“The first time I even remotely considered I might have ADHD was after my daughter was diagnosed and the doctor looked back and forth between my husband and I and asked, “So, which one of you has ADHD, too?”
This experience described by one of our clients in our psychotherapy practice is far from unique. The rate of diagnosis of attention deficit hyperactivity disorder (ADHD) is rising in adults at four times the rate of diagnosis for children. Notably, many adults are diagnosed with ADHD after one of their children received the same diagnosis. The “phenomenon” of the parent-child diagnosis is far from random. According to the National Institute of Mental Health (NIMH), ADHD is highly heritable. In fact, 3 out of 4 children diagnosed with ADHD will also have a relative with the same condition.
Notably, many adults are diagnosed with ADHD after one of their children received the same diagnosis.
Like Parent, Like Child: Being Diagnosed with ADHD Late in Life
Emily*, a forty-two-year-old mother of two, came to our practice for parenting support after her son’s teacher suggested he be assessed. Her first clue about her own neurodiversity came while completing questionnaires about her son. Emily was surprised by how many of his symptoms resonated with her own experiences. Once her son received his ADHD diagnosis, she sought out testing for herself.
Anna* also came to our practice for mental health support. Like many caregivers, Anna was struggling with her own anxiety and poor executive functioning skills while trying to help her child manage hers. She was extremely sensitive to noise and overwhelmed and disorganized at work and at home. After a thorough assessment through our practice and a neuropsych team, Anna was diagnosed with ADHD at 38.
Why Diagnoses were Often Missed
There are several reasons for the rise of ADHD diagnoses in adults: Changes in the diagnostic criteria (ADHD has only been included in the DSM – the Diagnostic and Statistical Manual of Mental Disorders handbook used by health care professionals – since 1987), reduction in stigma and increased understanding of neurodivergence are all contributing factors. Furthermore, many adults’ ADHD symptoms flew under the radar, having been missed because the individuals did not experience overt academic or behavioral issues.
This is especially true for girls, as their ADHD symptoms present differently. For many girls, the hyperactive symptoms ascribed to ADHD are not outwardly apparent. Rather, the excitable “behavior” manifests as anxiety, with constant worrying and perseverating on perceived mistakes, often leading towards perfectionistic tendencies. This was true for Emily, whose 4th grade teacher suggested that she might have ADHD, but her symptoms were dismissed by her school counselor because she was not disruptive in class.
Getting diagnosed with ADHD as an adult can be complex, in part because the diagnosis requires the presence of symptoms in childhood. If symptoms were misunderstood, arriving at a diagnosis later in life can be challenging to untangle. This was the case for Anna whose perfectionism, hyperfocus and rejection sensitivity dysphoria were diagnosed as symptoms of anxiety in childhood. Additionally, some adults have developed such a strong ability to mask their symptoms that uncovering ADHD can be a diagnostic challenge for both clinicians and clients.
The Blessing and the Burden: How it Feels to Be Diagnosed
For many parents, observing ADHD symptoms in their child is like a light switch turning on to a deeper understanding of themselves. However, integrating a new sense of identity as neurodivergent is bittersweet. For some, the discovery comes with profound relief. After many years on medication for anxiety which never quite addressed her symptoms, Anna was prescribed a stimulant medication for her ADHD which made her brain feel “calm.” For others, the late diagnosis comes with grief and regret. Emily described feeling sad for her younger self who was often made to feel stupid for daydreaming in class or forgetting her homework. She held many self-limiting beliefs about her competency and intelligence, contributing to low self-esteem that persisted into adulthood.
Nowadays there are more treatment options that work with, rather than against, the unique brains of neurodivergent people. Options include therapy, medication, executive functioning strategies and peer support (with studies stating the best results are using a combination). We recommend books like Divergent Mind, by Jenara Nerenberg, which challenges paradigms about neurodivergence that many adults encountered in childhood. There are also wonderful resources to support specific parenting challenges as a neurodivergent adult, including articles from ADDitude Magazine and the Struggle Care Podcast. Ultimately, while receiving an ADHD diagnosis is complicated, it is also an incredible opportunity to better understand yourself and your child. It is never too late to get support.
*All names have been changed to protect client privacy.
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