Why millions of adults with ADHD struggle to get treatment

More than 15 million U.S. adults have currently been diagnosed with attention-deficit/hyperactivity disorder, or ADHD, according to a recent CDC report. The report also noted that most adults with ADHD struggle with access to treatment for the condition. Ali Rogin speaks with Maggie Sibley, a clinical psychologist and professor of psychiatry and behavioral sciences, to learn more.
Laura Barrón-López:
ADHD, or attention deficit hyperactivity disorder, impacts the lives of nearly one in nine children in the U.S. And while the disorder is often associated with kids, it can affect people of all ages. Ali Rogan has more on the diagnosis and treatment of adult ADHD.
Ali Rogin:
More than 15 million U.S. adults currently have an ADHD diagnosis, and only about half of them receive their diagnosis before the age of 18. Those are the findings of a recent CDC report looking at the state of ADHD among adults in the US.
The report also notes that most struggle with access to treatment for the condition. Maggie Sibley is a professor of psychiatry and behavioral sciences at the University of Washington School of Medicine. She’s also a clinical psychologist at Seattle Children’s Hospital.
Maggie, thank you so much for joining us. Why are so many adults who have ADHD not diagnosed when they are children?
Maggie Sibley, University of Washington School of Medicine: This is a pretty interesting finding that we’re seeing coming out of the CDC. And if you look closer, it seems like there are certain people, especially women and people who are a little bit older, when ADHD might not have been as much on the public’s consciousness that are mostly responsible for this.
And we see that ADHD looks different in girls. And so we see that people who may not have been recognized when they were younger grow up, learn about what ADHD is and then often start to recognize it in themselves.
Ali Rogin:
You mentioned that it can be different in girls, but what about differences in the ages? Does it manifest itself differently in adults than it does in children?
Maggie Sibley:
So the core symptoms of ADHD, which are difficulty paying attention, which can look like carelessness, forgetfulness, disorganization, and difficulties in hyperactivity or impulsivity, which can look like having trouble thinking before you act, or being a really high energy person in a way that can get you in trouble, that stays the same no matter how old you are.
But the ways it interferes with your life can really change based on what period of your life are in. Hyperactivity in a young child can be running around and jumping on chairs and on furniture. Hyperactivity in an adult might be having a really active mind, not being able to settle down and relax. It might be taking on too much and then getting overwhelmed. So we see it basically coming out in different parts of people’s lives depending on how old they are.
Ali Rogin:
How has our understanding of ADHD in adults changed over time? What have we learned? What important things inform our understanding of how it presents in adults?
Maggie Sibley:
We really only realized that ADHD lasted into adulthood in most people in the last 20 years. And what we learned was that ADHD is a disorder that actually most people don’t grow out of. And when you become an adult, it can interfere with your work. It can interfere with your interpersonal relationships. It can also interfere with things like your financial stability and your health.
And so it’s really important for adults with ADHD to get diagnosed and get help so. So that it can prevent more serious problems from happening for them down the road.
Ali Rogin:
What about tools like smartphones, the Internet, social media? Do those modern tools exacerbate some of the symptoms of ADHD?
Maggie Sibley:
We’re all distracted, probably by the electronics in our world around us. But it’s really important to know that not all distraction and not all distractibility is ADHD. So ADHD is generally a biologically determined chronic condition that people have their entire life. They’re going to be experiencing those symptoms whether they’re in the age of smartphones or whether they’re not.
But if a person doesn’t have the symptoms of ADHD outside of the chaotic world that they’re living in, if you could take all that away and the person kind of goes back to a normal state, then we would not say that person has ADHD.
On the other hand, I think we are seeing, and I’ve seen census data on this in the last couple years, that more people feel they’re having trouble concentrating in their life.
But if you go to a good doctor who knows the difference between environmentally determined concentration problems and ADHD, they’ll be able to help you sort out whether or not this is a diagnosis that’s a fit for you, or whether you need to make some lifestyle modifications to help with your distractibility.
Ali Rogin:
And why are so many adults, though, who have been diagnosed with ADHD struggling to get the proper treatment?
Maggie Sibley:
Out of the pandemic we saw a huge spike in help seeking for ADHD, but the demand for care has far outgrown the amount of care that’s available. And so we’ve seen a stimulant medication shortage in this country over the last couple years. People haven’t been able to get medications because there’s been a higher demand for them than supply that’s available based on the quotas that the government sets on them because they’re a controlled substance.
We’ve seen wait lists for people to get psychological care that have been months and even years for people. And so people, you know, are realizing that they have this need for treatment. But we don’t have enough providers out there who are trained in ADHD care to meet their demands.
Ali Rogin:
Experts in this field are working now on guidelines to help better treat adults with ADHD. Why are those guidelines going to be important once they’re put in place?
Maggie Sibley:
It’s going to provide a compass for providers who want to learn how to treat ADHD well but haven’t known exactly how to do that. It’s tough to make diagnoses of ADHD in adults. So when we have clear guidelines on how to’s for professionals for good diagnosis and treatment and we start providing trainings at a society wide level on how to implement those guidelines, we’re going to see the standard of care in this country hopefully rise up pretty high. And that’s what we’re really looking forward to about those guidelines.
Ali Rogin:
Professor Maggie Sibley with the University of Washington School of Medicine, thank you so much.
Maggie Sibley:
Thank you so much.