Always on the move: ADHD in men

By Dr Rykie Liebenberg, Psychiatrist

ADHD is one of the most common neurodevelopmental disorders, with as much as 75% of adults with ADHD never being diagnosed. According to psychiatrist Dr Rykie Liebenberg, around 90% of men with undiagnosed ADHD may present with symptoms of aggression or behavioural disturbance – which makes diagnosis of ADHD in men vitally important.

“ADHD in men typically presents with inattention, impulsivity and hyperactivity, so it’s more easily picked up in men than in women, who tend to withdraw,” explains Liebenberg. In Liebenberg’s experience, symptoms of untreated ADHD are felt most profoundly by family members or partners.

Relationship drain
“Men with ADHD are prone to emotional outbursts, because they struggle to control their emotions,” says Liebenberg. “They’re impulsive both at work and at home, often walking out of jobs and relationships when they get bored or disinterested. This puts a huge strain on relationships, which is why rates of divorce are so much higher in partners where one individual has ADHD.”

Liebenberg describes the effects of untreated ADHD in men as existing on a spectrum from forgetting to buy bread and milk, to forgetting to pick up the kids. The same goes for addictive behaviour – it ranges from smoking, to pornography and gambling addictions, as well as substance abuse.

Can’t sit still
In dealing with men with ADHD (if they fall into the hyperactive subgroup) Liebenberg finds they often present as either the workaholic and/or extreme sportsman. These habits are adopted, Liebenberg suspects, as coping mechanisms to manage their own symptoms.

“The workaholic-ADHD man hardly ever takes a break or goes on holiday and when he does, he’s out on a 4×4 track or running, paddling and cycling. He struggles to sit still or take time off, which makes it tough for the people around him to relax and unwind – particularly a partner.”

At work, he’s up and out of his seat, describes Liebenberg, interrupting others and distracted by everything around him. Working as a paramedic, sales rep or IT developer usually suits men with ADHD, as they’re constantly on the move, talking to different people, and with varied stimuli, she says. Liebenberg finds they often become entrepreneurs, as they aren’t restricted by a schedule and can work their own hours.

Missed meds
Despite the common perception that men don’t want the stigma of diagnosis and therefore resist treatment, men with ADHD these days aren’t too put-out by the diagnosis.

“Admitting you can’t focus or sit still is much easier than admitting you have a deep-seated emotional issue, so I find men quite easily talk about their symptoms and accept the diagnosis and treatment,” describes Liebenberg. “The problem usually comes in when they have to stick to a routine in taking their medication – they frequently forget and take their meds at the wrong time.”

Treating with support
As with treating anyone with ADHD – men or women – understanding and patience is key, says Liebenberg. “It’s never easy adjusting to a new lifestyle and treatment plan, but the benefits are huge,” says Liebenberg. “With a little care and sensitivity, men with ADHD can manage their symptoms and enjoy a much more stable and organised life.”