ADHD is chronically under-diagnosed, with a staggering 80% of US adults remaining undiagnosed and untreated. This pervasive lack of recognition carries profound implications, setting the stage for a life shadowed by unseen challenges and enduring risks. In this exploration, we delve into the hidden turmoil of those suffering in silence, uncovering the long-term risks and consequences of untreated ADHD.
Risks Of Untreated ADHD In Adults
ADHD causes a wide range of functional impairments, from memory issues, struggles with focus and attention, disorganization and poor time management, difficulty regulating emotions, and more. While it was thought that ADHD goes away in adulthood, more recent research finds that in fact, this isn’t usually the case. Many people experience symptoms that persist into adulthood, though the way those symptoms show up may change. Without treatment or support, adult ADHD symptoms can have devastating effects across all domains of life. For example, research on the long-term effects of untreated ADHD in adults found increased risk of negative outcomes, from impaired quality of life to premature death from both accidents and suicide.
Career and Finances
Without a diagnosis, many people struggling with adult ADHD encounter serious financial and career challenges. Even without disclosing, many people who are aware that they have ADHD are able to identify potential accommodations at work, or at the very least, are better able to seek support and treatment. Otherwise, they are left to navigate these hurdles alone. Depressingly often, their attempts are unsuccessful. In fact, one study found that adults with ADHD were 42% less likely to be employed full-time, and that US adults with ADHD make on average $15,400 less per year than neurotypical peers.
Day to day, ADHD at work can create challenges with:
- breaking big tasks and projects into smaller steps
- prioritizing tasks
- time management (underestimating time needed for a task, arriving on time, completing projects on a deadline)
- memory issues (forgetting appointments, details of meetings or conversations, losing track of what they were saying or doing)
- clutter and disorganization
- overwhelm and burnout
- lack of focus and distraction
- inconsistent motivation and productivity
- boredom and job-hopping
But, financial problems in adult ADHD don’t stop once they leave the office. Financial decision-making is also a common challenge. They may struggle with:
- impulsive spending
- creating and sticking to a budget
- paying bills on time
- debt and late fees
- saving up for big purchases, like a home or vehicle
Education
Educational hurdles are just as common, and just as harmful, for people with ADHD. Studies found that college students with undiagnosed ADHD had, on average, lower GPAs, fewer years of education, and were less likely to have completed a university degree than people without ADHD. The same study reported students with ADHD more often required additional support in order to succeed in school, were more likely to have to repeat grades, were more likely to go on academic suspension, and were more likely to drop out of school altogether.
Relationships
In relationships, studies found that people with ADHD are more likely to get divorced, often reporting more frequent arguments and lower levels of relationship satisfaction than neurotypical peers. Common relationship challenges for people with ADHD include:
- impulsivity (outbursts of anger or hurtful statements, interrupting conversation)
- lack of focus (zoning out during conversation)
- memory challenges (forgetting important names or dates)
- emotional regulation (increased sensitivity to feedback, increased chances of experiencing relationship anxiety)
- difficulty with setting and maintaining healthy boundaries
Mental Health
Adults with ADHD are at increased risk for additional mental health diagnoses or co-morbidities like anxiety, depression, and substance use. In fact, one study found that addiction and substance use was twice as common in people with ADHD. For those who are undiagnosed, some experts believe that substance use may be an attempt at self-medicating. Common mental health risks in adult ADHD include:
- Substance use and addiction
- Depression, anxiety, and mood disorders
- increased risk of gender dysphoria
- low self-esteem and self-confidence
- feelings of shame, loneliness, or alienation
- higher risk of suicide and self harm
- disordered eating
Without a correct diagnosis, the challenges people with ADHD encounter are often blamed on the person themselves, and internalized as character flaws like laziness, lack of discipline, or selfishness. This can create a sort of snowball effect of worsening mental health outcomes.
Furthermore, according to an article from ADDitude magazine, women with ADHD were twice as likely to develop depression. And, in these women, depression “has an earlier age of onset, lasts longer, comes with more severe symptoms, a higher rate of suicidality, and a greater likelihood of requiring psychiatric hospitalization.”
Physical & Behavioral Health
Untreated ADHD can lead to significant long-term physical and behavioral health risks, exacerbating the challenges individuals face in leading a healthy and balanced life. For example, untreated ADHD is associated with a higher mortality rate. The mortality rate was highest in those who received an ADHD diagnosis in adulthood, rather than in childhood. Other risks include:
- increased rate of risky behaviors like unsafe sex and unplanned pregnancy, substance abuse, binge eating, and gambling
- difficulties with organization, planning, and motivation lead to increased difficulty adopting and maintaining healthy habits such as diet and exercise routines
- higher risk of heart disease
- increased risk of obesity and diabetes
- higher rates of chronic pain and fatigue
- higher mortality rate
- reduced life expectancy (6.5 yrs reduced for those with ADHD in childhood; 11 years reduced for those with ADHD continuing into adulthood)
- higher rates of sleep disorders and unhelpful sleep patterns
- greater risk of dangerous driving and motor vehicle accidents
Legal Issues
Legal issues were more common in people with ADHD, as well, potentially due to increased impulsivity or challenges with emotional regulation. People with ADHD are three times more likely to be arrested than those without ADHD. In fact, according to the Attention Deficit Disorder Association (ADDA), up to 40 percent of prison inmates have ADHD - most of them undiagnosed and untreated. A study in the UK found that ADHD was an even higher predictor of violent offending than substance misuse. Heartbreakingly, much of this criminal activity could have been prevented had ADHD been identified and treated early in life.
ADHD Diagnosis: Why Early Intervention Is Critical
Research indicates that individuals with untreated ADHD experience poorer long-term outcomes across various domains compared to those without ADHD. These outcomes encompass academic, occupational, social, and emotional well-being, highlighting the pervasive impact of untreated ADHD on overall life trajectories. Early diagnosis of ADHD is paramount in ensuring individuals receive the necessary support and interventions to navigate the challenges associated with this condition. Without timely identification and intervention, the consequences can be profound and far-reaching.
Individuals with ADHD who are misdiagnosed with other conditions, like anxiety or depression, are at risk of being prescribed incorrect treatments and medications. This not only fails to address the underlying issues but can also lead to unnecessary side effects and complications. Obtaining the correct diagnosis and treatment as early as possible keeps symptoms from worsening, at the very least. More often, it means significant improvement and improved long-term outcomes.
In summary, although treatment may not fully eliminate ADHD symptoms, it can help improve them. The sooner ADHD is recognized and treated, the better the chance of reducing the long-term impact of symptoms and difficulties. For instance, addressing academic struggles early on may prevent limitations in future job opportunities, and minimize the wage gap. Improving social skills could reduce conflicts with romantic partners, decreasing the risk of divorce and relationship dissatisfaction.
Next Steps: Adult ADHD Treatment
Treating ADHD in adults involves a multifaceted approach aimed at managing symptoms, improving daily functioning, and enhancing overall well-being. While there is no one-size-fits-all solution, several strategies have proven effective in addressing the challenges associated with adult ADHD.
- Medication: Medications are often a cornerstone of ADHD treatment in adults. There are both stimulant and non-stimulant options. Obtaining a diagnosis and medication is becoming easier, with several virtual ADHD medication services emerging in recent years.
- ADHD Therapy: Therapeutic interventions play a crucial role in managing ADHD symptoms and addressing related issues such as low self-esteem, relationship difficulties, and executive function deficits. Cognitive-behavioral therapy (CBT) is frequently utilized to help individuals develop coping strategies, improve time management skills, and enhance problem-solving abilities.
- Behavioral Interventions: Behavioral therapy techniques can be beneficial in modifying specific behaviors associated with ADHD, such as impulsivity and disorganization. These may include techniques such as behavioral reinforcement, organizational skills training, and self-monitoring strategies to promote more effective self-regulation.
- Lifestyle Modifications: Making lifestyle changes can also contribute to better symptom management and overall well-being. This may involve adopting strategies to improve time management, organization, and productivity, as well as incorporating regular exercise, adequate sleep, and a balanced diet into daily routines.
- ADHD Coaching: ADHD coaches can provide valuable guidance and encouragement throughout the treatment process. They can help you set up personalized strategies that fit your unique life to ensure that you can not only implement them effectively, but maintain them over time.
- Support groups: ADHD support groups are a safe space, offering practical advice, emotional support, and a sense of community for individuals navigating the challenges of adult ADHD.
Adult ADHD treatment is a collaborative effort. The most effective treatment strategy for most people combines one or more of the above interventions. By implementing a comprehensive treatment plan tailored to their specific circumstances, adults with ADHD can effectively manage their symptoms and improve their quality of life.
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