ADHD and Adults: Main Line Area Experts on the Rise in Diagnoses

Parents and other grownups are currently being diagnosed with the disorder at the same rate as children. Why now?

Looking back on his childhood, Jonathan can pinpoint when the problem was clearly apparent. “I always had a feeling I had ADHD—I even had friends in high school tell me I did,” says the Bryn Mawr resident. “But I never went through the process talking to my parents and getting diagnosed.”

In his late 20s, Jonathan was feeling overwhelmed at work. He reached out to his primary care physician, who suggested it might be dissatisfaction with his job. Knowing it was something deeper, Jonathan went to an ADHD specialist to get tested. He was diagnosed in 2022.

Due to the stigma that often accompanies ADHD, Jonathan asked that we withhold his last name. Even now, he has difficulty focusing and maintaining his schedule. He’s easily distracted and loses interest in tasks quickly. “I find myself twiddling my thumbs during long meetings or feeling like I need to sit on my hands so I’m not rude,” he says.

- Advertisement -

adhd

These days, adults and kids are being diagnosed with ADHD at the same rate, though symptoms are often evident in childhood. “Maybe they couldn’t sit still for more than a few minutes when studying as a high schooler, but they only started to have problems once they went to college or had a recent job promotion,” says Chris Pagnani, medical director and founder of Rittenhouse Psychiatric Associates in Paoli. “Their symptoms become apparent with increased work and life demands as an adult.”

ADHD isn’t suddenly popping up in adults at a higher rate. Increased awareness is leading to more diagnoses. Physicians are more attuned to the symptoms. “Most adults with ADHD who are older than 35 weren’t diagnosed as children because we weren’t looking for it as much then as we are now,” says West Chester-based psychologist Ari Tuckman. “And since we’re doing a much better job of looking for and identifying ADHD in kids, a lot of their parents are also being diagnosed in what I call the two-for-one diagnosis.”

Persistent symptoms are key to a proper ADHD diagnosis. “If someone’s struggles come and go, or if they’ve only been present in the last couple years or since a job change, then it isn’t ADHD,” says Tuckman. “It has to be lifelong without a lot of variability.”

For Jonathan, the symptoms have manifested themselves in different ways throughout adulthood. “Early on, I experienced hyperactivity as a kid—it was often dismissed as just being a boy,” he says. “As an adult, it’s causing problems when I try to focus on specific tasks without getting distracted.”

ADHD isn’t suddenly popping up in adults at a higher rate. Increased awareness is leading to more diagnoses.

- Partner Content -
adhd in adults

Many of Pagnani’s patients say cell phones and the internet have adverse effects on their ADHD, and mental health experts have been researching the impact of today’s technology on symptoms. For his part, Tuckman believes there’s a relationship. “Our world has become more distracting than it used to be,” he says. “We’re all working on the same devices that give immediate access to a million alternatives that are way more fun than the work we’re supposed to be doing.”

We all may feel that temptation on occasion, but those with ADHD can have a harder time resisting. “Tech isn’t creating more ADHD—it’s just better at revealing what was already there,” Tuckman notes.

In ancient hunter-gatherer societies, ADHD likely had its benefits. Today’s demands are quite different. “Sitting for hours at a time at a desk in front of a screen or piles of paperwork is a relatively new requirement for success,” says Pagnani.

When a parent has ADHD, there’s a 70% chance one of their children will have it as well. Now that he knows what to look for, Jonathan sees the symptoms in his father and grandfather, though both have yet to be diagnosed. And while kids with ADHD can grow out of their symptoms, 65% will meet the same criteria as adults. Common symptoms for the latter include disorganization, difficulty focusing, restlessness, hyperfocus, poor time management, forgetfulness and impulsivity.

Many adults with ADHD find they need considerable motivation to get anything done. “Individuals may want to complete a task, but it’s almost as if they are incapable of doing so until the stress builds up to a point where it drives them to complete it,” says Pagnani.

- Advertisement -

Michael McLeod sees ADHD as a much-misunderstood disorder. “At its core, it’s so much more than just an attention disorder,” says McLeod, founder of the GrowNOW ADHD executive function coaching service in Media. “If anything, these individuals have an abundance of attention and too much of it to give, meaning they can’t appropriately self-regulate. They respond to too many stimuli in their environment, making them seem distracted and scatterbrained.”

Of the estimated eight to nine million Americans struggling with ADHD, only half say they can successfully hold down a job. “Even when they’re more than capable of doing quality work, they struggle with consistency,” says Tuckman. “This is especially true for longer-term projects that have fewer check-ins with a boss or coworkers.”

ADHD infiltrates all aspects of one’s life, making relationships difficult. “Patients will often discuss difficulty being present with a partner in conversations, when working on joint tasks or even romantically,” says Pagnani. “Although they care very much about their partner and wish to be present, they have a great deal of difficulty doing so. This becomes more problematic when life gets more complicated, like when there’s a mortgage or a newborn. As much as they want to be a better partner, because of their distractibility and forgetfulness, they tend to fall short.”

Even these days, getting a clear ADHD diagnosis can be difficult. “Testing still needs a lot of work,” says McLeod. “Hopefully, this improves over the years.”

For those diagnosed with ADHD, there are several treatment avenues. “It’s important to understand that it’s a spectrum-based disorder, meaning that it’s different for each person who has it,” says McLeod, whose coaching service focusing on the four core executive functions of self-regulation, self-motivation, self-awareness and self-evaluation. “It’s all about tailoring everything toward the individual, finding their own set of strengths, needs, likes and dislikes,” he says.

Medication can also be beneficial. “Stimulants have been around for decades and are very well-researched,” says Tuckman. “They’re not magic, but they help people with ADHD be more reliable and consistent.”

Tuckman also warns of the adverse physical effects that can come with mismanaging the disorder. “Adults with ADHD have higher rates of obesity, diabetes and substance abuse,” he says. “Staying healthy requires attention to detail, resisting temptation in the moment and long-term follow-up on things like annual exams.”

Since his 2022 diagnosis, Jonathan is committed to his treatment path—a combination of medication, exercise, sufficient sleep, supplements, and a high-protein, low-sugar diet. “Treating my symptoms—and being aware of how they affect my everyday life—has made all the difference for me,” he says.

Where to Start

ADDA (Attention Deficit Disorder Association) is a hub for resources on symptom management and local support groups.

The website for the American Academy for Child and Adolescent Psychiatry includes sections on ADHD with information for families and medical professionals.

The Center for Management of ADHD at Children’s Hospital of Philadelphia is the region’s largest and most comprehensive facility of its kind, providing diagnostic evaluations, therapy and medication for children with ADHD and those at risk for developing it.

Funded by the U.S. Centers for Disease Control and Prevention, CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) is home to the National ADHD Resource Center. It provides information and support to individuals, their families and those who assist them while advocating for equity, inclusion and universal rights.

Related: An Inside Look at Ozempic Treatments Around the Main Line

Our Best of the Main Line Elimination Ballot is open through February 22!