The inability to sit still was a defining characteristic of Phillip Urbak's childhood.
While classmates would quietly sit at their desks, Urbak was a squirmer.
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He made good grades, he recalled, and often was on the honor roll. But he was easily distracted and had trouble with time management.
Those patterns continued into college, where he would procrastinate and then pull all-nighters to study for an exam.
He missed out on an internship one year because he forgot to show up for an interview.
And he was always losing things — his car keys, his cell phone and important paperwork.
Urbak said he received his degree and has gone on to have a successful business career.
"But my life was often a roller coaster," the Hagerstown man said. "I could be very focused and then suddenly inattentive. I was restless and disorganized."
That fidgety kid had grown into a fidgety adult.
It wasn't until his son was diagnosed with attention deficit hyperactivity disorder (ADHD) that Urbak finally made sense of his life.
"I was doing some research on the topic," he said, "and began to realize that I was reading about myself."
While most people associate ADHD with children, data from Medco Health Solutions, a New Jersey company that operates mail-order pharmacies across the U.S., indicates that about 1.5 million Americans between the ages of 20 and 64 are currently taking medication to treat the disorder. And most were diagnosed well into adulthood.
Urbak, 46, said he was diagnosed while he was in his 30s and leads "a transformed life" thanks to a combination of medicine and behavioral therapies.
His story is similar to other adults diagnosed with ADHD, including celebrities like comedian and actor Jim Carrey; Olympic medalist Michael Phelps; and Grammy-winning singer-songwriter Justin Timberlake.
According to the National Institute of Mental Health, attention deficit hyperactivity disorder is a condition caused by signaling problems in the brain. The primary symptoms are impulsiveness, restlessness, inattention, and poor self-regulation. It is one of the most common childhood disorders and can continue through adolescence and adulthood.
"As a child with ADHD matures into adulthood, symptoms may become less noticeable or change over time. But symptoms persist into adulthood in as many as 60 percent of cases," said Melissa Grove, licensed professional counselor with Summit Behavioral Health, an affiliate of Summit Health.
Grove noted that the prevalence of ADHD is estimated to be between 2 and 4.4 percent of adults.
If not diagnosed in childhood, Grove said there are several common signs of adult ADHD that include:
- Frequent forgetfulness
- Difficulty completing tasks or projects
- Ongoing problems with concentrating and paying attention
- Restlessness and fidgeting
- Excessive talking and/or interrupting others
- Difficulty listening when spoken to directly
While ADHD in children is characterized by hyperactivity and inattentiveness and usually is detected when kids struggle with peers or in school, diagnosing ADHD in adults can be trickier.
"Not everyone with ADHD displays all of the symptoms or to the same severity," Grove said. "To prevent misdiagnosis, someone with these symptoms would need to see a trained clinician for an accurate diagnosis."
Grove said the clinician will gather information from multiple sources to verify diagnosis, including ADHD symptom checklists, standardized behavior rating scales, a detailed history from the individual regarding past and present symptoms and information from family members and significant others.
According to the American Psychiatric Association, it's important to know that blowing a deadline or misplacing your sunglasses does not mean you have ADHD. The symptoms have to be strong enough to disrupt both work and family life and can be traced back to childhood.
Grove said treatment of ADHD in both adults and children is very similar, including counseling (play therapy for children), education on diagnosis, organizational skills, behavior techniques and medication.
"There are other approaches to treatment, such as diet, that individuals have found beneficial," she added. "However, most have little to no research to support their effectiveness. Medication and behavior management remain the most effective treatment for attention deficit hyperactivity disorder."
Left undiagnosed and untreated, Grove said, ADHD can create problems for adults in their work, family and social lives.
"These problems can have a significant impact on individuals and their self-esteem in multiple ways," she noted. "Two examples may include disorganization that leaves them feeling overwhelmed and exhausted or in a financial mess and difficulty paying attention, completing tasks and forgetfulness that can put a strain on relationships."
ADHD is a medical condition and with appropriate treatment for symptoms, it can be controlled, Grove stressed.
"There are other disorders that have similar symptoms or other disorders that an individual might have in combination with ADHD, making an accurate diagnosis essential," she said. "It's also important to seek education from qualified sources in order to understand the diagnosis and treatment and to dispel myths about ADHD."
While there is no cure, the National Institute of Mental Health notes that, with treatment, people with ADHD can be successful in school and work and lead productive lives.
According to NIMH, researchers are developing more effective interventions and using new tools such as brain imaging to better understand ADHD and to find more effective ways to treat and prevent the disorder.