ADHD Awareness Month: ADHD diagnosis for older adults
In recent years, Attention-deficit hyperactivity disorder (ADHD) has received increased recognition and understanding. Generally, people are moving away from thinking of ADHD as a “naughty boy syndrome” towards a better, more rounded understanding of how ADHD can present in different people. We still have a long way to go, but awareness of ADHD in schools is increasing and early recognition and interventions are leading to improvements in management of symptoms for many young people. Somewhat less talked about is the steady increase of ADHD diagnosis in adults nearing or at retirement age.
This month is ADHD awareness month, a great opportunity to shine a spotlight on diagnosis on ADHD in older adults who are approaching retirement age or retired at the point of diagnosis. As an assistant psychologist working in ADHD diagnosis at The Retreat in York, I would like to make it clear that whilst I have experience of assessing and speaking with a number of these adults, I don’t have first-hand experience of living with a diagnosis of ADHD. The best way to understand anything is always to speak with someone with personal experience. Having said that, I hope that my experiences of speaking with and assessing many adults with ADHD can provide some insight into the experience.
When I talk about my job, I’m often asked why someone would wait until retirement for an ADHD assessment. It’s true that as a neurodevelopmental disorder, ADHD symptoms will have been longstanding since early childhood. However, there are many reasons why ADHD may not have been recognised or diagnosed when someone was younger. I have spoken with many older people who struggled significantly in school but were told that “ADHD is just something that boys have” or that whilst they were finding themselves frequently becoming distracted and struggling to focus on tasks, it couldn’t be ADHD “because they weren’t running around shouting”. It’s also widely recognised that major life changes and transitions such as retirement can be challenging, particularly for people with neurodivergent traits. Adults leaving a structured supportive job and rigid daily routine may find the prospect of large amounts of unstructured time during retirement particularly challenging, and this may highlight difficulties that were previously managed with well-practiced strategies.
Generally, when adults are seeking assessment later in life, it’s because their difficulties weren’t picked up on or considered to be ‘disruptive enough’ when they were younger. Often these adults are not particularly loud, boisterous, and active, but may experience hyperactivity in a different, quieter way, less visible externally but with a higher emotional cost. I’ve assessed many adults who are hugely successful in their careers or personal lives, but can find themselves struggling to remain on task, drifting off during conversations, or devoting large chunks of time and attention to unrelated topics. They may not appear to be externally hyperactive but instead may spend lots of time daydreaming and have particularly active imaginations or constant streams of thought. It has been argued that different diagnostic criteria may be needed for adults over the age of 50.
Receiving a diagnosis of ADHD can be a hugely emotional experience for anyone, but arguably particularly for adults who feel they have lived much of their life “feeling different but not knowing why” or having their difficulties dismissed or downplayed by others. For some adults, the diagnosis comes with a huge sense of relief, a feeling of understanding how they have navigated life, and a newfound community of people with similar thought processes or life experiences. For others there is an overwhelming sense of frustration for their younger self who could have understood themselves and been supported better. Receiving a neurodevelopmental diagnosis is very much an individual journey. For some, it can feel like resolving a life chapter, and for others it can feel like starting a completely new book.
If you have been affected by any of the topics discussed in this article, you may find the following resources useful:
https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/
https://chadd.org/adhd-news/adhd-news-adults/more-older-adults-receiving-a-new-adhd-diagnosis/
https://www.adhdfoundation.org.uk/
If this blog has led you to have questions about ADHD, or you would like to find out more about how we can support people living with ADHD, please get in touch by using the form below, or emailing york@theretreatclinics.org.uk or manchester@theretreatclinics.org.uk.