Highlights
- Although around 7% of U.S. adults live with ADHD, only around 20% of these adults receive a diagnosis and treatment.
- If you live with undiagnosed adult ADHD, you might notice signs like fidgeting, problems managing focus, emotional outbursts, lack of motivation, and more.
- Living with undiagnosed ADHD can lead to significant negative consequences, including a higher mortality risk.
The first step to managing ADHD symptoms is to receive a diagnosis. Unfortunately, many people with ADHD, especially girls and women, go undiagnosed until adulthood. Although around 7% of U.S. adults are estimated to live with this condition, some studies show that less than
Dealing with undiagnosed ADHD in adulthood can be incredibly frustrating, leading to low self-esteem and a nagging feeling that you’re not meeting your full potential. Undiagnosed symptoms are also associated with poorer outcomes, meaning that you may be more likely to face serious life problems like unemployment and other mental health issues.
If you think you may be experiencing symptoms of undiagnosed ADHD, it’s essential to get assessed by a qualified mental health provider. Treating this condition is possible, but it won’t go away on its own.
Here, we’ll go over some of the most common signs and symptoms of undiagnosed ADHD in adulthood, discuss the complexities of ADHD diagnosis in adults, and provide tips for how to get a diagnosis and treatment.
10 Signs of Undiagnosed ADHD in Adulthood
While we often think of a child with ADHD as high on energy and “bouncing off the walls,” it’s important to understand that this condition can look differently in adults. The officially recognized symptoms of the condition are the same for children and adults, but they can manifest in different ways.
Here are some of the most common signs of undiagnosed ADHD in adulthood. If you can relate to many of them, it’s possible you may have it – although to know for sure, you need a proper diagnostic assessment.
Restlessness and Fidgeting
People with ADHD often have abounding restless energy. In children, this restlessness can manifest as being unable to sit still or running around at inappropriate times. Adults may not physically run around, but this restlessness can appear as fidgeting with their hands, tapping pens, shaking or tapping their feet, and so on.
Adults also often find it difficult to stay seated for long periods of time. If you have undiagnosed ADHD, you might stand up or pace during important meetings or frequently need to step outside for “fresh air.”
Disorganization
Adult ADHD can also cause problems with organization. For example, you might have a hard time keeping your living or working area tidy. Cluttered environments can often cause adults with this condition to misplace important items. Disorganization can also affect task management; you may find it difficult to prioritize your to-do list and frequently miss deadlines.
If you’ve always been a “messy” person or find it hard to keep track of your calendar, then it could be a sign of undiagnosed ADHD.
Problems With Focus
If you live with undiagnosed ADHD, you likely also have problems with focusing – a key characteristic of the inattentive type of this condition.
Inattentiveness is often misunderstood as an inability to focus, which can make it hard for undiagnosed adults to notice when it’s affecting them. But in reality, it can be better described as a difficulty managing focus. You might find it extremely difficult – almost impossible – to focus during boring or repetitive tasks. But when it comes to something that interests you, you might find the opposite to be true: You’re so hyperfocused on the task that you can’t move your attention away from it. Both ends of the spectrum can cause problems.
Lack of Motivation
Adults with ADHD typically live with a chronic lack of motivation. You might often feel so overwhelmed by the tasks in front of you that you have no idea where to start. Or you might know exactly what you need to do, but find yourself glued to the couch doing some mindless activity. It could be a sign of undiagnosed ADHD – this is a common phenomenon called ADHD paralysis.
Paralysis and a chronic lack of motivation can arise from the way adult ADHD affects the executive functioning of the brain. Executive functions are the brain’s more complex tasks, and include problem-solving, reasoning, and decision-making. Research has shown that people with ADHD experience deficiencies in executive functioning, which can make it more difficult to find intrinsic motivation to complete tasks.
Forgetfulness
The way ADHD affects the brain can also lead adults with the condition to be more forgetful. Research has found that people with ADHD have impaired working memory, which impacts the way they store and retrieve relevant information when it’s needed.
This forgetfulness can cause significant problems in your life. For example, your relationships might be impacted because you often forget important details, meetings, and anniversaries. Or you might have a hard time with daily living tasks like keeping up with bills or deadlines. You might even find yourself forgetting instructions only moments after they were told to you.
Emotional Dysregulation
If you often experience emotional or angry outbursts that seem to come “out of nowhere,” it could be a sign of undiagnosed ADHD. Both children and adults with this condition are more likely to experience emotional dysregulation, which is a difficulty managing and having self-control over your own emotions. The
For example, you might have severe mood swings, cry often, or become very angry suddenly. Adults, especially women, with ADHD are also more likely to have co-existing mental health conditions like depression and anxiety – which can also contribute to emotional dysregulation.
Poor Time Management
Adults with ADHD often experience something called “time blindness,” which makes it difficult to keep track of time. For example, you might often underestimate how long it will take you to get ready for an appointment, causing you to be late. Or you might become so focused on whatever you’re doing that you let hours go by without even realizing it.
If you’re chronically late without realizing it or have been told that you have no sense of time, it could be a sign that you live with this condition.
Impulsive Behaviors
If you tend to be more impulsive than other people your age, then it may be worthwhile to consider getting an assessment and diagnosis. Impulsivity alone isn’t enough for a diagnosis, but research shows that adults with ADHD are more likely to have problems with impulse control than those without.
For example, you might engage in risky behaviors like reckless driving or unsafe sex. You might sway between not being able to make even the most simplest of decisions to making very impulsive ones on the spot.
Lack of Attention to Detail
If you’ve been told you have great ideas – but have a hard time when it comes to the nitty-gritty details – then it could be a sign of undiagnosed adult ADHD.
For example, you might be able to complete the big-picture exciting parts of a project, but feel overwhelmed when it comes to wrapping up the smaller tasks. Or you might understand the broader implications of what was discussed but forget about the more detailed instructions. This lack of attention to detail can be disruptive, causing problems both at work and in relationships.
Problems With Follow-through
Adults with undiagnosed ADHD may also have trouble following through with commitments. If you’re the type of person to get excited about and start new projects, often running from one passion or interest to the next, but don’t tend to see any of them to completion, it could be a sign you have undiagnosed ADHD. Additionally, overpromising to complete tasks and spreading themselves too thin can lead you to lack follow-through.
As mentioned earlier, people with ADHD typically have no trouble sustaining focus on activities that interest them – but when they lose interest, it can feel almost impossible to stay attentive. The lack of attention to detail, trouble with instruction-following, and forgetfulness associated with adult ADHD can also make it hard to follow through with commitments.
The Risks and Consequences of Undiagnosed ADHD
Undiagnosed ADHD affects adults in every area of life. To get effective treatment, you must first get the right diagnosis – which means that adults with undiagnosed ADHD are going through life without the treatment they need and deserve. Living with undiagnosed ADHD can not only negatively impact your mental health, but can also cause very real consequences and risks, including:
- Low self-esteem: Adults who aren’t diagnosed have no explanation for why certain tasks might be more difficult for them. For example, they may have struggled at school as a child or feel chronically overwhelmed with the basic tasks of adult life (like maintaining a clean home or paying bills on time). This can cause them to internalize and blame themselves for their perceived “faults,” which leads to poor self-esteem.
- Financial and employment problems: Adults with ADHD are entitled to reasonable accommodations to help them succeed at work, but they first need to have a diagnosis. Undiagnosed adults could be labeled as disorganized or difficult, which can lead to problems with job security.
- Other mental health disorders: Adults with undiagnosed ADHD are much more likely to live with additional mental health conditions, including depression and anxiety.
- Substance use disorder: People with ADHD, especially when they’re undiagnosed, are more likely to abuse drugs and alcohol – in part as a way to self-medicate their symptoms. Not having a diagnosis means you live with untreated ADHD, so people who don’t get a diagnosis until adulthood are often more likely to use illicit substances to manage their symptoms (as opposed to taking prescribed medication).
- Difficulty with relationships: Adults with ADHD, both diagnosed and undiagnosed, can cause problems in relationships. The disorganization, impulsivity, and emotional outbursts associated with this condition can make relationships difficult.
- Higher mortality risk: Unfortunately, this is the most severe consequence of undiagnosed ADHD: a higher mortality risk (risk of dying younger). A study from 2015 found that not only do all adults with ADHD have a higher mortality risk, but people who didn’t receive the correct diagnosis until adulthood had an even
higher risk [4*] than those who were diagnosed as children.
Why Is ADHD So Hard to Diagnose in Adults?
Understanding the importance of ADHD diagnosis and the risks of going undiagnosed begs the question: Why don’t more people get an accurate diagnosis?
Children are often diagnosed with ADHD because they become disruptive or fall behind in the classroom, leading to an assessment referral. If your symptoms are presented differently – which it does for many people, especially girls and women – then you may reach adulthood without ever understanding your symptoms or being referred for treatment.
In adulthood, ADHD can be harder to catch and accurately diagnose. Here are some of the explanations as to why.
Symptoms of Co-occurring Conditions Hide ADHD
Many adults with ADHD end up seeking mental health treatment not because of their ADHD symptoms themselves, but because of other mental health concerns like depression and anxiety. Often, the symptoms of these co-existing conditions can hide immediate signs of ADHD, which leads to misdiagnosis.
Masking of Symptoms
Many adults with undiagnosed ADHD have also gotten to where they are today because they’re so good at masking and coping with their symptoms. This is especially true
Mental Health Stigma
Although we’ve come a long way, mental health stigma is still alive and well. Because of this stigma, some adults experiencing signs of ADHD may be reluctant to get mental health support. When they don’t seek support, they can’t get an assessment and diagnosis.
Poor Treatment Access
Lastly, many adults suffer from poor mental health treatment access, especially in the United States. They may be uninsured, which can make seeing a mental health provider prohibitively costly. Or they may live in a rural area without mental health treatment providers and not know where to turn for support.
Getting a Diagnosis
To get an ADHD diagnosis as an adult, you need to connect with a healthcare provider who can conduct an ADHD assessment. There’s currently no standardized tool or assessment that providers use to diagnose adult ADHD. To accurately diagnose you, your provider will likely use a combination of:
- Observation of symptoms
- Clinical interviews with you and other important people in your life (like your partner)
- The Diagnostic and Statistical Manual (DSM-V-TR), which includes the diagnostic criteria for every mental health condition
Get Connected With an ADHD Provider Today
Getting a diagnosis is the first step to getting the ADHD treatment that you deserve. There are many effective treatment methods for adult ADHD, including stimulant medications, non-stimulant medications, and therapy, that can help you manage the disruptive parts of ADHD and build a successful and fulfilling life.
