Paying Attention to Adult ADHD

Adult ADHD often exists with additional conditions and issues

September 11, 2012 / Author:  / Reviewed by: Joseph V. Madia, MD

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Everyone has trouble focusing from time to time, but for those with ADHD, the issue can place a large amount of strain and struggle on everyday life.

Some who have the disorder as children grow out of it, but for adults who retain their ADHD symptoms, understanding the disorder in the context of adulthood takes on a new importance.

Research is being done to understand just how many adults this affects, and what other issues commonly accompany the condition.

Adult ADHD Explained

According to The Mayo Clinic, attention deficit hyperactivity disorder (ADHD) always starts in early childhood, even if it goes undetected or undiagnosed for years.

Previous belief held that symptoms waned as patients exited childhood, but it is now known that for some, the disorder can last throughout their life.

Hyperactivity, impulsive behavior and inattention are the main symptoms of adult ADHD symptoms. Restlessness, disorganization, difficulties concentrating, mood swings and trouble dealing with stress or anger are common expressions of these symptoms.

For those with adult ADHD, it is common for their symptoms to cause additional difficulties in everyday life. Trouble at work or school, low self esteem and unstable relationships often stem from ADHD symptoms. Missing deadlines, forgetting meetings and hot tempers can be manifestations of these symptoms that lead to difficulties in work and social situations.

According to The Mayo Clinic, "Many adults with ADHD aren't aware they have the disorder — they just know that everyday tasks can be a real challenge."

While most people experience these symptoms occasionally, doctors only diagnose ADHD when they lead to significant problems in various areas (i.e., in both career and personal relationships).

Furthermore, in adults with ADHD, these symptoms have been a problem throughout life. If the symptoms only developed recently, it is not considered adult ADHD.

Adult ADHD is often difficult to diagnose, due to the fact that some symptoms overlap with other disorders, like mood disorders. On top of this, many adults with ADHD are also coping with anxiety or depressive disorders. Some studies have attempted to measure the rates of these additional problems.

Prevalence & Additional Difficulties

The Mayo Clinic reports that one in three people with ADHD grows out of the disorder, one in three experiences mild symptoms as adults, and one in three deals with ongoing severe symptoms throughout adulthood.

A 2006 Harvard Medical School and National Institute of Mental Health (NIMH) survey attempted to quantify the disorder's prevalence on a larger scale.

The study, lead by Ronald C. Kessler, PhD, and published in the American Journal of Psychiatry, is  known as the National Comorbidity Survey Replication (NCS-R). Comorbidity is the existence of existence of more than one disorder at once.

A sample of 3,199 adults, aged 18 to 44 years of age were surveyed for ADHD in particular. The initial, wider survey included an assessment of 9,282 adults, then a follow up for 5,692 of these respondents. 

Those assessed for ADHD were placed into four categories: people with no reported childhood ADHD, people with some reported symptoms, but not sufficient for a childhood ADHD diagnosis, people who had ADHD as a child but reported no adult symptoms, and those with childhood ADHD who did report symptoms during adulthood.

Results led authors to estimate that 4.4% of the adult American population is coping with ADHD.

The study found that these adults with ADHD were likely to be dealing with a number of other issues (comorbidity). According to the authors, adult ADHD is significantly comorbid with a variety of other mental health conditions, and the strength of this comorbidity doesn't vary greatly from class to class of disorder.

Depression, anxiety, mood disorders and substance abuse were common additional disorders found in the adults with ADHD.

These adults were mostly men (61.6 percent), and mostly non-Hispanic whites (81.8 percent). These adults with ADHD were also commonly divorced and fell into the "other" employment category - meaning they were unemployed, disabled or otherwise unable to work.

Moreover, while many of those with adult ADHD (specifically females) had received treatment in the previous year for substance abuse or other mental health issues (53.1 percent of the females with ADHD and 36.5 percent of the males), only 22.8 percent of the females and 27.7 percent of the males had ever undergone ADHD treatment.

Even lower were the counts of those who had received ADHD treatment in the past year - 12.1 percent of the females and 10.1 percent of the males.

It is important to note that this study was based initially on self reports, and that comprehensive follow-ups were only completed with portions of those surveyed, both of which may lead to some variation.

Furthermore, the presence of other issues does not necessarily mean that the ADHD causes these comorbid conditions, or vice versa, but only that they are both present.

However, this study does offer an interesting look into the prevalence of ADHD among adults, as well as other issues that may come along with this difficult disorder. 

For those that suspect they may have adult ADHD, The Mayo Clinic suggests scheduling a visit with a doctor and preparing before hand.  Writing down questions to ask, symptoms experienced, issues that have resulted from these symptoms, medications taken and recent life changes can help this initial appointment be effective.

As more is learned, both doctors and patients will become better able to treat and cope with adult ADHD and potential comorbid disorders. 

Reviewed by: 
Review Date: 
September 6, 2012
Last Updated:
February 1, 2013