Why ADHD is often undiagnosed in adults

People with attention deficit hyperactivity disorder (ADHD) have symptoms that many find relatable, like difficulty sitting still or being easily distracted. At one point or another you may even find yourself saying something like “I am so ADHD!” to describe your own experience.

This just does more harm to those who are diagnosed and undiagnosed, says Western Cape psychiatrist Professor Renata Schoeman.

“Being sleep deprived or very excited about something or having a lot going on in your environment and not being able to concentrate does not make you ADHD,” she says.

Schoeman joins this week’s episode of Sisters Without Shame to unpack the ins and outs, and stigmas associated with ADHD.

In episode 67 of Sisters Without Shame, psychiatrist Professor Renata Schoeman gets real about ADHD diagnosis in adulthood. Photo: Health For Mzansi

What is ADHD?

There are a lot of grown-ups who do not know that they have attention deficit hyperactivity disorder (ADHD).

Schoeman explains that ADHD is one of the most common neurodevelopmental disorders and is usually diagnosed in childhood and continues up to adulthood.

“I think it is very important to establish that there is not something like ‘adult-onset ADHD’. ADHD is always there since the beginning, it is a neurodevelopmental disorder, but it is often undiagnosed in adulthood,” Schoeman says.

“The sad part is that if it was never diagnosed in childhood, usually the people that have adult ADHD present with anxiety, depression or substance abuse or sleep disorders.”

How ADHD is diagnosed

The causes and risk factors for ADHD are unknown, but Schoeman says genetics plays an important role.

“In adulthood it looks a bit different, I mean you don’t have adults that are climbing up trees and furniture anymore, but we do have workaholics and people who engage in extreme activities.”

It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviours.

“In adulthood, we still diagnose it the same way. It is still a comprehensive assessment, it is not only a checklist of rating scales or ticked boxes. We look for a cluster of symptoms, different symptoms of inattentiveness, hyperactivity, and impulsivity.

“These symptoms need to be there across your lifespan but also across the moods. It is not something that only presents at work, or only present at month-end, it is there at work, at church, at home and it must cause distress or function impairment.”

On this episode Schoeman further expands on: