What Does Undiagnosed ADHD in Adults Look Like?

As an adult in the 21st century, it’s normal to lose focus and have difficulty completing tasks sometimes. Your phone, internet, and social media are pretty distracting, and a global pandemic doesn’t help.

But, do you find that you have always struggled to prioritize tasks and manage stress? Even when you try to do your checklist in an orderly fashion, your life always feels chaotic - to the point that you believe you’re not as “smart” as others. Perhaps you’ve noticed that your emotional health, the way you view yourself, and your performance have continuously suffered over the years. If you’ve experienced these feelings, you may have suspected you have ADHD or ADD.

Undiagnosed ADHD/ADD can be difficult, since you don’t know how to work with it, and you can feel out of control. You may be struggling with prioritization, poor stress management, and feeling chaotic when there seems to be a bit too much on your plate. You may turn inward, blaming yourself for something that’s not in your control.

When you have a proper diagnosis, you can have a better relationship with your ADHD, and subsequently, a better relationship with yourself. You can get help from practitioners. You can find community. You can begin to use your strengths when setting up your strategies to manage life stuff.

But First, What Exactly is ADHD?

You may have an idea of what ADHD is. But how does it affect your brain, and how does that impact your life?

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that can affect everything from how you process emotions, behaviors, task-completion and learning. To break it apart: neuro relates ADHD to the nervous system - the things in your body that dictate how you move, breathe, see, think, and more. This demonstrates that ADHD can really affect all parts of your life. The developmental part refers to it typically showing up during developmental periods (i.e., childhood) and can impact aspects of one’s growth into who we become. This is why ADHD going undiagnosed into adulthood can be so challenging, because you may have come to believe that the aspects of you that struggle with paying attention or finishing tasks may have a reflection on your character: you are lazy or you don’t care. That’s just not true. It’s a part of your nervous system that works differently than neurotypical people.

In terms of the neuroscience behind ADHD, the neurotransmitters like dopamine, can be affected. Here are the 4 parts of the brain are impaired:

‍Frontal Cortex

• This can affect your attention, how you execute tasks, organization, and your judgement.

Limbic System

• The limbic system can affect how you regulate your emotions and attention.

Basal Ganglia

• This part of the brain affects how your brain communicates. This can look like impulsive behaviors and a difficult time paying attention.

Reticular Activating System (RAS)

• The RAS plays a key role in how you maintain behaviors, how “present” you are, and your motivation.

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Many people think that ADHD is a behavioral condition. Something you can just turn “off.” But that couldn’t be further from the truth.

If ADHD stays undiagnosed, it can persist into adulthood. Everything can seem okay until it’s not. How can it affect you as an adult?

What Does Undiagnosed ADHD Look Like?

As an adult, there’s a lot you have to deal with. Work, appointments, paying bills, managing kids’ schedules (if you have any), maintaining relationships, and even taking care of yourself.

It’s normal to forget things once in a while, but with ADHD, this (and other symptoms) can happen everyday. This can be debilitating to not only your mental health, but also your physical and emotional wellbeing.

The dopamine (or “reward system”) in your brain is the communication network between your nervous system and nerve cells. This is responsible for feeling pleasure, which can affect how we think and execute tasks.

In the ADHD brain, studies suggest that dopamine levels are lower, which can affect a lot. This is where your emotions and behaviors can get massively affected.

In terms of behaviors, it can look like:

• Not taking care of yourself
• Difficulty starting and finishing tasks
• Trouble paying attention
• Drug abuse
• Impulsive actions

Emotionally, it can look like:

• Anxiety
• Depression
• Difficulty handling frustration
• Difficulty coping with stress
• Low self esteem or shame

But, it doesn’t look the same in everyone and undiagnosed ADHD in adults may look different based on different subtypes. There are 3 different subtypes of ADHDers: Inattentive (formerly ADD), hyperactive-impulsive, and a combination of both.

Inattentive ADHD

When you think back on your childhood, were you a daydreamer, “space-cadet”, or even ditzy? Maybe you weren’t the kid disrupting class, but you were the only that got lost in the middle of a lesson or had to check in with a friend after class about what homework was assigned. As you became an adult, you went to college or you went to work. It’s likely you even excelled in your courses or career because you found ways to overcompensate for your difficulties staying on track and just worked really really hard - like pushing your brain through a wall - to accomplish all that you’ve done. So, your struggle may have been missed. Other people don’t often see your intense procrastination, your motivation fueled by deadlines, your anxiety about missing something, and your disappointment when you can’t hold it together.

Inattentive ADHD is more common in females than in males and can be difficult to spot because it isn’t obvious. According to the CDC, for children, boys (12.9%) are more than twice as likely to be diagnosed with ADHD versus girls (5.6%) and a large part of this is due to the quieter nature of this subtype of ADHD. Thankfully, the outdated stereotypes of ADHD only being a hyperactive-boy issue are fading and more research is being done on female ADHDers and the inattentive subtype.

If inattentive ADHD is not diagnosed, it may have cascading effects in your adult life:

• Regularly forgetful. Anywhere from losing keys, running errands, to forgetting to pay your bills. You may even forget what you’re talking about or what your partner asked you to help out with.
• Lack of attention. Easily distracted by the external world like sounds, someone talking to you (or thoughts). You may have a hard time listening to others or paying attention at work.
• Procrastinates things that require a lot of mental effort (work projects, taxes, etc.). This makes it difficult to start and finish tasks.
• Difficulty organizing. Your room may be a mess, prioritizing can be difficult, and to-do lists go forgotten.
• Poor time management. It’s easy to underestimate how long it takes to complete a task. This can lead to being late, missing deadlines, and having the sense that you’re wasting time.

Hyperactive-Impulsive ADHD

As a child, were you the kid that couldn’t sit still? Maybe you’d call out an answer before getting permission to do so, get in trouble for talking with your neighbor, or always be fidgeting with something in your hands or your feet. If so, you might have hyperactive-impulsive ADHD.

Though this type is more common in males, females are not excluded from it. This is the most recognizable type of ADHD, since it’s easier to spot, and people can have harsh judgments towards it - making jokes or blaming the individual for not being able to keep their hands to themselves. It is also common for an individual to have more hyperactive symptoms when they are a child and more inattentive symptoms as they grow up.

But as an adult, undiagnosed hyperactive-impulsive ADHD can look like:

• Restlessness. Like regularly getting up in the middle of work, even though you’re supposed to be working. It can also look like having a difficult time relaxing.
• Fidgeting. You may play with your hair, fiddle with a pen, jiggle your leg, or find you can only focus while doodling or playing with a fidget-toy.
• Impatience. Whether it’s getting worked up over a slow car in front of you or waiting in line. It can also look like interrupting others in conversations.
• Excessive talking. You can easily rant or talk for extensive periods of time.
• Engaging in risky activities like drugs and dangerous activities for an adrenaline rush. This can lead to substance abuse.
• Low Stress Tolerance. This can lead to angry outbursts if your stress meter feels like it’s going through the roof.

Combination of Inattentive and Hyperactive

A combo means you have enough symptoms to meet criteria for both inattentive and hyperactive subtypes. Undiagnosed ADHD with the combination of both can be a whirlwind of struggles. With symptoms from both, this can lead to a range of behaviors and emotions that can be hard to keep up with. You may even feel “stuck.”

A combination of both types of ADHD can look like swapping between different symptoms that may look like:

• You’re either excessively talking or not present during conversations.
• A tradeoff of feeling like you’re “Driven by a motor” to having zero motivation to do anything.
• Getting regularly sidetracked, or obsessively doing something like work or chores.
• Switching between regularly moving around, or staying in the same position for hours.

Regardless of what kind of ADHD you have, it’s important to get a diagnosis to get to the root of the problem. An accurate diagnosis is an opportunity to learn how to develop a better relationship with your mind and self.

Why You Need a Proper Diagnosis

It can be incredibly difficult to manage ADHD when you remain undiagnosed. Mood disorders like anxiety or depression can arise, and can lead to more problems like getting fired (or impulsively quitting your job). You may think you’re less “successful,” or “intelligent,” but in reality, your brain just works differently and without knowing how it works, you may be working against yourself without knowing it.

Getting an ADHD diagnosis in adulthood (rather than childhood) is a lot more common than you think and can help because it gives you language and tools to understand how you function. By realizing that your struggles are not your fault and finding strategies that harness to your strengths rather than emphasize your weaknesses, your ADHD doesn’t have to be debilitating. You also may find that you get to stop working so hard and find some relief.

It’s important to get a proper diagnosis. A self-diagnosis or a brief questionnaire from your primary care physician can be a great start, but it’s not always the accurate way to tell you whether you have ADHD or not. Other things can complicate a picture of ADHD - anxiety, depression, trauma, learning disabilities, or even personality functioning.

A diagnosis is not the only thing you’ll get with a comprehensive evaluation. Yes, it’s great to know whether you fit criteria for the diagnosis because it can open you up to a community, resources, medication referrals, and even insurance coverage. But, what’s actually more important is the value of understanding what’s going on inside of you. Maybe you don’t fit criteria for a diagnosis; that doesn’t mean there isn’t something super helpful in understanding what’s going on. A diagnosis is just a (hopefully helpful) label. An evaluation will highlight how the symptoms look for you in your life. It will provide a complete picture of your overall functioning, including your mood and interpersonal functioning, and it will provide tailored recommendations for you so that you know what to do with all this information.

Schedule a consultation

At Relational Psych, we have a team of psychologists and post doctoral residents that specialize in helping people like you understand your functioning (and potentially your ADHD) so you can thrive in life. We approach the evaluation from a comprehensive, client-focused, depth-oriented approach to figure out if you actually have ADHD and how other factors (like mood, relationships, trauma, etc.) interact with your overall picture to affect your emotions and behaviors. We also have a team of therapists that can help support you after the evaluation if therapy is a recommended portion of your treatment.

Suspect that you have ADHD? You are not alone. Learn more about how to get tested for ADHD here, and if you’re ready to get help and are an adult in the Seattle area, schedule a free consultation today!