Untreated ADHD in Adults: Everything You Ever Wanted to Know

Living with untreated ADHD as an adult can be overwhelming.

Yet many adults don’t realize their struggles with focus, organization, or impulsivity stem from undiagnosed ADHD.

To make it worse, they often mistake these challenges for personal failings.

Without treatment, ADHD can lead to significant issues in work, relationships, and overall mental health.

However, understanding the signs and seeking effective support can dramatically improve one’s quality of life.

So, what are the signs?

Signs of Untreated ADHD in Adults

Untreated ADHD in adults shows up in ways that can make daily life a struggle.

Sustained attention, organization, or planning often feel impossible. Even more so with a deadline attached.

Adults with ADHD may frequently get distracted or sidetracked, leading to incomplete tasks and frustration. Sound familiar?

Other common signs include impulsiveness, forgetfulness, and restlessness. Misplacing items (like your keys or wallet), forgetting important tasks, or struggling to stay organized are frequent challenges.

Emotional symptoms, such as mood swings, low frustration tolerance, and poor self-regulation, can complicate both relationships and work performance. Physical restlessness, such as fidgeting or difficulty sitting still, is another hallmark sign.

Impact on Relationships and Life

According to ADHD therapist Carrie Buechner, hyperfocus and time management concerns can significantly impact relationships.

"An adult with ADHD may come across as uncaring or insensitive," she notes.

These challenges may lead to tension with partners or loved ones, who might misinterpret symptoms as a lack of effort or concern.

Social relationships can also suffer.

Impulsivity might make adults with ADHD seem like they always need to be the center of attention or struggle as conversational partners.

This understandably can turn others off. And it's something I see often in my couples counseling sessions.

Effect on Work

Untreated ADHD can have serious effects on work performance.

Buechner explains, "difficulty completing work on time due to forgetfulness, lack of motivation, and procrastination will seriously hurt job security or performance."

Another concern is hyperactivity, which doesn’t necessarily disappear in adulthood.

Hyperactivity may present as fidgeting, difficulty sitting still for long periods, or trouble resting.

These behaviors can often be mistaken for laziness or carelessness, but they stem from the brain’s difficulty regulating attention and behavior.

Understanding these signs is the first step toward addressing untreated ADHD effectively.

How ADHD Is Different in Adults

ADHD in adults often presents differently than it does in children, making it harder to recognize. While children with ADHD may exhibit overt hyperactivity, adults are more likely to struggle with restlessness, poor time management, and difficulties in focus and organization.

Meeting deadlines, maintaining attention in conversations, and staying on task can feel like constant uphill battles.

When Adults “Space Out”

According to Sean Brock, an ADHD Therapist in Denver, one of the most common traits of ADHD in both children and adults is "spacing out."

"Adults with ADHD often disengage from the present moment, which can look like forgetting tasks, failing to follow through on plans, or getting lost in conversations," adds Brock. "Unlike children, adults with ADHD may not display physical hyperactivity but instead show signs of chronic procrastination, forgetfulness, and difficulty completing projects."

These behaviors stem from the brain's struggle to remain engaged in routine or 'boring' activities.

Stimulation-Seeking Behaviors

One type of ADHD is inattentive.

Brock explains that some adults cope with their inattentive ADHD by seeking out stimulating behaviors to stay present.

For these individuals, the brain naturally craves more stimulation than the average person to remain focused.

This might lead to behaviors like video game addiction, impulsive spending, risky sexual activity, or even aggressive driving.

"Normal" activities can feel tedious or overwhelming, resulting in task-switching, juggling multiple responsibilities, or struggling to complete anything.

Restlessness and Emotional Challenges

According to Brock, "Pure hyperactivity is less common in adults than children, as adults learn to control their impulses over time. Emotional regulation challenges—such as irritability, mood swings, anxiety, and depression—are more prominent in adults with ADHD."

Brock notes that these mood disturbances can greatly affect mental health and self-esteem, as adults may feel like failures in relationships or work environments.

If this is an area you currently struggle with, keep reading. We'll get into solutions in the next section.

Recognizing the Differences

Recognizing that ADHD looks different in adulthood is critical to understanding its effects.

Children may present with outward hyperactive behaviors like running or climbing, whereas adults may appear "lazy" or "unmotivated" due to their struggles with focus and engagement.

These distinctions are essential for accurately diagnosing and addressing ADHD in adults, who often face unique challenges in their relationships, careers, and daily life.

As Brock highlights, understanding these differences can reduce the shame many adults feel and pave the way toward effective treatment and support.

Why Many Don’t Get Treatment

More and more Ontarians are receiving mental health diagnoses in recent years, yet many adults with ADHD still go undiagnosed and untreated.

Several factors contribute to this, ranging from misconceptions about ADHD to practical barriers in accessing care.

Misunderstanding ADHD

A common barrier to treatment is misunderstanding what ADHD actually looks like, especially in adults.

Many people still associate ADHD exclusively with hyperactive children and fail to recognize its symptoms in adulthood. For adults, ADHD often presents as chronic disorganization, forgetfulness, or difficulty following through on tasks.

These challenges are frequently misinterpreted as laziness, personality flaws, or stress, preventing individuals from seeking help.

According to Ann Arbor therapist Jesse Kauffman, “Another reason an adult with ADHD might not engage in treatment despite ADHD interfering with their life is the perception that ADHD only affects kids. It was not that long ago that the medical community believed that ADHD was a disorder that only affected children."

Medical professionals have been speaking more broadly about the effects of ADHD on adults for 20+ years now.

But it takes time for that emergent perspective to permeate into our mainstream understanding.

That begs the question: Are we on the cusp of a general understanding of ADHD in children AND adults?

Co-occurring Conditions

ADHD rarely exists on its own and often overlaps with other mental health conditions, making diagnosis more complicated. These include:

• Bipolar Disorder: Mood swings can resemble ADHD’s emotional dysregulation.
• Depression: Symptoms of low energy or hopelessness can overshadow ADHD.
• Eating Disorders: Impulsivity and emotional struggles can drive disordered eating.
• Generalized Anxiety Disorder: Constant worry can mask inattention and distractibility.
• Social Anxiety Disorder: Struggles in social settings may stem from or worsen ADHD symptoms.
• Substance Use Disorders: Adults may self-medicate with drugs or alcohol to manage their symptoms.

If you're concerned you may have ADHD and another condition, please contact me. We'll do a full evaluation and you can get clarity.

Masking or Self-Medicating to Hide Symptoms

Adults with ADHD often develop coping mechanisms to compensate for their struggles. These might include:

• overcompensating with rigid organization
• avoiding challenging situations altogether, or
• turning to substances like caffeine, alcohol, or drugs for temporary relief.

As Kauffman explains, “Some adults don't know or suspect that they have ADHD. As they've moved through life, they've naturally found coping strategies that have worked well enough and their life challenges haven't surpassed their capacity to manage them."

So as long as they are doing relatively well in life, they might just think of themselves as quirky or particular and that's it.

Unfortunately, these strategies often worsen symptoms over time, delaying proper diagnosis and treatment.

Stigma Around ADHD (and Mental Health More Broadly)

Societal stigma is another significant obstacle. Many adults feel ashamed to admit they’re struggling, fearing judgment from others.

ADHD is often misunderstood as a lack of effort or self-control, leading to shame and hesitation to seek help.

This stigma is especially pronounced in communities where mental health issues are heavily stigmatized.

Lack of Treatment Options

Access to ADHD treatment for adults remains limited.

Many healthcare providers are not trained to recognize ADHD in adults, making it difficult to find specialists.

High costs, long wait times, and limited insurance coverage can also create barriers.

Additionally, as Kauffman highlights, ADHD symptoms themselves can interfere with treatment:

“Significantly, many ADHD adults don't receive treatment because their ADHD is interfering with their ability to engage with treatment. ADHD symptoms can include difficulty maintaining focus, disorganization, and difficulty completing tasks."

For those with untreated adult ADHD, "scheduling a first appointment can take months or years," Kauffman concludes.

What Effective Treatment Looks Like

Effective treatment for ADHD in adults typically combines psychotherapy, medication, and self-help strategies. These approaches address symptoms holistically, allowing individuals to regain control over their lives and improve their overall well-being. For those in Ontario, local offices and online therapy options provide accessible and flexible solutions for care.

Psychotherapy

Therapy is a cornerstone of ADHD treatment, offering essential tools to navigate daily challenges. Cognitive Behavioral Therapy (CBT) is particularly effective, helping individuals identify and reframe negative thought patterns, develop organizational skills, and enhance emotional regulation.

Mindfulness-based approaches are also highly beneficial. These strategies help individuals reduce impulsivity, manage stress, and stay present—a common struggle for adults with ADHD.

Medication

Medications such as stimulants (e.g., Adderall, Ritalin) or non-stimulants (e.g., Strattera) are frequently prescribed to manage ADHD symptoms. These medications improve focus, reduce impulsivity, and enable better task management.

A healthcare provider will work closely with the individual to determine the right medication and dosage tailored to their specific needs, ensuring the best possible results.

Self-Help Strategies

Self-help empowers adults with ADHD to take an active role in their treatment. Tools like planners, task management apps, and checklists are essential for staying organized and managing time. Regular exercise, mindfulness practices, and healthy routines are also critical in improving focus and reducing restlessness.

Cole Butler, a therapist specializing in ADHD, recommends specific techniques for self-help:

• Box Breathing: "You simply inhale for a set amount of seconds, hold for the same amount of time, breathe out for the same amount of time, and then hold with the breath out for the same amount of time. This is a great way to anchor your attention and regulate your nervous system."
• Grounding Technique: "Use the 5-4-3-2-1 method when feeling distracted or overwhelmed. Focus on your five senses: identify five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste."
• Calendar Systems: "I suggest that all people that struggle with ADHD adopt a calendar system like Google Calendar to help manage their time and plan their days."

By incorporating these techniques into their daily lives, adults with ADHD can improve their ability to focus and manage symptoms effectively.

With the right combination of psychotherapy, medication, and self-help strategies, adults with ADHD can overcome their challenges and build a more fulfilling, balanced life.

Getting an ADHD Diagnosis As an Adult

If you suspect you have ADHD, taking steps toward a diagnosis can provide clarity and open the door to effective treatment. There are different methods available for obtaining an ADHD diagnosis, ranging from in-depth evaluations to shorter, more accessible approaches.

Neuropsychological Evaluation

The most comprehensive way to diagnose ADHD is through a neuropsychological evaluation. This method involves an in-depth assessment of your emotional, social, and cognitive functioning, resulting in a detailed report.

According to Kauffman, “A neuropsychological evaluation is also considered the most legitimate for the purposes of seeking academic or legal accommodations.”

While this type of evaluation provides the most thorough understanding of how ADHD impacts your life, it also requires significant time and effort.

Additionally, the administrative and financial costs of a neuropsychological evaluation can be prohibitive for many people.

Streamlined Diagnostic Tools

For those unable to pursue a full neuropsychological evaluation, shorter diagnostic tools offer an accessible alternative.

These self-report assessments, when used in collaboration with a licensed therapist, can still provide a reliable ADHD diagnosis.

Kauffman explains, “Recently, more professionals have begun to acknowledge the administrative and financial barriers that prevent many people from accessing a full evaluation. Shorter self-report diagnostic tools used in partnership with a licensed therapist can also provide the essentials for an ADHD diagnosis.”

This streamlined approach reduces the financial burden while still equipping adults with ADHD with the information they need to begin treatment and better understand their unique challenges.

Next Steps

Whether you choose a comprehensive neuropsychological evaluation or a shorter diagnostic approach, connecting with a licensed therapist or healthcare provider is essential.

A proper diagnosis is the first step toward developing a personalized treatment plan and improving your quality of life. And at Comfort In Mind, we can help determine if you should seek a full diagnosis, or if it’s likely something else.

We invite you to schedule a free consultation on our contact page. We’ll help you determine the root cause of your struggles, and rule out things that it is not. With the right diagnosis, you can make meaningful changes and improve your quality of life dramatically.