ADHD presents differently in adults than it does in children, and it can be more difficult to diagnose in adulthood, as well. While hyperactivity is a major indicator of childhood ADHD, this may decrease in an adult with ADHD while they still struggle with symptoms like difficulty paying attention, impulsiveness and restlessness. These symptoms can affect an individual’s work performance, relationships and self-esteem. So, receiving an ADHD diagnosis and appropriate treatment can have an incredibly positive impact on a person, not only in their daily lives, but also in providing clarity around the struggles they experienced during their childhood and teen years.
Childhood ADHD vs. Adult ADHD
According to the National Institute of Mental Health, 4.4% of U.S. adults between the ages of 18 and 44 are diagnosed with ADHD. However, rarely does this mean the condition developed during adulthood, rather the diagnosis was missed or misdiagnosed during the individual’s childhood. Even in adulthood, ADHD is often misdiagnosed as depression or anxiety, as the symptoms are similar and diagnoses often go hand-in-hand. Some behaviors and thought patterns that serve as criteria for ADHD in adults might be overlooked in children. For example, clinical psychologist Sam Von Reiche, PsyD, notes that symptoms like a lack of organization, poor listening skills, distractibility, and failure to follow through on tasks are often considered typical kid behavior or lack of maturity. A failure to recognize these behaviors, especially when they’re severe, can lead to a missed diagnosis of ADHD.Other symptoms of ADHD in adults include poor planning and time management, trouble multitasking, forgetfulness, low frustration tolerance and frequent mood swings. Many adults struggle with these symptoms without considering ADHD to be the source, which can often result in issues with self-confidence that lead to depressive thoughts, says Nima Fahimian, MD, medical director at TMS & Brain Health. “Many also experience chronic anxiety related to always feeling behind or like an outsider in social situations,” Fahimian says. “I’ve seen patients in their 30s come into our clinic thinking they’re depressed when in reality, they have undiagnosed ADHD. Getting an accurate diagnosis enables them to find and start an effective treatment plan, which is life-changing.”
The Power of Diagnosis
Research psychologist Karla Pretorius, M. Psych, an ADHD and autism advocate and expert contributor at Autism Parenting Magazine, was diagnosed with ADHD in her early 30’s. When she first received her diagnosis from a psychologist, she admits to feeling shocked and a bit disappointed. Historically, society has focused on the challenges of ADHD, rather than the positive aspects of receiving a diagnosis. “At first, when you receive a formal diagnosis you will probably not embrace it, but as soon as you have accepted it, you can utilize this powerful source of knowledge to your advantage,” Pretorius says. “Then it became one more thing that set me apart from my peers that were not able to accomplish what I could due to my hyper-fixation on my interests and passions.” A diagnosis can also finally provide an explanation for some of the struggles a person has faced in their life, she says. “It could mean that you can start accepting your entire self and focus less on what you have felt are some of your weaknesses,” she says. “This in turn can lead to optimizing and harnessing your strengths, which has infinite potential for any person.” Pretorius is one of countless adult women just now becoming aware of their diagnosis, as, historically, it was thought that women couldn’t be as affected by ADHD. This oversight has left an entire generation of women who could have benefited from a diagnosis to be “skipped” by medical professionals, says psychiatrist and ADHD specialist Sasha Hamdani, MD. “The dialogue that only hyperactive little boys can be diagnosed with ADHD is extremely limiting and has contributed to a delayed or missed diagnosis in many women,” Hamdani says. In girls, inattentive ADHD is common. Because symptoms are experienced internally without being outwardly disruptive, the condition is often overlooked, and girls progress through school without intervention. “As time proceeds, these women get better at masking their symptoms, which makes it more difficult to identify and to validate the diagnosis later,” Hamdani says.
Awareness of Adult ADHD
To dispel common myths like these and provide accessible and accurate information about ADHD, Hamdani has taken to TikTok and Instagram as @thepsychdoctormd. While it’s important to be mindful of your sources of information, social media has been a powerful tool for many adults to better understand their symptoms. “Because of the dearth of resources people cannot access formal clinical care,” Hamdani says. “If someone finds something that resonates with them, the eventual goal is a better understanding of your brain. There is a lot that you can do to behaviorally modify that can aid your life and perhaps better suit you as you progress down the journey of a more formal assessment.” Social media also provides a way to connect with other adults who received an ADHD diagnosis in adulthood, which can help an individual to feel less overwhelmed and “othered” by a diagnosis. Ultimately, this can improve an individual’s understanding of how to work successfully with their strengths and weaknesses, says clinical psychologist Dana Harron, PsyD, who has a special interest in ADHD. “An adult also has a greater perspective to be able to contextualize difference,” Harron says. “When you are a child, other people may make determinations about whether you need medication, how much or what kind would be helpful. As an adult, you are the sole arbiter of how you choose to approach this difference.”
