Common Risks of Untreated ADHD in Adults

Attention deficit hyperactivity disorder (ADHD) is commonly assumed to be a childhood disorder. However, in two thirds of cases, it continues into adulthood. The lifetime prevalence of ADHD in adults 18 to 44 years old in the U.S., by some estimates, is as high as 8.8%. Yet fewer than 20% of adults with ADHD are currently diagnosed and treated.

When ADHD goes untreated in adults, it can lead to functional impairments, particularly in relationships and in the workplace. Untreated ADHD may significantly affect a person's quality of life.

Read on to learn more about the risks of untreated ADHD in adults and how to get help.

What Is ADHD?

ADHD is known as a neurodevelopmental disorder because its onset is during the prenatal developmental period.

During the early stages of brain development, the central nervous system and neurological pathways in the brain are formed. Issues with neurodevelopment can create a deficit (deficiency) or delay in development and behavior.

In the case of ADHD, different parts of the brain are affected, including the front of the brain, or prefrontal cortex. This is the area of the brain that handles executive function, a set of mental skills that include:

• Working memory
• Organization
• Time management
• Focus
• Holding attention on a task

All of these are impacted by ADHD.

Signs of Adult ADHD

Adults with ADHD may exhibit inattention (lack of attention), hyperactivity (being overly active), and impulsivity (being easily swayed and acting on urges).

Inattention

• Having difficulty paying attention or staying focused to complete a task
• Having trouble following instructions at work and completing work-related tasks
• Lacking organizational and time-management skills
• Losing things such as wallets, keys, and smartphones
• Being easily distracted and forgetful

Hyperactivity

• Extremely restless and unable to sit still
• Fidgeting, squirming while seated, or tapping hands or feet
• Talking excessively
• Being always on the go

Impulsivity

• Acting without thinking
• Blurting hurtful or inappropriate remarks without considering the impact
• Having difficulty waiting in line or waiting for one's turn
• Interrupting others
• Intruding on others

Risks of Untreated ADHD in Adults

Untreated ADHD is connected to impairments in key areas of living, such as at work and school, in relationships, and quality of life.

A few risks of untreated ADHD in adults include:

• Low self-esteem: Adults with ADHD frequently experience negative attitudes because of the challenges in functioning caused by the disorder. Studies suggest that ADHD in adulthood is connected to overall lower-self esteem, but this can be improved with treatment.
• Anxiety: About 50% of adults with ADHD also suffer from an anxiety disorder. Medications and psychotherapy for ADHD and anxiety can improve both issues.
• Relationship problems: Multiple studies indicate adults with ADHD have elevated levels of emotional dysregulation (poor ability to manage emotions). Self-regulation of emotions, frustration, impatience, and anger are difficult to manage with untreated ADHD. Emotional reactivity negatively impacts relationships. Treating ADHD with medication and therapy to gain communication and relationship skills can help.
• Job instability: Adults with ADHD struggle with a variety of challenges in the workplace, including poor communication skills, distractibility, procrastination, and managing challenging projects. Psychotherapy can be helpful in gaining skills to manage ADHD in the work environment. It's also important to find a career path that plays to the strengths of ADHD, such as those in fast-paced environments.
• Substance use: Multiple studies indicate that people with ADHD are three times more likely to be nicotine dependent. Those with ADHD were 50% more likely to develop a drug or alcohol use disorder than those without ADHD. Research shows that treatment with ADHD medications reduces substance misuse.
• Increased mortality: Several studies indicate adults with ADHD have a small increase in premature death, mostly due to accidents and suicide. However, long-term treatment with ADHD medications significantly reduces accidents and the risk of suicide.

Treating Adult ADHD

Treating adult ADHD improves symptoms and typically leads to better outcomes and quality of life.

Studies have consistently shown that treatment—both medication and therapy—geared toward ADHD decrease accidents, brain injuries, criminality, substance misuse, suicide and self-harm, and improves work functioning and relationships.

Medications for Adult ADHD

The primary types of medications used to treat ADHD include stimulants, antidepressants, and non-stimulant medications. These are designed to influence neurotransmitters, such as dopamine, that send signals between nerve cells in the brain.

• Stimulants: Two main kinds of stimulant medications are Adderall (amphetamines) and Ritalin, Concerta, and Metadate (methylphenidate). Stimulant medications are typically the medications of choice for treating ADHD.
• Antidepressants: These drugs impact neurotransmitters such as norepinephrine. They include tricyclic antidepressants, monoamine oxidase inhibitors, Effexor (venlafaxine), and Wellbutrin (bupropion).
• Nonstimulants: These medications are often used when someone can't tolerate stimulants or they are not fully effective. They include Strattera (atomoxetine), Qelbree (viloxazine), and Intuniv and Tenex (guanfacine).

Psychotherapy for Adult ADHD

There are two main types of therapy that seem to be most effective for ADHD:

• Cognitive behavioral therapy (CBT): CBT is a type of psychotherapy, or talk therapy, that focuses on how thoughts, feelings, and behaviors impact each other. Thinking differently and exploring and challenging negative or maladaptive thoughts can change feelings and behavior. CBT helps to improve emotional self-regulation, impulse control, stress management, and everyday executive function, such as managing time, planning, and task completion. It also leads to more positive beliefs and thoughts about oneself.
• Dialectical behavior therapy (DBT): DBT is based on CBT but with several differences. DBT was specifically created to improve emotional self-regulation challenges in borderline personality disorder but has been applied to many conditions with emotional regulation challenges. There's a strong focus on self-acceptance and the ability to change through more adaptive, flexible thinking, skill building, and support and validation from the therapist. Skills training focuses on mindfulness, distress tolerance (managing actual or perceived emotional distress), emotion regulation, and interpersonal relationships.

Summary

Though commonly viewed as a childhood disorder, ADHD can continue into adulthood. However, adult ADHD often goes untreated. Untreated ADHD can lead to impairments in functioning. Treatments for adult ADHD, including medication and psychotherapy, are effective at improving quality of life.

A Word From Verywell 

As with many mental health conditions, there is an unfortunate stigma associated with ADHD, which may prevent adults from seeking treatment. It's important to remember that ADHD is brain-based and genetic. Treatment can make a significant difference in a person's quality of life. Speak with your healthcare or mental health provider about treatments that will work best for you.