Can ADHD Appear for the First Time in Adulthood?

According to the Centers for Disease Control and Prevention, attention-deficit/hyperactivity (ADHD) is one of the most common forms of childhood neurodevelopmental disorders⁽¹⁾.

While ADHD is often diagnosed in children, it may continue through adolescence and adulthood.

Current evidence also shows that ADHD may appear for the first time in adulthood. Diagnosing ADHD often includes ADHD symptom checklists, behavior rating scales, and a detailed history of one’s life⁽²⁾. Meanwhile, medical professionals have started using advanced medical imaging technology to help detect the condition.

New Ways to Detect ADHD in Adulthood

Given that ADHD is a neurodevelopmental disorder, advanced brain scans may help overcome the challenge of detecting ADHD. A 2017 study showed that brain magnetic resonance imaging (MRI) may distinguish individuals with ADHD from those without the condition⁽³⁾.

Moreover, a 2019 study used diffusion MRI to examine the effect of methylphenidate (common ADHD treatment) on the development of human brain white matter⁽⁴⁾. Results showed changes in specific tracts in brain white matter in men with ADHD.

A 2013 study compared the brain MRIs of adolescents with ADHD and those without⁽⁵⁾. The researchers noted that brain structure patterns correctly classified almost 80% of the test participants who had been diagnosed with ADHD.

Thus, these findings may help find an objective diagnostic tool based on brain imaging measures to aid with the subjective clinical diagnosis of ADHD.

Possible Emergence of ADHD in Adulthood

A 2016 study published in JAMA Psychiatry noted that the young adult ADHD population consisted of a large, late-onset ADHD group and a smaller group with persistent ADHD⁽⁶⁾.

The late-onset ADHD group included those without a childhood ADHD diagnosis.

Another longitudinal study, published in the same journal, investigated whether impaired young adults with ADHD symptoms always have a childhood-onset disorder⁽⁷⁾.

The majority of adult ADHD cases involved adults with no history of ADHD, and 87% of adult cases showed late-onset ADHD.

Both studies suggest that ADHD may emerge for the first time in adulthood.

In another study from The American Journal of Psychiatry, 90% of adult ADHD cases showed no history of childhood ADHD.

The adult ADHD group did not manifest neuropsychological deficits in childhood or adulthood, or polygenic (influenced by more than one gene) risks for childhood ADHD⁽⁸⁾.

These findings propose that adults with ADHD symptoms may not have a childhood-onset neurodevelopmental disorder.

The late emergence of symptoms may also have implications for studies of whether ADHD is genetic. However, more research is needed to confirm ADHD’s first emergence in adulthood.

Possible Reasons for Late Diagnosis of ADHD

Different factors may cause a late diagnosis of ADHD. Symptoms could not have been evident in childhood because of protective influences, such as parental guidance, a high IQ, or good grades.

Misdiagnosis of another disorder, like anxiety and depression, is also possible.

Moreover, there may be an occurrence of an entirely adult form of ADHD, which researchers have yet to prove.

Warning Signs and Symptoms of Adult ADHD

Adult ADHD can cause people to face difficulties with focusing, prioritization, forgetfulness, impulse control, impatience, organization, reckless behavior, or anger, to name a few. This can lead to missed meetings or deadlines, short tempers, difficulty finishing or starting tasks, dangerous situations, and problems socializing.

ADHD in adults often looks different than ADHD in children. Symptoms may also vary per individual. However, the common symptoms of adult ADHD include:

• Trouble paying attention to activities, like reading, conversations, and lectures
• Getting distracted by unrelated thoughts
• Frequently zoning out during conversations
• Failure to complete tasks, even the simple ones
• Overlooking details, resulting in careless mistakes and incomplete work
• Poor organizational skills
• Constantly losing or misplacing belongings
• Tendency to procrastinate
• Frequently forgetting meetings and deadlines
• Giving rude or inaccurate comments without thinking
• Acting recklessly without considering the consequences
• Hypersensitivity to criticism
• Constant fidgeting
• Getting bored easily

Tips to Manage Adult ADHD

ADHD can affect different areas in life— in family, career, and relationships. Here are some self-care strategies to help manage ADHD in adulthood.

Keep a Healthy Lifestyle

Exercise regularly to help balance aggression and extra energy. Eat healthy food and control sugar intake to help manage mood swings.

Also, try to get seven to eight hours of sleep to stay focused, productive, and on track with responsibilities.

Develop Time Management Skills

To stay focused and organized, set deadlines for all tasks, including the smallest ones. Use alarms and timers, take regular breaks, and prioritize time-sensitive tasks.

Practice Mindfulness

Contemplating may be hard for those with ADHD, but regular meditation helps calm the mind and body and control emotions.

Cultivate Relationships

Allot time for family and friends. Engage in fun activities with them, listen to them, and try not to interrupt when they talk.

Make sure to seek professional help to get the right therapy and medication.

If you think you might have ADHD, take ADDA’s ADHD screening test for adults.

References:

1. Centers for Disease Control and Prevention. (2020, Oct. 23). What is ADHD? Retrieved from https://www.cdc.gov/ncbddd/adhd/facts.html
2. CHADD. Diagnosis of ADHD in Adults. Retrieved from https://chadd.org/for-adults/diagnosis-of-adhd-in-adults/
3. Sun, H., Chen, Y., Huang, Q., Lui, S., Huang, X., Shi, Y., Xu, X., Sweeney, J. A., & Gong, Q. (2017). Psychoradiologic Utility of MR Imaging for Diagnosis of Attention Deficit Hyperactivity Disorder: A Radiomics Analysis. Radiology, 287(2), 620–630. doi.org/10.1148/radiol.2017170226. https://pubs.rsna.org/doi/10.1148/radiol.2017170226
4. Bouziane, C., Filatova, O. G., Schrantee, A., Caan, M., Vos, F. M., & Reneman, L. (2019). White Matter by Diffusion MRI Following Methylphenidate Treatment: A Randomized Control Trial in Males with Attention-Deficit/Hyperactivity Disorder. Radiology, 293(1), 186–192. doi.org/10.1148/radiol.2019182528. https://pubs.rsna.org/doi/10.1148/radiol.2019182528?_ga=2.57228778.1371896573.1610666479-1184649490.1610666479
5. Lim, L., Marquand, A., Cubillo, A. A., Smith, A. B., Chantiluke, K., Simmons, A., Mehta, M., & Rubia, K. (2013). Disorder-specific predictive classification of adolescents with attention deficit hyperactivity disorder (ADHD) relative to autism using structural magnetic resonance imaging. PloS one, 8(5), e63660. doi.org/10.1371/journal.pone.0063660. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656087/
6. Agnew-Blais, J. C., Polanczyk, G. V., Danese, A., Wertz, J., Moffitt, T. E., & Arseneault, L. (2016). Evaluation of the Persistence, Remission, and Emergence of Attention-Deficit/Hyperactivity Disorder in Young Adulthood. JAMA psychiatry, 73(7), 713–720. doi.org/10.1001/jamapsychiatry.2016.0465. https://pubmed.ncbi.nlm.nih.gov/27192174/
7. Caye, A., Rocha, T. B., Anselmi, L., Murray, J., Menezes, A. M., Barros, F. C., Gonçalves, H., Wehrmeister, F., Jensen, C. M., Steinhausen, H. C., Swanson, J. M., Kieling, C., & Rohde, L. A. (2016). Attention-Deficit/Hyperactivity Disorder Trajectories From Childhood to Young Adulthood: Evidence From a Birth Cohort Supporting a Late-Onset Syndrome. JAMA psychiatry, 73(7), 705–712. doi.org/10.1001/jamapsychiatry.2016.0383. https://pubmed.ncbi.nlm.nih.gov/27192050/
8. Moffitt, T. E., Houts, R., Asherson, P., Belsky, D. W., Corcoran, D. L., Hammerle, M., Harrington, H., Hogan, S., Meier, M. H., Polanczyk, G. V., Poulton, R., Ramrakha, S., Sugden, K., Williams, B., Rohde, L. A., & Caspi, A. (2015). Is Adult ADHD a Childhood-Onset Neurodevelopmental Disorder? Evidence From a Four-Decade Longitudinal Cohort Study. The American journal of psychiatry, 172(10), 967–977. doi.org/10.1176/appi.ajp.2015.14101266. https://pubmed.ncbi.nlm.nih.gov/25998281/