When most people think of attention-deficit/hyperactivity disorder (ADHD), the stereotypical image comes to mind of a young boy in school who has an abundance of energy, talks excessively during class, struggles with school work, and cannot sit still. This, however, is only one of many ways that ADHD might manifest in childhood.
Although nearly 10 million adults have ADHD, fewer than 20% of adults who suffer from the disorder are currently diagnosed or treated by a mental health professional according to the National Institutes of Health (NIH). Experts believe that this is due in large part to the fact that there are misconceptions surrounding what ADHD looks like combined with the fact that it presents differently in girls than it does in boys. Perhaps you did not meet the stereotypical ADHD criteria as a child. Maybe your grades were decent or you were a quiet kid. In many of these cases of undiagnosed ADHD, there were other telltale signs indicating it was there, but presented differently.
“Maybe you were in school and couldn’t keep all of your homework together and a wise teacher suggested keeping track of it on a phone or calendar somehow, so you might carry that on with you as an adult and keep using that strategy to help with the situation. That’s okay for a while, but then you get a job where there is no end to the work and you are never done and it adds more complexity to the problem,” says Joseph Siegel, a licensed clinical social worker with OSF HealthCare.
Siegel explains that ADHD symptoms typically need to be present for a prolonged period of time and in more than one area of a person’s life in order to be formally diagnosed. As a child, the places experts tend to look to for signs are at school and at home. If the stereotypical signs of ADHD did not present during school-age years, the disorder can fly under the radar into adulthood.
Some indicators of ADHD that may manifest in childhood and follow someone into adulthood include: making careless mistakes, trouble paying attention, talking excessively, interrupting others, being easily distracted, restlessness, and so on. Similar to the organizational skills that may have been adapted at a young age, an adult with undiagnosed ADHD may have developed other coping mechanisms over time to help them function on a day-to-day basis. But as the person gets older, circumstances change, and ADHD can continue to go undiagnosed, it can become harder to manage. Siegel says that mental health experts may look at how someone functions in adult relationships as another factor when diagnosing adult ADHD.
“As you get older and you start engaging in these more complex social relationships, ADHD symptoms can be challenging sometimes – especially when it comes to focusing on what your partner is saying. While they are talking to you, your mind may be drifting and you change the topic and they may say: ‘Hey, we’re not done talking about that.’ So it can cause some stressful situations in a relationship,” Siegel explains.
Many adults with ADHD initially seek the help of a mental health professional for issues like depression, anxiety, or stress due to how their symptoms are presenting, and may end up being treated for one of those instead. In these cases, symptoms often don’t improve, even with treatment which can be frustrating. However, it can signal that something else may be going on. This tends to occur more with females than in males, as females with ADHD can present differently. Generally, a female adult with ADHD is less likely to present with the stereotypical “hyperactive young boy in school” symptoms.
According to the organization Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), adult women with ADHD may struggle with paperwork and record-keeping, organizing personal finances, keeping up with the demands of their jobs, and feeling a lack of control. These women may also struggle with daily tasks like meals, laundry, and life management – perhaps jumping from task to task without completing one. They may not display their struggles publicly, appearing to be handling it all. Internally, however, they may feel like they are hanging on by a thread.
Most adults who decide to seek an evaluation for ADHD experience significant problems in one or more areas of living, according to CHADD. These may include inconsistent performance in jobs or careers, difficulty managing day-to-day tasks and responsibilities, forgetting things, getting upset easily over small things, and chronic stress and worry. The NIH adds that ADHD is a highly inheritable disorder, so having a parent who has been diagnosed with ADHD could be another indicator that someone has the disorder.
Receiving a proper diagnosis is a crucial first step in treating ADHD. If you think you might be struggling with the disorder, start by talking to your primary care provider or a mental health professional. Siegel strongly advises to avoid online quizzes or other assessment tools that seem to be gaining popularity, as they can be inaccurate, unsafe, and can misdiagnose people. It is important to get a thorough, proper evaluation performed by a certified health care professional.
“There is one way to ask questions, like: ‘Do you experience XYZ?’ or ‘Have you seen XYZ happening?’ Those questions help us understand what might be going on with the potential ADHD, but proper and in-depth evaluation isn’t asking about how you might be experiencing things, it actually measures how you do them,” explains Siegel.
The good news is that it is never too late to treat and manage ADHD, even in adulthood. Many people do best with a combination of medication and implementing tools that work best for them, while still making time for small things they enjoy throughout the day. Perhaps that means taking a five minute walk a couple times during the day, or calling a friend during a scheduled time, or playing with the dog when waking up. Using a timer when taking these breaks is important too, in order to not lose track of time – something that people with ADHD tend to struggle with. But whatever it might be, Siegel recommends finding their “pizzazz” and implementing that into their new routine.
“You hear a lot about organization and how that helps someone with ADHD. The idea is that you need some scaffolding around your day in order for you to live a fulfilling life and productive life and things like that. But there is nothing more boring to a person with ADHD than structure. You really need structure with pizzazz,” Siegel says.
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According to the National Institutes of Health (NIH), fewer than 20% of adults who suffer from ADHD are properly diagnosed and/or treated by a mental health professional.