Adult ADHD

Adult ADHD is not a lack of willpower, but a neurodevelopmental condition. Learn how it affects executive functions and why accurate clinical diagnosis matters.

Beyond the stereotype: the neurobiology of ADHD

Attention-Deficit / Hyperactivity Disorder (ADHD) in adults is not a personality trait, but a clearly defined neurodevelopmental disorder. It is associated with dysfunction of dopaminergic circuits in the prefrontal cortex, the brain region responsible for “executive functions”.

Unlike in childhood, motor hyperactivity in adults is often “metabolized” into constant inner restlessness, chronic procrastination and a sense that the brain works like an engine that cannot switch off.

ICD-10 coding

• F90.0: Disturbance of activity and attention.
• F90.1: Hyperkinetic conduct disorder.

The “mask” and comorbidity

One of the greatest obstacles in diagnosing adult ADHD is comorbidity. Many patients come to the clinic with symptoms of:

• Chronic anxiety: due to the constant effort to “keep up” with deadlines.
• Depression: as a result of repeated frustration and a sense of low self-efficacy.
• Burnout: from the excessive effort required to function in an environment that demands linear organization.

Often, irritability and emotional reactivity in anxiety disorders that do not respond well to anxiolytics or antidepressants may “hide” undiagnosed ADHD.

Management strategies

Treatment of adult ADHD at Smart CNS Center is multilayered and personalized:

1. Psychoeducation: Understanding how the brain works is the first step toward reducing guilt and self-blame.
2. Cognitive Behavioral Therapy (CBT): Focus on organizational skills, time management and emotional regulation.
3. Pharmacotherapy: When functional impairment is significant, specific medication — stimulant or non-stimulant — may help restore chemical balance in the brain.
4. Precision psychiatry (PGx): Use of pharmacogenomics to select the safest and most effective medication.

Frequently asked questions (FAQ)

Can ADHD be hidden behind other symptoms?

Yes. If there is a history of “treatment-resistant” anxiety or depression, the underlying cause may be the neurobiological basis of ADHD. Correct differential diagnosis is key.

What does the assessment include?

It is not a simple checklist. It requires a detailed history, use of DIVA-5 and assessment of functioning in work and relationships. See the Adult ADHD Assessment service.

Is medication necessary?

Not necessarily. The decision is shared and is based on the degree of difficulty experienced in daily life.

Clear associations — Entity graph

• Adult ADHD → Core deficit → Executive functions
• ADHD → Biological basis → Dopamine dysfunction / prefrontal cortex
• ADHD → Clinical tool → DIVA-5
• ADHD → Frequent comorbidity → Anxiety / depression
• ADHD → Therapeutic approach → Psychotherapy / PGx / pharmacology

References

• Kooij JJ, et al. (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry.
• Faraone SV, et al. (2015). Attention-deficit hyperactivity disorder. Nature Reviews Disease Primers.
• Barkley RA. (2012). Executive Functions: What They Are, How They Work, and Why They Evolved.

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