Can ADHD Appear for the First Time in Adulthood?

Have you recently noticed symptoms of attention-deficit/hyperactivity disorder (ADHD)?

If you’re concerned that you have ADHD, the good news is that it’s never too late to get reviewed or diagnosed for it, even as an adult.

Around 3.1% of adults across the globe are living with ADHD.^[1] And a large number of these ADHDers only found out that they had the condition in adulthood.

Despite only getting a diagnosis later in life, many who received the right support and treatment noticed considerable improvements in their lives, careers, and relationships.

You may be wondering how so many adults—perhaps yourself included —only learn about their ADHD later on in life. But can you actually develop ADHD symptoms as an adult?

Continue reading to explore adult-onset ADHD and how to best manage the condition.

Originally published on February 2nd, 2021, this article was updated and republished on March 14th, 2024.

How ADHD Can Be Detected In Adulthood

It’s possible to get diagnosed with ADHD in adulthood.

Currently, there is no single examination, brain scan, or blood test that will indicate whether or not you have ADHD as an adult.

Your doctor will likely conduct a thorough assessment by asking about your symptoms and challenges.

There are also ADHD rating scales for adults that can give your doctor a deeper understanding of your symptoms and how severe they are. One example is the Conner’s Adult ADHD Rating Scale.^[2]

In some cases, your doctor may request to talk to your parents or anyone else who knew you well as a child. This helps them to learn about the possible ADHD-related challenges you faced as a child.

Possible Emergence Of ADHD In Adulthood

Your healthcare professional may ask about your behavior when you were younger because ADHD typically appears in childhood.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), symptoms of ADHD must be present before the age of 12 for a diagnosis.^[3]

What this means is that a person cannot get adult-onset ADHD or only have ADHD develop in adulthood. 

There are some recent studies suggesting that ADHD can appear for the first time in adults. However, there’s still no clear evidence that adult-onset ADHD exists, and more research needs to be conducted to validate these claims.^[4]

Possible Reasons For Late Diagnosis Of ADHD

A late diagnosis of ADHD can happen for various reasons, including the following:

• Missed diagnosis in childhood. ADHD is tricky to spot. It can be difficult for parents or teachers to recognize the condition well enough to take the necessary next steps. Apart from this, ADHD can also be misdiagnosed as another condition, like anxiety or depression.
• Subthreshold childhood symptoms. Your ADHD symptoms might have fallen below the threshold to meet the criteria for a diagnosis when you were a child. As an adult, your symptoms may have worsened to meet the diagnostic criteria.^[5]
• Masking of symptoms. ADHD can be masked by different factors, for instance, having a high IQ or being in a protective family environment. That said, this reasoning is still not backed by concrete research.^[5]
• Increased stress and challenges in adulthood. Adults have heavier responsibilities and face more significant challenges. This amplifies their symptoms, nudging them to seek help and a possible diagnosis later on in life.

It’s also possible that the symptoms you’re experiencing aren’t due to ADHD. Of course, this doesn’t make your struggles any less valid.

ADHD and Co-occurring Conditions

ADHD can be tricky to spot and diagnose because it tends to co-occur with other mental health conditions.

Research suggests that up to 80% of adults with ADHD also have another mental health condition, such as depression or an anxiety disorder.^[6]

This can make it more difficult for your healthcare professional to make an accurate diagnosis and treatment recommendation. They will have to determine whether your symptoms are caused by ADHD, another mental health condition, or both at the same time.

ADHD also tends to have overlapping symptoms with certain conditions. For instance, difficulty focusing can be a symptom of both depression and ADHD.

Due to these reasons, ADHD might be mistaken for another condition or overlooked when a different diagnosis is made.

Warning Signs and Symptoms Of Adult ADHD

Keeping an eye out for possible symptoms of ADHD allows you to detect it and seek help earlier on.

The following are some symptoms of adult ADHD:

• Difficulty paying attention to activities like reading, conversations, and lectures
• Overlooking details, resulting in careless mistakes
• Frequently forgetting meetings and deadlines
• Getting distracted by unrelated thoughts
• Making inappropriate comments
• Zoning out during conversations
• Losing or misplacing belongings
• Hypersensitivity to criticism
• Inability to complete tasks
• Tendency to procrastinate
• Poor organizational skills
• Getting bored easily
• Acting impulsively
• Constant fidgeting

For a diagnosis to be made, these symptoms must be present in two or more areas of your life, such as at home, work, school, or while you’re out with friends.^[3]

Tips to Manage Adult ADHD

The challenges you face with adult ADHD aren’t just in your head. They’re real—but very possible to overcome and manage.

However, learning and implementing the right strategies will take work and perseverance.

Let’s explore some science-backed tips for managing ADHD:

1. Maintain a Healthy Lifestyle

The following are tips you can follow to lead a healthy lifestyle with ADHD in the picture:

• Schedule regular exercise into your routine. Research shows that exercise can help improve attention, mood, and motivation.^[7] Start with shorter workout sessions and slot them into your daily routine to make exercising a habit.
• Practice good sleep hygiene. This includes going to sleep and waking up at regular times, reserving the bedroom only for sleep and sex, and avoiding large meals, alcohol, and caffeine before bed.
• Eat healthy. You can start with small steps to implement a diet that may help your ADHD symptoms. For instance, you may replace unhealthy snacks at home with healthier snack options like yogurt or mixed nuts. You can also prep your meals in batches over the weekends.

2. Develop Time Management Skills

Time management is a common challenge for ADHDers.

To improve your time management with ADHD, you can try the following tips:

• Break down big tasks into smaller goals with their own deadlines.
• Use the Pomodoro technique, which involves alternating focused periods of work with short breaks.
• Use ADHD organization tools and productivity-enhancing apps, like Forest or Focus Keeper.
• Keep a to-do list of your tasks and prioritize them based on urgency or complexity.
• Use the body doubling technique to enhance your focus.

3. Practice Mindfulness

Mindfulness meditation is a technique that may help to improve ADHD symptoms.^[8]

You can start practicing mindfulness by yourself at home. Find a comfortable place away from noise and distractions. Focus on your breathing as you meditate for a couple of minutes. If you catch yourself drifting away, gently bring your mind back to focus on your breath.

You can practice mindfulness in your everyday life, such as when eating or conversing with someone.

4. Cultivate Relationships

Finding strength and support in a community can help you feel less alone. There are plenty of adult ADHD support groups you can join.

These groups allow you to connect with and exchange advice and tips with people who understand what you’re going through.

Adult ADHD Is Treatable—Don’t Wait to Seek Help

Even though you may not recall experiencing any challenges as a child, it’s still safest to get your current symptoms assessed by a medical professional.

There are various methods of managing ADHD that you can explore with your healthcare professional. Apart from medications, ADHD therapies like cognitive behavioral therapy (CBT) or working with an ADHD coach can also be effective in helping you progress toward your goals.

Access to a resource hub of tips, advice, courses, and webinars can also be helpful. ADDA+ offers exactly this, allowing you to learn more about ADHD, its challenges, and how you can best overcome them to reach your fullest potential in life.

References

[1] Song, P., Zha, M., Yang, Q., Zhang, Y., Li, X., & Rudan, I. (2021). The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis. Journal of Global Health, 11, 04009. https://doi.org/10.7189/jogh.11.04009

[2] Prakash, J., Chatterjee, K., Guha, S., Srivastava, K., & Chauhan, V. S. (2021). Adult attention-deficit Hyperactivity disorder: From clinical reality toward conceptual clarity. Industrial Psychiatry Journal, 30(1), 23–28. https://doi.org/10.4103/ipj.ipj_7_21

[3] Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 7, DSM-IV to DSM-5 Attention-Deficit/Hyperactivity Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/

[4] Taylor, L. E., Kaplan-Kahn, E. A., Lighthall, R. A., & Antshel, K. M. (2022). Adult-Onset ADHD: A Critical Analysis and Alternative Explanations. Child psychiatry and human development, 53(4), 635–653. https://doi.org/10.1007/s10578-021-01159-w

[5] Asherson, P., & Agnew-Blais, J. (2019). Annual Research Review: Does late-onset attention-deficit/hyperactivity disorder exist?. Journal of child psychology and psychiatry, and allied disciplines, 60(4), 333–352. https://doi.org/10.1111/jcpp.13020

[6] Choi, W. S., Woo, Y. S., Wang, S. M., Lim, H. K., & Bahk, W. M. (2022). The prevalence of psychiatric comorbidities in adult ADHD compared with non-ADHD populations: A systematic literature review. PloS one, 17(11), e0277175. https://doi.org/10.1371/journal.pone.0277175

[7] Dinu, L. M., Singh, S. N., Baker, N. S., Georgescu, A. L., Singer, B. F., Overton, P. G., & Dommett, E. J. (2023). The Effects of Different Exercise Approaches on Attention Deficit Hyperactivity Disorder in Adults: A Randomised Controlled Trial. Behavioral sciences (Basel, Switzerland), 13(2), 129. https://doi.org/10.3390/bs13020129

[8] Kretschmer, C. R., Göz Tebrizcik, B., & Dommett, E. J. (2022). Mindfulness Interventions for Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis. Psychiatry International, 3(4), 363–399. https://doi.org/10.3390/psychiatryint3040031