While attention-deficit/hyperactivity disorder (ADHD) is viewed as a childhood condition, it’s become increasingly common for adults to receive a diagnosis. In fact, about 2.5% of adults in the United States alone struggle with ADHD. ¹

This increase in diagnosis is largely due to awareness. Many discover others struggling with similar symptoms (i.e. through social media) and consult their doctors.

Still, even with a diagnosis, many don’t know why adult ADHD is so complicated. Beyond the difficulties in diagnosis, it can be difficult for an ADHD brain to properly adjust in modern-day society.

Complication From Symptoms

The most damaging effects of ADHD come from the symptoms they induce. Naturally, there are many adults without a diagnosis. With that, these adults go about their lives and struggle without answers.

While ADHD affects everyone differently, the most common symptoms among adults include: ²

• Easily distracted (by other tasks or thoughts)
• Inability to follow through with longer tasks
• Interrupting others (without a desire to)
• Restlessness (both inward and outward)
• Risky behavior (that provides immediate reward)

Symptoms are similar between adults and children. However, adults typically struggle with different types of symptoms more often. For example, it’s been found that more adults will have persistent inattention.

On top of this, whether with or without a diagnosis, an adult with ADHD may also struggle with other types of symptoms, including:

• Accidental injury
• Lower quality of life
• Premature death
• Substance abuse problems
• Suicidal ideation
• Unemployment

If you do have an ADHD diagnosis, chances are it’s costing you. One study reveals adults spend £18,000 a year on treatment and social support. ³ Not to mention, much of this support comes from the fact that adults with ADHD tend to also struggle with co-existing conditions. ⁴

Co-Existing Illness Complications

ADHD is already a struggle in and of itself. Never mind if you struggle with another condition.

Adults with ADHD are three times as likely to also receive a depression diagnosis. This condition leads to many of the symptom complications mentioned above. ⁵ Furthermore, nearly half of the adults with ADHD are on the bipolar disorder spectrum. ⁶

On top of this, 70% of adults with ADHD experience emotional dysregulation. This makes it difficult for someone to control their emotional responses and has led to other disorders. For example, nearly all adults with ADHD have rejection-sensitive dysphoria. ⁷

On a lesser note, people with ADHD may also struggle with:

• Memory – For example, it may be difficult to remember your shopping list. ⁸
• Oppositional defiant disorder – Reacting poorly to orders or rules. ⁹
• Time Blindness – The inability to perceive time. ¹⁰

These co-existing conditions will not be used as a means of diagnosing ADHD. However, they can certainly make life more complicated for those who already struggle with ADHD.

Diagnosis Complications

Some may wonder why adult ADHD is so complicated when it comes to diagnosis.

For an adult, it can be difficult to receive an ADHD diagnosis. An adult must show clear evidence that such symptoms have been prevalent since childhood. On top of this, it needs to be obvious these symptoms are inhibiting your daily functions.

There are a few reasons why a psychologist may not initially diagnose your symptoms as ADHD. The most common is a lack of evidence from childhood.

If you’ve had ADHD since you were a child, it’s expected that adults with the condition already know they have it. ¹¹ Still, if symptoms are mild during childhood, they can worsen into adulthood, leading to a lack of diagnosis.

Furthermore, there’s been some concern over young adults and ADHD medication abuse. ¹² Therefore, some psychiatrists may be hesitant to give a prescription for treatment if they aren’t certain of an adult’s diagnosis.

References

¹ Simon V, Czobor P, Bálint S, Mészáros A, Bitter I. Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry. 2009 Mar;194(3):204-11. doi: 10.1192/bjp.bp.107.048827. PMID: 19252145.

² Prakash J, Chatterjee K, Guha S, Srivastava K, Chauhan VS. Adult attention-deficit Hyperactivity disorder: From clinical reality toward conceptual clarity. Ind Psychiatry J. 2021 Jan-Jun;30(1):23-28. doi: 10.4103/ipj.ipj_7_21. Epub 2021 Jun 10. PMID: 34483520; PMCID: PMC8395556.

³ Daley D, Jacobsen RH, Lange AM, Sørensen A, Walldorf J. The economic burden of adult attention deficit hyperactivity disorder: A sibling comparison cost analysis. Eur Psychiatry. 2019 Sep;61:41-48. doi: 10.1016/j.eurpsy.2019.06.011. Epub 2019 Jul 6. PMID: 31288209.

⁴ Taurines R, Schmitt J, Renner T, Conner AC, Warnke A, Romanos M. Developmental comorbidity in attention-deficit/hyperactivity disorder. Atten Defic Hyperact Disord. 2010 Dec;2(4):267-89. doi: 10.1007/s12402-010-0040-0. Epub 2010 Nov 10. PMID: 21432612.

⁵ Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017 Aug 22;17(1):302. doi: 10.1186/s12888-017-1463-3. PMID: 28830387; PMCID: PMC5567978.

⁶ Salvi V, Ribuoli E, Servasi M, Orsolini L, Volpe U. ADHD and Bipolar Disorder in Adulthood: Clinical and Treatment Implications. Medicina (Kaunas). 2021 May 10;57(5):466. doi: 10.3390/medicina57050466. PMID: 34068605; PMCID: PMC8151516.

⁷ Ginapp CM, Greenberg NR, MacDonald-Gagnon G, Angarita GA, Bold KW, Potenza MN. “Dysregulated not deficit”: A qualitative study on symptomatology of ADHD in young adults. PLoS One. 2023 Oct 12;18(10):e0292721. doi: 10.1371/journal.pone.0292721. PMID: 37824501; PMCID: PMC10569543.

⁸ Ortega R, López V, Carrasco X, Escobar MJ, García AM, Parra MA, Aboitiz F. Neurocognitive mechanisms underlying working memory encoding and retrieval in Attention-Deficit/Hyperactivity Disorder. Sci Rep. 2020 May 8;10(1):7771. doi: 10.1038/s41598-020-64678-x. PMID: 32385310; PMCID: PMC7210977.

⁹ Noordermeer SDS, Luman M, Weeda WD, Buitelaar JK, Richards JS, Hartman CA, Hoekstra PJ, Franke B, Heslenfeld DJ, Oosterlaan J. Risk factors for comorbid oppositional defiant disorder in attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry. 2017 Oct;26(10):1155-1164. doi: 10.1007/s00787-017-0972-4. Epub 2017 Mar 10. PMID: 28283834; PMCID: PMC5610221.

¹⁰ Ptacek R, Weissenberger S, Braaten E, Klicperova-Baker M, Goetz M, Raboch J, Vnukova M, Stefano GB. Clinical Implications of the Perception of Time in Attention Deficit Hyperactivity Disorder (ADHD): A Review. Med Sci Monit. 2019 May 26;25:3918-3924. doi: 10.12659/MSM.914225. PMID: 31129679; PMCID: PMC6556068.

¹¹ Magnus W, Nazir S, Anilkumar AC, Shaban K. Attention Deficit Hyperactivity Disorder. 2023 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 28722868.

¹² Caye A, Swanson JM, Coghill D, Rohde LA. Treatment strategies for ADHD: an evidence-based guide to select optimal treatment. Mol Psychiatry. 2019 Mar;24(3):390-408. doi: 10.1038/s41380-018-0116-3. Epub 2018 Jun 28. PMID: 29955166.