Attention deficit hyperactivity disorder (ADHD) is often considered a childhood disease. However, in two-thirds of cases, it persists into adulthood. The estimated lifetime prevalence of ADHD among adults aged 18 to 44 in the United States is as high as 8.8%. However, less than 20% of adults with ADHD are currently diagnosed and treated.
If untreated, ADHD in adults can lead to functional impairment, especially in relationships and the workplace. Untreated ADHD can significantly affect a person’s quality of life.
Read on to learn more about the risks of untreated ADHD in adults and how to get help.
What is ADHD?
ADHD is called a neurodevelopmental disorder because its onset occurs during prenatal development.
During the early stages of brain development, the central nervous system and neural pathways in the brain are already formed. Neurodevelopmental problems can cause defects (deficits) or delays in development and behavior.
In ADHD, different parts of the brain are affected, including the front part of the brain or the prefrontal cortex. This is the area of the brain that processes executive function, a set of mental skills that includes:
- working memory
- time management
- focus on one task
All are affected by ADHD.
Signs of ADHD in adults
Adults with ADHD may exhibit inattention (inattentiveness), hyperactivity (hyperactivity), and impulsiveness (easily shaken and acted on impulse).
- Difficulty concentrating or staying focused to complete tasks
- Inability to follow instructions and complete work-related tasks at work
- Lack of organizational and time management skills
- Lost items such as wallets, keys and smartphones
- Easily distracted and forgetful
- Extremely restless, unable to sit still
- fidgeting, wriggling, or tapping hands or feet when sitting
- talk too much
- been on the road
- act without thinking
- obscuring hurtful or inappropriate remarks without regard to impact
- Difficulty waiting in line or getting your own turn
- interrupt others
- harass others
Gender Differences in Adult ADHD
Although ADHD is more common in men, symptoms and risks are slightly different in men than in women. Women have historically been undervalued. Some differences include:
- Men have more hyperactivity and impulsivity symptoms.
- For men, anger management can be a bigger problem.
- Male urges lead to more crashes and injuries.
- Men are more likely to have 3 or more concussions in their lifetime.
- Women have more symptoms of inattention.
- Women often seek treatment because they feel life is out of control, or because their finances, jobs and families seem to be in disarray.
- Women reported experiencing more anxiety, stress and exhaustion.
- Women with ADHD may have higher stress levels because they typically have more responsibilities at home and with their children.
Risks of Untreated ADHD in Adults
Untreated ADHD is associated with impairments in key areas of life, such as work and school, relationships, and quality of life.
Some risks of untreated ADHD in adults include:
- Low Self-Esteem: Adults with ADHD often feel negative about the functional challenges caused by the disorder. Studies have shown that ADHD in adulthood is associated with overall low self-esteem, but this can be improved with treatment.
- Anxiety: About 50% of adults with ADHD also suffer from anxiety. Medication and psychotherapy for ADHD and anxiety disorders can improve both problems.
- Relationship problems: Multiple studies have shown that adults with ADHD have elevated levels of emotional dysregulation (poor emotional management). Untreated ADHD makes it difficult to control mood, depression, impatience, and self-regulation of anger. Emotional responses can negatively impact relationships. Treating ADHD with medication and therapy to gain communication and interpersonal skills can help.
- Job instability: Adults with ADHD face a variety of challenges in the workplace, including poor communication skills, distraction, procrastination, and managing challenging projects. Psychotherapy can help gain skills to manage ADHD in the work environment. It’s also important to find career paths that leverage ADHD to your advantage, such as career paths in a fast-paced environment.
- Substance use: Multiple studies have shown that people with ADHD are three times more likely to be dependent on nicotine. People with ADHD are 50% more likely to have a drug or alcohol use disorder than people without ADHD. Research shows that treatment with ADHD medications can reduce substance abuse.
- Increased mortality: Several studies have shown a slight increase in the number of premature deaths among adults with ADHD, mostly due to accidents and suicide. However, long-term treatment with ADHD medication significantly reduces the risk of accidents and suicide.
Adult ADHD found as a parent
ADHD can be present from childhood, but is sometimes not recognized and diagnosed until adulthood. Often, an ADHD diagnosis in adults is found when their child is diagnosed with ADHD. Parents with ADHD are often overwhelmed by the demands of parenting and may struggle to meet their children’s needs. They may have been able to manage ADHD before becoming parents, and parenting presents new and different challenges that untreated ADHD struggles to cope with.
Treating ADHD in Adults
Treating ADHD in adults can improve symptoms and often lead to better outcomes and quality of life.
Research consistently shows that ADHD-targeted treatments (drugs and therapy) can reduce accidents, brain injury, crime, substance abuse, suicide, and self-harm, and improve work functioning and relationships.
Genetics of ADHD
If at least one parent has ADHD, their child’s risk of developing ADHD is significantly increased. Heritability is estimated at 77%–88%.
Medications for ADHD in Adults
The main types of drugs used to treat ADHD include stimulants, antidepressants, and non-stimulant drugs. These are designed to affect neurotransmitters, such as dopamine, that send signals between nerve cells in the brain.
- Stimulants: The two main stimulant drugs are Adderall (Amphetamines) and Ritalin, Concerto and Metadata (methylphenidate). Stimulant drugs are often the drug of choice for ADHD.
- Antidepressants: These drugs affect neurotransmitters such as Norepinephrine. They include tricyclic antidepressants, monoamine oxidase inhibitorExternal amplifier (Venlafaxine) and Wellbutrin (bupropion).
- Non-stimulants: These drugs are often used when someone cannot tolerate stimulants or when stimulants are not fully effective. They include Stratella (atomoxetine) and Intuniv and Tenex (Guanfacine).
What are the different types of medications for ADHD?
Psychotherapy for ADHD in Adults
There are two main types of treatments that seem to work best for ADHD:
- Cognitive Behavioral Therapy (CBT): CBT is a type of psychotherapy or talk therapy that focuses on how thoughts, feelings, and behaviors affect each other. Thinking differently, exploring and challenging negative or maladaptive thoughts can change feelings and behaviors. CBT helps improve emotional self-regulation, impulse control, stress management, and daily executive functions such as managing time, planning, and task completion. It also leads to more positive beliefs and thoughts about yourself.
- Dialectical Behavior Therapy (DBT): DBT is based on CBT, but with several differences. DBT is specifically designed to improve emotional self-regulation challenges in borderline personality disorder, but has been applied to many situations with emotional regulation challenges. There is a strong focus on self-acceptance and the ability to change through more adaptive, flexible thinking, skill development, and therapist support and validation. Skills training focuses on mindfulness, distress tolerance (managing actual or perceived emotional distress), emotion regulation, and interpersonal relationships.
Advantages of ADHD in Adults
While living with ADHD can be challenging, it also has advantages. These include:
- Creativity: People with ADHD are often innovative, creative, and creative thinkers.
- Hyperfocus: People with ADHD are often able to hyperfocus, which is total concentration on a task. This can allow for certain types of productivity.
- In flow: Research on hyperfocus shows that it is the same as being in a “flow state.” From a positive psychology perspective, flow states are heightened states of creative focus. This ability suggests that, under the right conditions (fun and engaging), people with ADHD can actually maintain attention and a higher level of task focus.
Although often viewed as a childhood disease, ADHD can persist into adulthood. However, ADHD in adults often goes untreated. Untreated ADHD can lead to functional impairment. Treatment of ADHD in adults, including medication and psychotherapy, can be effective in improving quality of life.
As with many mental health conditions, the unfortunate stigma associated with ADHD can deter adults from seeking treatment. It’s important to remember that ADHD is brain-based and genetic. Treatment can significantly change a person’s quality of life. Talk to your healthcare or mental health provider about the treatment that’s best for you.
Frequently Asked Questions
Does ADHD get worse with age?
Will not. In general, ADHD is not known to worsen with age. However, with treatment, medication for ADHD, and psychotherapy, ADHD may actually improve with age.
Can ADHD be cured?
No, there is no cure for ADHD. However, treatment has proven to be very effective in managing the symptoms and difficulties associated with ADHD.
Can ADHD develop into other mental illnesses?
ADHD does not usually develop into other psychiatric disorders. However, many people with ADHD have co-existing conditions. Other conditions that often co-occur with ADHD include anxiety, depression, and mood disorders.