Study Looks at Whose ADHD Goes Untreated and for How Long

From self-medication to academic underachievement, impaired social skills to increased driving risk, ADHD can cause problems in almost any part of people’s lives. And yet the condition often goes undiagnosed, sometimes for years.

A new study from researchers in Italy zeroes in on the phenomenon of untreated ADHD. The study explored how long ADHD tends to go untreated and whether certain characteristics put people at higher risk of going without treatment for years.

To shed light on those questions, the study’s authors surveyed 150 adults with diagnoses of ADHD, asking them about their symptom and treatment histories. Using that information, the researchers found that the average adult with ADHD in their study had symptoms for 17 years before beginning treatment.

It’s worth noting that the study only included people who had finally been diagnosed with ADHD. If you take into account those with ADHD who never receive diagnoses at all, the number of years an average ADHDer goes without treatment could turn out to be even longer.

In any case, 17 years is a huge length of time to live with an untreated mental health condition. The inefficiency of the current systems in place for diagnosing and treating ADHD is measured in decades of people’s lives, which should be a sharp wake-up call.

The authors of the study also found that specific traits made some people more likely to have a long lapse of time between first symptoms and treatment:

• Employment and education: Those who had jobs and who had higher levels of education tended to have a longer duration of untreated ADHD. It’s possible that ADHD symptoms will be harder to spot when someone is coping well enough to finish school or hold down a job. Someone in that position might even be told they’re too smart or too successful to have ADHD.
• A history of depression: Comorbid conditions often accompany ADHD, and depression is one of the most common. With another mental health condition in play, it’s easier for doctors to misdiagnose ADHD, or mistakenly attribute ADHD symptoms to the other condition. The ADHD side of the ADHD + depression combo shouldn’t be overlooked, though, because treating the ADHD may help substantially in treating the depression.
• Predominantly inattentive subtype in childhood: The study also found that those who’d had predominantly inattentive symptoms as children tended to go longer before receiving treatment. That finding fits with the intuition that hyperactive children, whose symptoms are more externally obvious, are more likely to have their symptoms recognized. Children without hyperactivity who mostly struggle with inattentive symptoms such as trouble sustaining attention or staying organized may be referred less frequently to be evaluated for ADHD.
• Family history of ADHD: ADHD is highly heritable and often runs in families. When it does, it may be more likely to go undiagnosed, with the study finding that those with a family history of ADHD were predisposed to go with untreated symptoms for longer. One explanation put forward by the researchers is that parents who have ADHD may be “so unaware of their dysfunctional core symptoms” that they also miss those symptoms in their children, instead mistaking the symptoms for typical behavior.

The long duration that often separates the appearance of ADHD symptoms and the beginning of treatment highlights the work that remains to spread awareness and improve knowledge of ADHD among medical professionals.

If you’ve lived with untreated ADHD symptoms for years or even decades, know that you’re certainly not alone. In fact, this study suggests that going an extended period of time before receiving treatment is the norm among adults with ADHD rather than the exception.

And if you’re wondering about possible signs of ADHD in your life or someone else’s, you may want to familiarize yourself with the symptoms and check out some of the questionnaires that are used to make a diagnosis.