Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder, often diagnosed in childhood. But did you know that ADHD can persist for a lifetime? In this article, we will explore the changes that occur during this time to better understand the characteristics of ADHD in children and adults.
A brief overview
ADHD is associated with substantial harm to the individual, family, and community. In childhood, this disorder affects learning and relationships at home and school. In adulthood, ADHD affects maintaining relationships, managing personal finances, and controlling mood and temperament.
Over the years, ADHD was refined about its clinical nature, neurobiology, symptoms, and terminology (we may talk about this in the future). At the beginning of the last century, it was described as a hyperkinetic response in childhood with “minimal brain damage” – only in the 1940s, ADHD-like symptoms were associated with changes in the Central Nervous System.
The existence of the adult form of ADHD was officially recognized only in 1980 by the American Psychiatric Association. Until then, it was believed that symptoms disappeared with age.
The American Psychiatric Association defines ADHD as a lifespan neurodevelopmental condition with specific criteria for children and adults.
How symptoms of ADHD change with age
ADHD affects 5% of children and adolescents and 2.5% of adults worldwide. Approximately two-thirds of youths with ADHD remain with functional impairment as adults. But only 15% meet all criteria for a diagnosis in adulthood (note: ADHD diagnosis is based on clinical symptoms reported by patients or informants).
Throughout a lifetime, the occurrence of developmental changes can internalize or modify some symptoms.
In childhood, ADHD symptoms are identified as:
Hyperactivity – child often climbs on tables, can't stand still
Impulsive symptoms - speaking or acting without thinking first
Inattentive symptoms - lack of concentration or focus.
From adolescence to young adulthood, hyperactivity and impulsivity tend to decrease, but the inattention persists and continues to cause impairment.
In adulthood, symptoms of ADHD may manifest as follows:
Feeling of inner restlessness
Difficulty for relaxing
Lack of focus
Problems with organizing and planning your day-to-day activities
Difficulty with time management
Procrastination and distraction
Brain development and ADHD symptoms
ADHD is a complex and heterogeneous disorder. People with ADHD display differences in brain structure, connectivity, and function.
Youth (younger than age 17 years) with ADHD show a 2–3 year delay in reaching peak thickness of the cerebral cortex and smaller volumes in multiple subcortical structures, including those associated with attention and reward systems.
In addition to structural deficits, youth with ADHD show reduced functional connectivity of certain signaling pathways, as in the dopaminergic and noradrenergic pathways (consistent with delayed maturation of the cerebral cortex).
The brain continues to develop and change in adulthood, but childhood and adolescence are important stages in its development. In ADHD, some brain alterations observed in childhood normalize with age, which could explain the changes in the symptoms throughout the lifetime.
What do you need to know?
ADHD is often misdiagnosed due to the diversity of symptoms and their presentation among individuals. If you recognize yourself in any of these symptoms, maybe that's your first step. So, keep in mind:
To obtain an ADHD diagnosis, look for a specialized professional
ADHD can be treated with medications, therapies, skills training, or a combination of these
Medication is effective, improving cognitive function and reducing symptoms of ADHD
Look for options that help improve your quality of life, such as physical activities
Learn about ADHD, it can help you better understand this disorder.
There are millions of people with ADHD worldwide, if you get the diagnosis, you are not alone.
Faraone, S., Asherson, P., Banaschewski, T. et al. (2015) Attention-deficit/hyperactivity disorder. Nature Reviews Disease Primers, 1, (15020).