ADHD in Adults: A Psychiatrist Explains

Attention-deficit/hyperactivity disorder (ADHD) has traditionally been considered a childhood condition, especially among boys, and often linked to behavioral issues in the classroom.

But in recent years, a growing number of adults are being diagnosed with ADHD, including women and people of color, two groups experts say have been historically underdiagnosed. While it has long been known that ADHD symptoms that begin in childhood can persist into adulthood, receiving a diagnosis as an adult was uncommon until recently.

According to data from Truveta, a health care analytics company, ADHD diagnoses in people older than 30 have been on the rise since 2021. From January 2021 to October 2024, the rate increased by approximately 61% in adults ages 30 to 44 and 64% in those 45 to 64.

Eunice Yuen, MD, PhD, a Yale Medicine psychiatrist who treats children, adolescents, and adults, has noticed this rise firsthand—especially among middle-aged adults who are parents.

“I have several hypotheses of why there is an increase, including the high-demand lifestyles many people live, with always having to be ‘on,’” Dr. Yuen says. “There’s also a tendency to self-diagnose using social media or other resources outside the health care profession. I think people turn to these places seeking, answers, solutions, and identity.”

ADHD is a neurodevelopmental disorder, meaning it involves how the brain grows and develops. In children, it often shows up as an inability to pay attention, control impulses, or stay still.

While it is normal for kids to experience trouble focusing from time to time, for children with ADHD, the symptoms can be severe and can interfere with daily functioning at school, home, and in social settings.

In adults, the condition may look different. For many, ADHD was always present but went undiagnosed. As life becomes more complex—with careers, relationships, and parenting—the symptoms can become more pronounced. Hyperactivity may appear as restlessness or may not be present at all.

Adults with ADHD, according to the CDC, may struggle with managing their attention, completing lengthy tasks that don’t interest them, staying organized, controlling their behavior, and feeling fidgety.

Dr. Yuen agrees. “I often treat parents and caregivers with ADHD. They are less likely to have the hyperactivity element than children and more likely to be attention-deficit,” she says. “I also see gender differences. Males, especially boys, with ADHD present more with impulsivity and emotional dysregulation, with or without attention-deficit. But females, including women and girls, tend to have more subtle attention-deficit.”

This, Dr. Yuen believes, might be because girls who aren’t diagnosed with ADHD develop overcompensation. “It might manifest in things like saying they can’t ever sit and read a book, or they struggle with today’s high-information era where there is so much coming at us 24/7,” she says.

She adds that the condition can become more noticeable for caregivers. “A person might have managed fine before kids, but once they're juggling parenting and work, deficits in executive function can surface,” she says.

Similar to how ADHD is diagnosed in children, diagnosing ADHD in adults typically involves a detailed clinical evaluation. This often includes a checklist for rating symptoms and a review of behavior and developmental history. A medical and psychological exam may be done to identify health conditions that can cause similar symptoms and often occur with ADHD, including anxiety, depression, sleep troubles, alcohol and substance use, and learning disabilities.

“People who suspect they have ADHD should seek a thorough evaluation by a mental health provider. While the internet may provide easy access to information on ADHD and wonderful peer support, an accurate diagnosis should come from a valid clinical expert,” Dr. Yuen says. “An evaluation includes a whole-person consideration including biological, psychological, social, and cultural factors, as well as a neurodevelopmental assessment dating back to one's earlier life history.”

Usually, ADHD symptoms begin by age 12, so providers often ask about early signs—even if they were mild or overlooked until adulthood. Dr. Yuen recommends visiting a psychiatrist, which may require a referral from a primary care provider.

Treatment for adult ADHD is often multimodal, meaning it combines psychotherapy with medication when needed. Psychotherapy is often the first treatment and it may include cognitive behavioral therapy (CBT), which allows people identify and change negative or unhelpful thoughts and patterns.

For adults with ADHD, CBT can help people manage executive function challenges, including difficulties with planning, organization, managing time, and regulating emotions. In addition to CBT, mindfulness-based cognitive therapy (MBCT) can help individuals to focus and control impulses. Dialectical behavioral therapy (DBT) can help people struggling with emotional dysregulation and interpersonal challenges.

Medication may also be recommended in tandem with therapy.

“We only prescribe medication if the ADHD is really affecting someone’s daily functions,” Dr. Yuen says. Stimulant medications, such as Adderall and Concerta, are the first-line treatment—unless other conditions such as anxiety, bipolar disorder, or substance use are present, in which case we prescribe nonstimulant medications or first prioritize treating other co-morbid conditions.”

Stimulants work by increasing levels of dopamine, a brain chemical that helps improve focus and motivation. Because these medications are controlled substances, they require careful management.

The best results usually come from combining therapy and medication, Dr. Yuen says. “Therapists can also serve as coaches, helping with stress management and setting priorities,” she says.

For many adults she treats, receiving an ADHD diagnosis can be validating, Dr. Yuen says. “Having ADHD can be debilitating, so to have an answer and an explanation is helpful,” she says. “Often, they say, ‘Oh, wow! All my life I have been stumbling along and having trouble and now I have an answer.’ And if we get them the appropriate treatment, they find relief.”