ADHD in adults remains a controversial topic with some denying its very existence. However, recent data suggests that roughly one-third of children with ADHD continue to meet diagnostic criteria through adulthood, while around 65% still experience significant symptoms (Young et al., 2020, p. 2). Individuals who were not diagnosed in childhood often remain undiagnosed in adulthood for several key reasons.
First, hyperactivity and impulsivity tend to naturally decrease with neurocognitive maturity, and thus adults are more likely to display features of the inattentive subtype of ADHD (Zalsman and Shilton, 2016, p. 71). Furthermore, while environmental demands during school years are relatively consistent among children and young adults, they vary enormously in adulthood as individuals enter the workforce. While some may find ADHD-friendly jobs that place fewer demands on their attention than an educational setting, others may find themselves struggling even more to compensate after graduation.
Furthermore, the symptoms of ADHD can be difficult to identify in adults as they may be masked by coping mechanisms developed over many years. Reported symptoms in adults include restlessness, excessive talking, and needing drugs or alcohol to relax, and they are more likely to suffer from mood disorders, health problems, divorce, and poor career outcomes (Kooij et al., 2019, p. 20). While many adults with ADHD can achieve high levels of functioning, this is often only with immense effort and an emotional burden that may cause anxiety or depression.
While diagnosis of ADHD in adults is decidedly challenging, there are a variety of treatment options that have been proven effective. Management of adult ADHD has been shown to be most beneficial when multi-modal, with cognitive behavior therapy and stimulant medication being the most effective combination (Kooij et al., 2019, p. 25). Therapy is particularly important in newly diagnosed adults as they often have experienced considerable interpersonal dysfunction and emotional distress secondary to years of untreated ADHD.
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