Untreated ADHD in Adults: What are the Risks?

Attention-deficit/hyperactivity disorder (ADHD) is a mental health condition with a long and controversial history, especially in recent times. Often considered over-diagnosed or overmedicated, ADHD is a condition that has grown steeply in diagnostic rates among children over the last two decades, with dramatic headlines about ADHD epidemics, long-term effects of ADHD, untreated ADHD in adults, and more.

Is ADHD Growing?

But is ADHD really “growing”? Or has it always been around, and we’re only just picking up on it? The reality is that it might be a little bit of both. Yes, misdiagnoses happen. Yes, overdiagnoses happen. It’s important in each individual case to work with professionals and advocate for your child, and to realize that the diagnostic criteria for ADHD can change over time.

The most recent diagnostic criteria for ADHD leave room for the reality that some children develop ADHD because of school and social pressures, rather than internal factors alone. It also places emphasis on treating cases of ADHD on the basis of symptoms, rather than impairment (meaning a child with “functional” ADHD might still get help). In general, research has shown us that:

• There is much more awareness around ADHD and other neurodevelopmental disorders, which affects the perception that rates are “growing.”
• ADHD is being identified more steadily and effectively today than in decades prior.

What About Untreated ADHD in Adults?

This brings us to an important topic: ADHD in adults, especially undiagnosed and untreated ADHD in adults. While ADHD is a neurodevelopmental condition with a pre-adolescent onset and is mostly associated with children and teens, it is also a lifelong condition. Many adults have ADHD without knowing it or were only diagnosed and treated later in life.

Research shows us that untreated ADHD can have a major impact on a person’s life, especially the development of co-occurring conditions (substance use, depression, and anxiety disorders), occupational and social impairment, and maladaptive or harmful coping mechanisms.

What is ADHD?

ADHD is a neurodevelopmental disorder characterized by symptoms of inattention (lacking time-management and organizational skills, easily distracted, difficulty focusing most of the time), hyperactivity (excessively talkative, unable to calm down, restless, fidgeting/stimming), and/or impulsivity (poor risk assessment, poor social skills, difficulty waiting, acting/speaking without thinking).

Some of these traits are also character or personality-dependent – some children and adults are more talkative than others, more socially attentive, and more or less impulsive. In some cases, these symptoms may also be indicative of a different developmental disorder or could be explained by trauma.

ADHD and the Brain

ADHD affects the brain, particularly the prefrontal cortex. In people with ADHD, this part of the brain may face developmental issues which interfere with the following:

• Focus and attention (people with ADHD can still focus, but it might be extremely selective or narrow)
• Time management
• Executive functioning (organizational skills, awareness, task management)
• Working memory (ability to retain information)

In and of themselves, these qualities are not indicative of a disorder. But it is the severity of these symptoms, as well as the way they interact in tandem, that may lead to a diagnosis and eventual treatment.

In adults, these symptoms may appear subdued or less obvious than they might in children – some children learn to hide or manage their ADHD symptoms without receiving a diagnosis or formal treatment. But they can still have an effect for decades.

The Risks of Untreated ADHD in Adults

Children and teens who are affected by ADHD and become adults without treatment are at a much higher risk of developing:

• Relationship issues due to difficulty with emotional self-regulation and impulsivity, and poorer communication skills.
• Anxiety disorders, as over half of people with ADHD, typically develop an anxiety disorder if left untreated.
• Lower self-esteem because of the stigma associated with their condition-related challenges, such as the inability to meet deadlines or pay attention.
• Job troubles, as ADHD can affect both time management and organizational skills, making it harder to hold down a job.
• Substance use, at a rate of over 50 percent.
• Higher suicide risk.
• Greater likelihood of premature death by accident.

Treating ADHD in Adults

Treatments for ADHD in adults are like those in children and teens – a combination of medication and therapy. However, the kind of medication and type of therapy is decided on a case-by-case basis.

Most patients respond better to one kind of medication or therapy over another. While most people are aware of the use of stimulants in the treatment of ADHD – especially amphetamine and methylphenidate – other types of medication are used as well, including antidepressants and non stimulant drugs for patients who do not tolerate stimulants well.

Therapies for adults with ADHD often include cognitive behavioral therapy or dialectical behavior therapy. In these sessions, patients are encouraged to accept themselves, improve their ability to regulate emotions and impulses, work on stress management skills, and improve their time management and organizational abilities.

Learning to Live With ADHD

ADHD is a condition that affects approximately 4.4 percent of adults. In many cases, people can go their entire lives without ever getting diagnosed with this condition. While it can make life more difficult, some adults who might have had ADHD since early childhood can and do learn to cope with it themselves, either constructively or destructively.

In some cases, adults with functional ADHD even learn to utilize the “strengths” of this disorder, such as notable hyper fixation, hyperfocus, greater creativity, and improved flow states (the ability to sustain attention on a single task, if the conditions are right).

Treatment for ADHD

Treatment for ADHD is similar, in the sense that it aims to soften the edges of ADHD through medication – reducing the degree to which ADHD’s symptoms can cause lifelong struggles in work or academic environments – while helping adults navigate effective coping skills and therapeutic methods to harness their unique strengths and overcome challenges.

ADHD is a condition that requires treatment in many cases to avoid debilitating symptoms and years of struggle. However, one reason ADHD is often seen as a “childhood disease” is because those who go undiagnosed and untreated often learn to “live with it,” in one way or another.

This doesn’t mean these adults have successfully grown out of ADHD. ADHD can cause impairments that limit a person’s potential, precluding them from opportunities they may have had given early treatment. Even in undiagnosed, untreated cases, it can and does leave its mark, whether through the way its symptoms affect productivity and personality or through the stigma it imparts, even when unrecognized, such as being labeled “lazy” for years.

Getting Help for ADHD

As our ability to diagnose, recognize, and treat ADHD has improved, we can continue to retroactively help people who developed ADHD decades ago learn to leverage treatment options, such as medication and therapy, to improve their attentiveness, productivity, and happiness.

If you want to learn more about adult ADHD, how our residential treatment program can help, or wish to find out if you have ADHD, contact us today.

Reach out, Amend Treatment is here for you.