Signs of ADHD in Adults, and When They Are Worth Checking

What are the common signs of ADHD in adults?

ADHD (attention-deficit/hyperactivity disorder) involves a lasting pattern of inattention, hyperactivity and impulsivity. Some adults mostly have trouble with attention, some mostly have hyperactive and impulsive symptoms, and some have both. You can meet the criteria for ADHD without any hyperactivity at all.

The National Institute of Mental Health (NIMH) lists these among the ways symptoms can affect adults:

• Getting distracted often and having trouble paying attention
• Disorganization, procrastination and poor time management
• Trouble remembering daily tasks, and often losing things
• Trouble focusing on a large task, following instructions or finishing projects
• Interrupting others or being very talkative
• Difficulty sitting still for long periods, fidgeting, or a feeling of restlessness
• Choosing an immediate reward over a later reward or consequence

How can ADHD show up at work, at home, with money and in relationships?

A list of symptoms can feel abstract, so it may help to think about where life keeps going wrong. The table gives examples. Having a few of them does not mean you have ADHD, and many people with ADHD would not recognize themselves in every row.

Living with these problems for years can also wear on how you see yourself. Adults with ADHD may experience low self-worth, sensitivity to criticism and harsh self-criticism, possibly because they have heard so much criticism over the years.

How is this different from being forgetful or busy?

Almost everyone misplaces a phone or puts off a dull task. What sets ADHD apart is how much, how often and how long. NIMH describes adult symptoms as more severe, frequent and persistent than ordinary lapses. They interfere with daily life, occur across more than one situation and last at least 6 months.

Symptoms also have to cause real trouble. For adults and youth over 16, a diagnosis calls for at least five symptoms of inattention, or of hyperactivity and impulsivity, along with problems in at least two areas of life, such as home and work. Someone who has several symptoms but no significant problems from them may not meet the criteria. A provider makes this judgment, and it depends on your whole history, not a count alone.

Why is ADHD often missed until adulthood?

Plenty of adults with ADHD were never told they had it as children. The American Psychiatric Association cites a recent study estimating that about half of U.S. adults with an ADHD diagnosis received it in adulthood. NIMH gives several reasons this happens:

• Teachers and parents did not recognize the disorder.
• A supportive home or school helped the person do well despite it.
• The symptoms were milder and could be managed until the stress and demands of adult life, especially work.
• Symptoms in girls and women are especially likely to have been missed. Women are more likely to have inattentive symptoms than hyperactive ones, which may be less likely to lead to a referral, and more likely to develop coping strategies that mask symptoms.

Why does childhood history matter so much?

ADHD is considered a developmental disorder, so symptoms have to begin in childhood, before age 12. A problem that truly began at 35 points a provider toward other explanations. This is the part of an adult evaluation people are often least ready for, because the question is not only how you are doing now but how you were doing at 8 or 10.

Many adults with ADHD have patchy memories of their early years, or remember the details but not the problems. It can help to ask a parent or sibling what you were like, or to look through old report cards for comments about daydreaming, talking or unfinished work. You do not need to have been a troubled student. To see how a provider works through this, read how adult ADHD is evaluated.

What else can look like ADHD?

Poor focus and restlessness are common to many problems. That is why a list of symptoms, including this one, cannot tell you what is causing yours. These can produce similar symptoms, and some can occur together with ADHD:

• Sleep problems, which NIMH says affect up to 70% of adults with ADHD and can also cause poor focus on their own
• Anxiety, which has its own guide: ADHD or anxiety
• Depression and other mood disorders
• Stress, substance use and learning disorders
• Medical causes, including thyroid problems, seizure conditions and head injuries, and some medications such as steroids

When is it time to get evaluated?

Consider asking for an evaluation if these problems go back to childhood, if they follow you from one job or relationship to the next, or if you have tried harder and built systems that keep falling apart. A partner or family member raising the question is also a fair reason to look into it. NIMH is clear that it is never too late to seek a diagnosis and treatment.

Treatment can reduce symptoms and improve functioning, and the most common options for adults are medication, usually stimulant medication, and therapy such as cognitive behavioral therapy. Often more than one element is combined, and sometimes people try several treatments before finding what works for them.

What does getting checked look like at DanShalom Behavioral Clinic?

ADHD is one of the main areas of experience for Victor Onodjacha, MSN, PMHNP-BC, a board-certified psychiatric-mental health nurse practitioner. A first visit lasts about 60 minutes and is mostly a conversation about your history and daily life. It takes place in person in Sugar Land or by secure video if you are physically in Texas, Idaho, Arizona or Maryland at the time. We see patients ages 5 to 65, and you see the same provider at every visit.

To start, use the request form. We check your coverage before the first visit, and details on plans, self-pay and the sliding scale are on our insurance page.

DanShalom Behavioral Clinic is not an emergency service. If you are in crisis or having thoughts of suicide, call or text 988, and in a life-threatening situation call 911.