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The truth about adult ADHD: Why do many people discover they have the problem only in adulthood?
Adult Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder in which symptoms must be present in childhood. According to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ADHD in adults usually manifests multiple symptoms in children before the age of 12 years, and this change in the criteria is intended to increase the number of adults with ADHD. Diagnostic resilience. Research shows that about two-thirds of childhood ADHD cases persist into adulthood, but the severity of these symptoms can change over time, affecting an individual's daily life.
“ADHD in adulthood may show different characteristics, and many times, people are not even aware that they have the disorder.”
According to DSM-5 criteria, ADHD is considered a "lifelong neurodevelopmental condition," and this diagnosis requires children to demonstrate six or more symptoms in areas of inattention or hyperactivity-impulsivity. For teenagers and adults 17 and older, at least five symptoms must have been shown before age 12. Although there is no unified standard for the age of onset of ADHD, the International Classification of Diseases, 11th Revision (ICD-11) updated its diagnostic criteria to make them more consistent with the requirements of DSM-5.
Different manifestations of ADHD
ADHD is generally classified into three different manifestations:
- Prominent inattention (ADHD-I)
- Marked Hyperactivity-Impulsivity (ADHD-HI)
- Mixed Presentation (ADHD-C)
In adults, marked inattention is the most common, occurring in approximately 45% of cases. The proportions of mixed performance and hyperactive-impulsive performance were 34% and 21% respectively.
“Adults with ADHD often have difficulty initiating and completing tasks, and are unable to focus on anything.”
The impact of ADHD
ADHD can have significant negative effects on school, work, and relationships. Adults with ADHD often exhibit deficits in self-regulation and self-motivation, which may lead to common characteristics such as distraction, procrastination, and disorganization. Still, the learning potential and overall intelligence of adults with ADHD is actually not inferior to that of people without the disorder. As adults age, their hyperactive behaviors diminish, but they often experience constant inner restlessness and racing thoughts.
Diagnosis and Challenges
The diagnosis of ADHD must be made by a qualified clinician, which usually involves obtaining a complete medical history through a comprehensive structured interview. According to research, adults face multiple challenges when receiving a diagnosis, including clinicians' lack of knowledge about adult ADHD or the presence of overlapping symptoms with other mental health issues, resulting in ADHD symptoms often being overlooked. Many adults choose not to seek medical treatment due to social stigma.
“Delays in diagnosis are often due to the development of compensatory skills in high-functioning adults, which may mask some of the salient symptoms.”
The impact of ADHD on gender
In terms of gender differences, males and females have different manifestations of adult ADHD. Men are more likely to exhibit overt behaviors and have higher rates of incarceration in adulthood. In contrast, women often present with subtler inattention and impulsive behavior, making them more likely to delay diagnosis. Women often develop compensatory strategies during adolescence that mask the main symptoms of ADHD. This is partly due to society's expectations of women, causing more distress and low self-esteem.
Future research directions
The causes of ADHD are not fully understood, but researchers are increasingly aware of the influence of genetic and environmental factors on the disorder. As our understanding of the neurobiology of ADHD increases, these effects will be explored more fully in the future and how more appropriate treatment options can be developed for adults.
In this ever-changing world, people who discover ADHD as adults may face many challenges. How to find a suitable way to deal with these challenges, and can you take the time to look back on your childhood and seek professional support?
