03/11/2025
The rise in adult ADHD diagnoses is largely a correction, as awareness and understanding have improved over time. The pandemic played a key role by removing external structures like school and work, making it harder for individuals to self-organize—something those with ADHD have long struggled with. Increased focus on mental health, better information, and expanded access to telepsychology also contributed to more adults seeking assessment and treatment.
Adult ADHD symptoms remain the same as in childhood, but they often manifest differently. Inattention, including distractibility and difficulty refocusing, is the most persistent. Impulsivity also remains but shifts from speaking out of turn to behaviors like overspending or procrastination. Hyperactivity becomes more internalized, appearing as restlessness or fidgeting. Historically, ADHD in women was underdiagnosed, particularly hyperactive-impulsive symptoms, but recent research suggests they exhibit similar levels to men, just in different ways. CDC data shows that half of ADHD diagnoses now occur in adulthood, with women making up 61% of that group, reflecting a correction in underdiagnosis.
ADHD has long been underdiagnosed in females, with childhood diagnoses once showing a 10:1 male-to-female ratio, now reduced to about 1.5:1 in adulthood. While ADHD is a neurodevelopmental disorder present from childhood, many adults are diagnosed later due to varying symptom presentation and environmental demands. The diagnostic process includes confirming symptoms before age 12 (though some argue 16 may be a better marker).
Studies suggesting "adult-onset" ADHD often found alternative explanations, such as cognitive challenges in new environments, substance use, or emerging mood disorders. Since attention difficulties are a broad symptom, a thorough evaluation is essential to distinguish ADHD from other conditions.
ADHD impacts nearly all aspects of adult life due to impaired self-regulation and executive functioning. It can lead to financial struggles, workplace challenges, difficulties in relationships, and even poorer physical health. Studies suggest ADHD can reduce life expectancy due to behavioral factors, but targeted treatments can help.
Relationships, including co-parenting and committed partnerships, can suffer due to issues with responsibility and reciprocity. ADHD-related forgetfulness or disorganization is often mistaken for a lack of care, which can create strain. However, while ADHD is not the individual's fault, it is their responsibility to manage it through treatment and coping strategies.
Diagnosis in adults remains complex, with new U.S. guidelines in development alongside existing international standards. Effective treatments include stimulant and non-stimulant medications, as well as cognitive behavioral therapy (CBT), which has shown strong results when therapists understand ADHD-specific challenges. ADHD coaching is emerging as another helpful intervention, focusing on real-world implementation of strategies.
A key takeaway is that ADHD is not a knowledge problem but a performance problem—people with ADHD often know what they should do but struggle to execute it in the moment, making structured support essential.
ADHD can significantly impact adulthood, leading to missed job opportunities, academic failures, and eroded trust in relationships due to difficulties with organization, responsibility, and impulsivity. For example, people with ADHD may fail to submit assignments on time or violate attendance policies despite producing high-quality work, which can undermine personal and professional credibility.
Coaching for adults with ADHD is often needed for more frequent check-ins, as traditional therapy sessions may not provide enough ongoing support. ADHD coaches focus on helping clients implement strategies and stay on track, using methods like phone calls, texts, or site visits. These coaches are specifically trained to address ADHD challenges, unlike general therapists who may not have experience with ADHD.
The most effective treatment for adults typically combines medication and cognitive behavioral therapy (CBT). Medications help manage core ADHD symptoms like inattention, while CBT helps with emotional regulation and executive functioning skills. Many adults with ADHD also experience comorbid conditions like anxiety and depression. However, some individuals may choose to treat ADHD with just medication or CBT, depending on their preferences and needs.
A recent survey indicated that many adults believe they may have undiagnosed ADHD, partly due to increased awareness and content about the disorder on social media. While self-diagnosis is becoming more common, it's essential to differentiate between normal behavior and symptoms of ADHD. ADHD is often a dimension of human traits, making it difficult to pinpoint without professional evaluation. However, self-diagnosis can be helpful in initiating the process of seeking formal assessment and treatment.
The discussion emphasizes the importance of self-screening and self-diagnosis in identifying ADHD, but stresses the need for a professional evaluation by someone experienced with ADHD. Maggie Sibley's advice is highlighted as a helpful framework for diagnosing and understanding ADHD. The speaker discusses the value of thorough evaluations, which may involve ruling out other conditions like depression, anxiety, trauma, OCD, and substance use. They recommend the World Health Organization's Adult ADHD symptom rating scale as a free and accessible screening tool. For further evaluation, they suggest using professional organizations like CHADD and the Attention Deficit Disorder Association to find qualified professionals. Additionally, reaching out to experts in the field can help locate specialists in different regions.
https://www.caddra.ca/wp-content/uploads/ASRS.pdf
