5 Signs of Undiagnosed Adult ADHD

As an adult psychotherapist with ADHD, I’ve mastered the fine art of doing everything except what I’m supposed to be doing. Except, that wouldn’t get me very far as a professional, would it? Thanks to my diagnosis, which I got in college, I have been able to develop helpful strategies and responses to my ADHD to help me be successful.

Although some individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) are diagnosed in childhood, many adults with ADHD, particularly women like myself, remain undiagnosed until adulthood. It is estimated that more than 15 million adults in the United States have ADHD. Yet, several studies suggest that less than 20% of American adults with ADHD are aware of their condition. This means many adults continue to struggle with symptoms without context or realizing their symptoms may be related to ADHD.

One of the major benefits of being diagnosed with ADHD is the opportunity to understand how my brain works differently from a neurotypical person's, allowing me to tailor my approach to tasks and responsibilities in a way that suits my unique cognitive patterns. This self-awareness has been empowering, as it’s helped me develop systems that work with my tendencies, such as using routines, reminders (thank you Siri!), setting clear goals, breaking tasks into smaller, manageable steps, and other ADHD neuroscientifically supported strategies.

Rather than constantly feeling frustrated by my challenges, I’ve learned to approach them with empathy for myself, recognizing that my brain's way of processing information may not align with conventional methods, but it's still valid. By embracing these differences and developing strategies that align with my natural rhythm, I’ve been able to reduce feelings of inadequacy and guilt. Additionally, seeking adequate professional support, such as therapy or medication, has been instrumental in providing me with tools and guidance to navigate life more effectively. Understanding and working with my ADHD has given me the confidence to advocate for myself and approach challenges with a clearer mindset, making daily life more manageable.’

Disclaimer:

It’s important to note that a formal diagnosis of ADHD can only be made by an accredited healthcare professional through a comprehensive evaluation process. While the information in this post is designed to help you better understand the potential signs of ADHD, it is not intended to replace professional assessment or diagnosis. Online quizzes and self-assessments are not sufficient for an accurate diagnosis. If you suspect you may have ADHD, seeking an evaluation from a licensed psychologist, psychiatrist, or another qualified healthcare provider is the appropriate next step. This post is intended for educational purposes only and to help individuals recognize when further professional evaluation may be needed.

If you may suspect you have undiagnosed adult ADHD, here are 5 signs you might and should follow up with a qualified professional:

1. Difficulty concentrating vs. hyperfocus

Untreated adult ADHD can make it incredibly difficult to focus on responsibilities and tasks, often leading to persistent distractions and difficulty completing work. Does it feel like your mind constantly jumps from one thing to another, making it hard to stay on track? Do you find yourself feeling frustrated because sustaining attention feels impossible? Yet, despite this difficulty, people with ADHD can also experience periods of hyperfocus, where they become so absorbed in an activity that they lose track of time and neglect other important tasks.

Neuroscience research shows that untreated ADHD leads to reduced activity in the prefrontal cortex, impairing attention, impulse control, and executive functions. Additionally, dopamine dysregulation and impaired brain connectivity make it harder for individuals with ADHD to sustain focus, especially on less stimulating tasks, while hyperfocus occurs when the brain becomes intensely engaged in something highly interesting or rewarding. This fluctuation in attention can interfere with personal relationships, job performance, and overall well-being, as simple tasks become overwhelming and take much longer than they should.

2. Time management, chronic procrastination, and trouble following through

Undiagnosed ADHD can often result in poor time management, chronic procrastination, and difficulty following through on tasks, as individuals with ADHD struggle to prioritize and manage their time effectively. They may start projects with enthusiasm but quickly lose focus, leading to unfinished work and a growing sense of frustration. As a result, important deadlines are missed, and tasks become overwhelming.

Neuroscience explains that this difficulty stems from underactivity in the prefrontal cortex, which is responsible for executive functions like planning, decision-making, and task initiation. Additionally, dopamine dysregulation in the brain makes it harder for individuals with ADHD to experience the motivation needed to follow through on tasks, particularly those that are less rewarding or stimulating. This combination of factors contributes to poor time management and a cycle of procrastination, making even simple tasks feel like significant challenges.

Do you struggle with chronic procrastination and have trouble following through on tasks? Is it common to start projects excitedly only to lose focus quickly and leave them unfinished? Do you struggle to prioritize or manage time effectively, leading to a growing sense of frustration as tasks pile up?

3. Disorganization and forgetfulness

Untreated ADHD often leads to disorganization and forgetfulness, making it difficult to keep track of tasks, appointments, and personal items. Individuals with ADHD may frequently misplace things, struggle to maintain an organized workspace, or forget important deadlines, which can cause stress and disrupt daily routines.

Do you or someone you know constantly struggle with staying organized, often misplacing items or forgetting important appointments? Is it hard to keep your workspace tidy or remember deadlines, even when they feel urgent? Could your brain feel like it's constantly juggling too many things, making it difficult to prioritize or keep track of details?

These challenges might stem from untreated ADHD, where the brain’s executive functions—responsible for managing tasks and memory—don’t work as efficiently. With underactivity in the prefrontal cortex, the brain's ability to prioritize, manage time, and store information effectively is compromised, leading to frequent lapses in memory and disorganized behavior.

4. Impulsivity and emotional dysregulation

Do you find yourself making decisions quickly, trying to follow the thrill of life, only to regret them later when you realize that you didn’t consider the long-term consequences? Do you experience intense emotional reactions or mood swings that feel unproportional to the situation? During conversations, do you find yourself interrupting others, even when you intend to listen or wait your turn?

Well, untreated ADHD can lead to rashness and emotional dysregulation, causing individuals to make quick decisions without thinking through the consequences and experience intense emotional reactions or mood swings. People with ADHD may find themselves acting on impulse, interrupting others, or making spur-of-the-moment choices that they later regret. This occurs because the brain's prefrontal cortex, which helps control impulses and regulate emotions, is often underactive in individuals with ADHD. As a result, they have difficulty managing their emotions, which can lead to heightened frustration, irritability, or extreme emotional responses to even minor stressors.

5. Sleep Issues

Adults with undiagnosed ADHD often experience sleep issues, such as difficulty falling asleep, staying asleep, or waking up feeling unrested. One reason for these sleep disturbances is that ADHD affects the brain's ability to regulate arousal levels, making it hard to wind down at night or stay calm enough to fall asleep. Additionally, the dopamine dysregulation seen in ADHD can interfere with the sleep-wake cycle, leading to restless nights or inconsistent sleep patterns. The hyperactivity and restlessness common in ADHD can also cause individuals to feel an inner sense of agitation, making it difficult to relax and settle into a restful state. As a result, sleep becomes fragmented, leading to fatigue and difficulty functioning during the day, which can further exacerbate ADHD symptoms.

Why It’s Important to Get Diagnosed

Undiagnosed ADHD can lead to feelings of inadequacy, frustration, and low self-esteem. It’s not uncommon for individuals to struggle with a sense of “not measuring up,” especially when their symptoms don’t align with the typical expectations of productivity, focus, and organization. Therapy, coaching, and medication (when appropriate) can help individuals manage their symptoms and improve their quality of life.

If any of these signs resonate with you or someone you know, seeking a professional evaluation is an important step toward gaining clarity and support. As a psychotherapist, I have seen firsthand how understanding ADHD and learning to manage its symptoms can lead to profound positive changes in a person’s life. Therapy, particularly when combined with ADHD-specific interventions, can offer a pathway to greater self-acceptance, productivity, and emotional well-being.

Remember, ADHD doesn’t define a person’s potential. With the right tools and support, adults with ADHD can lead fulfilling, successful lives, and better manage the challenges they face.