Introduction
ADHD is commonly assumed to be a childhood disorder, however, in the majority of cases, people do not outgrow their ADHD but continue to experience the symptoms into adulthood. Despite our growing awareness of adult ADHD, fewer than 20% of adults with ADHD receive a diagnosis or treatment.
Why Do So Many Adults Go Untreated?
Lack of knowledge about ADHD
In my experience, most of my adult patients with ADHD escaped diagnosis as children because they grew up in a time or place where knowledge of ADHD and access to diagnosis and treatment was limited.
Inattentive Subtype
Those who were undiagnosed in childhood often have the inattentive subtype of ADHD which is characterized by quiet, daydreamy behavior and is more difficult to recognize than the hyperactive/impulsive subtype which presents as restless or disruptive behavior.
Compensation
ADHD often goes unnoticed in those with a very high IQ who did well in school, despite the challenges of ADHD. Others masked their ADHD by developing a rigid, perfectionistic personality which kept them on track. Some compensated with the help of a highly structured home, school or work environment.
How does ADHD present in adulthood?
ADHD often presents in childhood as daydreamy or disruptive behavior in the classroom. ADHD in adults can look different. The following is a list of ADHD symptoms that may be present in adulthood.
Inattentive Symptoms of ADHD:
- Failure to pay close attention or making careless mistakes at work
- Quickly becoming bored with things
- Difficulty concentrating on a conversation
- Failing to finish things or meet deadlines
- Difficulty with planning, organization, time management
- Avoidance and procrastination
- Losing things
- Forgetting appointments and obligations
Hyperactive Symptoms of ADHD:
- Feeling restless (including feeling restless “on the inside”)
- Being able to control restlessness but feeling stressed as a result
- Constantly feeling like you must be doing something
Impulsive Symptoms of ADHD:
- Talking a lot
- Speaking loudly when it is not appropriate
- Coming across as tactless or “a blabbermouth”
- Having difficulty waiting in line or in traffic jams
- Having difficulty respecting other people’s boundaries
What Are The Risks of Untreated ADHD in Adults?
Academic problems
Untreated ADHD is associated with educational difficulties such as poor academic performance, needing extra help or special classes, repeating grades, as well as higher rates of academic failure, suspension and dropping out.
Relationship problems
Those with ADHD are significantly more likely to be divorced and to be less satisfied with their personal, social and professional lives.
Job instability
Adults with ADHD experience challenges with time management, organization and self-regulation which can result in unemployment and financial hardship.
Poor mental health
ADHD is associated with an increased risk of anxiety, depression and substance use. As many as 80% of adults with ADHD have at least one other psychiatric disorder.
Risky Behavior
ADHD has been associated with increased risk-taking behavior. As a result, those with ADHD have higher rates of traffic citations and motor vehicle accidents, more emergency room visits and hospitalizations and a lower life expectancy.
Low self-esteem
It is easy to imagine that those with ADHD, having suffered a lifetime of academic failure or underperformance, relationship problems and employment issues, will struggle with poor self-image and a lack of self-confidence. Some adults with ADHD compensate for this by developing a harsh inner critic and intense perfectionism.
Conclusion
Even though ADHD is commonly thought of as a childhood disorder, its symptoms usually persist throughout the lifetime and result in significant social and occupational impairment, poor mental health and low self esteem. Studies have consistently shown that addressing ADHD in adulthood leads to better outcomes and quality of life.
