People Unknowingly Living with ADHD: Undiagnosed and Misunderstood

Sarah's day starts out normal, she wakes up and heads to the bathroom to brush her teeth and wash her face, but her feet are cold, so she goes and puts on some socks and then heads to the kitchen to make breakfast. Afterwards, she sits down at her laptop and realizes she has a bill due, so she grabs her wallet. Back at her laptop she opens Amazon's website after seeing an ad for black Friday deals, and with wallet in hand she proceeds to take advantage of the situation and do some shopping. Not even ten minutes into being awake she has already forgotten two very important tasks without even realizing it due to her Attention Deficit Hyperactivity Disorder. The CDC estimates that 9.4% of children age 3-17 years old in the United States have ADHD and the National Institute of Mental Health estimates that 4.4% of adults have it. Sarah is not alone in her struggle. However, family therapist Marylin Wedge Ph.D. in her 2018 article Is ADHD Real? So Why Does Everyone Think It Is? claims that, just as her title suggests, ADHD does not exist. She is not alone when it comes to this opinion. While there are many people in society who say that individuals with ADHD do not have an actual mental disorder and that it does not exist, this leads to the the significant issue of how many individuals go undiagnosed while suffering from the symptoms, but this can be alleviated by raising awareness and dispelling the stigmas surrounding ADHD.

What exactly is ADHD? The CDC defines attention deficit hyperactivity disorder as a mental health disorder that causes above average levels of impulsiveness and hyperactivity, with symptoms such as: difficulty paying attention, a lower than average attention span, difficulty controlling behavior and staying focused. People associate ADHD with a stereotypical child who can not sit down for more than two minutes at a time without causing some sort of disturbance or losing attention like a dog who has seen a squirrel. While these symptoms do exist and may be prevalent in many cases, they are not the only symptoms of ADHD, especially in adults with the condition. At first glance these symptoms may be traits of someone who is lazy or less intelligent, but this is a common misconception. I can't focus on anything, my mind feels like it's constantly racing 24/7, and I feel like all I can think about is playing video games because it keeps my attention, Reddit contributor ItzDomos describes daily life in his post on the ADHD subreddit. There are many incredibly smart people who live with ADHD, and even they have most likely lost more debit cards than one person could count on both hands and feet. These symptoms are not simply a little fidgety or a little impulsive, they are extreme and sometimes uncontrollable.

In 1902 British pediatrician Sir George Still found, an abnormal defect of moral control in children, the first first instance of recorded ADHD symptoms. It would take more than sixty years after this event for individuals with the condition to finally be recognized as suffering from an actual disorder. This group of people living with symptoms including impulsiveness, extreme forgetfulness, problems paying attention, anger, and many more would not receive recognition until 1968 by the American Psychological Association. As time went on the diagnosis rates went up as doctors became more equipped to recognize symptoms as well as it being more widely accepted in the medical field through the 1990s (Holland and Higuera). The CDC estimates through nation-wide surveys that diagnosis rates have steadily risen from just over 6% in 1997 to just under 10% in 2017. It should also be noted that there are also disparities in the rates of diagnosis between races of color and whites for a couple different reasons. Cultural differences play a part but may not be the biggest factor in the US. Until recently, a student of color who has disruptive behavior was looked at as just a bad student, but when a white student exhibits the same behavior there must be something medically wrong with that student, says Raul Padraza, a counseling program specialist for the San Bernardino Unified School District.

Even though ADHD has been recognized as a mental condition there are still people who claim that it is not real, and their arguments do have some actual merit. However, by saying that it does not exist at all is damaging to those suffering and overall not true. There is no such thing as ADHD, says Wedge, ADHD is not a real disease, is one example of a damaging claim that could dissuade people from seeking treatment. Even though her main statement is inherently abrasive, her argument that many ADHD symptoms are caused by environmental factors holds some truth. The condition has been linked to a chemical imbalance within the brain but not every case shares that same imbalance, and this is because there are certain environmental factors that may cause ADHD like symptoms. Padraza believes based on his experience that there are cases of a chemical imbalance but also attributes symptoms to technological conditioning. Television shows, and now Youtube videos that many children watch may be thirty minutes long and able to hold their attention but within that thirty minutes there are multiple smaller segments. This is conditioning children to have smaller attention spans and changing the way they see life in the real world and not just in front of their technology causing ADHD symptoms (Padraza).

The first reason going undiagnosed and untreated is the main issue posing a threat to people with ADHD is how it affects their family and home life. Many people would assume that only an ADHD child can affect life at home, but that is not the case. Alla M. Hamed, a professor at the Iowa University Carver College of Medicine found that parents suffering from the condition are prone to frustration and struggle with controlling their emotions due to the nature of their symptoms. This creates tension between them and their children and can lead to more arguments and hostile interactions. It has also been linked to an increased risk of domestic violence between spouses (Hamed). There are a few different ways that a child with the condition can have a negative impact. Due to increased behavioral problems that increase stress within a household marital strifes and complications are incredibly common (myVMC). Obviously, this is a huge concern and a big reason why this group needs proper diagnosis and treatment. Strains on the family do not stop at parents and the affected child either, siblings are often negatively impacted as well. A small study of thirteen siblings found that ten out of those thirteen had complications placed on them from dealing with their ADHD siblings. Disruptive conditions varied between care taking and victimization. Siblings felt that they were responsible for taking care of their ADHD sibling while their parents were too exhausted but did not feel like they were being taken care of, especially when being treated poorly by their ADHD sibling (myVMC).

The second and equally as important reason why going undiagnosed and untreated is the biggest issue that individuals within this group face is how dramatically it affects academics. Researchers found that children treated with stimulants showed academic gains on several measures relative to children who did not receive treatment and this is important because some of these children continue to be affected into their teens and adult life (Hamed). It directly impacts their potential in school and into college. College is already difficult for those with no learning impairments and is made even worse for those with ADHD making it crucial to receive treatment. Dr. Russel Barkley, a clinical professor of psychiatry and expert on ADHD, reported that 21% of teens with ADHD skip school repeatedly, 45% of teens with ADHD have been suspended, and 30% of teens with ADHD have failed or had to repeat a year of school (qtd. in additude) These are shocking statistics, and they only account for the cases where the condition is diagnosed. Every student that exhibits severe ADHD symptoms and goes untreated is at risk of academic underachievement which can lead to being a burden on society.

Imagine a student named John, he is intelligent but finds it extremely difficult to find the motivation to start tasks or projects, but when he does find the motivation, he hyper focuses all his attention onto the project at hand. However, that project may not be school related and now any chance he had at getting that essay done is gone. He is labeled a procrastinator even though he at times feels like he has no control. Due to the nature of his symptoms John is at risk of becoming another high school dropout. 35% of teens with ADHD eventually drop out of school (attitude). Therefore, treatment such as behavioral therapy, or medication that would help him control his spontaneous hyper focus is crucial. High school dropouts are three times more likely to be unemployed based on recent Bureau of Labor Statistics data. However, it must also be taken into consideration that even if an individual with no high school diploma finds a job, they will be earning far less that someone who graduated (Amos). Lowering the rate of drop outs and decreasing the risk of unemployment within this group is imperative, and would benefit not only people with ADHD, but society.

ADHD poses an increased risk of crime and substance abuse among people within this group when gone untreated. Impulsiveness paired with financial issues that many people with untreated ADHD face are factors for increased criminal activity. Researchers found that ADHD was directly linked to an increase in both minor crimes such as speeding and traffic violations to more serious crimes that end in incarceration. The most prevalent serious crimes were theft, carrying a concealed weapon, and drug possession (Russel et. Al). Financial issues that stem from having struggled with school and having less education may be a factor for increased criminal activity, and the symptoms that held them back in school may also affect their performance in the workplace making it harder to hold a job. Individuals with untreated ADHD are also more likely to abuse controlled substances, nicotine and alcohol. It is important to note that the increased risk was not linked to the medication but specifically the untreated symptoms (Hamed). Every source found pointed to the fact that when untreated, ADHD leads to negative consequences through life and increases chances of criminal activity. Therefore, this is another area in which society as well as the group's individuals benefit from proper treatment.

There is one sole benefit when it comes to the increased dangerous driving habits that persist within this group when untreated, and it is increased funding for police through excessive tickets. Obviously, this is an issue and does not serve to benefit this group, society, or the people sharing the roads with them. When compared to non-ADHD individuals, teens with ADHD have two to four more times as many traffic violations and quadruple the amount of auto accidents. On top of that, they are seven times more likely to be involved in a second accident and found at fault at four times the rate (additude). When it comes to fixing driving habits medication alone may not be effective enough at fixing the problem. Therefore, the most effective treatment here would be behavioral therapy combined with medication. The medication gives them the ability to focus and pay attention to the road and the therapy allows them to take advantage of that focus and use it to their full potential. A decrease in these numbers through having more individuals receiving treatment would not only benefit themselves but other drivers as well. However, the police may need to make a few budget changes to make up for lost incomea cut-back on doughnutsis highly suggested.

The most important reason why this group's biggest issue is going undiagnosed is that the condition has directly been linked to a higher rate of mortality, and at even higher rates when going undiagnosed until adulthood. An incredibly large-scale study done by Dr. S??ren Dalsgaard, PhD. et al. for The Lancet medical journal followed two million individuals from the Danish registry with over thirty-two thousand of them being people with ADHD. These people were followed for a maximum of thirty-two years starting from their first birthday to 2013, and it was found that having ADHD doubled the chances of premature death. There were 107 premature deaths within the ADHD group with seventy-nine being from unnatural causes, and forty-two of those seventy-nine being accidental. They found that age of diagnosis also played a part in the results with rates of mortality increasing as individuals go undiagnosed into adulthood. Now John is not only at greater risk of academic underachievement but because he is eighteen years old and still undiagnosed, he is twice as likely to die early compared to someone diagnosed before the age of six and four more times likely compared to someone his age who does not have the condition (qtd in eureka). For all the people like Sarah and John, steps need to be taken to increase their chances of success and even survival within society.

Luckily, there are some different ways of dispelling the stigmas surrounding ADHD.

Works Cited

Wedge, Marilyn. Is ADHD Real? Psychology Today, Sussex Publishers, 24 Mar. 2018,

www.psychologytoday.com/us/blog/suffer-the-children/201803/is-adhd-real.

Hamed, Alaa M., et al. Why the Diagnosis of Attention Deficit Hyperactivity Disorder Matters

Frontiers in Psychiatry, vol. 6, no. 168, Nov. 2015, pp 1-6. PMC,

doi:10.3389/fpsyt.2015.00168.

https://all4ed.org/take-action/action-academy/the-economic-case-for-reducing-the-high-school-dropout-rate/ Amos

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4451079/ Russel

https://www.myvmc.com/lifestyles/the-family-impact-of-attention-deficit-hyperactivity-disorder-adhd/ myVMC

https://www.additudemag.com/the-statistics-of-adhd/ attitude

https://www.healthline.com/health/adhd/history holland and higuera

https://www.cdc.gov/ncbddd/adhd/timeline.html cdc

https://www.eurekalert.org/pub_releases/2015-02/tl-tlp022415.php the lancet article (eureka alert)

https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd.shtml national institute of mental health Personal interview Raul Padraza

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