ADHD (Attention-Deficit/Hyperactivity Disorder) is commonly associated with childhood; however, it persists into adulthood. While many symptoms overlap with those seen in children, adult ADHD can manifest differently, often due to the development of coping mechanisms and changes in life demands. Recognising ADHD in adults is essential, as untreated symptoms can significantly impact work, relationships, and overall quality of life (Asherson et al., 2016).
1. Signs of Inattention in Adults
Adults with ADHD may find it challenging to maintain focus, organise tasks, and manage responsibilities. Unlike hyperactivity, which may lessen with age, inattentive symptoms will persist and can affect various aspects of daily life.
- Difficulty focusing on tasks: Adults with ADHD may struggle to stay focused on lengthy or complex tasks, especially in environments with distractions. This tends not to be the case if they are genuinely interested in what they are doing, as interest provides stimulation.
- Frequent mind-wandering: Adults minds wander frequently, drifting during conversations, meetings, or while reading. This can however have advantages, since the mind-wandering can be productive, such as being creative or problem-solving.
- Trouble following instructions: Multi-step tasks can be challenging, leading to incomplete work or errors in detail – but this tends only to be when innate interest is missing from the task(s).
- Forgetfulness: Adults with ADHD may frequently forget appointments, deadlines, or essential tasks, impacting their personal and professional lives (though learned coping strategies may have solved some of this, including via excessive worrying about forgetting)
- Disorganisation: They may struggle with organising schedules, managing paperwork, or keeping track of daily responsibilities (also sometimes solved through coping strategies by the time they reach adulthood) (Barkley, 2015).
2. Signs of Hyperactivity in Adults
Although hyperactivity tends to decrease with age, many adults still experience restlessness or a feeling of being “on edge.” Hyperactive symptoms in adults are often more internal than external.
- Inner restlessness: Adults may feel mentally or physically restless, even if they appear calm outwardly. Hyperactivity has in-effect been internalised, becoming a hyperactive mind (which has advantages, due to an increased ability to think of original and innovative ideas)
- Difficulty relaxing: They may find it hard to relax or slow down, even during leisure time.
- Talking excessively: While less common than in children, some adults with ADHD may talk more than others, especially in informal settings.
3. Signs of Impulsivity in Adults
Impulsivity is a common ADHD symptom in adults, potentially impacting decision-making and self-regulation.
- Making hasty decisions: Adults with ADHD may make impulsive choices without fully considering the consequences, which can impact work and personal relationships.
- Impulsive spending: Adults can sometimes make impulsive financial decisions, such as spontaneous purchases (Kooij et al., 2010).
- Difficulty waiting or delaying gratification: They may become frustrated when forced to wait or delay action, which can affect social interactions, and leads to impatience at work when waiting on others.
- Interrupting conversations: Adults may struggle to hold back from speaking, especially when excited about the topic.
- Emotional impulsivity: Some adults with ADHD experience strong emotional responses, which can lead to outbursts or difficulties managing anger (Asherson et al., 2016).
- Risk-taking behaviours: Risky activities, such as unsafe driving, substance abuse, or unplanned adventures, are more common in adults with ADHD due to impulsivity.
How Adult ADHD Differs from Childhood ADHD
While children with ADHD often display more overt hyperactivity, adults with ADHD may experience this as an internal feeling of restlessness. Additionally, adults face more complex responsibilities, such as work, relationships, and financial management, where their inattention and impulsivity can become more pronounced. Many adults with ADHD have also developed coping mechanisms or learned to mask their symptoms, making diagnosis more challenging (Kooij et al., 2010).
Gender Differences in Presentation
Adult ADHD symptoms may also vary by gender. Women with ADHD often exhibit more inattentive symptoms and may internalise their struggles, leading to difficulties with self-esteem and mental health. This can contribute to later diagnosis, as their symptoms may be less outwardly disruptive and therefore less noticeable (Quinn & Madhoo, 2014).
Importance of Recognition and Support
Identifying ADHD symptoms in adults is crucial for accessing effective support, including medication, behavioural therapies, and workplace accommodations. Unrecognised ADHD can lead to challenges with mental health, including anxiety and depression, which often co-occur with ADHD (Kooij et al., 2010). With the correct diagnosis, adults can work to develop coping strategies, seek support, and make lifestyle changes that help them manage their symptoms.
References
Asherson, P., Buitelaar, J., Faraone, S. V., & Rohde, L. A. (2016). Adult attention-deficit hyperactivity disorder: key conceptual issues. The Lancet Psychiatry, 3(6), 568-578.
Barkley, R. A. (2015). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. Guilford Press.
Kooij, S. J. J., Bijlenga, D., Salerno, L., Jaeschke, R., Bitter, I., Balázs, J., … & Thome, J. (2010). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry, 25(7), 377-389.
Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. The Primary Care Companion for CNS Disorders, 16(3).