ADHD Across the Lifespan

The severity of ADHD symptoms – as well as what symptoms you exhibit – change with environmental factors such as stress, lack of sleep, or an increase in responsibilities.  They also change with age, and yes, they can get more severe later in life.

Overview of ADHD as You Age

Research and clinical experience suggest that there is a common pattern that goes something like this for people diagnosed as children:

Children with signs of ADHD may be diagnosed early – and they often start to struggle around 5th grade when work becomes more taxing, and they are expected to stay in their seats and sit still.  The brains of children with ADHD mature later than those without it, so ADHD kids tend to lag their peers in developing sound judgment.  While ‘mature’ critical thinking capabilities generally mature around age 24 or 25, for those with ADHD it is more like age 27. 

About 30% of children diagnosed with ADHD will no longer show symptoms into adulthood, either through maturity or developing critical coping skills. Many outgrow hyperactivity (or get it better under control) as they move into adulthood, as well.

In their 20s, and once on their own, young adults tend to discount the importance of their ADHD symptoms and undermanage them until they see themselves falling behind their peers.  So there is often a dropping of treatments in the early 20s (and a corresponding increase in symptoms) then a re-engagement in the late 20s and early 30s (this for folks who knew they have it.)  Issues that come with having their own children aren’t so much about a flare in ADHD symptoms as they are an addition of a bunch of responsibilities that aren’t in the ADHD sweet spot PLUS more sleep deprivation (which does make symptoms worse.)  So adults get a flare in the relationship from a decrease in the ability of the ADHD partner to contribute proportionately to the added workload.

As you know if you have read much at this site, almost 60% of the time ADHD symptoms and responses to those symptoms cause marital dysfunction that needs to be addressed, and can add stress that increases the expression of ADHD symptoms.

Later in life, natural changes in the brain can increase ADHD symptoms, particularly forgetfulness and distractibility.  Women have an additional issue - menopause decreases estrogen by about 60% and, as estrogen is tightly linked to the production of dopamine, causes a significant drop in already-low dopamine levels.

And, throughout the life, ADHD symptoms can be temporarily made worse through increase stress, decreased sleep, decreased exercise, a change in treatment regimen, and co-existing conditions such as anxiety, to name just a few.

A Man with ADHD Tells His Story

A participant in my current seminar happened to write to me of his story with ADHD.  It is classic, so worth sharing:

“I am a 41 year old married father of 2, I was diagnosed with a “learning disability” in the early 80s as a young boy around age 7 or 8 - this was before the term ADD or ADHD was coined. Through the initial testing I was observed to show the signs of what is now ADHD behavior/symptoms - distractibility, anxiety, focusing on tasks, starting tasks, etc. We started to do the “tricks” to help with memory, focus, impulse control, etc. which worked for a while until I began middle school. That is when I was officially diagnosed with ADD and under the care of a Dr. of Psychiatry - now enters Dexadrine spansul to my treatment agenda. All I have to say about this medication is WOW! Talk about focus! It calmed the noise in my head so I could focus on class work- so I could remember and recall the information. I was in control of where my mind went and how long it would be there. I stayed on this medication but in high school added a short acting Dexadrine pill to cover my after school activities and homework time. I stayed on this medication throughout high school and college. In general I was a good student - I worked my ass off to make the grades I did and there was a lot of help from my Mother, my Doctor, tutors and teachers that assisted along the way.

I am happy to say in May of 1999 I graduated with a degree in Occupation Safety and Health and have been working as a Safety Professional ever since. After college I got off all ADHD medications because I thought I did not need them any more. I knew my “tricks” to keep me focused and I would be fine . Yeah right - that lasted 2 years. So in 2002 I got back on medication and this time it was Adderall. This did well but the crash when I was coming down was a lot more harsh than the dexadrine. It made me grumpy/bitey for a few hours. Luckily I could sense when the meds were wearing off so I would go for a walk or go for a drive. This round of ADHD treatment with medication lasted for 3 years and I had the grand idea that it was time to come off the meds again - 2005..."

Marriage…with More Classic ADHD Experiences

"...My wife and I married in 2006 and had our first child in 2009. I got back on meds - Vyvance in 2012 and have been on this ever since. The main reason I got back on this was to combat the Symptom / Response / Response cycle that had developed in my marriage. My wife would tell me - “ I miss us.”, “I miss you.” And all the times I let her down by saying or doing something without thinking of how it would make her feel. All I could say was,” I am sorry.” If she pressed and kept on reminding me of how I let her down I would get angry and finally tell her “I am not a mind reader.” Also I began to lie to my wife about being at work - I would leave work on a Friday and go grab a few beers with the fellas - with every intension to be at home at my usual time but would lose track of time and would have to make up a lie about being at work handling an issue but would drink a few more and then go home. When I got home she would let me have it - as rightly she should have. This happened a few more times and stopped when she said she would leave and take the boys. She was right - no one deserves that - especially not from their husband. I have all the fear of disappointing others, fear of being viewed as not a partner to my spouse, and all the other fears an ADHD individual has that are referenced in your books…"

What if You Are Diagnosed Later in Life?

Sadly, it is still the case that between 80-90% of adults with ADHD don't yet know that they have it.  That means that they have the 'shadow' of ADHD in their lives (i.e. the symptoms that are affecting them) but no explanation for what is going on.  The chronic and difficult nature of ADHD symptoms means that they suffer when they don't need to.  ADHD researcher, Russell Barkley Ph.D., and others estimate that 50-80% of adults with ADHD can manage their symptoms very well once they know they have it.  So, if you are diagnosed later in life is it GOOD NEWS - you can finally do something about the struggles you may be facing.  You will have some catching up to do, as entrenched coping strategies can take time to change, but can make great progress in managing the issues your ADHD presents.  Yes, as you age you will experience the same sorts of ADHD changes that others in your age group experience, but you are on your way!