ADHD can be the worst kind of guest: one that shows up, wreaks chaos in your life, and refuses to ever leave. The latest estimate is that about half of children with ADHD still have the disorder as adults, but whatever the exact number, we’ve known for a while that ADHD sticks around into adulthood for many people.
Knowing it’s more or less a coin toss whether childhood ADHD is just stopping by for a visit or is here for the long haul, it’s reasonable to ask: is there any way of predicting whether childhood ADHD will go away?
I was spared this “will it, won’t it” drama since I wasn’t diagnosed until college. Now in my mid-twenties, I guess there’s still some chance I’ll be struck by an attack of late-onset normalcy, but looking the trajectories of other people in my family with ADHD, I’m not counting on it.
That’s not to say that family history is a perfect predictor of when ADHD will persist into adulthood, but for now, it might be the best indicator we’ve got. One study of 8395 twin pairs done in the UK last year (that’s a lot of twins!) estimated that genetics accounted for 81 percent of whether hyperactive-impulsive symptoms and 54 percent of whether inattentive symptoms continued into adulthood.
For researchers looking at this topic, the holy grail would be a brain scan that predicts whether any given case of ADHD is a childhood nuisance or the beginning of a lifetime of disorderliness.
Right now, that brain scan is pretty far down the ADHD research wish list, somewhere between a blood test that diagnoses ADHD and a perfect medication with no side effects. But scientists have noticed some general differences in the brains of people with remittent and persistent ADHD.
An fMRI study last year found that when the brains of adults with remittent ADHD, persistent ADHD and no ADHD were scanned, the persistent ADHDers differed from the remittent ADHDers and non-ADHDers in how they processed rewards. There were also more subtle differences between the remittent ADHDers and the non-ADHDers, hinting that people that “grow out” of ADHD take a different developmental path to a similar but not identical destination as people who never have ADHD symptoms.
The emphasis on rewards is similar to a lot of ADHD research looking at how people with and without ADHD respond to rewards in different ways.
Personally, when I look at the continuity of my ADHD symptoms from childhood to adulthood, my feeling is that yes, a lot of it does come down to how I react to rewards.
If I had to summarize my experience of ADHD in a sentence, I’d say a lot of it comes down to easily feeling bored and understimulated, causing me to seek out rewarding, interesting, stimulating things that make my brain wake up – while neglecting everything that doesn’t fit these criteria.
When I was a kid, I got in trouble a lot in school. Not because I wanted to make life hard for my teachers, but because I would get bored and end up on impulse doing the things I wasn’t supposed to do instead of the things I was.
As an adult, the specifics of my symptoms are different, but not because it feels like my ADHD itself has changed that much. I still end up doing the things that give the reward my brain is hungry for, to the detriment of the important but boring things that don’t. It’s just that my environment is different.
The good news is that I’m not expected to sit in a classroom all day every day. I’m constantly thankful for that!
The bad news is that adulthood brings a whole slew of understimulating but essential responsibilities. I’d list them out, but I don’t want to remind myself of the things I probably should be doing instead of writing this blog post – or you of the things you should be doing instead of reading it for that matter!
If you’re an adult with ADHD, you might notice a similar thread of continuity from your symptoms in childhood to adulthood. And if you do, please comment – I’m interested to hear how your ADHD has changed over the course of your life.
If you’re a parent of a child with ADHD, however, you might have a more practical question on your mind: is there anything I can do to increase my child’s chances of ditching their ADHD symptoms in adulthood? After all, more than half of it may be genetics, but there’s still an environmental component, right?
There’s no one who can give a definitive, scientific answer to that. But my thinking is that the biggest service you can do for a child with either persistent or remittent ADHD is help them develop coping strategies.
For children with persistent ADHD, learning coping skills while they’re young will create more possibilities for them later in life. I was diagnosed as an adult, and I can vouch that while it’s possible to play catchup in this area, it’s not necessarily fun. As far as remittent ADHD, I’m not going to say that learning compensation strategies is going to contribute to the brain changes that make ADHD go away, but it probably won’t hurt!
The most important thing, though, is that even when ADHD stays around for a lifetime, it’s not the end of the world. We just have to acknowledge that ADHD can and often does continue into adulthood. Doing so is the first step to helping children develop coping skills that will make all the difference later in life and helping adults gain access to the support they need.