Attention deficit hyperactivity disorder (ADHD) is commonly associated with childhood — but adults can experience it too, and it often goes unrecognized for years. Tracey Peachey, a primary care provider at Riverside Healthcare, shares what adult ADHD looks like, why it's frequently missed, and what you can do about it.
Symptoms Specific to Adult ADHD
Adult ADHD is characterized by executive dysfunction, inattention, impulsiveness, restlessness, and emotional dysregulation. Emotional dysregulation might show up as irritability, anger outbursts, low frustration tolerance, or lack of motivation. Executive dysfunction involves difficulty with self-directed actions — things like setting goals, organizing steps to reach them, and following through.
"In daily life, that might look like trouble remaining focused on a task, organizing activities, time management, completing tasks," Peachey explains. "Collectively, these symptoms lead to significant issues in a patient's ability to function day to day. In adulthood, inattentiveness is typically more predominant than hyperactivity, which is often seen in children with ADHD."
Why Is ADHD Underdiagnosed in Adults?
While there's long been debate about whether ADHD is over-diagnosed in children, the opposite is true for adults — especially women. The Attention Deficit Disorder Association reports that less than 20% of adults with ADHD are appropriately diagnosed and treated.
One key reason is that ADHD symptoms overlap with other conditions like anxiety, depression, and substance use disorders. Another is that many providers — and patients themselves — still think of ADHD as a childhood condition.
"Inattentiveness might not be as obvious, or they develop strategies to compensate for the symptoms they're experiencing every day," notes Peachey. Many adults simply don't connect their daily struggles to ADHD.
The Diagnostic Process
When assessing for ADHD, healthcare professionals use a number of screening tools and begin by ruling out other conditions that might cause similar symptoms. Symptoms also need to be persistent and severe enough to have caused significant impact on daily functioning — ADHD won't be diagnosed based on a rough week at work.
For a diagnosis, at least five symptoms from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) must be present for at least six months and must negatively impact social, academic, or occupational outcomes.
Treating ADHD in Adults
The most recommended initial treatment for adult ADHD is a combination of medication and psychotherapy — specifically cognitive behavioral therapy (CBT). CBT helps individuals change their thinking patterns and develop new coping strategies. For example, breaking a large work project into smaller, manageable steps.
The first-line medication approach for adults typically involves stimulants, similar to treatment in children. "There are many different types, many different forms. The decision regarding medication is individualized for each patient and should be based between the patient and the provider, considering goals, lifestyle, and any other health conditions," notes Peachey.
It's important to understand there's no perfect solution — finding the right regimen takes time. But Peachey is encouraging: "There are many different options and things that can be adjusted to help patients achieve the best function possible."
Additional strategies can help too, including maintaining a healthy lifestyle (eating well, exercising, and getting enough sleep), limiting screen time and external stimulation, using time management and organization tools, keeping a consistent routine, and building a personal support system.