In Adult ADHD: The Journey to Adulthood we explored some of the peaks and valleys those with ADHD might encounter over the years. At some point our young ADHD friends will either go to college or enter the workforce.
Those who take the college route will find they have less academic assistance, little family support and minimal structure. If they succeed, it will be because they reach out for (and accept) help. Others who enter the workforce realize that getting support and assistance to succeed becomes even more difficult.
ADHD is Not Just for Kids
Adults with ADHD often have fewer obvious symptoms. In fact, until 2011 the guidelines for diagnosing ADHD did not include adults. The thinking until recently was that kids would ‘outgrow’ ADHD after puberty. Research has shown what I and millions of others can attest to – 50-65% of us continue to have symptoms into adulthood. The symptoms may be to a lesser degree, or change a bit, but they are ever-present.
Because this disorder is often misunderstood, many people who have it do not receive appropriate treatment and, as a result, may never reach their full potential. Part of the problem is that it can be difficult to diagnose, particularly in adults. There are an estimated 4 million adults with ADHD, and only 10% of adults with ADHD receive treatment.
Hyperactive/Impulsive Type: By adulthood only 5% of kids who had this type of ADHD still show outward signs of hyperactivity.
The primary symptoms in adulthood are feelings of restlessness, acting/speaking without thinking, fidgeting, impulsive or compulsive behavior (eating, shopping, gambling, drinking, sex, etc.), impatience, problems regulating emotions, acting without thinking, etc.
Inattentive/Disorganized Type: 20% of adults with ADHD have Inattentive type. Many women who were not diagnosed as kids recognize the symptoms when they leave the structure of home and high school for college, work and/or running a household.
The symptoms include procrastination, time management, losing things, not finishing projects or chores, wandering thoughts, clutter, tardiness, forgetfulness, thinking without acting - cognitive anxiety.
Combined Type: 75% of adults with ADHD have Combined type. These people have symptoms of both Inattentive and Hyperactive ADHD. This can be very unpredictable.
As an adult with Combined ADHD, I have some days when the symptoms of hyperactivity or impulsivity are worse, and other days when the inattention/disorganization is worse. There are really crazy days when all the symptoms are flaring up, but these are rare and based solely on what is happening in my life at the time. Those with one type or the other report that there are days when the symptoms seem worse, and other days when they feel ‘almost normal’.
Changes in Our Environment and Expectations Affect ADHD Symptoms
Perhaps the most confusing thing about ADHD is that it occurs in some situations but not others.
Why is that?
ADHD symptoms increase when:
Variables increase (Distraction, choices)
Structure decreases (Accountability, deadlines)
Less stimulating tasks (Less dopamine produced)
Adulthood often brings about many of these changes. Those who choose the college route find that many of the safeguards that helped them succeed in high school as a kid or teen no longer exist. That includes a lack of accountability (missing class can be a huge issue and professors are unlikely to have the checks and balances for keeping up with class assignments) and many additional variables (classes are scheduled on different days at different times – new and varied social and peer activities take on more importance, competing with study time, etc.).
The most obvious change is the lack of parental oversight, support and control. Most college freshmen struggle with time management and prioritizing. Those with ADHD had difficulty with these things under more ideal circumstances. Freshman year away from home with more freedom and independence often creates the perfect storm for young adults with ADHD. Many fall into the lure of the party life.
Adult ADHD Statistics Are Frightening
In a long-term study conducted by Russell Barkley and others, of those who continued to have ADHD symptoms, 38% had dropped out of high school—more than triple the dropout rate for Wisconsin students as a whole. Only 22% went to college, and only 5% graduated. In the control group, 77% of kids attended some type of college, including technical schools, and 35% completed a college degree, comparable to the national average.
Barkley found that 22% or more of young adults with ADHD struggle with addictive behavior, including alcohol and drug abuse and gambling. 60% or more of people with ADHD have problems with food, reporting eating disorders, being overweight or obesity. Researchers at Mass General Hospital found 32% of those studied with ADHD developed an addiction, and are very high risk for nicotine addiction.
Is There Any Good News for Adults with ADHD?
There is some good news. As one who struggled to stay in school due to undiagnosed ADHD (before it was mainstream in the early 60s), I can say that progress in the research has greatly improved our understanding and treatment of the disorder. It is much easier to recognize now, and even adults who were not diagnosed as children have an opportunity to get proper treatment. People who get diagnosed and treated have much better outcomes. There are also many things you can do daily to manage the symptoms, but there is no cure.
· Diet and exercise: Eating a diet that is high in protein and low in carbs is helpful. Protein is a precursor of the neurotransmitter dopamine. Exercise also helps regulate dopamine and norepinephrine. These two lifestyle choices can be easily adapted to help with symptom management.
· ADHD Coaching or Therapy: College students may need some assistance from an ADHD coach or therapist to develop healthy coping skills, learn how to plan, prioritize and manage daily tasks, etc. Check out The Edge Foundation – their coaches specialize in helping college students.
· Self-management: The term discipline takes on a whole new meaning when you are learning to live independently, succeed in college and manage a social life. Learn to make choices based on what is best for you in the big picture – some parties may have to be skipped to complete school work. Many people use timers, planners, white noise, specially arranged study areas and more to help with this. A coach or therapist who specializes in ADHD can help you figure out what works for you.
· Sleep and Downtime: Free time is a rare commodity in college, but a necessary one. Get plenty of rest – take naps if you need to. 70% of adults with ADHD report sleep problems, so find the schedule that works for you and get your 8 hours.
· Accommodations: If you need accommodations in the classroom, talk to someone at your college about your needs. These requests are usually handled by the Office of Disabilities – ADHD is a disability for many who have severe symptoms. You will need official documentation of the disorder from a medical provider. Once you provide that, your rights are protected under the Americans with Disabilities Act.
Find out more about Adult ADHD in the Workplace and Adult ADHD: Self Care, Management and Treatment Recommendations.
"ADHD Linked to Substance Abuse Risk | Harvard Gazette." Harvard Gazette. Harvard.edu. Web. 31 Oct. 2013.
"Adult ADHD Outcomes." Adult ADHD Help. Web. 31 Oct. 2013.
Pierce, LuAnn. "Adult ADHD and Self-Advocacy: 10 Tips for Facing Giants." Adult ADHD Help. Web. 31 Oct. 2013.
"Recommended Accommodations for College Students with ADHD." College Accommodations. Attention Deficit Disorder Association. Web. 31 Oct. 2013.