Could I have adult-onset ADHD?
The quick and dirty answer is: probably not. Let’s think this one through. ADHD is a complicated diagnosis to make for children, let alone adults. Many individuals believe that ADHD is mainly characterized by hyperactivity and distractibility; however, it is much more complex than that. According to the DSM-V (the diagnostic rulebook), ADHD is defined as “A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development…”. If you pay read closely, the individual could have symptoms of inattention and hyperactivity-impulsivity, or hyperactivity-impulsivity, or a combination of the two. Examples of ADHD-inattentive presentation include trouble focusing on a single task, difficulty paying attention to details, frequently misplacing items, or appearing to not listen when others are speaking. Symptoms of ADHD-hyperactive type include fidgeting, difficulty staying seated, difficulty with self-control, interrupting others, and running around. The third type of ADHD is the combination type, which requires criteria from both the hyperactive and inattentive type ADHD.
Let’s start with the inattentive type of ADHD. As a young child, symptoms of this type of ADHD are frequently missed because the behaviors are not particularly disruptive. Added to that, a parent, caregiver, or teacher is oftentimes helping the child significantly with organization and reminding them to engage in certain behaviors (i.e., Johnny, don’t forget your field trip form, math homework, and social studies project!). With all of this additional help, certain signs of ADHD can be masked. Symptoms may begin to emerge in your teenage years when you are becoming increasingly independent and are expected to better manage your own responsibilities. Inattentive ADHD symptoms might continue to go under the radar as a teen if you continue to gain significant academic and social support from parents, teachers, and tutors (more so than is needed for the average teen).
If the inattentive ADHD continues with no diagnosis and no treatment throughout the teen years, the college student or the working professional may begin to notice difficulties with focus, completing assignments, or completing tasks at work as quickly and efficiently as necessary. What is happening here? The demand is increasing at a much faster rate than the skills of the individual. It is not that you are unable to meet the demand of the task, but you may require extra support from a psychotherapist or executive functioning coach. If the symptoms are significant enough and therapy or coaching is unsuccessful, medication is another route that might be beneficial.
ADHD-predominantly hyperactive presentation has a more distinct and observable presentation than the inattentive presentation. These are the kids who can’t stop moving, get up from their seat frequently, talk to no end, and have trouble completing any task or assignment quietly. These are the children who are recognized as early as the preschool years and frequently get treatment in a timely manner. However, even these children can be overlooked. Many preschool settings allow for frequent movement and allow the children to learn through physical activity. As the child ages and is required to sit quietly and pay attention to instructions for the teacher, the disruptions become more transparent and cause more difficulties in day-to-day activities. Although an adult with hyperactive ADHD might not be running around the house and jumping on couches, adults will frequently feel an internal sense of restlessness making it difficult to focus or even relax to engage in enjoyable activities. They can hold back the impulse to jump and run around because that is not something that adults do in society and it would be frowned upon. Adults may continue interrupting others, have difficulty with impulse control. and have a low toleration for frustration.
As you can see, ADHD is a complex diagnosis that changes over time. If you think you have ADHD, contact a therapist. Psychologists can complete a diagnostic assessment to determine if you truly have ADHD. If you simply want to work on symptom management, a psychologist or therapist well-versed in ADHD treatment would be of great benefit.
Feel free to reach out to me for more information!