Untreated ADHD in Adults

Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral condition that usually starts during childhood. ADHD can affect adults as well, whether they were diagnosed in childhood or not.

Unfortunately, it is not uncommon for ADHD in adults to go untreated, either because people don't recognize the need for treatment or don't realize that they even have ADHD.

This article explores the potential effects of untreated ADHD in adulthood, including how it can affect important areas of a person's life.

Signs of Untreated ADHD in Adulthood

Symptoms of untreated ADHD in adulthood can involve:

• Difficulty multitasking
• Distractability
• Forgetfulness
• Impulsiveness
• Low frustration tolerance
• Mood swings
• Poor listening skills
• Poor planning
• Poor time management
• Problems staying on task
• Restlessness

Adults with ADHD may also have problems with interrupting others when they are speaking, misplacing things, missing important deadlines, and struggling to deal with stress or frustration.

The problem is that these symptoms are often labeled as immaturity or misdiagnosed as anxiety or depression. Because people with ADHD frequently have those conditions as well, being misdiagnosed or underdiagnosed then leads to undertreatment.

In adults, signs of inattention can include paying less attention to detail, having problems, and not managing time effectively. Signs of hyperactivity can involve problems with sitting through work meetings or changing jobs frequently.

While ADHD symptoms are often more readily apparent in children because they interfere in classroom performance and behavior, adults have more options when it comes to making changes in their life to cope with symptoms. For example, they might rely on a more-organized partner to deal with time management issues or choose jobs that are suited to their needs.

Why Is ADHD Often Untreated in Adulthood

There are a number of different factors that can contribute to the underdiagnosis and undertreatment of ADHD in adulthood. 

Lack of Awareness

One reason why ADHD in adults goes without treatment is that people are often unaware of how the condition can affect behavior. This includes both those with the condition and healthcare providers.

It was previously believed that ADHD was primarily a childhood disorder that mostly went away as children transitioned to adulthood. While the research now indicates that the condition does often persist into adulthood, many people are unaware that adult ADHD is a valid diagnosis.

It is also common for people to miss the symptoms of the condition in adulthood because they believe that the condition is primarily marked by hyperactivity. However, these symptoms not only appear differently in adults, but it is also more common for some adults, particularly women, to have more inattention than hyperactivity and impulsivity.

The Presence of Co-Occurring Conditions

Studies also indicate that adult ADHD frequently co-occurs alongside other mental health conditions, including anxiety disorders and substance use disorders.

Some of the most common co-occurring disorders include:

• Bipolar disorder
• Depression
• Eating disorders
• Generalized anxiety disorder
• Social anxiety disorder
  
• Substance use disorders

Unfortunately, the presence of co-occurring conditions not only sometimes complicates the diagnosis but also affects the course of the condition. People who have more than one condition tend to experience more severe symptoms that last longer and cause more complications.

Masking or Self-Medicating Symtoms

Adults who live with untreated ADHD often utilize a variety of strategies to disguise or compensate for their struggles. These behaviors are sometimes called 'masking.'

Also known as camouflaging or impression management, masking can involve actions that are helpful or adaptive at times. An example of this would be choosing a fast-paced job to deal with excess energy or an inability to stop moving. 

In other cases, these behaviors can be unhealthy or even destructive. For example, people with untreated ADHD might avoid situations that cause distress or become overly perfectionistic to hide problems with forgetting.

Stigma

Stigma about mental health problems can also play a part in explaining why ADHD often goes untreated in adults. People may suspect that they have ADHD but may choose not to get an official diagnosis for fear of getting labeled. Others may have worries about taking medications to manage the symptoms of the condition. 

All of these factors can play a role in whether a person chooses to talk to a healthcare provider about the symptoms they are experiencing.

Poor Access to Treatment

Lack of access to healthcare can also affect whether or not people get the treatment that they need. Not having adequate health insurance problems is still an issue for many people.

One older study found that the average annual medical costs for adults with ADHD ranged between $4,929 and $5,651 per year. The increased costs of healthcare may mean that these numbers have grown since that time.

Effects of Untreated ADHD in Adulthood

Potential complications associated with a 'missed' ADHD diagnosis include increased criminal involvement, car accidents, unemployment, relationship problems, and substance misuse.

Because ADHD in adulthood is often undiagnosed, people who have the condition may struggle to understand the signs and behaviors they are experiencing. They might attribute the symptoms to anxiety or depression, which can have similar symptoms, but they may also believe them to be character flaws. This can contribute to a lack of self-confidence, feelings of shame, and poor self-esteem.

Studies suggest that untreated ADHD in adults increases the risk for:

• Accidental death
• Addiction
• Anxiety
• Depression
• Impaired quality of life
• Relationship problems
• Unemployment
• Suicide
  

Treatment for ADHD in Adulthood

Getting a diagnosis of ADHD in adulthood is often a relief for those with the condition. It allows them to better understand the source of many of their problems and recognize that these symptoms are due to a neurobehavioral condition and not because of their own failings. 

Treatment for adult ADHD often involves a combination of medications, psychotherapy, skills training, and self-help strategies. 

Medications

Stimulant medications are often used to treat ADHD in both adults and children. Non-stimulant options are also available. Both can be effective, although non-stimulants take longer to work than stimulants.

However, some people may experience side effects; stimulants should be avoided if a person has a substance use disorder.

Psychotherapy

Different types of psychotherapy can help adults with ADHD learn new strategies to manage their condition. Therapy can also be helpful for addressing some of the symptoms of co-occurring conditions.

Cognitive behavioral therapy (CBT) can help people change negative thinking patterns that make it hard to cope. Couples therapy or family therapy can also be helpful for improving relationships.

Self-Help Strategies

Adults With ADHD may benefit from a variety of self-help strategies. However each person is unique and each strategy will work for everyone. Some techniques that might be helpful:

• Use lists: Make lists of tasks that you need to accomplish each day. Check off each one as you complete it. Consider carrying a planner or appointment book with you so you can keep track of important information or appointments.
• Break projects up into smaller tasks: It is easy to feel overwhelmed by large projects, but breaking them down into smaller components and tackling them step by step can make it less intimidating.
• Have a routine: Having a structured schedule can help adults with ADHD stay on track and reduce distractibility. 
• Minimize distractions: Reducing clutter and eliminating distractions may also be helpful when you are trying to stay on task.

Because untreated ADHD in adults can have an impact on many different areas of a person's life, including their relationships and self-esteem, it is essential to receive an accurate diagnosis if you think you have symptoms of the condition.

Summary

While ADHD is often considered a childhood condition, it frequently affects adults as well. Unfortunately, the condition often goes undiagnosed and untreated in adults. The reasons for this are complex, but lack of awareness about the symptoms, stigma, masking of symptoms, and barriers to treatment can all play a potential role. 

Untreated ADHD in adults can contribute to a number of complications including problems with work and relationships. Effective treatments are available that can include medication, therapy, skills training, and self-help strategies.

A Word From Verywell

If you suspect that you might have adult ADHD, getting an official diagnosis can often come with a sense of relief and understanding. Knowing more about your condition and how it can affect behavior and functioning may help you recognize the impact that untreated ADHD has had on your life.