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!
- MelissaOrlov's blog
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Comments
Thank you for opening this topic
Submitted by Chevron on
As for the decades after the age of 40, pieces like this NIH article give food for thought...and encouragement to believe that preparation needs to be made.
"Normal Cognitive Aging"
Caroline N. Harada, Marissa C. Natelson Love, and Kristen Triebel
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015335/#!po=1.38889
From the article:
"Concepts of crystallized and fluid intelligence are used to describe patterns of cognitive change over the lifespan. Crystallized intelligence refers to skills, ability, and knowledge that is overlearned, well-practiced, and familiar.4 Vocabulary and general knowledge are examples of crystallized abilities. Crystallized abilities remain stable or gradually improve at a rate of 0.02 to 0.003 standard deviations per year through the sixth and seventh decades of life.13 Because crystallized intelligence is due to accumulation of information based on one’s life experiences, older adults tend to perform better at tasks requiring this type of intelligence when compared to younger adults. In contrast, fluid intelligence refers to abilities involving problem-solving and reasoning about things that are less familiar and are independent of what one has learned. Fluid cognition includes a person’s innate ability to process and learn new information, solve problems, and attend to and manipulate one’s environment.14 Executive function, processing speed, memory, and psychomotor ability are considered fluid cognitive domains. Many fluid cognitive abilities, especially psychomotor ability and processing speed, peak in the third decade of life and then decline at an estimated rate of −0.02 standard deviations per year.13"
Makes sense
Submitted by vabeachgal on
Thank you for the information. My husband was also diagnosed with LD at about 4th or 5th grade. He also experienced the trauma of his father's death at that time. Related? Probably. There has been quite a bit of commentary on the site about this topic. Intuitively, I assumed that ADHD could get worse with age because it involves cognitive and short term memory and processing deficits. We ALL experience a decline as we age. The age of 40 - well, that makes sense to me also. I can look back and say that the tipping point of my husband's ADHD feeling manageable or not was between 40 and 42. He was aging. Life at home was changing. Suddenly I was asking him to help with high level conceptual issues like college selection and PLANNING. After working and raising children, my expectations of life changed. The status quo at home changed. Suddenly, there were changes with his employer and he was expected to perform at a higher level and PLAN. Those things aren't in his wheelhouse. I felt the burden of even MORE disproportionate work and responsibility and grew in resentment. His solution to all things stress is generally to disappear into work. Add in financial wreckage (which contributed to his depression and also mine, after I discovered it). I can see how this played out. I didn't have the objectivity at the time the circumstances were playing out. I did, however, suggest seeing a therapist for what I perceived as significant depression on his part.
Can the situation be helped and remedied? Sure. Would it be hard work? Of course. Does it depend on two people doing the work? Yes. There's the rub when even maintaining a prescription is too much work and trouble. So sad.
The science of this clarifies the picture a lot
Submitted by Chevron on
Vabeachgal what you described was vivid....so later in life your husband struggled to master planning and execution of tasks at a higher rate and level. Aging does increasingly stack the deck against anyone, especially someone with ADHD, who has a habit of declining and avoiding.
What scared all the petals off my chrysanthemum, is that AS that is going on in my husband as he ages, as cognitive waning increasingly combines with his ADHD challenges, I'm going to be declining in the areas described by that NIH piece, myself. Holy moly. I sort of knew the probabilities from watching my parents and their cohort age, but scientific study does put the dot on the i.
I wish you a ton of well Vabeachgal.
Learning?
Submitted by c ur self on
We must be careful not to learn more than we are capable of consuming w/o fear....Prepared? Yes, Fearful? NO :)
https://emilymueller143.wordpress.com/2010/02/07/the-adhd-christian/
You might like this girls blog; and those who responded to it....It is quiet honest and refreshing to hear them talk about the reality of living w/ adhd.....
C
Which fear about aging?
Submitted by Chevron on
Thank you very much for the link, C. I appreciate your self statement, also.
In response, thinking that you and I might be in a moment of exchange, here are
8 minutes on appropriate fear vs. procrastination and denial. http://bustedhalo.com/podcasts/appropriate-fear-god
A book on trusting oneself and acting, instead of denying one's own intuitions and reactions, and not acting: Gavin de Beker, The Gift of Fear
Last, on beliefs that you and I share, C, here's an old favorite of mine, Rudolf Otto, The Idea of the Holy, about human experience of Divine Presence. In a wonderful coincidence, a 3.0 earthquake that rattled everything happened as I was reading the chapter on the mysterium tremendum, which is human experience of knowing one's own insufficiency and need in the face of what is vastly larger and more than what one is. The mysterium tremendum feeling accompanies what we know about ourselves standing on the rim of the Grand Canyon or when our small boat is so far out to sea that we see no coastline and know how puny and alone we are, away from the help of other people.
I propose to you that there are times of life when it's better not to stick my head in the sand, to cling to my own past understanding, comfort and security. We talk so much on this board about what an impediment it is to live in denial...
Being open to what we cant by ourselves do or dont know elicits fear, if we're honest I dont know about you, but everything I've ever done that has mattered, in which much was being left behind and the future was not yet seen, has. had a quotient of awe, foreboding because no I wasnt in control nor knew everything,and knowing my self small, in the face of what was going to happen.
It's my reality at the moment that I'm taking the measure of aging. Which is no small thing. Aging , to somewhat bend a quotation from a writer I love, is an inexorable drive toward a condition of complete simplicity, costing no less than everything
For me, the thing to watch and discipline is anxiety, not fear. The two are not identical. There are, as the first link says, and I believe, appropriate fears. Anxiety is so human, but doesnt much help anything
I'll use the tail end of this to say something about another subject connected to Melissa's original post: no matter what, I believe people can (with persistence, help from outside themselves and courage) change for the better and grow. My ADHD husband is proof of that. So also is my mother, who made a wonderful change in the last year of her life.
Fear that moves us.....
Submitted by c ur self on
The Human emotions I experience do tell a story about me....And there is much I need to learn, and hopefully have learned about myself as I experience these emotions....Do I react? Or do I ignore it like it's not happening?
It's amazing how for much of my childhood, and even as an adult I would ignore much of my emotion...Just in the last 5 or so years has the pain of this "It will OK, if I keep doing the right thing" attitude, not been enough...I've had to as you say "take my head out of the sand" and Question myself....
When circumstances and others are allowed to mold us....Then our anxiety and even unhealthy fears aren't really manageable, because we are allowing influences that just keep repeating themselves. And if we don't **learn to do things differently** we will just continue to allow human emotion to flood our thinking, feelings and behaviors.....So the cycle just continues for me anyway....
CHANGE :)
Yes dear friend, taking positive actions has had to be part of it for me the last several years....Looking back, I see a time when the circumstances forced me to take that painful long look...And I realized I had to change...Also I realized that no one else would or could do that for me....Without self care Mentally, Physically and emotionally I was doomed to a world of anxiety and Fear....
Sure my faith plays a big role in this...Without spiritual truth and revelation I probably would try to take credit for the good things in my life....
Thank you for your personal feelings and the web site...I will check it out after breakfast:) Need my coffee, even if it's decaf :(
C
Fear that paralyzes us and shuts us up
Submitted by jennalemone on
Yes, C, I have had to learn to do things differently. I thought that if I just kept working extra hard, sacrificed some of my own wants and needs and followed "the rules" that eventually things would be the best they could be. I trusted that if I would just act and talk "as if" things were good and solid that eventually they would be that way. You know...."The Law of Attraction" and all that. That optimism has not served me well. Maybe I understood it wrong. Prayers are not always answered and I have come to realize and accept that I cannot ordain what is best for me better than what my creator has in mind for me. Life can best be served by acknowledging that I am not in charge of everything or anything. I can only ask that I am able to withstand and accept that life is the way it is and it is the way it is supposed to be according to "not me".
I had/have lost my ability to follow my own course. Know my own tuition. Hear my own voice. I had been so keen on being "good" according to any and all rules I could find, that I was no more than an obedient dog or servent trying to get a pat on the head and nod of approval from any source of superior....and it seemed that everyone was my superior because I was bent on being "humble" as I was taught.
This has not served my family or my self or anyone who knows me other than those who benefited from my physical service or generosity that I shared. And there are those who took advantage of that including my H who said to me, "What did you EVER do for me?" after I devoted my entire adult life to him. But I, as an individual, had not matured into a force of my own. It is a symptom of immaturity that I wanted others to tell me what was the right thing to do for my own life. Playing by the rules (as I chose to live my life) made me pretty one dimensional. I love my obedient dog but he does not get my attention as much as my last dog who had a will and courage to go up against me now and then. My biggest challenge these days is to know WHAT i might want. I only wanted to be of service and love (I thought) but I guess there is more that I want because I am at odds with myself now. I have to learn how to stand firmer with a conviction that comes from inside of ME that makes me me. Rather than standing firm on rules and directives that come from religion of long ago or old white men's preaching to me about how to be a good young girl. They spoke with authority about things they did not know. And I was primed to listen quietly. My conviction is to find out who I am and to not be afraid to find my own voice.
I enjoyed the 8 minute message.....
Submitted by c ur self on
I also agree with him; of course it doesn't matter if I agree or not, when he is getting it from the source....If the only fear I ever carry around is a healthy fear for the Sovereign Father who determines all things, including the destination of my eternal soul than I am doing quiet well....
(I'll use the tail end of this to say something about another subject connected to Melissa's original post: no matter what, I believe people can (with persistence, help from outside themselves and courage) change for the better and grow. My ADHD husband is proof of that. So also is my mother, who made a wonderful change in the last year of her life. )
I also believe this, and have experienced it in my family as well....
There is so much confusion when it comes to the actions and behaviors of people...(humans just can't look into the heart of other humans, no matter how we try)...And if we truly have that appropriate fear the speaker was teaching about...We surely will consider that fear, along with our own sin, before we just judge another human....It's just easier to label people when we don't completely understand (And hope that covers their actions)...Of course we are also told that the fruit of our living of life, identifies our hearts...So based on that truth, there really isn't a whole lot of thinking I need to do about another person...(unless I'm praising them, encouraging them or praying for them...sadly this hasn't always been the case.)
C