ADHD (Attention-Deficit/Hyperactivity Disorder) is often associated with overly-active children who can’t sit still or concentrate. But many adults are receiving a diagnosis of ADHD later in life, likely because they were able to cope with their symptoms without anyone - including themselves - noticing. So, the uptick in adult ADHD diagnoses isn’t indicative that ADHD can develop later in life — or is it?
What is ADHD?
Let’s start with the basics. ADHD is a neurodevelopmental condition displaying symptoms of impulsivity, difficulty paying attention, and hyperactivity. According to the Centers for Disease Control and Prevention (CDC), ADHD is one of the most common childhood neurodevelopmental disorders.
Unfortunately, the research on adult ADHD is lacking. A 2021 review of epidemiological studies found that, in 2020, 366 million adults dealt with symptoms of ADHD — 140 million of which had confirmed ADHD diagnoses in their childhood. But these statistics could be inaccurate due to the age range of participants. It’s possible that these numbers could be much higher in reality.
The bottom line: scientists need to include adults in more ADHD studies.
Adult ADHD diagnosis
To get an ADHD diagnosis, adults need to have at least five inattentive and/or hyperactive symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). In addition, the symptoms must have been present before the age of twelve.
Untreated childhood symptoms of ADHD can be more noticeable as an adult due to an increase in daily stress and obligations, so it makes sense that many do not seek a formal evaluation until their adulthood. In fact - according to Len Adler, M.D. - at least 75% of adults who have ADHD don’t even know they have the condition.
But where does it come from in the first place?
Researchers are still trying to determine exactly what causes ADHD, but they have some promising leads.
What causes ADHD?
The exact causes of ADHD are still unknown, but there are several risk factors that scientists are considering. It’s important to note that environmental factors - like screen time or sugar intake levels - have been disproven and are not directly linked to the onset of ADHD.
Scientists believe that ADHD could be caused by:
- Traumatic Brain Injury (TBI)
- Premature birth or low weight at birth
- Early* environmental exposures (e.g. pesticides, lead)
- Substance use during pregnancy
*during infancy in high doses
Can someone suddenly develop ADHD as an adult?
In short - no. ADHD doesn’t just show up out of nowhere during adulthood. Adults don’t wake up one day and suddenly have ADHD — but it can certainly feel that way for some.
The stress of adulting can make your ADHD surface
Maybe you have a new job that comes with thousands* of new responsibilities, or perhaps you’re trying to write your dissertation while juggling a toddler and mortgage payments. All of this can feel overwhelming — like you no longer have control over your life or anything in it.
These added “adulting stressors” can lead to executive dysfunction and careless mistakes; they may cause you to forget everyday things like where you put your keys or when your doctor’s appointment is. These small glimpses of your previously unnoticed ADHD symptoms come through when you least expect them to.
This can be a confusing and frustrating time, and you're definitely not alone.
But, if an adult can’t suddenly develop ADHD, what exactly is going on? Why are you experiencing these suspiciously ADHD-like symptoms all of a sudden?
*That was an exaggeration.
Possible explanations for newly-developed ADHD symptoms in adulthood
#1 Traumatic Brain Injury (TBI) can cause ADHD
According to the Mayo Clinic, a traumatic brain injury can occur when an object penetrates your head or skull, or you suffer a heavy blow to the head. In either of these cases, the brain tissue is damaged, and normal functioning is adversely affected.
TBI is often a result of:
- Assault or abuse
- Car accidents (or accidents involving other types of motor/vehicle transportation)
- Sports injuries
A TBI can cause ADHD by changing parts of your brain associated with ADHD, namely the prefrontal cortex (PFC) in the frontal lobe. Closely monitoring a TBI patient is important and early intervention and treatment is key.
#2 You’ve been masking your ADHD all along
You may have had ADHD your entire life — you’ve just managed to hide it until now. This ADHD masking is common in the neurodiverse community, and it’s nothing to be embarrassed about.
There are several reasons why your mask may have fallen enough for your symptoms to surface. You may have experienced an increase in stress levels or burnout, or your responsibility levels have increased. Whatever the reason, it’s time to start figuring out how to manage your symptoms by exploring available resources.
#3 Your thyroid is acting up or your hormones are imbalanced
The thyroid is an important gland that controls a variety of biological and cognitive processes. It’s been shown that irregularly high levels of the hormones that interact with the thyroid are correlated with lower cognitive functioning. This, in turn, can cause symptoms like forgetfulness, inattentiveness, and fatigue.
Similarly, hormones have a direct effect on mood and cognition. The main hormones that can interact with (and alter) cognition and executive functioning include:
- Dopamine (as a hormone)
- Serotonin (as a hormone)
Dysregulated production of any of these can negatively impact the way we process new information and respond to our environment. For those without ADHD, it can cause ADHD-like symptoms; and for those with ADHD, it can make those symptoms harder to manage.
#4 Your untreated ADHD has been exacerbated by the pandemic
The pandemic taught us a lot about our society and ourselves. It also caused a lot of stress and left many of us struggling to keep normal routines. It’s easier to notice little nuances about yourself and your behavior when you’re stuck in the house — and that’s where your ADHD symptoms may have shown through.
If this sounds like you, you’re one of many.
#5 You may not have ADHD
Maybe you don’t have ADHD after all! But — that doesn’t mean you aren’t struggling.
Most people experience stress and have some level of difficulty coping with the reality of adulthood at some point in their lives. Some may also experience social difficulties, or make poor choices when it comes to coping mechanisms.
But that doesn't mean they have ADHD.
The fine line between ‘distracted’ and having ADHD
Do you ever walk into a room only to stand there, staring blankly at the wall without any idea of why you walked into the room in the first place? Perhaps you’re easily distracted or have trouble concentrating.
ADHD is only diagnosed when it problematically interferes with your day-to-day life on a regular basis.
If it’s not ADHD, it could be...
So, what’s causing you to struggle? Maybe one or more of these reasons is to blame:
- Mood or emotional dysregulation
- Hormonal shifts, including those related to menopause, contraceptives, puberty, menstruation, hormone replacement therapy, pregnancy, and postpartum
- Lack of sleep (maybe you’re partaking in some revenge bedtime procrastination?)
- Increased stress
- Chronic fatigue
- Lack of support
- Another underlying health condition
Too long; didn’t read
Adults don’t suddenly develop ADHD. It’s possible that new ADHD symptoms are popping up because they’ve been able to cover or manage them until a stressful event or new demands. If you’re still concerned that what you’re dealing with might be ADHD, mention it to your doctor at your next visit. In the meantime, try to stay healthy. Get enough rest, move your body, eat well, and do things you enjoy.