Was an ADHD diagnosis missed as a child or can it develop as your hormones change in adulthood?

The jury is still out on whether adults with “new” attention deficit hyperactivity disorder (ADHD) had it undiagnosed in childhood or if symptoms of ADHD can show up when you’re an adult. Most researchers believe that this developmental disorder begins in childhood.

But researchers acknowledge that you can have ADHD symptoms when you’re well into adulthood even if you did not have obvious signs and symptoms as a child.

Adult ADHD may also have different risk factors, diagnostic criteria, and causes. Even if you’re an older adult, it’s never too later to be diagnosed and get treatment for ADHD and any other mental health condition. There are treatment plans that can help improve your life in every way.

  • genetics
  • poor nutrition while in the womb
  • exposure to substances, such as alcohol and drugs, while in the womb
  • premature birth
  • brain injury during birth
  • poor nutrition during early childhood
  • simultaneous mental health conditions

Doctors are not sure exactly what causes ADHD. Like many mental health and developmental conditions, there is probably more than one cause for childhood ADHD and adult ADHD. It is estimated that almost 3 in every 100 adults in the United States have ADHD. Many others may be living with an undiagnosed case of the disorder.

Some causes of adult ADHD may happen later in life when you’re a teenager or adult, like:

  • brain injury
  • environmental exposure to toxins
  • heavy alcohol use

Whether you have adult ADHD from childhood or late-onset ADHD, you might have other health-related conditions. They may be more likely to happen alongside ADHD or act as triggers and risk factors. Other health conditions, behavioral issues, and lifestyle choice, can be relative to ADHD, such as:

  • poor nutrition
  • lack of exercise
  • having obesity
  • cannabis dependence
  • alcohol dependence
  • substance use
  • generalized anxiety disorder
  • depression
  • sleep disorders
  • learning disorders
  • personality disorders
  • conduct disorders
  • autism spectrum disorders

One study from 2018 even suggests that using social media too much may trigger ADHD symptoms in some teenagers and young adults.

Students self-reported on nine inattention symptoms like difficulty organizing or finishing tasks, and nine hyperactivity-impulsivity symptoms like trouble sitting still in class or giving undivided attention.

If a teen reported six more symptoms in either category, researchers classified them as having ADHD symptoms.

This might not be very surprising if you’ve ever scrolled through social media endlessly (and who hasn’t?), but more research is needed on this potential link to adult ADHD.

If you think you may have adult-onset ADHD, you can talk with your doctor or a psychiatrist about your symptoms. Your doctor can determine whether your symptoms are due to ADHD.

A diagnostic assessment will usually be set up with a trained psychologist. The comprehensive evaluation can take up to 6 hours before a diagnosis is confirmed and medication is prescribed. It would also involve having someone you’re close to rating their observations of your symptoms.

Other life stressors, mental health conditions, and other health disorders can cause symptoms that are similar to ADHD in adults. Your doctor may recommend a complete checkup and blood tests to rule out other health conditions.

According to mental health guidelines, adults ages 18 years and over need to have a range of symptoms of inattention and hyperactivity that meet certain conditions to be diagnosed with ADHD. These include:

  • five or more inattention symptoms
  • five or more hyperactivity-impulsivity symptoms
    (can be in addition to — or instead of — inattention symptoms)
  • symptoms must happen in two or more settings, like at home and at work
  • pervasive symptoms that interfere with daily life
  • symptoms rated at three or higher on a scale of 1–5

According to the National Institutes of Health, some doctors require that you must have several symptoms of ADHD that started before age 12 years to be diagnosed with ADHD as an adult.

While a diagnosis of childhood ADHD is more common in boys than girls, adult ADHD has a more even 1-to-1 ratio for men and women.

This might be because girls are less likely to have hyperactivity symptoms than boys with ADHD but more inattentive symptoms that aren’t as disruptive. As it interferes with adult goals, a young or mature woman may seek a diagnosis as an adult.

Adult ADHD symptoms

Adults may also have more inattentive symptoms like forgetfulness or difficulty concentrating, while children with ADHD have more hyperactive symptoms.

If you had milder ADHD symptoms during childhood and were not diagnosed, the demands and responsibilities of adult life may intensify your symptoms.

Some symptoms from childhood ADHD can also change in adults. For example, hyperactivity may look like restlessness or getting bored easily and taking unnecessary risks as an adult.

Treatment for adult ADHD

If you are diagnosed with ADHD as an adult, your doctor may recommend prescription medication as part of your treatment plan. This may include common medications called stimulants that are also used to treat ADHD in children.

Your doctor may begin medications at a lower dose and then increase it as needed. Common ADHD medications include:

Tell your doctor if you are being treated for chronic health conditions like anxiety, depression, diabetes, or high blood pressure. Some ADHD medications may interact with other drugs.

In addition to medication, psychotherapy and coaching can help you learn life skills to manage your ADHD symptoms. Support groups for adults with ADHD can also help bring more clarity around this condition.

You don’t have to tell your workplace about your condition unless you need more time or different arrangements to get tasks and projects completed.

But it’s good to know that information remains confidential to adhere to legal privacy standards, and you can’t be fired for requesting accommodations that will set you up for success in your work.

A new ADHD diagnosis in adult life can seem surprising and leave you feeling a little nervous. But with education, some tweaks in your work-life operation, and a dose of patience with yourself, it’s readily manageable.