ADHD in Young Adults

For most of Zach’s school years, he struggled with procrastination and had a hard time getting organized. People would often tell him that he needed to manage his time better or find systems that would help handle his schedule. But those suggestions never seemed to solve the problem.

So he wasn’t surprised when he was diagnosed with attention deficit hyperactivity disorder (ADHD) at age 22.

“My go-to had always been, ‘I’m just wired this way, and there’s really nothing I can do about it,’” says Zach, who asked that we not use his last name for privacy reasons.

Signs of ADHD usually start in early childhood and continue into adulthood. But sometimes, ADHD isn’t diagnosed until someone is a young adult.

Adults’ symptoms might not be as obvious as those in children, but they’re similar. Young adults with ADHD usually don’t show as much hyperactivity as they did when they were kids. But they can be restless, with trouble controlling impulses and paying attention.

Like Zach, some young adults might start to wonder about ADHD when they notice that they have trouble with daily tasks. Or maybe your family, professors, or friends notice patterns in your behavior that make you seem inconsistent or forgetful. Warning signs include:

• Trouble focusing
• Problems controlling impulses
• Trouble with priorities
• Lack of organization
• Poor time management
• Trouble multitasking
• Restlessness
• Frustration
• Mood swings
• Trouble planning
• Problems finishing tasks
• Issues handling stress

These symptoms can lead to problems with your job, school, or social life. Young adults with ADHD might find it hard to meet deadlines, make it to meetings or events on time, or control their emotional outbursts.

To make a diagnosis, your doctor will most likely do a series of tests. They’ll give you a physical exam to rule out other conditions, ask about your medical history and other conditions you may have, and do psychological tests and use ADHD rating scales to take a deeper look at your symptoms.

There are three main types of ADHD, and testing may depend on your symptoms. The types are:

• Hyperactive-impulsive. This is the least common form of ADHD. It causes you to act on impulse and have restless tendencies.
• Inattentive. This type involves issues with your ability to pay attention.
• Combined. This is the most common kind and shows symptoms of both of the other forms.

Sometimes, a person who doesn’t have one of the first two types will go years without a diagnosis. Because they have symptoms of only one type, their doctor might not recognize their ADHD earlier on.

People with ADHD might also be what doctors call “high functioning,” which means they’ve been able to get through life without any major issues. They may not realize they have ADHD and may have developed coping skills to mask their symptoms.

Zach is now a graduate student at the Rockefeller University in New York. He says that being high functioning carried him through his primary education and most of college. “It can sometimes be easy to not see those that are high functioning,” he says.

No matter the type of ADHD, the symptoms can pose challenges for young adults. “From the time you start college to getting your first job, renting your first apartment, buying your first house — all of that adulting stuff requires a lot of executive functioning skills,” Zach says. These skills — like adaptable thinking, planning, self-control, self-monitoring, time management, memory, and organization – are key to development. But many people with ADHD struggle with them.

Without treatment, ADHD can lead to lots of trouble for young adults. It may make you more likely to have money issues, get into problems with the law, have trouble keeping a job, have substance or alcohol use issues, get into car accidents, deal with relationship troubles, have an unplanned pregnancy, get an STD, or have a poor self-image and other mental health issues.

David W. Goodman, MD, director of the Adult Attention Deficit Disorder Center of Maryland, says ADHD treatment is especially important for young people. “When you live with this your whole life, you begin to think ‘this is just me. … This is just kind of who I am,’” he says. “When, in fact, it’s not who you are, this is a disorder you have. This is the manifestation of the disorder.”

He finds that treatment helps young adults separate themselves from their condition. With the right help, “they realize that their capacity to do more is so much greater,” Goodman says. “That’s when their self-confidence goes up.”

If you’re diagnosed with ADHD, your doctor will offer resources where you can learn about your condition. Goodman suggests that it’s best for people to read up on ADHD before they start treatment so they can understand what it is, how it affects the chemicals in their brain, and how treatment can help them live better. Many experts recommend starting with an organization like Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

Your doctor will also talk to you about medications to treat your ADHD. You might try a stimulant like methylphenidate (Concerta, Ritalin) or amphetamine (Adderall, Vyvanse) to balance the chemicals in your brain. Or you may use nonstimulant medications like antidepressants if you can’t take stimulants because of side effects or other conditions.

Keep in mind that you’ll most likely need to work with your doctor to find the medication and dose that works for you. This might take some time.

Once your symptoms have improved with medication, Goodman often suggests therapy to work on organizational skills, interpersonal skills, and time management.

Cognitive behavioral therapy is a common type of psychotherapy for people with ADHD. It can help you learn how to manage your behavior and take control of your thinking patterns.

You may also want to consider marital counseling or family therapy to help you and your loved ones understand ADHD. These sessions can improve your at-home communication and teach you to face challenges more positively.

Medication and therapy aren’t the only ways to improve your ADHD symptoms. Carly Duryea, 23, found out that she had inattentive/distractible type ADHD when she was a freshman in high school. She shares these strategies that help her stay on top of her schedule:

• Getting it in writing. Duryea calls herself a “list-maker.” She uses written reminders and lists to help keep track of her day. This may include grocery lists, event planning, or simple to-do checklists.
• Visual reminders. Keeping notes around the house and objects in their proper place helps Duryea jog her memory when she needs it. She finds visual cues more helpful than trying to remember various tasks over the course of the day.
• A clean environment. An organized workspace allows for a streamlined focus to get work done on time.
• Preparedness. When Duryea goes out of town or on a day trip, she packs things like extra pain medication, towels in case it rains, drinks, snacks, and anything else she thinks someone could need. It may seem like overkill to some, she says, but it’s one of her best ways to tackle symptoms like forgetfulness.
• Accountability. Duryea asks her loved ones to keep her in check. “I work so much better under accountability,” she says. “My boyfriend can keep me accountable for certain things … whether it’s something small and insignificant or if it’s something more important like school or a deadline.”