or emotional fluctuations; the multiple unstable factors to overcome now have a “main task.”
Consequently, more and more young individuals are eagerly seeking ADHD diagnoses as a form of emotional outlet. This positive trend is, in part, a response to the real need for attention amid the fragmented information era.
So, how can individuals with ADHD or similar traits alleviate attention challenges beyond receiving a diagnosis?
Both experimental literature and clinical experts have mentioned the beneficial effects of consuming Omega-3. While most clinical trials focus on children and adolescents, the implications for guiding treatment for adult ADHD are still noteworthy.
Research shows that ADHD children have lower levels of omega-3 compared to normal children. Given the changes in membrane fluidity and function of membrane-bound proteins, Omega-3 polyunsaturated fatty acids are highly concentrated in phospholipids of neurons and cardiomyocytes. In animals, Omega-3 deficiency is related to decreased dopamine levels in the prefrontal cortex and serotonin levels.
A systematic review and meta-analysis from 2018 involving 8 studies revealed that supplementation with Omega-3 fatty acids (DHA+EPA) as a standalone treatment can improve clinical symptoms and cognitive performance in children and adolescents with hyperactivity disorder.
@青衫Aspie, who focuses on the Chinese adult ADHD population, has shared cases related to supplementing with fish oil as a treatment.
Renowned ADHD treatment authority and psychologist Russell Barkley once said, “ADHD is one of the most likely psychiatric conditions to be treatable.” Compared to other mental disorders, individuals with ADHD have multiple effective and safe treatment options available to significantly improve their lives.
It must be emphasized that the road of ADHD research is long and demanding, with strict diagnosis and prescription medication from professional doctors still being the preferred treatment.
Beyond professional treatment, if you are struggling with attention deficits or impulsive behavior, seek professional help.