Adult ADHD

For many, “ADHD” brings to mind a hyperactive 9-year-old boy who is climbing on a table. In addition, many people believe that ADHD is a disorder of childhood and that kids will “grow out of it”. Both stereotypes are incorrect. The “inattentive” subtype presents quite differently. People with this subtype tend to be daydreamers who are lost in thought and easily distracted. Children with inattentive ADHD, particularly girls, can mask their symptoms and do “okay” – until life throws too much at them and the wheels start to fall off (often during puberty or early adolescence).  Anxious children may put extra effort into masking symptoms and be working twice as hard. Both adults and children with ADHD may be able to use their ability to hyperfocus to excel in very specific areas of life (e.g., work, art, sport, writing). For these reasons, it is NOT uncommon for ADHD to be missed in childhood or adolescence.

Children with ADHD become adults with ADHD. They do not simply grow out of it (although the symptoms may fluctuate and change over time). I tend to think that rather than growing out of it, children tend to grow into it. With the right treatment (medication, support, and strategies) children can do well. There is no “quick fix”, however, children can learn a range of different strategies to harness their strengths and deal with things they find challenging (e.g., executive function skills and emotion regulation). In contrast, not receiving treatment for ADHD in childhood is a factor that contributes to the likelihood of difficulties associated with ADHD persisting into adult life.  

Up until about 20 years ago, it was thought that there was no such thing as adult ADHD. Professionals believed the children grew out of ADHD (eventually), However, there has since been a wealth of research and evidence to show that this is not true. A recent study has found that adult ADHD is far more prevalent than was previously thought. Ayano et al. (2023) estimated that the global prevalence of ADHD is 3.1%. The international team analysed 57 research studies (including a total of over 21 million participants!) and found that it is likely that 180 million adults worldwide have ADHD. Interestingly, the data found that most adults with ADHD have the inattentive subtype.

ADHD is highly heritable. If you have a child with ADHD, there is a high chance that you or your partner may also have it.  There has been an explosion of interest in the media lately around adult ADHD, particularly ADHD in women. Some of the press has been negative, e.g., portraying adult ADHD as some kind of new trend. Be assured it is not!

Many women seek a diagnosis after their child has been diagnosed as they realise that many of the struggles, they have faced in their life can be attributed to the same symptoms their child is experiencing. We know that ADHD can present very differently in girls and symptoms are often masked. Females tend to experience more inattentive symptoms and may not receive a diagnosis until later in life. This may correspond with changes in hormone levels during pregnancy, perimenopause or menopause. Difficulties with executive functions are just as common in females. There is also a strong association with other mental health conditions such as depression and anxiety (again this can make the path to diagnosis tricky). To make things even more difficult, parenting a child with ADHD is associated with increased stress and anxiety, regardless of whether or not a parent has a diagnosis of ADHD.

If you or your child has ADHD, there are many good reasons to seek treatment (at any age). One study that has had a fair amount of recent media attention found that adults with ADHD are nearly three times as likely to develop dementia (including Alzheimer’s disease) than adults without ADHD.  This association remained even when other risk factors (e.g., cardiovascular conditions) were accounted for. The study followed a very large sample (n=109,218) for 17 years (2003-2020).  The data are NOT cause for alarm. Dementia occurred in 13.2% of those with adult ADHD and 7.0% of adults without ADHD (this difference was significant, (P <.001). However, there was NO obvious increase in the risk of dementia associated with adult ADHD in those who were taking psychostimulant medication (Levine et al., 2023).

Stimulant medication is known to modify the “trajectory of cognitive impairment”. The authors of the study above hypothesise that untreated ADHD symptoms may reduce a person’s ability to compensate for the effects of cognitive decline that occur later in life.

The data from both of these studies are important for a couple of reasons. First, many within this group have a child with ADHD. Secondly, we know that ADHD is STRONGLY heritable, and research shows that there are many, many adults out there who have not received a diagnosis (or received a diagnosis late in life, often after their child (or children) were diagnosed. This leads us to the conclusion! If you have a child with ADHD and you experience symptoms yourself, please reach out. The diagnostic process tends to be slightly different for adults - in general, your GP is the best place to start for a referral.

I work a lot with adults with ADHD and parents who have a child with ADHD so if you need further support and would like to book a no-cost discovery call or a session, please see HERE.

And … if you want ALL of the tools to help your child with executive functions skills and emotion regulation - I have a VERY reasonably priced short course that includes all of the information you need here Executive Functions Course

References

Ayano, G. et al. (2023). Prevalence of attention deficit hyperactivity disorder in adults: Umbrella review of evidence generated across the globe. Psychiatry Research, 328, 115449.

Levine, S.Z. et al. (2023). Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia. JAMA Network Open, 2023; 6 (10): e2338088.

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