Can you outgrow ADHD or does it stay with you into adulthood?

Mention the medical condition ADHD and up pops an image of a fidgety, talkative and, at times, impulsive child or teenager. But did you know that not everybody outgrows ADHD and that you can have it as an adult?

ADHD stands for attention deficit hyperactivity disorder. Classic symptoms in childhood are being inattentive, disorganized, impulsive, hyperactive and easily distracted. It’s believed about 10% of children have this disorder. When it comes to adult ADHD, it’s much less common, affecting about 5% of adults.

Research shows that if you didn’t have ADHD as a child, it’s highly unlikely that as an adult you’re suddenly experiencing it. Some authors have claimed a substantial number of adult-onset ADHD cases, but that’s doubtful. It’s more likely the diagnosis was missed in childhood because the symptoms weren’t as obvious or these children had superior intelligence, allowing them to function in school despite undiagnosed ADHD. This is based on a 16-year follow-up of the Multimodal Treatment Study of ADHD (MTA) that followed over 200 children to age 25 who didn’t have ADHD at the beginning as well as over 400 who did.

What does adult ADHD look like?

If you were diagnosed as a child with ADHD, chances are your symptoms have diminished or changed over time. Hyperactivity tends to wane with age, often changing to an inner restlessness that’s not obvious to a casual observer. Signs can be frequently checking the time during a boring meeting or talking excessively but in a more polite manner than constantly interrupting like in childhood. Inattentive symptoms can be more persistent and obvious, such as making mistakes on a job. And, when it comes to forgetfulness, it could be failing to pay bills or constantly losing keys or glasses. While a child may wear out friends and have difficulty keeping them, an adult with ADHD may experience divorce.

Both genetics and lifestyle factors play a role in who’s likely to get ADHD. There’s a large genetic contribution, but genes are only expressed by interaction with the environment, including lifestyle choices. Some genes may make you more vulnerable to toxins or sensitive to certain foods or additives. Others may make you more sensitive to disruption of the sleep cycle and/or the blue light emitted by electronic screens. Sleep deprivation can mimic ADHD and worsen already-present ADHD, as can lack of exercise and nutritional insufficiencies.

What to do about adult ADHD

The MTA study mentioned above shows that while 60% of those studied had ADHD symptoms in adulthood, some were no longer impaired by it. That’s the key—if you’re stressed out or having trouble functioning because of your ADHD, it’s time to seek professional help. You may end up taking the same medication as a child, but the response may be different. For example, you may respond a bit better to amphetamine than to methylphenidate or better to an antidepressant than you did as a child. Also helpful is looking into cognitive-behavioral therapy or coaching from a professional. If you develop good habits for things that can be handled automatically (i.e. habitually) like always putting things in the same place or paying a bill as soon as it comes, you don’t have to pay attention to those things, so difficulty in paying attention isn’t such a handicap. The good news is that ADHD usually isn’t as severe as in childhood, can be manageable with the right help and can be responsive to options not available to children, such as changing jobs.

L. Eugene Arnold is a psychiatrist at The Ohio State University Wexner Medical Center and a professor emeritus at The Ohio State University College of Medicine.