In Lydia Denworth's Scientific American article "Kids with ADHD May Still Have Symptoms as Adults," she highlights the evolving understanding of Attention Deficit Hyperactivity Disorder (ADHD), emphasizing that the condition often persists into adulthood, despite previous assumptions that it was confined to childhood.
Childhood ADHD Persists into Adulthood
Historically, ADHD was considered a developmental issue that would naturally resolve as a person matured. This belief was reflected in insurance policies and medical treatment, which frequently ceased support for individuals diagnosed in childhood once they reached adulthood. The result was that many young adults, upon entering college or the workforce, were forced to either forgo necessary medication or face financial hardship to maintain treatment.
Denworth explains that research has since shown that ADHD continues in approximately 2.5 to 3 percent of adults, compared to 5 to 6 percent in children. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, adjusted its criteria to better diagnose adults by lowering the symptom threshold for adults and acknowledging the differing manifestations of ADHD with age. For instance, while hyperactive behaviors like climbing on furniture may be common in children, adults might struggle with attention and focus in work settings, maintaining relationships, or managing daily responsibilities like paying bills.
The article underscores that despite these developments, many adults with ADHD remain undiagnosed because mental health professionals may not screen for it. This lack of diagnosis is significant since ADHD in adults can manifest in various ways, such as difficulty completing tasks or maintaining focus in professional and personal environments. Denworth points out that the prevalence of adult ADHD may be underestimated; recent studies suggest that, based on symptoms alone, the rate of ADHD in young adults could be as high as 9 percent and around 4 percent in adults over 60.
While some individuals appear to outgrow ADHD, this is less common than previously thought. A 2022 study led by Margaret H. Sibley found that only 9 percent of people diagnosed as children showed no signs of ADHD in adulthood, with those cases often involving milder childhood symptoms and strong parental support. More commonly, ADHD symptoms fluctuate throughout life, with periods of remission and recurrence depending on environmental factors, such as stress levels.
Denworth also addresses the misconception that ADHD can first develop in adulthood. Most adult diagnoses are either misattributions of other conditions (e.g., anxiety or substance abuse) or missed cases from childhood. Interestingly, parents and even grandparents often realize their own ADHD symptoms when their children are diagnosed, particularly in females, whose childhood ADHD symptoms tend to be more inattentive than hyperactive, making them less likely to be identified early.
The article also touches on the treatment of ADHD, noting that while stimulant medications such as Ritalin are commonly prescribed, a significant number of patients—up to 50 percent—discontinue their medication within the first year. This is especially prevalent among adolescents transitioning into adulthood, where they face new challenges such as rising costs, loss of parental oversight, and a lack of trained adult ADHD specialists. Discontinuation rates peak at age 18, a critical transition period when young adults shift from pediatric to adult psychiatric care.
Denworth points out the health implications of untreated ADHD, including increased risks of hypertension, cardiovascular diseases, obesity, substance use, and sleep problems. Despite these risks, there is hope as awareness of adult ADHD grows, leading to better diagnosis and treatment options. Proper treatment can significantly improve the quality of life for adults struggling with ADHD, making it an important area for continued focus in the medical community.
Key Takeaways
ADHD is not confined to childhood; research shows it often persists into adulthood, affecting around 2.5 to 3 percent of adults.
Adult ADHD symptoms may differ from those in children, with issues like difficulty completing tasks, maintaining focus, and managing responsibilities being more prominent.
Many adults with ADHD remain undiagnosed due to a lack of screening in adult mental health care settings, and the true prevalence in adults may be higher than reported.
ADHD symptoms can fluctuate, with periods of remission and recurrence, often influenced by environmental factors such as stress.
Treatment discontinuation is common in young adults transitioning out of pediatric care, contributing to negative health outcomes like cardiovascular issues and substance use.
Growing recognition of adult ADHD is improving diagnosis and treatment options, offering hope for those affected.
Conclusion
Denworth's article sheds light on the challenges and misconceptions surrounding ADHD, particularly as individuals age. While historically considered a childhood disorder, ADHD persists for many into adulthood, where it continues to impact daily functioning. With better recognition and understanding of how ADHD presents in adults, and with ongoing developments in treatment and diagnosis, there is a promising path forward for improving the lives of those who struggle with this condition throughout their lives.
Open-Access Article
Denworth, L. (2024). Kids with ADHD may still have symptoms as adults. Scientific American.
Glossary
ADHD (Attention Deficit Hyperactivity Disorder): a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning.
Diagnostic and Statistical Manual of Mental Disorders (DSM-5): the fifth edition of the American Psychiatric Association’s manual used for diagnosing mental disorders. It outlines the criteria for diagnosing ADHD, including adaptations for adult symptoms.
hyperactivity: a core symptom of ADHD characterized by excessive movement, restlessness, and difficulty sitting still, typically more pronounced in children.
inattention: a primary symptom of ADHD involving difficulty sustaining focus, organizing tasks, following instructions, and maintaining attention in daily activities.
neurotypical: individuals whose neurological development and functioning align with societal norms, in contrast to those with neurological differences, such as ADHD.
remission: a temporary or permanent reduction or disappearance of symptoms. In ADHD, remission refers to periods when symptoms lessen or disappear.
Ritalin: a stimulant medication commonly prescribed to treat ADHD by improving focus, impulse control, and hyperactivity through its effects on brain chemicals.
stimulants: a class of drugs used to treat ADHD by increasing the activity of certain neurotransmitters in the brain, which helps improve attention and control hyperactivity.
wax and wane: a phrase used to describe the fluctuation of ADHD symptoms over time, with periods of symptom intensity followed by periods of remission or reduction.
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