Attention deficit disorder (ADD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Many people do not realize they have ADD because the symptoms can be subtle and are often mistaken for laziness, moodiness, or difficulty focusing. However, undiagnosed ADD can negatively impact a person’s quality of life. Here are some signs you may have ADD without realizing it.
Inattentiveness
People with ADD often have difficulty sustaining focus and are easily distracted. Some signs of inattentiveness include:
- Having a short attention span
- Daydreaming frequently
- Struggling to follow conversations or instructions
- Losing things often
- Forgetfulness and disorganization
- Avoiding tasks that require concentration
- Making careless mistakes
If you exhibit several of these behaviors, you may have the inattentive form of ADD, which was previously called ADD without hyperactivity. Adults and teenagers are more likely to display inattentive symptoms than hyperactive ones.
Hyperactivity
Hyperactivity refers to excessive movement or restlessness. Symptoms include:
- Fidgeting
- Inability to sit still
- Excessive talking
- Interrupting conversations
- Acting without thinking
- Difficulty doing quiet activities
- Feeling restless or “on the go”
While hyperactivity tends to decrease with age, adults with ADD may still experience inner restlessness. They may report feeling restless, agitated, or impatient.
Impulsivity
People with ADD may display impulsive behavior such as:
- Poor self-control
- Blurting out socially inappropriate comments
- Interrupting or intruding on others
- Engaging in risky behavior
- Overspending or impulse shopping
- Making important decisions without thinking
- Addiction problems
Impulsivity can lead to relationship problems, financial instability, accidental injuries, and difficulties at work or school. It is a key component of ADD at any age.
Difficulty Managing Life Tasks
Although not a formal symptom, many adults with undiagnosed ADD have difficulty managing responsibilities of daily life. They may struggle with:
- Staying organized and managing time
- Paying bills on time
- Planning ahead and multi-tasking
- Keeping track of appointments
- Returning calls and emails
- Running errands and getting places on time
These difficulties are not due to laziness or irresponsibility, but impairments in executive functioning associated with ADD. Seeking treatment can help.
Work and School Difficulties
Many intelligent adults with undiagnosed ADD experience problems in school or work environments. Common issues include:
- Poor performance despite trying hard
- Difficulty learning in traditional classrooms
- Losing jobs due to inattention
- Missing deadlines and falling behind
- Losing things and forgetting assignments
- Unfinished projects and difficulty meeting long-term goals
These symptoms often lead to significant underachievement and lost opportunities. Seeking assessment and treatment is important.
Relationship Conflicts
The symptoms of ADD can lead to problems in relationships with partners, family members, and friends. Common issues include:
- Missing important conversations
- Forgetting events or commitments
- Being distracted, inattentive, or bored
- Interrupting, blurting things out
- Procrastinating on chores and responsibilities
- Impulsive decisions without consulting others
This can cause loved ones to feel hurt, resentful, and uncared for. Explaining that you may have undiagnosed ADD can help improve relationships.
Mental Health Difficulties
Adults with undiagnosed ADD are at higher risk for other mental health issues like:
- Anxiety
- Depression
- Bipolar disorder
- Addiction disorders
- Eating disorders
These conditions are believed to stem from the brain abnormalities associated with ADD. Seeking treatment for ADD can potentially improve these co-occurring disorders as well.
Low Self-Esteem
Living with undiagnosed ADD can take a toll on self-esteem over time. Adults may start to feel:
- Incompetent
- Lazy
- Unintelligent
- Irresponsible
- Crazy
- Worthless
Knowing that what you’ve struggled with has a name and can be treated medically is empowering. Don’t write yourself off as incapable without exploring if ADD could be the issue.
Other Physical Symptoms
Some adults with ADD report additional physical symptoms, although the cause is unclear. These may include:
- Headaches
- Stomach aches
- Sleep disturbances
- Clumsiness
- Sensory sensitivity
These physical symptoms can exacerbate problems with inattention. Let your doctor know if you experience any physical issues in addition to ADD symptoms.
What Causes ADD in Adults?
ADD is a neurobiological disorder with genetic links. Imaging studies show differences in brain structure and activity in people with ADD compared to neurotypical brains. ADD is characterized by deficiencies in certain brain chemicals and circuits that regulate executive functions.
Specifically, people with ADD appear to have problems with:
- Dopamine activity – Dopamine is a neurotransmitter involved in motivation, rewards, attention, and impulse control. Low dopamine levels are linked to inattention, restless energy, and addiction risk in people with ADD.
- Norepinephrine – This brain chemical regulates alertness, arousal, focus, and effort. People with ADD may have insufficient norepinephrine.
- Frontal lobe circuits – Areas like the prefrontal cortex that govern focus, planning, organization, and regulating emotions and impulses are thought to function differently in people with ADD.
Additionally, people with ADD may have fewer dopamine transporters which clear excess dopamine from the synapses between neurons. They may also have abnormal activity in the cingulate cortex, basal ganglia, cerebellum, and various frontal lobe circuits.
Why Wasn’t it Diagnosed Sooner?
There are several reasons why adults can reach adulthood without an ADD diagnosis, including:
- Lack of obvious external hyperactivity in those with inattentive ADD
- Normal or high intelligence masking functional impairments
- Teachers punishing what they saw as laziness or disobedience
- Symptoms being mislabeled as depression, anxiety, OCD, ODD, etc.
- Less awareness of ADD in the past
- Underdiagnosis in girls due to different symptom presentation
- Adults hiding their struggles out of shame or embarrassment
But with better understanding of how ADD presents, more adults are now getting diagnosed and treated for this condition.
Should I Get Evaluated for ADD?
If the symptoms outlined above sound familiar, consulting with a mental health professional is advisable. But keep in mind that everyone occasionally struggles with things like procrastination or losing focus – that by itself does not mean you have ADD.
Key indicators of possible adult ADD include:
- Symptoms present since childhood (before age 12)
- Ongoing significant impairment in major life spheres (work, relationships, etc.) despite efforts to manage
- Symptoms across multiple settings like home and work, not just one context like an uninteresting job
- Clear evidence of inattention, hyperactivity, and/or impulsivity
Self-rating scales like the World Health Organization’s Adult ADHD Self-Report Scale can also give you an initial sense of whether your symptoms may be consistent with ADD. But only a licensed mental health provider can make an official diagnosis.
Types of Mental Health Professionals Who Can Diagnose ADD
The following professionals can evaluate, diagnose, and treat ADD:
- Psychiatrists – Can prescribe medications and have specialized training in diagnosing mental health conditions.
- Psychologists – Have a PhD/PsyD and expertise in testing for learning disabilities, cognitive deficits, etc.
- Licensed clinical social workers – Have mental health training to diagnose conditions like ADD and provide counseling.
- Licensed mental health counselors – Can diagnose and treat mental health disorders through counseling.
- Developmental pediatricians – Diagnose ADD in children but some still serve adults.
- Neurologists – May help diagnose and treat comorbid neurological problems.
Choose a provider who specializes and has experience specifically with adult ADD. Testing and diagnosis can take 1-3 appointments. Recommended treatment typically involves medication, counseling, education, skills training, and lifestyle adjustments.
Assessment Process for Adult ADD Diagnosis
Adults seeking an ADD assessment should expect the following process:
- Interview – The provider will ask about current symptoms, family history, school performance, work history, relationships, etc. Bring examples that demonstrate your struggles.
- Rating scales – You’ll fill out standardized questionnaires about your symptoms, like the Adult ADHD Self-Report Scale.
- Cognitive testing (sometimes) – Tests memory, attention, problem-solving. Not always needed but can identify learning disorders.
- Medical history – The provider will want to rule out other potential causes like thyroid disorders, sleep apnea, or traumatic brain injury.
- Collateral input (sometimes) – People close to you may be asked for observations about your symptoms.
After collecting the above information, the provider will synthesize the data to determine if your symptoms and history meet the DSM criteria for an adult ADD diagnosis. If criteria are met, treatment recommendations will be made.
ADD Symptom Checklist for Adults
Use this checklist of common adult ADD symptoms to get a sense if you may benefit from an evaluation. Check off any items that apply:
| Inattention Symptoms | Hyperactivity Symptoms | Impulsivity Symptoms |
|---|---|---|
| Short attention span | Fidgeting or restlessness | Poor self-control |
| Easy distractibility | Inability to sit still | Impatience |
| Difficulty concentrating | Feeling “on the go” | Frequent interruption of others |
| Forgetfulness | Excessive talking | Poor planning |
| Disorganization | Racing thoughts | Blurting out thoughts |
| Avoiding focused tasks | Running/climbing excessively | Difficulty awaiting turn |
| Losing things | Impulse purchases | |
| Boredom | Risky behaviors | |
| Mind wandering |
If you checked off several items in one or more categories, consider talking to your doctor or a mental health professional about the possibility of having ADD.
Benefits of Getting Diagnosed and Treated
Getting properly diagnosed and treated for ADD as an adult can lead to many positive outcomes, such as:
- Understanding yourself and your struggles better
- Accessing accommodations at school or work
- Boosting your performance and reaching your potential
- Improving relationships
- Gaining coping skills and lifestyle strategies
- Treating co-occurring mental health issues
- Feeling more in control of your life
While ADD can’t be cured, with the right management many adults see their symptoms improve dramatically and are able to accomplish goals that previously seemed unattainable.
Conclusion
Many intelligent and capable adults struggle through life with undiagnosed ADD. They may experience problems like forgetfulness, disorganization, procrastination, restlessness, and difficulty managing responsibilities without realizing ADD could be the reason. Other mental health issues like anxiety and depression can also develop in those with unrecognized ADD.
If you see yourself in the symptoms and examples provided in this article, consult with a mental health professional about the possibility of having adult ADD even if you were never diagnosed as a child. Effective treatment is available involving medication, counseling, education, skills training, and lifestyle adjustments. Addressing ADD can help adults gain control of symptoms and maximize their abilities and potential.