Five reasons why ADHD is often diagnosed later in life

The British actor, comedian, and screenwriter Simon Pegg has opened up about his recent ADHD (Attention Deficit Hyperactivity Disorder) diagnosis, revealing that it “confirmed a lot of stuff that I’d [he’d] been wrestling with”.

The 56-year-old, who is perhaps best known for his roles in films such as Hot Fuzz and Shaun Of The Dead, spoke about the diagnosis during an appearance on the podcast I’m ADHD! No You’re Not.

Speaking on the podcast, the actor explained: “There was a lot of build-up and suspicion and it just took a while actually to get there.

“It confirmed a lot of stuff that I had been wrestling with and that I had been attributing to character faults.”

He added: “I felt like it was something that had come on in later life because I wasn’t a naughty child.

“I’ve had bouts of depression in my adult life since 18 and I thought maybe it had come on with that.

“Maybe over the years with therapy and medication – whatever – I’ve been treating the symptoms and not the cause of why I feel that way.”

But Pegg is far from alone. Many people discover that they have ADHD during adulthood.

With this in mind, we spoke to Dr Asif Bachlani, adult and neurodevelopmental consultant psychiatrist and divisional medical director at Cygnet group private services, who outlined five common reasons why ADHD is often diagnosed later in life.

1. Adulthood strips support systems away

Bachlani explains that during childhood and adolescence, support systems provided by parents and school schedules can mask executive dysfunction caused by ADHD.

“ADHD is often missed in childhood because of what we call ‘scaffolding’, which is the support systems that you or the people around you create,” highlights the psychiatrist.

Therefore, when people with undiagnosed ADHD enter adulthood and face greater responsibilities, underlying difficulties can become more visible and disruptive.

“As you get older, you’re expected to be much more independent and managing day-to-day life gets much more complicated. You have to do more with less support, and that cognitive burden increase can become really challenging for someone with ADHD,” says Bachlani.

He adds that ADHD evaluations and diagnoses frequently peak during major life transitions.

“When you get married, change jobs or have kids, you’re doing something completely new which creates extra pressure on your brain’s executive functioning, which is when ADHD symptoms such as being forgetful and easily distracted, can become more prominent,” says Bachlani.

2. Subtle symptoms are often missed until later in life

“ADHD can be quite subtle, especially if you’re intelligent and high functioning,” says Bachlani. “When people think about ADHD symptoms, they tend to immediately think about concentration issues, distraction and hyperactivity.

“Therefore, inattentive symptoms related to ADHD, such as staring out the window, and things like messiness and poor management, which are related to executive dysfunction, are often missed.”

These more subtle symptoms of ADHD particularly fly under the radar in women.

“A big cohort where ADHD is often missed in childhood is in women and girls,” adds Bachlani.

“The classical view of ADHD is boys running around and climbing up trees, and obviously you can have hyperactive girls and women, too, but in general ADHD tends to be a bit more contained and less obvious in girls and women.”

3. Coping mechanisms can be adopted to mask symptoms which can delay diagnosis

Bachlani highlights how many people mask ADHD symptoms and adopt coping mechanisms to manage signs of hyperactivity, such as fidgeting, which can delay diagnosis until later in life.

“Fidgeting can be managed by doodling in books, or playing with hair bands, or playing with Blu Tack,” says Bachlani.

4. Greater public awareness has driven many adults to seek ADHD assessments later in life

“There’s definitely been a shift and an increased awareness about ADHD in recent years,” says Bachlani.

“When I was training, many people thought of ADHD as a childhood/adolescent condition that people could grow out of. It only became more accepted and common for people to be diagnosed with ADHD as an adult from 2008 onwards.

“In addition, lots of people have started talking about their diagnosis of ADHD later in life on social media, including celebrities, which has raised awareness about it and has lead to more people seeking evaluations.”

5. Many parents realise that they have ADHD after their child receives a diagnosis

“When children go through the ADHD assessment process and parents hear the questions that a clinician is asking their son or daughter, it can cause them to think ‘Oh my God, this is just like me’,” says Bachlani.