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Can you live with ADHD and not know it?

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity and impulsivity. Many adults live with undiagnosed ADHD because they were never evaluated for it as children. Going through life with undiagnosed ADHD can make daily tasks more challenging.

What are the symptoms of ADHD in adults?

The core symptoms of ADHD include:

  • Difficulty paying attention and staying focused
  • Being easily distracted
  • Difficulty organizing tasks and activities
  • Being forgetful about daily activities
  • Fidgeting and restlessness
  • Excessive talking
  • Difficulty waiting their turn
  • Interrupting conversations or activities

Adults with undiagnosed ADHD may have trouble managing time, being organized, setting goals and meeting deadlines at work. They are at increased risk for car accidents, substance abuse, relationship problems and unemployment. Many adults with undiagnosed ADHD also suffer from low self-esteem, anxiety or depression.

What causes ADHD in adults?

The exact causes of ADHD are unknown, but research suggests that genetics and differences in brain development and chemistry may contribute to ADHD. Abnormalities in the prefrontal cortex, basal ganglia and cerebellum have been associated with ADHD. Dopamine and norepinephrine play important roles in executive functions that are impaired in ADHD such as attention, planning and impulse control.

Why do many adults remain undiagnosed?

There are several reasons why ADHD often remains undiagnosed in adults:

  • Lack of recognition – People used to think ADHD only affected children. There is now more awareness that ADHD symptoms persist into adulthood in most cases.
  • Able to compensate – Adults learn coping strategies that allow them to function even with ADHD symptoms.
  • Different symptoms – Hyperactivity tends to decrease with age, making inattentive ADHD harder to recognize.
  • Misdiagnosis – Symptoms may be mistaken for other conditions like anxiety, depression or learning disabilities.
  • Denial – Adults may be in denial about struggles being due to ADHD.
  • Lack of screening – Many adults are never assessed for ADHD.

What are the consequences of undiagnosed ADHD?

Living with undiagnosed ADHD can have many negative effects:

  • Poor academic performance
  • Problems maintaining employment
  • Relationship issues
  • Increased risk of substance abuse
  • Financial struggles
  • Low self-esteem
  • Symptoms of anxiety or depression

Research shows that adults with undiagnosed ADHD have higher rates of being fired, quitting or changing jobs frequently, being disciplined at work, and having difficulty paying bills on time.

When should adults consider an ADHD evaluation?

Adults who experience ongoing issues with focus, disorganization, forgetfulness or restlessness should consider an ADHD assessment if these symptoms:

  • Date back to childhood
  • Negatively impact work, relationships and daily functioning
  • Cannot be better explained by other conditions

Getting evaluated for ADHD can help adults understand whether ADHD is contributing to their difficulties. Effective treatment is available for ADHD.

How is ADHD diagnosed in adults?

Diagnosing ADHD in adults involves:

  • Personal history – The doctor will ask about current symptoms, childhood history and family members with ADHD.
  • Physical exam – This checks for conditions that could cause similar symptoms.
  • Psychiatric assessment – This evaluates for mental health disorders that may coincide with ADHD.
  • Neuropsychological testing – Tests of attention and concentration may be performed.
  • Rating scales – ADHD rating scales will be given to the patient and people who know them well to assess symptoms.

Diagnosing ADHD does not involve any blood tests or brain scans. It is based on a thorough evaluation of symptoms, history and testing over time. Formal testing is not always needed.

What treatments help adults with undiagnosed ADHD?

Effective treatments for ADHD include:

  • Medications – Stimulants like methylphenidate (Ritalin) and amphetamines (Adderall) are commonly prescribed. Non-stimulants may also be used.
  • Education – Learning about ADHD and self-management strategies.
  • Coaching – ADHD coaches teach organizational and productivity skills.
  • Psychotherapy – Therapy focuses on improving coping abilities.
  • Skills training – Programs help improve executive functioning and memory.
  • Lifestyle changes – Exercise, diet, sleep and stress management support overall health.

Treatment is tailored to the individual’s needs. Medication and therapy together are often the most effective approach. Treatment can improve functioning, productivity and quality of life.

What tips help adults manage undiagnosed ADHD?

Here are 10 tips to help adults manage undiagnosed ADHD:

  1. Make to-do lists and break down large tasks.
  2. Use reminders and alarms to stay organized.
  3. Schedule your most challenging tasks for when you have the most focus.
  4. Take regular breaks when working on something mentally taxing.
  5. Minimize distractions in your work area.
  6. Exercise and eat healthy to manage symptoms.
  7. Get enough sleep.
  8. Try to limit stress where possible.
  9. Find an understanding support system.
  10. Don’t be too hard on yourself.

Being patient and compassionate with yourself is key. Consult a doctor if lifestyle changes are not sufficient to manage symptoms.

What jobs are suitable for adults with undiagnosed ADHD?

Some jobs may be better suited for adults with undiagnosed ADHD symptoms such as:

  • Creative fields like arts, design, photography
  • Freelance work with flexible schedules
  • Entrepreneurship or small business opportunities
  • Trade jobs using hands-on skills
  • Sales positions with less paperwork
  • Customer service roles in active environments
  • Teaching physical education or coaching sports
  • Park ranger or forestry technician
  • Police, firefighter, paramedic
  • Fitness instructor, personal trainer

It’s most important to choose a career that you find engaging and are passionate about. Seek environments with less rigid office routines. Structure your schedule to maximize productivity.


Many adults remain undiagnosed but live with symptoms of ADHD. This can negatively impact school, work, relationships and mental health. Getting effective treatment requires a thorough evaluation for ADHD. A combination of medication, education, skills training and lifestyle changes can greatly improve functioning for adults with ADHD.