Untreated ADHD in adults

Symptoms of ADHD in adults

ADHD presents in adults in many different ways, and symptoms can be different for men and women. Most commonly, ADHD makes planning, setting priorities and focusing on tasks more difficult. As a result, people with ADHD may miss appointments, forget to pay bills or need to extend deadlines. For some people, impatience and mood swings are also part of ADHD.

Common symptoms of adult ADHD:

• Difficulty multitasking: Those affected may struggle to switch between one task and another or focus on more than one task at the same time.
• Poor time management: This includes difficulty meeting deadlines, keeping appointments and making sense of time and scheduling.
• Difficulty focusing: Challenges with focus may prevent people with ADHD from finishing tasks or carrying through with difficult or complex tasks.
• Restlessness or hyperactivity: Many adults with ADHD feel continually restless and need to stay active, making it harder to sit still for long periods of time or concentrate on important tasks.
• Disorganization: Many struggle to stay organized, possibly leading to problems such as unpaid bills, unmet responsibilities and difficulty completing tasks.
• Inability to cope with frustration: Some adults with ADHD may not manage frustration and disappointment well. For example, a setback others may see as small may seem like an impossible obstacle for someone with ADHD, leading to more frustration and stress.
• Inability to manage stress: Some people with ADHD can’t effectively manage stress, and stress can accumulate from personal, professional and academic challenges presented by other ADHD symptoms.

Because of the challenges ADHD presents, people with the condition may appear to be aloof, irresponsible and disinterested, contributing to interpersonal and relationship issues that can be difficult to navigate.

Treatment and management of adult ADHD symptoms can help people with ADHD live successful lives and achieve their goals on their own terms without feeling limited by ADHD symptoms.

How ADHD presents differently in men and women

ADHD may be different for men and women, just as symptoms can differ for individuals. Generally, women internalize their ADHD symptoms more often and may be better at hiding their ADHD than men, who often present their ADHD symptoms externally and more visibly. ADHD in women may also be undiagnosed for longer periods than men, according to research.

Some researchers believe that differences in symptoms between men and women lead to different rates of diagnosis. According to research, women may be less likely to receive an ADHD diagnosis than men without highly prominent symptoms. One study found that men may show more severe ADHD symptoms during childhood, which could lead to more men being diagnosed with the condition.

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Challenges in getting an ADHD diagnosis

ADHD in adults isn’t always properly diagnosed. This is in part due to ADHD stereotypes — many people imagine that everyone with ADHD is a young boy acting out in class with behavioral problems and the inability to sit still. The reality is that ADHD impacts people of every gender and age, with varying presentations.

There are subtypes of ADHD, such as inattentive ADHD, with internal symptoms that are harder to recognize, reducing the likelihood of a diagnosis or referral from school for ADHD testing. If you or a loved one has ADHD that’s less visible to others, you may not realize you have the condition until you encounter consistent challenges at work (e.g., inattentiveness or impulsivity) or at home with a partner (e.g., a tendency to overspend).

Those with ADHD often deal with other mood conditions, many of which are diagnosed before providers notice ADHD. Patients may have anxiety, depression, an autism spectrum disorder or other conditions alongside ADHD and seek treatment for these before realizing ADHD is also a factor.

Other barriers to obtaining a proper diagnosis:

• Lack of access to care/adequate insurance coverage
• Cultural differences
• Provider awareness/education

Seeking adult diagnosis

To be diagnosed with ADHD as an adult, you need testing and an official diagnosis from a qualified mental health professional (i.e., physician, psychiatrist, neurologist or psychologist).

Without a diagnosis, it’s harder to get treatment or accommodations from work and school (such as providing a quiet workspace at the office, a flexible schedule or more time for testing) that could help you achieve your goals.

Don’t delay screening if you think you have ADHD. Here’s how to get ADHD testing:

1. Review your symptoms: The typical presentation of ADHD involves inattention, impulsivity and hyperactivity. Within these three categories, people with ADHD can present a variety of symptoms, including poor time management, disorganization, missed deadlines, tendency to interrupt others, inability to sit still for long periods of time, and repetition of words and actions. Think about what ADHD signs apply to you and whether these interfere with your activities of daily life.
2. Read the DSM-5 criteria: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) sets official criteria for an ADHD diagnosis. The criteria require at least five symptoms of inattention or hyperactivity and impulsivity for at least six months starting before age 12. Symptoms should impact two or more areas of life (e.g., school, work, personal life) and interfere with your functioning. Finally, another mental health condition must not explain your symptoms. To be diagnosed, these criteria must apply to you and must impact your quality of life.
3. Take a self-screening test: With a self-assessment test, you can check your symptoms against typical ADHD symptoms. Most of these tests are made up of questions with yes/no answers asking you about your symptoms or asking you to rank yourself (for instance,”How often do you feel distracted when you’re listening to a conversation?”’). Self-screening isn’t a diagnosis strategy, but it helps you familiarize yourself with common symptoms. Once you get your results, if your score is consistent with ADHD, that’s helpful information to share with your health care provider.
4. Talk to your health care provider: With what you know about your symptoms and past experiences, if you think you may have ADHD, you should ask your health care provider for more information. Your provider may diagnose you, or they may refer you to a qualified ADHD specialist who can diagnose you.
5. Find a specialist who can diagnose ADHD: A family doctor, neurologist, psychiatrist or psychologist may diagnose you with ADHD and provide treatment. Not all providers can prescribe medications or provide therapy for ADHD, however.
6. Complete your ADHD evaluation: Your health care provider will assess you for ADHD, screen for other conditions, ask about your symptoms and challenges, possibly interview someone who knew you as a child (such as a teacher or your parent) and rule out other conditions. If you are diagnosed, your provider will talk about possible treatment options.
7. Learn about ADHD treatment: People with ADHD can use medication, therapy and/or coaching to help them manage symptoms. ADHD coaches can help you set goals, manage your time and choose priorities to make daily activities more manageable. Therapy can help you address anxiety and executive function symptoms as well as improve your self-esteem. Many people with ADHD use stimulant or nonstimulant medications shown to be effective at reducing symptoms. Learn what you can about treatment options and consider what works best for you.

Long-term effects of untreated ADHD

If your ADHD isn’t treated, your symptoms may worsen or adversely impact your life by interfering with your ability to focus, plan and control impulsiveness. Without treatment, you may experience:

• Work/academic effects: Lower productivity, missed deadlines, difficulty listening, lower achievement, disappointing others and failing expectations
• Social/interpersonal effects: Misunderstandings, forgetting names/conversations and difficulty making and keeping friends
• Mental/physical effects: Increased stress, anxiety and depression

Over time, untreated ADHD symptoms can make it more difficult to finish school, hold down a job, accomplish your goals and make plans.

ADHD and co-occurring disorders

Since there are other mental conditions and health care issues that can mimic or overlap with ADHD, it’s a good idea to talk to your health care provider if you suspect you have ADHD and think you might also have a co-occurring condition. Co-occurring conditions can make treating ADHD more complicated — for example, treating an anxiety disorder and ADHD may mean taking multiple medications and making sure each condition improves and doesn’t worsen.

Common co-occurring conditions:

• Mood disorders: Bipolar disorder, dysthymia (a long-lasting form of depression) and depressive disorders are common mood disorders that may co-occur with ADHD and contribute to mood swings.
• Anxiety: Obsessive-compulsive disorder (OCD), social phobia, agoraphobia, post-traumatic stress disorder (PTSD), panic disorder, a specific phobia or generalized anxiety disorder often accompany ADHD.
• Substance abuse: Alcohol and drug dependence and abuse commonly co-occur with ADHD.
• Intermittent explosive disorder: With little or no warning, someone with intermittent explosive disorder becomes angry and may verbally or physically attack others. This disorder may be present alongside ADHD.

To treat a co-occurring condition, your health care provider will need to review your health history, consider your symptoms and recommend a treatment plan incorporating treatment for your conditions.

ADHD impact on relationships and daily life

ADHD can pose daily challenges that impact relationships, everyday routines and achievement. People with ADHD may struggle to achieve career success, live independently and meet their own expectations and societal expectations. For these reasons, ADHD symptoms can cause frustration and adversely impact well-being.

To improve quality of life, many people with ADHD seek treatment for symptoms and look for opportunities to strengthen their executive functioning skills. If you have ADHD, you should know the condition is often highly treatable and that there are many options available to help you achieve your goals. Your health care provider is a great resource for helping you find appropriate treatment, coaching and therapy options.

ADHD treatment for adults

Adults with ADHD have many options for managing and treating symptoms, including medication, therapy and coaching. Stimulant and nonstimulant medicines are designed to provide some relief for symptoms of ADHD. Coaching provides ADHD strategies for addressing symptoms and strengthening executive function skills, such as planning and managing time. Therapy can help people with ADHD manage emotions and improve their sense of well-being.

Self-help may also be effective. Many people with ADHD use organizational systems, such as special planners, memory tricks and productivity hacks (like planning work periods around moments of hyperfocus), according to the Attention Deficit Disorder Association (ADDA).

You can experiment with different productivity techniques (e.g., working with a timer or making lists) — whatever works for you. Reading more about ADHD and how others manage their symptoms could also help you find strategies that may work for you.