If you think attention deficit-hyperactivity disorder (ADHD) is a childhood condition, think again.
More than one million South Africans between the ages of 20 and 50 are affected by adult ADHD.
Characterised by severe and impaired levels of inattention, hyperactivity and impulsivity, if left untreated, the disorder can be detrimental to the long-term health and quality of life of those affected.
Adult ADHD only recently took a turn in the spotlight after the 2014 death of comedian Robin Williams.
Many did not know at the time about his battle with the disorder and severe depression.
He was found dead after hanging himself.
Other famous celebrities diagnosed with ADHD include chef Jamie Oliver and swimmer Michael Phelps.
The country’s first guidelines for adult ADHD were recently published in the South African Journal of Psychiatry.
Compiled by psychiatrists Drs Renata Schoeman and Rykie Liebenberg of the South African Society of Psychiatrists Special Interest Group for adult ADHD, the guidelines for medical professionals takes a holistic approach by including assessment procedures, drug treatment options and the treatment plan for long-term health.
The recommendation originates from Schoeman’s MBA completed at the University of Stellenbosch Business School in 2015, when she explored the situation with regards to the prevalence and treatment of adult ADHD in South Africa.
“In South Africa, there is poor identification and treatment of common mental disorders at primary healthcare level, and limited access to specialist resources, with a service delivery and treatment gap of up to 75 percent,” said Schoeman.
She also points out that despite the known efficacy of treatment and the costs involved of untreated ADHD, access to healthcare and treatment is not a given for many patients in South Africa.
“More often than not ADHD is not diagnosed, or is misdiagnosed and can have a severe impact on the functioning of the patient and lead to costly medical aid or private out-of-pocket expenses,” said Schoeman.
Adults with ADHD go untreated for most of their lives, which in turn can lead to significant increases in the risk for other psychiatric conditions such as anxiety and mood disorder, as well as substance abuse.
“In the work environment their poor time management, goal setting, stress management and organisational skills can have a considerable impact on their colleagues and employers,” says Schoeman – hence the need for these guidelines.
The guidelines outline the requirements for comprehensive assessments and diagnostic certainty prior to medical treatment.
This is where Schoeman stresses the importance of a proper assessment.
“This is not possible during the average 15-minute GP consultation, and it is, therefore, strongly advised that the diagnosis of adult ADHD and treatment initiation should be made by a psychiatrist well versed in the complexities of ADHD and the co-morbidity thereof.”
Although some children appear to “outgrow” their ADHD, it becomes more a case of some managing the symptoms better as adults and compensating for their impairment through lifestyle and career choices.