Can you have a successful life with ADHD?

An Attention Deficit Hyperactive Disorder (ADHD) can be devastating. We think, “This can’t be good! ‘Disorder’ is right there in the name.” Yes, inattention, hyperactivity and impulsivity can cause problems at school, at work and in relationships.[i] And people with ADHD face a lot of stigma.[ii] But we find what we look for, and we’ve been looking for the problems ADHD causes for a long time. Remember, mental health isn’t only about not having an illness or disorder. Mental health is about recovery, coping, well-being and flourishing.[iii] With ADHD, your brain works differently, but not all those differences are bad.[iv] Broader studies find ADHD attributes like high energy, creativity, hyperfocus, agreeableness, empathy and a willingness to help others.[v]

infographic success with adhd

There are many successful people with ADHD. That fact alone is a clue. But even better, these people often succeed because of the positive traits of their ADHD. Their ADHD helps them flourish.[vi] ADHD impairments exist across a spectrum, and there’s no denying severe impairments can make life tough. But as we expand our search, we’re finding more positive aspects of ADHD. ADHD helps with divergent thinking[vii] and creativity that delivers real world achievements[viii]. People with ADHD use hyperfocus to enhance productivity. The “focused work-rate that hyperfocus produces enables creative genius to flourish”[ix]. People with ADHD “don’t fit in,” feeling like outsiders.[x] This individuation lets them blaze their own trail instead of following the crowd[xi]. Life with ADHD has taught them self-acceptance. Impulsivity, showing up as adventurousness or intuition, is an advantage in many careers. Hyperactivity can make it hard to sit still in school, but many adults harness that ADHD drive. When you are passionate about a goal, your ADHD energy drives performance and productivity.[xii]

You can have a successful life with ADHD; however, like anything else, it will present challenges. But there are positive aspects of ADHD. And when you can see these as benefits, resources, skills or strategies you can begin to use it to overcome many challenges.

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About the Author

Duane Gordon

Duane Gordon, President, Attention Deficit Disorder Association (ADDA). Gordon lives in Montreal, Canada. An adult with ADHD, Gordon has been a passionate advocate in the ADHD community for over 25 years.


Footnotes

[i] Able SL, Johnston JA, Adler LA, Swindle RW (2007) Functional and psychosocial impairment in adults with undiagnosed ADHD. Psychol Med 37(1):97–107

[ii] Thornicroft G, Brohan E, Kassam A, Lewis-Holmes E (2008) Reducing stigma and discrimination: candidate interventions. Int J Ment Health Syst 2(3):1–7

[iii] Repper J, Perkins R (2006) Social inclusion and recovery: a model for mental health practice. Bailliere Tindall, UK

[iv] Epstein JN, Loren REA (2013) Changes in the definition of ADHD in DSM-5: subtle but important. Neuropsychiatry (London) 3(5):455–458

[v] Mahdi S, Vijoen M, Massuti R, Selb M, Almodayfer O, Karande S, de Vries PJ, Rohde L, Bölte S (2017) An international qualitative study of ability and disability in ADHD using the WHO-ICF framework. Eur Child Adolesc Psychiatry 26(10):1219–1231

[vi] Sedgwick J, Merwood A, Asherson P (2018) The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders 11:241–253 https://doi.org/10.1007/s12402-018-0277-6

[vii] Guilford JP (1967) The nature of human intelligence. McGraw-Hill, New York

[viii] White HA, Shah P (2006) Uninhibited imaginations: creativity in adults with attention-deficit/hyperactivity disorder. Pers Individ Differ 40:1121–1131

White HA, Shah P (2011) Creative style and achievement in adults with attention-deficit/hyperactivity disorder. Pers Individ Differ 50:673–677

[ix] Fitzgerald M (2010) Attention-deficit hyperactivity disorder link to genius, Thursday, 4 February 2010. http://news.bbc.co.uk/2/hi/health/8496955.stm. Accessed 10 September 2020

[x] Jung CG (1921) Psychological types. In: Collected works of C.G. Jung, Vol. 6, Eds., G. Alder and RFC. Hull (1971), Princeton, NJ: Princeton University Press

[xi] Jung CG (1921) Psychological types. In: Collected works of C.G. Jung, Vol. 6, Eds., G. Alder and RFC. Hull (1971), Princeton, NJ: Princeton University Press

[xii] Deci EL, Vansteenkiste M (2004) Self-determination theory and basic need satisfaction: understanding human development in positive psychology. Ricerche di Psicologia 27:23–40


Why are there so many people with ADHD in the prison population?

We see people every day in clinic who are failing in life, whether that’s at school, college or work. It may be that they are struggling in their relationship or indeed they don’t have any. For this portion of our ADHD community, life is hard. Self-esteem can be incredibly low, depression and anxiety are common, and from those points forward, anything can influence the ADHD person’s life. If they are lucky they will have a positive influence, “a significant adult.” If they are unlucky, they can find friendship and solace inappropriately. When this happens, we find the vulnerability of these emotions allows a negative influence, drugs are tried, crime rewards their friendships, and maybe for the first time “I feel I fit in.” Add to this heady mix of emotional vulnerability some impulsivity, inattention to the many attempts to tell them what is “right from wrong” and always being the person with a “buzz” and energy, and, sadly, we can see the recipe for breaking our laws. We can go further and discuss controlling emotions and lashing out, as a child that may mean hitting a sibling, as an adult that could mean hitting another grown up, or damaging someone’s possessions. 

Infographic adhd in prison

We know that people with ADHD feel rejected and “different” from at least the age of 6. But we can reverse this trend with education, training, and cultural change amongst professionals who care and have responsibility for our children. And let’s be clear, this needs to happen now. ADHD is incredibly pervasive, it can cruelly destroy a bright future, and the damage to our economy if far greater than the investment needed to change things. It costs the UK a whopping £74million1 a year to house our ADHD prisoners it’ll cost about £30 thousand to treat them. Even if we invested heavily in training and support, even if we only halved the number in prison, there is no doubt we would make a huge difference. And as a final note, if we could divert those 10,000 people we could keep out of prison into being tax payers we would recoup the costs of doing this.


1 Costs per place and costs per prisoner by individual prison HM Prison & Probation Service Annual Report and Accounts 2017-18 Management Information Addendum Ministry of Justice Information Release

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About the Author

Phil Anderton

Phil Anderton PhD entered the world of ADHD as a senior police officer in the UK, realising that the causation factors for young people entering the criminal justice system included neurodiversity and this was very much misunderstood, if considered at all.  His work led to him publishing books, papers and addressing conferences worldwide. He was the first police officer to address the American Academy of Child & Adolescent Psychiatry and he trained police officers in the References between ADHD And crime across the USA and Europe. Since retiring from the police Phil has set up his own Healthcare Business, ADHD 360 Limited, and his company now manages a patient caseload of c600 patients from assessment through to treatment for their ADHD. Phil lives in rural England, works too hard and is married to Samantha, who incidentally is the person that insists he works too hard.

What are the long-term health implications of ADHD?

More than 50 years ago, studies on ADHD (then called hyperactive child syndrome or hyperkinesis) began to show markedly elevated risks for accidental injuries of virtually all forms among children and youth with the disorder, including burns, poisonings, dental trauma, lacerations, broken bones, as well as closed head trauma, among others.  Moreover, ADHD is linked to increased adverse consequences in nearly every major domain of life activity studied to date whether in children, teens, or adults.  Many of those domains have a direct or indirect impact on health, such as risk for increased reactive aggression, crime and drug use, poor diet, sedentary activities, personal stress, and intimate partner violence.  Adverse driving outcomes, including more vehicular crashes, are also associated with ADHD as is an increased risk for suicidal ideation, attempts, and completions.  Among the more recently studied domains have been the direct adverse health consequences linked to growing up with ADHD.  These include an increased risk of seizures, obesity, eating pathology, tobacco, alcohol, and marijuana use, dental caries, and plaque (besides trauma), sleeping problems, migraines, and risk for future coronary heart disease.  The disorder is also associated with a decreased involvement in preventive health, nutrition, and dental hygiene activities.

Infographic ADHD Health Implications

All of these findings would predispose to an increased risk for greater morbidity (injury and disease) and likely earlier mortality.  Hence, one should not be surprised that studies over the last 20 years showed that children with ADHD are nearly twice as likely to die by age 10 than are typical children, primarily due to accidental injury.  This risk doubles again by adulthood where several studies showed that adults with ADHD are 4-5 times more likely to die by mid-life than are typical adults.  This early mortality often results primarily from accidental injury but also by suicide and homicide.  Many of the health conditions cited above are well-known correlates of reduced life expectancy and are used in algorithms that predict life expectancy as occurs in public health research and in the life insurance industry. 

Does ADHD reduce total estimated life expectancy (ELE) if left untreated? 

One recent study by Dr. Mariellen Fischer and myself was the first to focus on that issue.  It found a striking reduction in ELE linked to the disorder by young adulthood.  It reported that cases having hyperactive child syndrome, or ADHD-Combined Presentation, in childhood manifested a 9.6 year reduction in healthy ELE in remaining years, a 1.2 year period of greater unhealthy life expectancy in remaining years, and an overall 8.4 year reduction in total life expectancy than did control children by young adulthood.  Moreover, the persistence of ADHD to adult follow-up was associated with an even worse impact on these ELE measures, with a 12.7-year reduction in healthy life expectancy and an 11.1-year reduction in total ELE than was seen in control cases.   Persistent cases had a 5.3-year reduction in healthy life expectancy and a 4.6-year reduction in total ELE than nonpersistent ADHD-C cases.  And both persistent and nonpersistent ADHD cases had significantly lower ELEs by adulthood than did control cases.  

The magnitude of such reductions in life expectancy is both stunning and sobering when one realizes that such reductions are far greater than those associated with smoking, obesity, alcohol use, high cholesterol, and high blood pressure either individually or combined!  Why?  Because ADHD has been found to predispose individuals to engage in a number of such adverse health and lifestyle activities. 

For instance, we noted that the disorder reduced ELE in our study through its association with eight of the 14 variables entered in the ELE calculations. These included the demographic factors of reduced education, lack of high school graduation, and lower annual income in the ADHD-C groups but also in the health and lifestyle factors of greater alcohol consumption, poorer overall health, reduced sleep, increased likelihood of smoking and of smoking more than 20+ cigarettes per day, and possibly greater adverse driving consequences resulting in license suspensions and revocations.  It is chiefly the background trait of behavioral disinhibition that biases those with ADHD toward poorer health choices, less use of health maintenance practices, and so to eventual adverse health outcomes. 

Recently, a large-scale study that scanned the human genome of thousands of cases involving ADHD as well as typical people showed that there is a shared genetic risk between ADHD and certain health related outcomes.  Those included lower educational attainment, obesity, diabetes, smoking, sleep, level of high-density lipid cholesterol, earlier age of parenthood, risk for rheumatoid arthritis, earlier menopause, etc.  All of this further supports the conclusions that ADHD and its linkage to poor inhibition and low conscientiousness are important genetic background or second order factors that link to the first order factors involving health and lifestyle choices that are shortening the life expectancy in those with ADHD.

These findings should give impetus to efforts to try to educate those with ADHD and their families to such risks as well as to reduce those first order healthy choice factors that are predisposing to reduced life expectancy, such as obesity, smoking, excess alcohol use, poor diet, poor sleep, limited exercise, etc.  After all, estimated life expectancy is malleable – change the adverse health and lifestyle factors affecting it and one can improve quality of life as well as life expectancy.  Adding ADHD medications and evidence based psychosocial treatments to address the background traits predisposing those with ADHD to engage in these first order adverse health activities is also likely to be necessary and effective. 

Recent large-scale studies find that ADHD medications reduce many of the health and lifestyle risks noted above including those for accidental injuries, mortality, driving risks, antisocial activities, and drug use, among others.  These findings also argue for making primary care physicians more aware of the linkage between ADHD and reduced life expectancy as they are the ones most likely to be trying to improve the adverse health and lifestyle activities of individuals.  Yet they are not screening for the significant role that ADHD may be playing in the failures of their patients to do so.


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About the Author

russell barkley

Dr. Barkley is a Clinical professor of Psychiatry at the Virginia Commonwealth University Medical Center in Richmond, Virginia, USA. He has published more
than 27 books, rating scales, and clinical manuals and more than 300 scientific papers and book chapters on ADHD, and has presented more than 800 invited lectures in more than 30 countries. His latest books are Taking Charge of ADHD:
The Complete, Authoritative Guide for Parents
(4th ed., June 2020, Guilford press) and The 12 Principles for Raising and Child with ADHD (October 2020, Guilford
Press). His website is https://www.RussellBarkley.org.


Supporting Scientific Articles

  • Barbaresi, W. J., Colligan, R. C., Weaver, A. L., Voigt, R. G., Killian, J. M., Katusic, S. K. (2013). Mortality, ADHD, and psychosocial adversity in adults with childhood ADHD: A prospective study. Pediatrics, 131, 637-644.
  • Barkley, R. A. (2015c). Health problems and related impairments in children and adults with ADHD.   In R. A. Barkley (ed.) Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th Ed)(pp. 267-313).  New York, NY: Guilford Press.
  • Barkley, R. A. & Cox, D. J. (2007).  A review of driving risks and impairments associated with Attention-Deficit/Hyperactivity Disorder and the effects of stimulant medication on driving performance.  Journal of Safety Research, 38, 113-128.
  • Barkley, R. A. & Fischer, M.  (2019).  Hyperactive child syndrome and estimated life expectancy at young adult follow-up: The role of ADHD persistence and other potential predictors.  Journal of Attention Disorders, 23, 907-923.
  • Barkley, R. A., Murphy, K. R., & Fischer, M. (2008).  ADHD in adults: What the science says.  New York: Guilford Press.
  • Dalsgaard, S., Ostergaard, S. D., Leckman, J. F., Mortensen, P. B., & Pedersen, M. G. (2015).  Mortality in children, adolescents and adults with attention deficit hyperactivity disorder: a nationwide cohort study.  Lancet, 385, 2190-2196.
  • Demontis, D.  et al. (2018).  Discovery of the first genome wide association significant risk loci for attention-deficit/hyperactivity disorder.  Nature Genetics.  Epub ahead of print. doi.org/10.1038/s41588-018-0269-7
  • Jokela, M., Ferrie, J. E., & Kivimaki, M. (2008).  Childhood problem behaviors and death by midlife: The British National Child Development Study.  Journal of the American Academy of Child and Adolescent Psychiatry, 48, 19-24.
  • London, A. S., & Landes, S. D.  (2016). Attention deficit hyperactivity disorder and adult mortality.  Preventive Medicine, 90, 8-10.
  • Mohr-Jensen, C., & Steinhausen, H. C. (2016). A meta-analysis and systematic review of the risks associated with childhood attention-deficit hyperactivity disorder on long-term outcome of arrests, convictions, and incarcerations.  Clinical Psychology Review, 48, 32-42.
  • Nigg, J. T. (2013). Attention-deficit/hyperactivity disorder and adverse health outcomes.  Clinical Psychology Review, 33, 215-228.
  • Virtanen, M., Lallukka, T., Alexanderson, K., Ervasti, J., Josefsson, P., Kivimaki, M., & Mittendorfer-Rutz, E. (2018).  Work disability and mortality in early onset neuropsychiatric and behavioral disorders in Sweden.  European Journal of Public Health, 28, Supplement 4, p. 32. 

What are the most common relationship issues when one partner has ADHD?

ADHD brings very consistent patterns to romantic relationships, particularly when it goes undiagnosed or under-managed. One of the most common, and most destructive, is what I call “parent/child dynamics.” In this pattern, the ADHD partner makes promises but has trouble following through on those promises for reasons that include: distraction; difficulty planning; trouble completing; trouble remembering to do the thing, and more.

infographic ADHD relationship issues

The ADHD partner is “consistently inconsistent,” which means the other partner cannot rely on him or her. Because the non-ADHD (or more organized other ADHD) partner never knows what will or won’t happen, s/he takes on more and more responsibility to compensate. Many adopt an ‘if I don’t do it, it won’t get done’ attitude. Unfortunately, the burden of taking on so much eventually leads to resentment and anger in the non-ADHD partner, particularly after children are added to the family. In response to the non-ADHD partner’s anger, the ADHD partner then also gets angry. It becomes a negatively reinforcing, downward spiral of interactions.

Other common relationship issues include: chore wars; having the non-ADHD partner who feels unloved because it’s so hard to get the ADHD partner’s attention; misinterpreting ADHD symptoms in a negative way; lying and cover ups of ADHD symptomatic behaviors; and difficulties with their sex life. The good news is that once partners better understand ADHD and learn how to deal with it, they can find the love they thought they had lost.

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About the Author

Melissa Orlov

Melissa Orlov is the founder of ADHDmarriage.com, and author of two award-winning books on the impact of ADHD in relationships, including The ADHD Effect on Marriage (rev. 2020). She is considered one of the foremost authorities on the topic of how ADHD impacts adult relationships.


References

What other diagnoses are seen with ADHD?

ADHD usually starts early in life, typically between ages six and 12. Besides the core symptoms of hyperactivity, impulsivity, inattention and also emotional instability, many affected people suffer from other mental disorders that are found more frequently than expected by chance – so called comorbid disorders. The pattern of comorbid disorders however changes considerably over the life span. In childhood, oppositional defiant disorder (ODD) or conduct disorder (CD) are the most frequent comorbid disorders. However, ADHD can also occur together with autism spectrum disorders and learning disorders.

What other diagnosis are seen with adhd

When people get older, ADHD may persist into adulthood and around two thirds of people continue to experience impairing symptoms. ODD and CD may develop further into antisocial personality disorder, and substance use disorders (for both legal substances like alcohol and illicit drugs such as cannabis or cocaine) may become a problematic comorbidity with respective overall health consequences. Most frequently however, adults with ADHD suffer from anxiety or mood disorders; up to 50% of people suffering from adult ADHD also experience at least once in their life an episode of major depression. Furthermore, overall mortality rate is increased due to higher risks of suicide and unintentional injuries.

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About the Author

Andreas Reif

Prof. Andreas Reif, MD is head of the Department of Psychiatry, Psychosomatic Medicine and Psychotherapy of the University Hospital Frankfurt, Germany. His clinical and research interests comprise ADHD and mood disorder, with focus on mechanisms to enable new treatments. He coordinates the large EU consortium CoCA on comorbid conditions of ADHD.


Further reading

Franke B, Michelini G, Asherson P, Banaschewski T, Bilbow A, Buitelaar JK, Cormand B, Faraone SV, Ginsberg Y, Haavik J, Kuntsi J, Larsson H, Lesch KP, Ramos-Quiroga JA, Réthelyi JM, Ribases M, Reif A. Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. Eur Neuropsychopharmacol. 2018 Oct;28(10):1059-1088. doi: 10.1016/j.euroneuro.2018.08.001. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379245/

Chen, Q., Hartman, C. A., Haavik, J., Harro, J., Klungsøyr, K., Hegvik, T. A., Wanders, R., Ottosen, C., Dalsgaard, S., Faraone, S. V., & Larsson, H. (2018). Common psychiatric and metabolic comorbidity of adult attention-deficit/hyperactivity disorder: A population-based cross-sectional study. PloS one13(9), e0204516. https://doi.org/10.1371/journal.pone.0204516 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157884/

Solberg, B. S., Halmøy, A., Engeland, A., Igland, J., Haavik, J., & Klungsøyr, K. (2018). Gender differences in psychiatric comorbidity: a population-based study of 40 000 adults with attention deficit hyperactivity disorder. Acta psychiatrica Scandinavica137(3), 176–186.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838558/

What is the connection between ADHD and sleep problems?

Is ADHD a sleep disorder?

ADHD and sleep problems are intimately intertwined in the majority of children as well as adults. The sleep problems usually also start in early childhood. Most people have difficulty falling asleep on time, in children described as ‘bedtime resistance’ and adults are called ‘evening types’ or ‘night owls’. This circadian rhythm disorder, or Delayed Sleep Phase Syndrome is associated with a delayed onset of the sleep hormone melatonin, as was objectively measured in saliva (van Veen 2010). ADHD itself is associated with a dysregulation of the neurotransmitter dopamine, which is typically produced during daytime. So disturbances in the rhythm of day and night seem implicated in ADHD. Which leads to the question: could ADHD (also) be a sleep disorder?? (Bijlenga 2019). We are testing this hypothesis in our research. If this is true,  treatment of the delayed rhythm may improve ADHD symptoms, leading to a new perspective in the treatment of ADHD.

infographic connection between ADHD and sleep problems

Besides the delayed sleep rhythm, there are several other sleep disorders associated with ADHD: Restless Legs (restlessness before falling asleep)/Periodic Limp Movement Disorder (restlessness during sleep), Insomnia (arousal, worrying in bed) and Sleep Apnea (sleep breathing disorder) (Vogel 2017; Wynchank 2016, 2017). Some people with ADHD even have several sleep disorders. If disturbed sleep is not treated, the treatment of ADHD will be suboptimal due to sleep loss, that induces memory & attention problems and irritability.

Treatment of sleep and ADHD

Every sleep disorder has its own specified treatment:

Delayed sleep is treated by ‘Chronotherapy’ consisting of

  1. sleep hygiene measures (no screens at night, or wearing orange goggles to protect the eyes from the blue light, no caffeine at night, shower before bedtime, and many more)
  2. Melatonin in the evening, and
  3. Light therapy in the early morning (7-8 am). This combination is an effective way to reset the late sleep rhythm in a few weeks. Only sleep hygiene is usually insufficient.

Insomnia is effectively treated by a special Cognitive Behavior therapy for Insomnia (CGT-I).

Restless legs by supplementing ferritin levels if too low, and medication.

Sleep apnea by diet (often in obese people), prevention of supine position, devices in the mouth to advance the jaw or tongue, and CPAP (Continuous Positive Airway Pressure).

Knowledge about sleep disorders is increasing, but treatment is not always available in psychiatry or at the GP. When ADHD is treated with medication and coaching or CBT, and the sleep disorder according to the guidelines, the rhythm of night and day, memory, attention and mood improve, as well as control over appetite and weight. In the long term, this may prevent the development of chronic diseases.

Sleep is our natural medicine.

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About the Author

Sandra Kooij

Prof. Dr. J.J. Sandra Kooij is a psychiatrist and researcher specialized in ADHD and sleep in adults. She is affiliated with Amsterdam University Medical Center/VUmc and PsyQ, psycho-medical programs in the Hague, the Netherlands.

References

A clarifying easy read is the book Why We Sleep by Matthew Walker.


What is the relationship between ADHD and obesity / eating habits?

Individuals with ADHD have a higher body mass index (BMI) and a higher prevalence of obesity, with the odds ratio increasing with age. Indeed, the pooled prevalence increase by about 70% in adults and 40% in children. Additionally, individuals with ADHD suffer more from eating disorders (OR=3.82*), especially binge eating (OR=4.13).

Infographic - Relationship between ADHD and eating habits

Several mechanisms have been suggested to account for this association including shared genetic transmission, dysregulation of dopamine, mood lability, psychiatric comorbidities, and low participation in physical activity, impulsivity, inattention, and poor eating habits. It was found that both children and adults with ADHD consume less healthy foods (such as vegetables, fruits, and dairy products) and more unhealthy foods (fatty, sweet and processed foods, such as snacks, candies, “fast food” and “junk food.”)

*OR=3.82 means 3.82 times more likely

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About the Author

Shirley Hershko

Shirley Hershko is the director of the diagnostic and support center, a senior teacher, and a researcher at the Hebrew University in Israel. Her study won an award at the World Congress on ADHD.


References

What are the risk factors for people with ADHD during the coronavirus pandemic?

Emerging studies from the COVID-19 pandemic show that ADHD symptom severity appears to be increasing during this global event. Several factors may be to blame. First, students with ADHD must adjust to low-structure, online learning platforms. These school environments demand more self-discipline than regular school, which can make concentration and motivation very challenging. For older high school and college students with ADHD, disengaging from virtual school may pave a slippery path towards formal dropout. Warning signs include a build-up of missing work, avoiding virtual class meetings, and slipping grades.

Risk factors for people with ADHD in coronavirus time

Second, social isolation is a known consequence of COVID-19 and is a risk factor for depression and suicide. During COVID-19, social isolation may be particularly severe for people with ADHD, who often have few close friends or may have trouble getting motivated to set-up social activities. On top of this concern, increased ADHD symptoms can be triggered by high stress situations. COVID-19 brings stressors that include safety concerns, economic hardship, and increased family conflict during confinement. In addition to worsening ADHD symptoms, ongoing stress exposure can also create risks for depression. To prevent these concerns, individuals with ADHD and their family members can:

  1. ensure that proper academic supports are in place at school,
  2. prioritize social interaction (even if it means getting creative) during COVID-19,
  3. practice stress reduction behaviors such as outdoor and physical activity, spending positive time with loved ones, and practicing favorite hobbie, and
  4. reach out to mental health providers early on if you notice signs of emerging school disengagement or depression.

Both mental health therapy and medication can support children, adolescents, and adults with ADHD through these challenging times.

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About the Author

Margaret H. Sibley, Ph.D. is Associate Professor of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine and a Licensed Clinical Psychologist at Seattle Children’s Hospital. Her research is focused on ADHD in adolescence and young adulthood.


References

  • Behar‐Zusman, V., Chavez, J. V., & Gattamorta, K. (2020). Developing a measure of the impact of COVID-19 social distancing on household conflict and cohesion. Family Process, 59(3), 1045–1059.
  • Becker, S. P., Breaux, R., Cusick, C. N., Dvorsky, M. R., Marsh, N. P., Sciberras, E., & Langberg, J. M. (in press). Remote learning during COVID-19: Examining school practices, service continuation, and difficulties for adolescents with and without ADHD. Journal of Adolescent Health.
  • Bobo, E., Lin, L., Acquaviva, E., Caci, H., Franc, N., Gamon, L., … & Purper-Ouakil, D. (2020). How do children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) experience lockdown during the COVID-19 outbreak?. L’encephale.
  • Cortese, S., Asherson, P., Sonuga-Barke, E., Banaschewski, T., Brandeis, D., Buitelaar, J., Coghill, D., Daley, D., Danckaerts, M., Dittmann, R. W., Doepfner, M., Ferrin, M., Hollis, C., Holtmann, M., Konofal, E., Lecendreux, M., Santosh, P., Rothenberger, A., Soutullo, C., … Simonoff, E. (2020). ADHD management during the COVID-19 pandemic: Guidance from the European ADHD Guidelines Group. The Lancet Child & Adolescent Health, 4(6), 412–414. https://doi.org/10.1016/S2352-4642(20)30110-3
  • Courtet, P., Olié, E., Debien, C., & Vaiva, G. (2020). Keep socially (but not physically) connected and carry on: Preventing suicide in the age of COVID-19. Journal of clinical psychiatry, 81(3), e20com13370-e20com13370.
  • Eadeh, H.-M., Bourchtein, E., Langberg, J. M., Eddy, L. D., Oddo, L., Molitor, S. J., & Evans, S. W. (2017). Longitudinal evaluation of the role of academic and social impairment and parent-adolescent conflict in the development of depression in adolescents with ADHD. Journal of Child and Family Studies, 26(9), 2374–2385. https://doi.org/10.1007/s10826-017-0768-7
  • Ellis, W. E., Dumas, T. M., & Forbes, L. M. (2020). Physically isolated but socially connected: Psychological adjustment and stress among adolescents during the initial COVID-19 crisis. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 52(3), 177.
  • Hall-Lande, J. A., Eisenberg, M. E., Christenson, S. L., & Neumark-Sztainer, D. (2007). Social isolation, psychological health, and protective factors in adolescence. Adolescence, 42(166), 265-. Gale Academic OneFile.
  • Hartman, C. A., Rommelse, N., van der Klugt, C. L., Wanders, R. B. K., & Timmerman, M. E. (2019). Stress exposure and the course of ADHD from childhood to young adulthood: Comorbid severe emotion dysregulation or mood and anxiety problems. Journal of Clinical Medicine, 8(11), 1824. https://doi.org/10.3390/jcm8111824
  • Horesh, D., & Brown, A. D. (2020). Traumatic stress in the age of COVID-19: A call to close critical gaps and adapt to new realities. Psychological Trauma: Theory, Research, Practice, and Policy, 12(4), 331.

Zhang, J., Shuai, L., Yu, H., Wang, Z., Qiu, M., Lu, L., … & Chen, R. (2020). Acute stress, behavioural symptoms and mood states among school-age children with attention-deficit/hyperactive disorder during the COVID-19 outbreak. Asian journal of psychiatry, 51, 102077.