“ADHD is a chronic, life-long disorder. Symptoms may be less impairing as we learn to live with them and develop strategies and a lifestyle to better cope.” ~ Dr. Patricia Quinn

ADHD (Attention Deficit Hyperactivity Disorder) is a common neurodevelopmental disorder. The average age at diagnosis is seven years, with boys almost twice as likely to be diagnosed as girls.[1] 

Because of its prevalence in children, it was previously thought that ADHD did not affect adults. It was widely thought in the scientific community that ADHD was a childhood-only disorder, disappearing by early adulthood.  It was not until the late 60s that the American Psychiatric Association (APA) formally recognized ADHD as a mental disorder, and it took many more years before it was widely recognized and understood within society. We now understand that this is a life-long disorder in which coping strategies can help reduce symptoms as a child grows into adulthood. Persistence rates, however, vary, ranging from 6%[4] to 30%[5] and perhaps even higher.

In recent years, there has been an upsurge in adults being diagnosed with ADHD.  New diagnoses in adults  are not usually because their ADHD is recently occurring but is likely due to their symptoms being passed off as “bad behavior” when they were young.  In the United States, an estimated 8.4 percent of children and 2.5 percent of adults have ADHD. [2],[3]  In the U.K., however, an estimated 4% of adults have been diagnosed with ADHD. 

While many new diagnoses are the result of symptoms being overlooked in childhood, there are some instances where the symptoms are newly occurring in adults. A longitudinal study led by Kings College in London suggested that ADHD can show up problematically for the first time in adulthood — even if those adults never had diagnosable symptoms of ADHD in childhood. Jessica Agnew-Blais, co-author of the U.K. study, stated that the “absence of a childhood diagnosis should not prevent adults with ADHD from receiving clinical attention.” [6]  Since ADHD has only recently been reconceptualized as a disorder than can begin in adulthood, there is a significant lack of research into this field. It is now understood that, for some, adult- or adolescence-onset ADHD may be associated with different risk factors and outcomes than childhood ADHD. 

The lack of research and understanding had led many adults to suffer from chronic, debilitating ADHD symptoms, to be misdiagnosed, and to not receive the care and treatment they deserve. These adults may suffer serious psychological consequences after a lifetime of blaming themselves for ADHD symptoms.

Symptoms of ADHD

Children are frequently diagnosed with ADHD after teachers or parents notice their symptoms becoming problematic. However, with adults, an evaluation usually occurs once a peer, family member, or colleague observes problems within relationships or at work. 

Inattention, hyperactivity, and impulsivity are important symptoms for a childhood ADHD diagnosis, and symptoms in children must convey an established pattern. With adults, it must have been present for 12 months or more. 

With children, the key symptoms are:

• Difficulty concentrating and focusing 
• Forgetfulness and disorganization
• Distractibility
• Restlessness
• Domination of conversation Talking over people

Symptoms among adults commonly include:

• Excessive activity or restlessness
• Forgetting names and dates
• Trouble multitasking
• Distractibility and disorganization
• Regular bouts of frustration and anger
• Impulsivity and risk-taking behavior
• Missed deadlines 
• Extreme emotionality and rejection sensitivity
• Generalized Anxiety and other mood disorders

ADHD that is undiagnosed and untreated as an adult can have wide-reaching effects and cause problems in virtually every area of one’s life. It can lead to frustration, anxiety, hopelessness, disappointment, and feelings of desperation.

It is also common for adults with ADHD to experience the following issues:

Work and financial difficulties: Individuals who have untreated ADHD are likely to struggle with their jobs as the symptoms listed above result in their failing to meet deadlines, multi-tasking but doing nothing well, prioritizing ineffectively, having difficulty maintaining relationships with managers, and/or having trouble following rules. Individuals can therefore find themselves struggling to hold down a job and experiencing financial difficulty, not only from a lack of work but also because of the challenges they face organizing and staying on top of bills, etc. 

Relationship issues: The aforementioned symptoms can strain romantic, family, friendship, and work relationships. An adult suffering from ADHD can have severe emotional dysregulation[7], meaning that they may over- or under-react to situations, fail to communicate effectively, and interpret others’ feelings inaccurately. This can lead to an individual suffering with ADHD feeling increasingly isolated and being less likely to receive the help and care that they need.

Physical and mental health issues: The symptoms of ADHD can contribute to various chronic health problems, including eating disorders, substance use, anxiety, depression, and chronic stress. [8] Sufferers may also forget to take medications, ignore or forget medical advice, and miss essential appointments. 

Causes of ADHD

According to the National Institute of Mental Health[9], risk factors that could cause the onset of Attention-Deficit/Hyperactivity Disorder may include:

• Ancestry/Genetics 
• Premature delivery/low birth weight
• Maternal drug , alcohol, or tobacco use while in-utero
• Exposure to toxins, such as lead, in utero or in early childhood
• Brain injury

Conclusion

Adults with ADHD often experience multiple life difficulties, including financial issues, relationship issues, depression or anxiety, anti-social behaviors, lowered socioeconomic status due to work-related problems, and substance use. [10]  It is also common for adults suffering with ADHD to face extreme social difficulties, resulting in potential social anxiety or low self-esteem due to difficulties in affect recognition[11], emotional dysregulation, and an inability to express anger or frustration appropriately. [12]  The prevalence of co-occurring mental and physical health disorders are of great concern to the individual, as ADHD is known to impart substantial morbidity to those suffering with the condition. [13]

Fortunately, adult ADHD can be effectively treated and managed. The treatment options are likely to provide profound relief to the sufferer once they get past the issues of misdiagnosis, faulty perception, and social stigma surrounding the illness. Treatment plans for adults living with ADHD can include medication, therapy, and family support. Cognitive Behavioral Therapy (CBT) can be helpful with managing symptoms and establishing positive coping strategies. 

It is also vital for an adult with Attention-Deficit/Hyperactivity Disorder to establish core healthy living practices such as getting enough sleep and regular exercise, eating healthily, and abstaining from intoxicants. These will ensure that an individual’s physical and mental health are at optimum levels to allow ADHD sufferers to manage the daily challenges that ADHD presents.

If you are concerned about any issues discussed in this blog, please contact Heather R. Hayes & Associates.  Call 800-335-0316 or email info@heatherhayes.com today.

 [1] “Data And Statistics About ADHD | CDC”. Centers For Disease Control And Prevention, 2020, https://www.cdc.gov/ncbddd/adhd/data.html.

[2] Danielson, Melissa L. et al. “Prevalence Of Parent-Reported ADHD Diagnosis And Associated Treatment Among U.S. Children And Adolescents, 2016”. Journal Of Clinical Child & Adolescent Psychology, vol 47, no. 2, 2018, pp. 199-212. Informa U.K. Limited, doi:10.1080/15374416.2017.1417860. Accessed 16 Nov 2020.

[3]Asherson, P. “Review: Prevalence Of Adult ADHD Declines With Age”. Evidence-Based Mental Health, vol 12, no. 4, 2009, pp. 128-128. BMJ, doi:10.1136/ebmh.12.4.128-a. Accessed 16 Nov 2020.

[4] Kessler, Ronald C. et al. “The Prevalence And Correlates Of Adult ADHD In The United States: Results From The National Comorbidity Survey Replication”. American Journal Of Psychiatry, vol 163, no. 4, 2006, pp. 716-723. American Psychiatric Association Publishing, doi:10.1176/ajp.2006.163.4.716. Accessed 10 Apr 2021.

[5] Barbaresi, W. J. et al. “Mortality, AD.HD, And Psychosocial Adversity In Adults With Childhood ADHD: A Prospective Study”. PEDIATRICS, vol 131, no. 4, 2013, pp. 637-644. American Academy Of Pediatrics (AAP), doi:10.1542/peds.2012-2354. Accessed 10 Apr 2021.

[6] Agnew-Blais, Jessica C. et al. “Evaluation Of The Persistence, Remission, And Emergence Of Attention-Deficit/Hyperactivity Disorder In Young Adulthood”. JAMA Psychiatry, vol 73, no. 7, 2016, p. 713. American Medical Association (AMA), doi:10.1001/jamapsychiatry.2016.0465. Accessed 10 Apr 2021.

[7] Retz, Wolfgang et al. “Emotional Dysregulation In Adult ADHD: What Is The Empirical Evidence?”. Expert Review Of Neurotherapeutics, vol 12, no. 10, 2012, pp. 1241-1251. Informa U.K. Limited, doi:10.1586/ern.12.109. Accessed 10 Apr 2021.

[8] Brod, Meryl et al. “Comparison Of The Burden Of Illness For Adults With Attention-Deficit/Hyperactivity Disorder Across Seven Countries: A Qualitative Study”. Health And Quality Of Life Outcomes, vol 10, no. 1, 2012, p. 47. Springer Science And Business Media LLC, doi:10.1186/1477-7525-10-47. Accessed 10 Apr 2021.

[9] NIMH » Attention-Deficit/Hyperactivity Disorder”. Nimh.Nih.Gov, 2019, https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml.

[10] Barkley, Russell A. et al. “Young Adult Follow-Up Of Hyperactive Children: Antisocial Activities And Drug Use”. Journal Of Child Psychology And Psychiatry, vol 45, no. 2, 2004, pp. 195-211. Wiley, doi:10.1111/j.1469-7610.2004.00214.x. Accessed 10 Apr 2021.

[11] Rapport, Lisa J. et al. “Experienced Emotion And Affect Recognition In Adult Attention-Deficit Hyperactivity Disorder.”. Neuropsychology, vol 16, no. 1, 2002, pp. 102-110. American Psychological Association (APA), doi:10.1037/0894-4105.16.1.102. Accessed 10 Apr 2021.

[12] Richards, Tracy L. et al. “Driving Anger And Driving Behavior In Adults With ADHD”. Journal Of Attention Disorders, vol 10, no. 1, 2006, pp. 54-64. SAGE Publications, doi:10.1177/1087054705284244. Accessed 10 Apr 2021.

[13] Brod, Meryl et al. “Comparison Of The Burden Of Illness For Adults With Attention-Deficit/Hyperactivity Disorder Across Seven Countries: A Qualitative Study”. Health And Quality Of Life Outcomes, vol 10, no. 1, 2012, p. 47. Springer Science And Business Media LLC, doi:10.1186/1477-7525-10-47. Accessed 10 Apr 2021.