Written by Dr Sara Tookey
Attention Deficit Hyperactivity Disorder (ADHD) has historically been viewed as a childhood condition characterised by inattention, hyperactivity, and impulsivity. However, in recent years there has been a surge in adult ADHD diagnoses. Some are wondering if adult ADHD has merely become the latest trend.
The official definition of a trend is “a general direction in which something is developing or changing,” and this is true whether that something is positive or negative. The data tells us that adult ADHD is very much a real and an increasingly recognised condition, not just a passing fad. While there are conflicting views on whether it is over-diagnosed in some cases, most experts agree the rising prevalence reflects improved screening, decreasing stigma, and a better understanding of how ADHD presents across the lifespan.
Let's look at some of the evidence and perspectives around this issue.
The Rising Prevalence of Adult ADHD
Estimates vary, but research suggests around 4-5% of adults in the US and UK have ADHD, with higher rates of men being diagnosed than women. A recent research study, published in the British Medical Journal, reported approximately a twenty-fold increase in ADHD diagnoses between the years 2000 and 2018 and nearly fifty-fold increase in ADHD prescriptions in men between the ages of 18 and 29 (from 0.01% to 0.56%) (McKechnie et al., 2023). Incidence of of females diagnosed in their mid-to-late 20s and 30 - 50 age range has nearly doubled fro 2020 to 2022, indicating an increase in female ADHD diagnoses, which tend to be later in life (Russel et al., 2023).
Compared to childhood ADHD, which affects around 9.8% of kids, adult ADHD was relatively under-diagnosed and overlooked until fairly recently. Now, diagnosis rates in adults outpace those in children.
The rising numbers likely reflect greater awareness and improved screening, not necessarily that more adults have ADHD than any other time period that's come before. Many adults lived with undiagnosed and untreated ADHD symptoms for years before receiving an evaluation. As Kat Brown suggests in her book "It's Not a Bloody Trend":
"Removing the stigma around one thing can mean someone feeling comfortable enough to seek help for something else. It doesn't mean more people necessarily claiming that for themselves, but it does mean that people who have suffered for a long time can get the support they need to end their struggle" (Brown, 2023).
The History of ADHD (“The Fidgets”):
It may surprise you to know that ADHD, in children and adults is not a new phenomenon. It was first documented by Scottish physician, Dr Alexander Crichton, in 1798. He was the first to characterise the condition and named it “the Fidgets”. He described the condition from behavioural observations of adults with what would now fit the criteria for a diagnosis of ADHD:
“In this disease of attention, if it can with propriety be called so, every impression seems to agitate the person, and gives him or her an unnatural degree of mental restlessness.
People walking up and down the room, a slight noise in the same, the mowing stable, the shutting a door suddenly, a slight excess of heat or of cold, too much light or too little light, all destroy constant attention in such patients, inasmuch as it is easily is exited by every impression.”
Why Is Adult ADHD More Recognised Now?
There are a few key reasons why adult ADHD has gained more attention and risen into the public consciousness:
1) Decreased Stigma Around Mental Health:
As the stigma around mental health conditions has decreased, more adults have been willing to explore whether they may have ADHD and seek professional assessment. A diagnosis is no longer seen as shameful or a sign that someone is "broken". Rather, many adults now seek an ADHD diagnosis as a pathway to access support, improve symptom management, develop greater self-understanding and cultivate a more compassionate perspective toward themselves and the challenges they face with daily living.
2) Increased Awareness and Understanding of ADHD:
We now know that ADHD is a lifelong neurological condition, not a childhood phase kids typically outgrow. Persistent inattention, restlessness, impulsivity and other traits can significantly impact daily functioning for adults.
More people are recognising their struggles may be due to ADHD. However, as Kat Brown explains in her book, the perception of increasing neurodivergence is often due to reduced stigma rather than a rise in prevalence: "The refrain 'there didn't use to be all this' can be refuted by data on left-handedness, another form of neurodiversity" (Brown, 2023). Brown explains how despite left-handers existing throughout history, stigma led to their concealment through practices like forcing right-handed writing. A 2007 study found left-handedness rates increased from 3% in the Victorian era to 11% recently (McManus, 2007).
The rise in identified cases of left-handedness was not due to more people being left-handed, but likely an increased acceptance, allowing people to embrace their natural inclinations without shame or coercion (McManus, 2007). Similarly, the growing rates of ADHD diagnosis likely reflect greater societal acceptance and understanding, not an actual increase in the condition's prevalence.
3) Expanded Definition of ADHD:
In the past, only children who were hyperactive were diagnosed with ADHD. The definition has been expanded to include other symptoms associated with inattention. As a result, more individuals have been diagnosed with the disorder. This is particularly true in girls, who more commonly exhibit signs of inattention rather than hyperactivity and are as a consequence often overlooked by teachers as "daydreaming" in class rather than presenting with hyperactive behaviour that is often deemed "disruptive" in class (as is more often the case with boys).
4) Improved Screening and Diagnostic Practices:
As clinicians understand the nuances of how ADHD manifests in adults, they are better able to accurately screen for it during assessments instead of overlooking symptoms. Adult ADHD-specific screening tools have also been developed.
5) Increased Accessibility to ADHD Information Online:
The growth of short-form video content on platforms like TikTok, Instagram, and YouTube Shorts has made information about ADHD more accessible than ever before. Rather than requiring sustained focus to read through lengthy materials, these bite-sized videos cater to those who struggle with attention and concentration.
The rise of blogs, social media channels, and online communities dedicated to ADHD spreads awareness and enables people to share insights about the adult experience of living with ADHD. This increased online presence makes it more likely for relevant information to reach those who need it most.
Moreover, these online resources provide a way for adults with ADHD to relate to and find validation in the shared experiences of others who have gone through similar struggles.
*You can find a list of online ADHD communities and resources at the bottom of this article.
Is Adult ADHD Overdiagnosed?
While most agree the rising rates reflect increased recognition, some people have raised concerns about potential overdiagnosis of ADHD in adults (and children). Reasons cited include: lack of clinician training in ADHD assessment, applying child criteria too broadly to adults, failing to rule out other conditions with overlapping symptoms, or mistaking normal lapses in concentration for ADHD symptoms. Overdiagnosis could potentially lead to unnecessary treatment with stimulant medications.
However, many specialists argue that in regions with good clinical practices, overdiagnosis is not as prevalent a problem as underdiagnosis. These reports are consistent with findings from research, which investigates this issue directly (Abdelnour, 2022). When comprehensive, multi-modal evaluations are conducted by trained clinicians, accurate ADHD diagnosis is very achievable. Despite research supporting this view, some reports in the media continue to propagate the message that ADHD and other mental health conditions are overdiagnosed. While often well-intentioned, this backlash against the perceived overdiagnosis of mental health conditions like ADHD and the culture of self-diagnosis on social media has had an unintended consequence - it may instil a sense in people with severe, chronic distress that their problems are just "normal," so they don't need support. This view ignores the reality that conditions like ADHD are also underdiagnosed due to misdiagnosis and co-occurring conditions, like learning disabilities, depression, or anxiety.
While often well-intentioned, this backlash against the perceived overdiagnosis of mental health conditions like ADHD and the culture of self-diagnosis on social media has had an unintended consequence - it may instil a sense in people with severe, chronic distress that their problems are just "normal," so they don't need support. This view ignores the reality that conditions like ADHD are also underdiagnosed due to misdiagnosis and co-occurring conditions, like learning disabilities, depression, or anxiety.
As author and neurodiversity advocate Kat Brown notes,
"Years of feeling defective, less than or a bit 'off' aren't easy to solve, especially when your level of self-trust may not be operating on the level you'd hope for a mature adult. This is partly why so many people, me included, report feeling deeply anxious ahead of our assessments in case it's found that we don't have it and that we are 'just like this' ... I am the only one who’s playing at being human because everyone else knows what they’re doing” (Brown, 2023).
While intended to raise awareness of overdiagnosis, some media narratives may unintentionally reinforce societal biases that compound self-doubt and avoidance of care for those in need.
The re-stigmatisation risk posed by an excessive preoccupation with overdiagnosis is explored in Sam Woolfe's insightful article. It highlights the nuanced balance between legitimate concerns around overdiagnosis and the importance of de-stigmatising mental health issues.
By viewing all mental health issues cynically through the lens of "overdiagnosis culture," we risk perpetuating stigma by accusing those in distress of overcautiously self-pathologising or buying into passing "fads." As the article eloquently argues, an excessive preoccupation with overdiagnosis creates additional barriers to appropriate care for many.
Seeking Diagnosis: The Importance of Proper ADHD Assessment
Like any medical condition, ADHD must be properly evaluated by qualified and experienced mental health professionals trained in identifying symptoms of ADHD and other mental health and neurodevelopmental conditions to facilitate ruling out of other potential causes through clinical interviews and testing. With increasing waiting lists for adult ADHD assessments in the UK's National Health Service (NHS) - often years-long, people are increasingly seeking private assessments. However, assessing the quality of these services can be challenging. Here are some key aspects to look for to ensure a reliable and comprehensive assessment.
A comprehensive ADHD assessment should include (including 1 to 4 sessions to complete):
Clinical interview about symptoms across multiple settings
Self-report ADHD rating scales and checklists
Information from partners, friends or family about observable traits
Screening for co-existing conditions like anxiety, depression, etc.
Testing of cognitive abilities and executive functions tied to ADHD
Assessments should then provide a detailed report presenting the symptoms and difficulties and identifying where this person may or may not meet the diagnostic criteria for ADHD. This report should also include a complete neurodevelopmental, social, psychiatric, family and medical history with a treatment plan, recommendations and evaluation of potential risks posed to this person.
When identified through this rigorous process, by a specialist, an adult ADHD diagnosis should be taken seriously - not dismissed as someone simply jumping on a trend bandwagon. Proper assessment and treatment can be life-changing.
The Impacts of Missed/ Late-diagnosis
For many adults who struggled through school, work and in relationships before receiving an ADHD diagnosis and support, a diagnosis provides a long-awaited explanation for their difficulties and a path forward. Failing to identify and treat ADHD in adults can have major negative impacts which may include:
Chronic low self-esteem from being labeled lazy or underachieving
Strained relationships
Elevated risks developing substance misuse problems, depression, anxiety and emotional dysregulation/liability
Financial stresses from disorganisation, impulsivity, procrastination
Academic underachievement and dropping out of school or university
Underperformance at work and in career despite intelligence
When supported through education, coaching, psychotherapy, CBT, medication and/ or lifestyle adjustments, many find their ADHD symptoms are very treatable. A diagnosis allows them to finally get the support they need to reach their potential.
Strengths of the Adult ADHDer
It's also important to understand that ADHD is a neurological difference, NOT a dysfunction or a disease. While it presents challenges in certain aspects of life, many adults with ADHD leverage their natural abilities in creative, entrepreneurial, and fast-paced roles that are an optimal match for their ADHD traits. These may include:
Hyperfocus on areas of passion or interest
Creativity and out-of-the-box thinking
High energy levels to sustain long work hours
Strong sense of empathy
Risk-taking tendencies, needed for a role as an entrepreneur for example
Strong problem-solving skills
Viewing adult ADHD through a neurodiversity lens, it becomes clear that these divergent cognitive traits and tendencies have real-world advantages in certain professional environments and situations.
Common Symptoms of Adult ADHD
While the core symptoms of ADHD are similar across the lifespan, they often present differently in adults compared to children. Common signs of adult ADHD include:
Inattentive Symptoms:
Poor concentration or easily distracted
Difficulty following instructions
Procrastination
Frequently misplacing things
Trouble meeting deadlines
Avoidance of tasks requiring sustained mental effort
Hyperactive/Impulsive Symptoms:
Restlessness and fidgeting
Excessive talkativeness
Impatience, frequent interrupting in conversation
Making impulsive decisions
Feelings of restlessness or boredom
Difficulty relaxing or "unwinding"
Internalised hyperactivity can also include: Overthinking, rumination or racing thoughts
Gender Differences in ADHD
While ADHD impacts both men and women, there are some key differences in how it manifests:
In Men: Research suggests that cis men are more likely to exhibit hyperactive or impulsive behaviours. They have higher rates of comorbid substance abuse issues and more coordination and learning difficulties.
In Women: Cis women are more likely to be diagnosed with the inattentive subtype rather than the combined hyperactive subtype. They may have more internalised symptoms like low self-esteem. They present with higher risks of anxiety, depression, eating disorders, and show a tendency towards lower-energy or daydreaming. The presentation of commonly less visible ADHD symptoms may contribute to late-diagnosis or misdiagnosis. Hormones also may play a key role in this (a topic will be exploring in detail in an upcoming blog article).
Compensatory Strategies Mask Adult ADHD
One reason many adults live with undiagnosed ADHD for years or decades is their ability to develop coping strategies and mechanisms that temporarily "mask" or manage their symptoms. This compensation allows them to function, at least for a while, despite underlying ADHD.
Examples of Compensatory Strategies:
Relying heavily on planners, apps, and calendars
Structured environments like school or the military
Simplified living situations like living alone
Involvement of an organised spouse or partner
Working extreme hours or in highly stimulating jobs
Why Masking Eventually Fails
While these coping methods provide temporary relief, they are not a cure for ADHD. Over time, masking becomes more difficult as life changes, demands increase, or the individual's personal situation shifts, such as:
Hormonal fluctuations (pregnancy, menopause, etc.)
Trauma or significant life stressors
Career transitions or new responsibilities
Breakdown of relationships or living situations
Lack of structure during retirement or job changes
It's often at major life transitions or periods of increased stress when adults realise they need professional guidance and support. An assessment can finally pinpoint ADHD as the underlying issue or challenge. See our article on how high-functioning ADHD can lead to burnout and breakthrough.
Along the path to an ADHD diagnosis, individuals are frequently misdiagnosed with other mental health conditions before receiving appropriate treatment for ADHD. Once they receive effective ADHD treatment, many experience a resolution of their previously diagnosed mental health difficulties for the first time.
While coping strategies provide temporary relief, long-term management through a multimodal approach – combining medication, therapy, coaching, and lifestyle adjustments – is crucial for many adults to successfully manage ADHD's impact across all areas of life.
What can I do if I suspect I have ADHD?
If you or a loved one suspect ADHD may be contributing to daily challenges, seeking an evaluation from a provider specialising in adult ADHD assessment and treatment is highly recommended. Choose a clinician who specialises in the specific struggles you face to ensure the right fit for personalised treatment aligned with your values and life goals. An evaluation can definitively rule ADHD in or out, allowing you to develop an individualised care and management plan.
Our psychologists at True North Psychology have experience in working with neurodiverse individuals, some with expertise, and identifying neurodiverse, with personal experience of being diagnosed with ADHD and or Autism in adulthood.
Conclusion and Summary
The rising rates of adult ADHD diagnosis do not reflect a passing fad, but rather a legitimate neurological condition that impacts millions worldwide. This increase is more likely attributed to several key factors: greater public awareness and decreasing stigma around mental health, an expanded clinical definition beyond stereotypical childhood hyperactivity, improved adult-specific screening methods and more clinicians trained to evaluate patients across the lifespan. With prevalence estimated at about 1 in 20 of adults, ADHD is a relatively common neurodevelopmental profile. However, comprehensive clinical assessments remain crucial to differentiate ADHD from other potential cognitive issues and avoid misdiagnosis or overdiagnosis. The growing recognition of adult ADHD represents positive strides in identifying and supporting a long-overlooked population.
Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance.
WANT TO LEARN MORE?
Below are recommended resources and supportive communities exploring Adult ADHD.
ADHD Books:
ADHD an A-Z: Figuring it Out Step by Step by Leanne Maskell
ADHD 2.0 by Edward M. Hallowell, M.D. and John J. Ratey , M.D.
Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood by Edward M. Hallowell, M.D. and John J. Ratey, M.D.
The ADHD Effect on Marriage by Melissa Orlov
Understand, Survive and Thrive - Midlife ADHD Diagnosis by Emma Mahony
Your Brain’s Not Broken: Strategies for Navigating Your Emotions and Life with ADHD - by Tamara Rosier
The Year I Met My Brain: A travel companion for adults who have just found out they have ADHD - by Matilda Boseley
Women with Attention Deficit Disorder: Embrace Your Differences and Transform Your Life - by Sari Solden
The Mindfulness Prescription for Adult ADHD: An 8-Step Program for Strengthening Attention, Managing Emotions, and Achieving Your Goals - by Lidia Zylowska
Order from Chaos by Jaclyn Paul
Books about Neurodiversity
Different, Not Less: A Neurodivergent's Guide to Embracing Your True Self and Finding Your Happily Ever After -by Chloe Hayden
Divergent Mind: Thriving in a World That Wasn’t Designed For You - by Jenara Nerenberg
How Not to Fit In: An Unapologetic Guide to Navigating Autism and ADHD - by Jess Joy and Charlotte Mia
The Neurodivergent Friendly Workbook of DBT (Dialectical Behaviour Therapy) Skills - by Sonny Jane Wise
The Pocket Guide to Neurodiversity by Daniel Aherne
The Power of Different: The Link Between Disorder and Genius - by Gail Saltz
Websites with free resources on adult ADHD:
ADDitude - https://www.additudemag.com/
TotallyADD - https://totallyadd.world/
CHADD - https://chadd.org/
ADHD UK - www.adhduk.co.uk
Podcasts:
Online Forums/Groups:
Reddit's ADHD Community (r/ADHD) - https://www.reddit.com/r/ADHD/
ADDitude Forums - https://www.additudemag.com/forums/
CHADD Online Support Groups - https://chadd.org/attending-a-meeting/
TotallyADD Forums - https://totallyadd.world/forums/
Social Media:
Facebook ADHD Groups (ADHD Adults, Adult ADHD Support Group, etc.)
Instagram ADHD Hashtags (#ADHD, #ADHDAdults, #ADHDLife, etc.)
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References
Abdelnour E, Jansen MO, Gold JA. ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis? Mo Med. 2022 Sep-Oct;119(5):467-473. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616454/PMID: 36337990; PMCID: PMC9616454.
Brown, K. (2023). It's Not A Bloody Trend: Understanding Life as an ADHD Adult. Jessica Kingsley Publishers.
McKechnie DGJ, O’Nions E, Dunsmuir S, Petersen I. Attention-deficit hyperactivity disorder diagnoses and prescriptions in UK primary care, 2000–2018: population-based cohort study. BJPsych Open. 2023;9(4):e121. doi:10.1192/bjo.2023.512
McManus C. (2019). Half a century of handedness research: Myths, truths; fictions, facts; backwards, but mostly forwards. Brain and neuroscience advances, 3, 2398212818820513. https://doi.org/10.1177/2398212818820513
Rucklidge J. J. (2010). Gender differences in attention-deficit/hyperactivity disorder. The Psychiatric clinics of North America, 33(2), 357–373. https://doi.org/10.1016/j.psc.2010.01.006
Russell J, Franklin B, Piff A, Allen S, Barkley E. Number of ADHD Patients Rising, Especially Among Women. Epic Research. https://epicresearch.org/articles/number-of-adhd-patients-rising-especially-among-women. Accessed on May 23, 2024.
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