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Attention-Deficit/Hyperactivity Disorder (ADHD) is often thought of as a childhood condition, yet many adults live with it – some without ever knowing. Below, we answer the most common questions we hear about ADHD in adults: what it is, what causes it, and how it is assessed and treated.
ADHD stands for Attention-Deficit/Hyperactivity Disorder. It is a neurodevelopmental disorder, meaning it affects how the brain develops and works. According to the DSM-5, the diagnostic manual used by mental health professionals, its symptoms fall into two main groups.
The first is inattention: difficulty sustaining focus, being easily distracted, making careless mistakes, losing things, forgetfulness, and struggling to organise tasks or follow through on them.
The second is hyperactivity and impulsivity: restlessness or fidgeting, difficulty staying seated, talking excessively, interrupting others, and finding it hard to wait one’s turn.
For a diagnosis, several of these symptoms must have appeared before the age of 12, be present in more than one setting (for example, at work and at home), and clearly interfere with daily functioning.
ADHD is a neurodevelopmental condition with a strong biological and genetic basis. Research suggests differences in the functioning and regulation of neurotransmitter systems (the messengers that carry signals between brain cells) – particularly dopamine and noradrenaline – as well as differences in the development and activity of brain networks involved in attention, motivation, impulse control, and executive functioning. These differences can contribute to difficulties with inattention, hyperactivity, and impulsivity.
However, someone experiencing high levels of anxiety may also appear inattentive, restless, forgetful, or easily distracted – not necessarily because they have ADHD, but because worry is taking up much of their mental capacity. When the brain is preoccupied with anticipating threats, replaying situations, or managing physical anxiety symptoms, it can become much harder to concentrate, retain information, organise tasks, or sit still.
This is one reason a thorough assessment matters. Several other conditions and circumstances – including anxiety, depression, chronic stress, trauma, poor sleep, learning difficulties, and some physical health conditions – can cause symptoms that resemble ADHD. These difficulties can also coexist with ADHD, making the picture more complex. A careful assessment considers when the symptoms began, whether they have been present since childhood, how consistently they occur across different settings, and the extent to which they affect everyday functioning.
There is no single, definite cause of ADHD. It does have a strong genetic component – it is one of the most heritable mental health conditions. ADHD often runs in families, so having a parent or sibling with ADHD increases a person’s likelihood of having it. However, it is not caused by one particular gene. Instead, many genetic variations appear to contribute to susceptibility, alongside other biological and environmental influences.
Other factors that may play a role include premature birth, low birth weight, and exposure to alcohol or tobacco during pregnancy. These are considered risk factors rather than definite causes: having one does not mean that a person will develop ADHD, and many people with ADHD have none of them.
Importantly, ADHD is not caused by poor parenting, eating too much sugar, or simply spending too much time on screens. However, factors such as poor sleep, an overstimulating environment, and unstructured screen use can make attention, impulsivity, and emotional regulation more difficult for someone who already has ADHD.
Definitely. ADHD begins in childhood, so an adult with ADHD will have experienced some symptoms before the age of 12, even if these were not recognised at the time.
Difficulties may have been mild, mistaken for personality traits or other problems, or masked by intelligence, structure, family support, or effective coping strategies. For some people, the impact only becomes clear when the demands of university, work, relationships, parenting, or independent living increase.
ADHD can also look different in adulthood. Obvious physical hyperactivity may become less pronounced or be experienced as inner restlessness, difficulty slowing down, or a need to stay constantly busy. Meanwhile, difficulties with organisation, time management, sustained attention, prioritising tasks, emotional regulation, and following things through may become more noticeable.
Technically, ADD (Attention Deficit Disorder) is an older term that was used when someone had attention difficulties, with some impulsive behaviour, but not necessarily hyperactive.
The term was officially retired from the diagnostic manuals in the late 1980s, and today everything falls under the single diagnosis of ADHD, with the clinician specifying its presentation: predominantly inattentive, predominantly hyperactive-impulsive, or combined. In other words, what used to be called ADD is now known as ADHD, predominantly inattentive presentation. Many people still say “ADD” in everyday conversation, but it is no longer a formal diagnosis. Physical hyperactivity may become less obvious with age or be experienced more as inner restlessness, while difficulties with attention, organisation, time management, and follow-through often remain.
There is currently no treatment that cures ADHD. However, its symptoms and impact can often be managed very effectively. Treatment may include medication, psychological therapy, practical skills and strategies, environmental adjustments, or a combination of these approaches.
I heard that some people have it as children but grow out of it when they become adults – is that true?
As mentioned above, ADHD is a lifelong condition, so if someone truly has the disorder, it does not simply disappear. That said, there are a few reasons why it can seem to. First, symptoms – especially hyperactivity – often become less obvious with age. Someone with a milder form may also have learned effective coping strategies over the years that keep the symptoms so well contained they appear to be cured.
The gold standard for diagnosing ADHD is for the person to meet with a psychiatrist (and often also a psychologist) for one to two hours. During this session, the mental health professionals conduct a structured interview gathering background information from early childhood – sometimes as far back as pregnancy and birth – up to the present day. The person will also complete a questionnaire, and another version of the questionnaire will be completed by someone who knows them well (usually a spouse, sibling, or parent). The mental health professionals then analyse all of this information together to reach a conclusion about the diagnosis.
There are times when the background information and questionnaire data are not sufficient, so the professional may refer the person for a more comprehensive assessment involving cognitive testing, usually conducted by a clinical psychologist trained in those assessments. This further assessment usually takes five to six hours in total, divided across different days, and includes cognitive testing that assesses intellectual ability (IQ), executive functioning skills, and memory. These cognitive tests add an objective, standardised component to the assessment. Combined with the background information and questionnaire results, the cognitive tests make the diagnostic picture much clearer.
Can someone opt for cognitive testing directly, without going to a psychiatrist first? And are there additional benefits compared with the 1–2 hour sessions mentioned earlier?
Yes, anyone can start with the more comprehensive cognitive testing directly, without seeing a psychiatrist first. In that case, the clinical psychologist will still gather the background information through the structured interview, then conduct the cognitive tests afterwards. In terms of additional benefits, cognitive testing provides a detailed report explaining how the person functions cognitively – for example, whether they process verbal information better than visual information, whether they memorise auditory information better than visual material, whether they can multitask efficiently, and so on. The report also includes detailed, tailored recommendations that the person can apply in their daily life, therapy sessions, and workplace. Picture this: the report becomes a blueprint of the person, and whenever they see a therapist or psychiatrist, the mental health professional has a clear, objective profile of them.
It is also worth noting that many countries and organisations only require an ADHD diagnosis to be formally confirmed by a psychiatrist after the comprehensive cognitive testing – particularly when medication, insurance coverage, official documentation, or educational and workplace accommodations are involved – so you may wish to consider psychiatric assessment if you are likely to need your diagnosis recognised for these purposes.
Treatment is tailored to each person and usually involves one or a combination of the following:
The right combination depends on the person’s symptoms, goals, and overall health – which is why treatment always starts with a thorough assessment.
Yes, we have multiple trained and licensed professionals who can help with different types of assessments, prescribe medication, and provide behavioural therapy.
If you want to enquire or book a session, please get in touch with our team.
Written by: Mina Shafik
Clinical Psychologist
