Margaret V. Austin, Ph.D., edited by C. E. Zupanick, Psy.D.
image by Mo Riza (lic)Until recently, ADHD (Attention Deficit Hyperactivity Disorder) has always been considered a children's disorder. During the past few decades, both public and professional awareness of ADHD has dramatically increased. This increased awareness has prompted improvements in the early identification and treatment of this disorder. However, many adults did not benefit from this increased knowledge and awareness during their own childhood. In the era of their childhood, ADHD symptoms were either missed entirely, or misattributed to something else (e.g., a lack of motivation, laziness, trouble-maker). Moreover, in the past it was believed that children simply outgrew ADHD.
Thankfully, recent research has corrected many of these erroneous beliefs. However, this research did not occur soon enough to benefit some adults with ADHD. Unfortunately for these adults, their symptoms may be misattributed to other causes, and/or misdiagnosed. Because it is now widely recognized that ADHD can affect people throughout their lives, more adults are being properly diagnosed and treated. Despite this increased recognition, there are only a limited number of qualified professionals with specialized experience in adult ADHD. It is estimated that 60% of children with ADHD will go on to experience adult symptoms as well. Roughly 1 to 5% of American adults have some form of the disorder (Kessler et al 2006).
Besides improved recognition of the disorder, there are other reasons that children might go on to become adults with undiagnosed ADHD. For example, many girls have an inattentive form of ADHD. They appear to be passively distracted (so-called, 'daydreamers'). Since they lack the hyperactive component of the disorder, this may allow them to escape the attention of adults (Collingwood, 2013). Adult women tend to be diagnosed later in life, often during their own child's diagnosis for the disorder (Gromisch, 2013). It should be noted there are conflicting findings related to gender differences in adults with ADHD. Although more males than females have the disorder in childhood, many researchers find that the numbers seem to even out by adulthood (Collingwood, 2013). The reasons for this are complex. It may be due to reasons that are non-specific to ADHD. For instance, women often self-refer, and demonstrate more initiative in health-care-seeking behaviors than do men.
However, just because a diagnosis was not made during childhood, does not mean diagnosis relies on adult symptoms alone. By definition this disorder cannot suddenly appear in adults. This is because similar symptoms can result from head injuries, hyperthyroidism (high levels of thyroid hormone) or seizure disorders. Therefore, Adult ADHD is distinguished from these sorts of adult-onset events because there must be evidence that the symptoms began during childhood. In another section, we will review these distinctions.
For many adults, being diagnosed with ADHD during adulthood can be a great relief. It helps them to finally understand the cause of their many difficulties. However, a late-in-life diagnosis can also lead to a new set of problems. There can be a tremendous sense of loss, grief, or anger over what life might have been. In these cases, questions about "if only" and "what if" can preoccupy thoughts. Many women tend to blame themselves during challenging times. This may create additional problems of depression, anxiety, and alcohol and other drug abuse. Researchers believe this occurs because women often have an internalizing response to their disorder (Gromisch, 2013). Men, on the other hand, tend to externalize their responses and blame others (vs. self) and become angry, even argumentative, and may also turn to alcohol or other drugs. Both genders may become discouraged because of a history of problems that has built up over time. The recognition of a cause for these problems does not make those problems go away. A sense of defeatism can set in and interfere with treatment.
Undiagnosed and untreated adults with ADHD remain limited in reaching their full potential as students, workers, family members, and friends. Therefore, proper diagnosis and treatment are important regardless of the age at which the diagnosis is made. We hope this article provides hope and encouragement for all adults with ADHD.