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Adult ADHD Symptoms Your Doctor May Have Missed

Attention deficit hyperactivity disorder (ADHD) is a condition that causes hyperactivity, trouble concentrating, inattention, and decreased emotional control.

While it’s most common in children, adults also get ADHD. Adult ADHD is harder to diagnose, and doctors don’t always catch it.[1]https://pubmed.ncbi.nlm.nih.gov/27052374/

Many adults go for years without a formal ADHD diagnosis, although they struggle to concentrate and are easily distracted at work. Here’s a closer look at the symptoms of adult ADHD, as well as strategies to improve your focus.

Symptoms of Adult ADHD

In children, ADHD often presents with obvious symptoms, like restlessness, hyperactivity, and poor social skills (talking over others, being unable to sustain a conversation, etc.).

In adults, however, ADHD can be harder to detect. Symptoms of adult ADHD include[2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2957278/:

  • Fatigue
  • Lack of motivation
  • Difficulty getting started on tasks
  • Poor persistence in tasks that require sustained attention
  • Hyperfocus (obsessive focus on tasks you find interesting)
  • Impulsivity and low frustration tolerance
  • Distraction
  • Frequent boredom
  • Restlessness
  • Anxiety
  • Poor time management

Most adults with ADHD have figured out coping strategies to function in their daily lives. They may seem fine on the surface despite a constant mental struggle. In addition, a lot of adults with ADHD assume that the way they function is normal, so they never seek help. These dynamics make adult ADHD particularly difficult to diagnose.

Short attention span? Trouble focusing on your work? Take this quiz to get a step closer to drug-free motivation and focus.

Adult ADHD and Substance Abuse

A significant number of adults with ADHD abuse substances to try to manage symptoms.[3]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827421/

People with ADHD are two to three times more likely to use tobacco products (cigarettes, vapes, dip, etc.), and also have a higher risk of stimulant abuse (amphetamines, cocaine, etc.)[4]https://pubmed.ncbi.nlm.nih.gov/29039714/.

Researchers believe that people with ADHD are more likely to abuse substances for two reasons: first, a desire to relieve symptoms and focus better, and second, increased impulsivity that makes it more difficult to resist substances in the moment.

Medication for ADHD

Prescription stimulants are the first-line treatment for ADHD. The most common medications are:

  • Amphetamine (Adderall)
  • Lisdexamfetamine (Vyvanse)
  • Methylphenidate (Ritalin, Concerta)

Stimulants work by increasing activity in your prefrontal cortex—the part of your brain just beneath your forehead. Your prefrontal cortex controls attention, planning, impulse control, and other functions that manage your focus and mental energy.

In ADHD, your prefrontal cortex is underactive. It struggles to ignore distractions, inhibit boredom, plan ahead, and resist impulses. Prescription stimulants increase prefrontal cortex activity, restoring balanced brain function and relieving ADHD symptoms.

Stimulants are very effective at reducing ADHD symptoms for most people,[5]https://pubmed.ncbi.nlm.nih.gov/12142863/[6]https://pubmed.ncbi.nlm.nih.gov/21254791/ although they sometimes come with significant side effects.

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ADHD Medication Side Effects

Prescription stimulants are addictive and have potential for abuse.[7]https://pubmed.ncbi.nlm.nih.gov/18596945/ In addition, you build tolerance to stimulants over time, meaning you have to continue increasing the dose in order to get the same effect.[8]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036556/

For this reason, some doctors recommend occasional, supervised breaks from taking stimulants, to reduce tolerance and prevent severe withdrawal.

In rare cases, prescription stimulant use can cause psychosis. A 2019 study found that using amphetamine (Adderall) or methylphenidate (Ritalin/Concerta) caused psychosis in one out of every 660 ADHD patients.[9]https://pubmed.ncbi.nlm.nih.gov/30893533/

ADHD medication can also cause more mild side effects, including:

  • Insomnia
  • Mood swings
  • Irritability
  • Decreased appetite
  • Weight loss
  • Physical and behavioral tics (eye twitching, repetitive speech or movement)
  • Headache
  • Stomachache

3 Alternatives to ADHD Medication for Adults

Because ADHD medication comes with potential serious side effects, many adults with ADHD prefer to manage their symptoms in other ways.

Here are three ways to manage adult ADHD without medication.

Cardio Exercise

Working out is one of the most well-established ways to manage ADHD.

A recent study analysis of more than 30 studies found that cardio exercise (running, cycling, swimming, etc.) is especially effective at reducing ADHD symptoms. Several of the studies found that cardio was as effective as prescription medication at managing ADHD.[10]https://pubmed.ncbi.nlm.nih.gov/28917364/

Another large review found similar results.[11]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5281644/ However, this review also looked at other types of exercise, and the authors note that non-cardio exercise (like lifting weights) did not show the same cognitive benefit for people with ADHD.

If you’re going to exercise to increase focus and manage ADHD, cardio seems to be your best bet.

Nootropics

Nootropics are supplements that stabilize and improve brain function. You can use nootropics to enhance focus, prolong alertness and attention, increase resilience to mental stress, improve memory, and more.[12]https://pubmed.ncbi.nlm.nih.gov/23042218/

A 2012 study reviewed nootropics as a possible way to manage ADHD symptoms.[13]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353150/ If found that nootropics improve attention, planning, problem-solving, sustained focus, and emotional stability.

A 2016 study found similar results, and the authors noted that nootropics are a promising way to improve attention and reduce hyperactivity without the side effects that can accompany prescription stimulants.[14]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968082/

There’s no single nootropic that works for everyone. Because brain activity varies from person to person, you typically take nootropics as a stack—a combination of cognitive enhancers, vitamins, minerals, and other compounds that balance your brain function.

A nootropics quiz can help you find the ideal combination of cognitive enhancers to improve your focus and attention.

Sleep Hygiene

Sleep disturbances very common in people with ADHD, and they can create a negative feedback loop in which poor sleep worsens ADHD symptoms, which further impairs sleep, and so on, gradually making ADHD more severe[15]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299464/.

Research shows that improving sleep hygiene can significantly reduce ADHD symptoms.[16]https://pubmed.ncbi.nlm.nih.gov/27614815/[17]https://pubmed.ncbi.nlm.nih.gov/34679425/[18]https://pubmed.ncbi.nlm.nih.gov/32204604/

Sleep hygiene involves setting up your bedroom and your daily schedule to promote deep, restorative sleep. Simple ways to improve sleep hygiene include:

  • Block out light at night. Ideally, your bedroom should be dark enough that you can’t see your hand in front of you. Nighttime light inhibits sleep hormone production and decreases your sleep quality[19]https://pubmed.ncbi.nlm.nih.gov/30311830/. Try light-blocking shades, turn on night mode on your phone and computer, and cover up any light-emitting electronics in your room (like alarm clocks or WiFi routers).
  • Take magnesium. Magnesium is a mineral that your brain uses to make several neurotransmitters, including ones that affect sleep. A double-blind, placebo-controlled study from 2012 found that taking magnesium before bed improved participants’ sleep quality and increased their sleep hormone levels.[20]https://pubmed.ncbi.nlm.nih.gov/23853635/

Final Thoughts

ADHD can be hard to detect in adults and it often goes undiagnosed. It can cause a variety of symptoms, including fatigue, decreased productivity, anxiety, and poor time management.

If you think you have adult ADHD, your doctor can give you an attention test to help diagnose you. You have several options to improve your brain function, including prescription stimulants and lifestyle changes.

However you choose to address it, ADHD is manageable in almost all cases. Work with your doctor and try the above approaches to see what works for you.

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