NEW YORK (AP) — Allison Burk's teenage daughter struggled with uncontrolled emotions, a shrinking attention span and a growing tendency to procrastinate. A family doctor suggested ADHD testing, which led to an unexpected discovery: The teen had ADHD, and Burk did too.
During her daughter's evaluation, Burk thought, "Wait a minute. This sounds familiar," she recalled.
“I was able to piece together that this might be something I was experiencing,” said Burk, of Columbus, Ohio. She subsequently underwent her own testing and was diagnosed with ADHD — at age 42.
More adults are being diagnosed with attention-deficit/hyperactivity disorder. Diagnoses have been rising for decades but seem to have accelerated in the last few years.
A recent suggested that more than 15 million U.S. adults — roughly 1 in 17 — have been diagnosed with ADHD. The condition always starts in childhood, but about half of adults with it are diagnosed when they are 18 or older.
Some doctors say the number of people coming in for evaluation is skyrocketing.
“Just in our clinic, requests for assessments have doubled in the last two years,” said Justin Barterian, a psychologist based at Ohio State University.
Here's a look at the phenomenon, and how to know if you might have the condition.
ADHD symptoms in adults
ADHD makes it hard for people to pay attention and control impulsive behaviors. It can be inherited, and is often treated with drugs, behavioral therapy, or both.
“It's like there's an engine in you and you feel like it's always running, and you can't turn it off except with medication,” said Judy Sandler, a 62-year-old Maine woman who was diagnosed in her 50s.
ADHD has been called the most commonly diagnosed mental health disorder in U.S. children, with more than kids diagnosed. Historically, it was thought to mainly affect boys (perhaps because boys with ADHD were seen as more disruptive in school) and to be something that kids grew out of.
But experts believe many people aren't diagnosed as kids and live with symptoms into adulthood.
Adults with the condition talk about having trouble focusing on tasks, juggling responsibilities, and planning and managing their time. Some talk about not putting things away, and straining personal relationships with their restlessness, mood swings and impulsiveness.
Burk said she was grouped with talented and gifted students in grade school but didn't complete college until her 30s because, “when I was 19, I hitchhiked across the country on a whim” and ended up a single mother in her early 20s. She now works in marketing and media relations for Ohio State University's College of Veterinary Medicine.
Diagnoses have been rising
Diagnoses have been climbing in both kids and adults, and the recent government report found adult ADHD was more common than earlier estimates.
“We haven’t had (federal) adult ADHD data in a long time,” said one of the study’s authors, Angelika Claussen of the Centers for Disease Control and Prevention.
There were indicators of the rise, she added. Increasing demand for ADHD medication led to widespread after the COVID-19 pandemic hit in March 2020. A showed the rise in prescriptions was particularly notable in adults — especially women.
ADHD diagnoses and prescriptions were increasing before the pandemic, due partly to a change in general diagnostic criteria in 2013 that broadened the definition of ADHD and reduced the number of symptoms a patient needed to have.
But case counts really seemed to jump in 2020, when schools were closed and many adults were forced to work from home.
“It’s very difficult to focus when you are home and you have kids,” Claussen said. “That may have exacerbated the symptoms for people who’d had mild ADHD but were able to cope” before the pandemic.
How ADHD is diagnosed in adults
The last few years have seen growing cultural acceptance and curiosity about the condition, fueled by a proliferation of “I have ADHD” social media videos and online medical start-up companies offering 5-minute diagnostic quizzes.
Indeed, the long-held belief that ADHD was underdiagnosed in adults has given way to recent debates about whether it's become overdiagnosed.
There’s no blood test or brain scan for ADHD. Experts say it is diagnosed when symptoms are severe enough to cause ongoing problems in more than one area of life, and when those symptoms can be traced to pre-adolescent childhood.
Ideally, a psychologist or psychiatrist diagnoses it by taking careful histories from patients and from people who know them, experts say. They also might ask patients to take tests designed to check their memory and ability to concentrate. Doctors also must rule out anxiety, depression and other conditions that can have similar symptoms.
But getting an appointment with a mental health professional can take months, and intensive ADHD evaluations can cost thousands of dollars. Many patients turn to family doctors or even online diagnostic quizzes, some of them connected to telehealth companies that prescribe medications.
“There is wide variability in this country in how people diagnose, how strict they are, and who they diagnose,” said Margaret Sibley, a University of Washington psychologist.
The American Professional Society of ADHD and Related Disorders is drafting a first national set of diagnosis and treatment guidelines for health professionals who treat adults, and expects to release them later this year.
The goal is "to improve the accuracy of diagnoses in this country," said Sibley, who is leading the work on the guidelines.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
