Adult ADHD: Symptoms, Causes, & Treatments

What Is Adult ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by issues with attention, hyperactivity, and impulsivity. Symptoms of ADHD develop in childhood but continue to affect individuals across their lives into adulthood. Adults living with ADHD face unique challenges at work, in relationships, and sometimes with finances or criminality.

ADHD Symptoms in Adults

Adult ADHD can manifest as primarily impulsive, primarily hyperactive, or combined symptoms. The types of ADHD in adults significantly impact how one behaves and navigates life.

Inattention, impulsivity, or hyperactivity will usually remain present into adulthood. However, adults may learn ways to appear “high-functioning” or practice ADHD masking to disguise their symptoms. Additionally, how symptoms manifest can change. For example, hyperactivity in adults may resemble restlessness rather than energy bursts seen in childhood.

Common symptoms of ADHD in adults include:

Adult hyperactive/impulsive ADHD 

• Restlessness and fidgeting: Adults with hyperactive/impulsive ADHD often struggle to sit still. They may feel “constantly on the go” or fidget excessively.
• Impulsiveness: They may act without thinking, frequently interrupt others, blurt out responses, or make impulsive decisions with negative consequences.
• Difficulty with patience and waiting: Adults with this subtype of ADHD often struggle to wait their turn, whether in conversations, lines, or activities. Some may display signs of frustration or agitation.
• Poor impulse control: They may have a hard time controlling their urges, leading to impulsive behaviors such as excessive spending, risk-taking, or addictive behaviors.
• Talking excessively: Hyperactive/impulsive individuals may tend to talk excessively or disrupt conversations, not allowing others to speak.

Adult inattentive ADHD

• Inability to focus or sustain attention: Adults with inattentive ADHD have difficulty concentrating on tasks or conversations, often becoming easily distracted by unrelated thoughts or external stimuli.
• Forgetfulness and disorganization: They may frequently lose track of items, miss appointments, or struggle with staying organized.
• Lack of attention to detail: Adults with inattentive ADHD may make careless errors in work or overlook important details in tasks.
• Difficulty with time management: They may struggle with managing their time effectively, frequently underestimating the time required for tasks and missing deadlines.
• Daydreaming and getting lost in thoughts: Individuals with inattentive ADHD may appear absent-minded, getting lost in their thoughts and having difficulty staying mentally engaged in the present moment.

ADHD in Adult Women Vs. Adult Men

Symptoms of ADHD in men are often more prominent than in females, partially because inattentive ADHD in women is far more common than hyperactive ADHD. Men may be more prone to impulsiveness and restlessness, while women exhibit more challenges with staying focused or organized.

Hyperactivity is easier to recognize, and studies also suggest ADHD in women is more likely to present as depression, anxiety, and low self-esteem. These factors mean many women may be misdiagnosed or underdiagnosed because of their symptom presentation.¹ They also tend to focus less on fixing existing problems and more on compensating for unfinished or forgotten tasks.²

Signs of ADHD in Adults

One key characteristic of ADHD in adults is difficulty with sustained attention and focus. They may struggle to concentrate on tasks and become distracted by external stimuli or racing thoughts. Others may exhibit more impulsive behavior, sometimes leading to overspending or overlooking important responsibilities to focus on more pleasurable activities.

Signs of adult ADHD may include:

• Procrastinating important work assignments
• Disorganized or messy work and home environments
• Financial risk-taking behaviors
• Poor time management and time blindness
• Problems focusing on tasks, easily sidetracked
• Mood swings
• Irritability or low frustration tolerance
• Starting but rarely finishing tasks
• Unable to multitask
• Restlessness or fidgeting

Complications of Adult ADHD

Symptoms can change over time and vary from setting to setting, meaning they may be less or more noticeable depending on the situation and external factors. However, regardless of symptom presentation, untreated or unmanaged ADHD can contribute to poor decision-making that negatively impacts multiple aspects of home, work, and social life.

Adult ADHD & Work Performance

Because of issues related to inattention and focus (i.e., ADHD paralysis), those with ADHD often face difficulties with organization, prioritization, procrastination, and task completion. These challenges can lead to poor occupational performance, attainment, and attendance.  Some may struggle with honoring deadlines or meeting set standards, especially when overwhelmed with multiple tasks.

Unfortunately, many jobs do not accommodate the needs of neurodiverse populations. Employers may misinterpret ADHD symptoms as laziness, immaturity, or poor cooperation.² On the contrary, individuals with ADHD simply possess different skills and abilities than neurotypical people, and they could utilize and build on these strengths in the correct and accepting environments.

Adult ADHD & Substance Use

Adults with ADHD may use substances or alcohol to self-medicate, alleviate, mask, or numb their symptoms. Due to decreased inhibition and lack of impulse control, they are also more likely to start misusing alcohol and drugs at an earlier age, although genetics can play a role as well.³

Adult ADHD & Criminality

While having ADHD alone does not lead to criminality, studies have found a higher prevalence of ADHD among individuals in the criminal justice system.⁴ Some possible contributing factors include impulsivity, poor impulse control, and difficulty with executive functioning. These challenges can affect decision-making, self-control, and the ability to consider long-term consequences, leading to risky behaviors that may result in legal trouble.

What Causes ADHD in Adults?

The exact causes of ADHD in adults are not yet fully understood, but researchers believe both genetic and environmental factors play a role. For instance, ADHD tends to run in families. Brain differences, particularly in regions related to attention and impulse control, are also often observed in individuals with ADHD. ADHD is a complex disorder, and the interplay of these factors can vary among individuals. A thorough evaluation by a healthcare professional is necessary for an accurate diagnosis.

Below are possible causes of adult ADHD:

• Genetic factors: Research suggests ADHD has a strong genetic component. Individuals with a family history of ADHD are more likely to develop the disorder themselves. Additionally, some evidence found an association between ADHD and genes related to dopamine regulation, neurotransmitter activity, and brain development.
• Brain differences: Studies have shown individuals with ADHD often have structural and functional differences in brain regions involved in attention, impulse control, and executive functioning.
• Environmental factors: Certain environmental factors may contribute to the development of ADHD in adults. Prenatal exposure to tobacco smoke, alcohol, or drugs and complications during pregnancy or birth can increase the risk. Additionally, exposure to lead, living in a highly stressful environment, or experiencing childhood trauma may be contributing factors.
• Neurotransmitter imbalances: Dopamine and norepinephrine imbalances may play a role in inattentive symptoms and low-impulse control.

Adult ADHD & Co-Occurring Mental Health Concerns

Adults with ADHD often face the challenge of dealing with co-occurring mental health concerns. Navigating a neurotypical world with different communication methods, higher energy levels, or concentration problems can impact well-being. Individuals may struggle with anxiety as they fear others will judge them for their differences.

Sometimes, those with ADHD may develop depression if they feel their symptoms limit their ability to function. Others may exhibit symptoms of a behavioral disorder due to challenges with impulse control or emotional regulation. These additional challenges can complicate the management of ADHD symptoms and significantly impact self-esteem, relationships, and confidence.

Common disorders that co-occur with ADHD include:¹

• Generalized anxiety disorder (GAD)
• Social anxiety disorder
• Major depressive disorder
• Intermittent explosive disorder (IED)
• Oppositional defiant disorder (ODD)
• Substance use disorders (SUD)
• Personality disorders
• Obsessive-compulsive disorder (OCD)
• Tic disorder
• Autism

How Is Adult ADHD Diagnosed?

Diagnosing adult ADHD involves a comprehensive evaluation process. No single test can confirm the diagnosis, so healthcare professionals rely on a combination of methods to assess symptoms. The process typically includes a thorough medical history review, clinical interviews, self-report questionnaires, and feedback from family members or close associates. Professionals may also conduct physical exams to rule out potential underlying health conditions.

ADHD Treatment for Adults

Treatment for adult ADHD often includes a combined effort of therapy and medication. Pharmaceutical treatments can help improve attention/focus and impulsivity/hyperactivity, while therapy can assist individuals in developing healthy coping skills and behavioral interventions.

Therapy

Therapy can be a crucial component of treatment for adult ADHD. A therapist can help individuals develop ADHD coping strategies, improve time management and organizational skills, and address any emotional or psychological challenges that may arise. Consider finding a neurodiversity-affirming therapist specializing in ADHD, as these professionals understand the nuances associated with your challenges.

Types of therapy for adult ADHD may include:

• Cognitive behavioral therapy (CBT): CBT for ADHD focuses on identifying and changing negative thought patterns that may contribute to unwanted behavior. This approach helps adults with ADHD develop practical strategies to manage impulsivity and reduce distractibility.
• Mindfulness-based cognitive therapy (MBCT): MBCT combines cognitive therapy and mindfulness practices to help individuals become more aware of their thoughts, emotions, and behaviors. This awareness can enhance attention, promote self-regulation, and reduce stress and anxiety associated with adult ADHD.
• Dialectical behavior therapy (DBT): DBT emphasizes specific skills to reduce emotional dysregulation, impulsivity, and relationship difficulties.
• Psychoeducation: Psychoeducation involves learning about ADHD, its symptoms, and potential impacts. Knowledge helps adults better manage their symptoms and make informed decisions about treatment and self-care.
• Coaching: ADHD coaching focuses on specific strategies and techniques to improve executive functioning skills, such as planning, organization, and time management. Coaches provide support, accountability, and guidance to help adults with ADHD achieve their goals and navigate daily challenges.

Medication

Medications for adult ADHD typically include stimulants and non-stimulants. Individuals should always discuss their symptoms and medical history with a prescribing doctor to determine whether stimulants or non-stimulants are the best treatment. Stimulant medications are controlled substances, so many general practitioners will refer patients to a psychiatrist for diagnosis and medication management.

Stimulants increase dopamine and norepinephrine levels in the brain, helping improve symptoms of inattention and impulsivity. As with any medication, stimulants come with the risk of adverse effects, particularly dependence or addiction.

Non-stimulant alternatives are available for adults with ADHD who react negatively to stimulants or have a history of substance misuse. Non-stimulant ADHD medications work similarly to stimulants but only increase norepinephrine in the brain. Always consult a prescribing doctor or physician before considering or taking medication.

Common medications for adult ADHD include:

• Ritalin (methylphenidate)
• Concerta (methylphenidate)
• Focalin (dexmethylphenidate HCL)
• Adderall (amphetamine/dextroamphetamine)
• Strattera (atomoxetine)
• Intuniv (guanfacine)
• Qelbree (viloxazine)
• Kapvay (clonidine)

Is ADHD Curable?

While an ADHD cure does not exist, appropriate support can help individuals cope with and manage unwanted symptoms. A combination of medication, therapy, and lifestyle modifications can reduce the impact of challenges and improve functioning. An ADHD prognosis can be positive, as ADHD comes with benefits when individuals focus on honing their strengths and celebrating their achievements.

Living With ADHD as an Adult

Living healthily with ADHD in adulthood means taking several simple, everyday practices to improve focus, organizational skills, and time management. Developing coping skills for ADHD can drastically improve your life as you navigate new challenges and stressors.

Here are seven helpful self-help strategies for managing adult ADHD:

1. Create a Routine

Creating a routine can improve organization, reduce impulsivity, and enhance time management skills. A consistent daily routine can include specific times for waking up, meals, work or study periods, exercise, relaxation, and bedtime. Following these routines can help adults with ADHD create a sense of order in their daily lives.

2. Get Organized & Maintain Organization Daily

Create designated spots for work supplies, shoes, clothes, and other household items. An ADHD doom box can help you keep track of easily misplaced daily essentials, like your keys or wallet. A clutter-free and relaxed environment can help improve focus and attention, especially when tackling long and arduous tasks.

3. Think Through & Limit Distractions

Creating a dedicated and organized workspace, turning off notifications on electronic devices, and using noise-canceling headphones can minimize unnecessary obstructions to productivity. Additionally, visual aids or reminders can assist in staying on track and avoiding potential distractions.

4. Take Scheduled Breaks

Taking scheduled breaks is another approach to managing adult ADHD symptoms. By incorporating regular breaks into their routine, individuals can give themselves opportunities to recharge and reduce mental fatigue. Schedule these periods at specific intervals to allow time for relaxation, movement, or engaging in preferred activities.

5. Search For & Create Positive Opportunities

Identify areas where you excel and build off these strengths. For example, consider joining a sports group or local art club if you enjoy incorporating social interaction with your hobbies. Activities like these promote positive relationships and provide a sense of accomplishment. In many cases, they provide much-needed dopamine boosts to help you manage ADHD dopamine deficiencies.

6. Maintain a Healthy Lifestyle

Maintaining a healthy lifestyle is crucial when living with adult ADHD. Pay attention to your eating habits, exercise, sleep, and stress management. A balanced diet of nutritious fruits, vegetables, whole grains, and lean proteins can support overall brain health and improve focus and concentration. Regular exercise can help reduce restlessness, increase dopamine levels, and improve cognitive function.

7. Try Body-Doubling

Body doubling can be especially beneficial if you struggle with task initiation or completion. Having someone nearby focusing on their own work or task can provide motivation when stuck in paralysis. However, ensure you have a buddy who is not distracting. You can offer each other quiet nods of approval as you work toward your goals.

8. Foster New Relationships

Building a support network of understanding and supportive individuals can provide a sense of belonging and reduce feelings of isolation. Connecting with those who have ADHD or similar experiences offers a unique opportunity to develop positive coping skills for managing symptoms. Additionally, friends can hold you accountable to your goals, fostering personal growth, learning, and enhanced social skills.

9. Identify & Manage Your Triggers

Managing triggers is crucial for preventing and responding effectively to situations that may worsen symptoms. Common triggers for ADHD can include stress, disorganization, noise, clutter, and sensory overload. Identifying these stressors means you can develop strategies to avoid or minimize their effects.

10. Embrace the Positive

Focusing on the challenges and limitations associated with adult ADHD can be easy. However, acknowledging and celebrating your strengths and achievements is essential when navigating any diagnosis. Doing so can boost self-esteem and motivation, helping direct you toward overall well-being and success. Embracing the positive also includes practicing self-compassion by understanding and forgiving yourself when facing difficulties or setbacks.