You’ve passed school.You’ve completed your schooling. You held jobs. You built a life. But there’s always something that’s more challenging for you than it is for others: the deadlines you’ve caught yourself facing just to do last minute, the meetings where you’ve found yourself lost in translation, the projects you’ve initiated but never completed, the years you’ve heard, “just try harder.”
If this sounds familiar, you might be one of the millions of adults diagnosed with ADHD late in life, who lived for years (and sometimes decades) with an unrecognised disease with a name, a meaning and a treatment. An adult’s diagnosis of ADHD is not a failure of “catching up”. It is a beginning.
This article discusses the definition of late diagnosis, why so many adults remain undiagnosed, what an adult’s symptoms of ADHD are like, who you can see for a diagnosis and what steps you can take if you are in New Jersey.
What “Late-Diagnosed ADHD” Actually Means
ADHD is a neurodevelopmental disorder; that is, it begins in childhood, even if it is not diagnosed. Depending on the person, a late diagnosis can occur in the 30s, 40s or even 50s, and often years of adult life start to feel like something is a bit off. Others might realize they have it when they hear about ADHD in their own child and see a familiar description. Others have hit a snag at work, in a relationship or are just plain old tired and are asking for help.
The case of having ADHD and not being diagnosed until adulthood does not exist in the rare category. Studies have shown time and time again that a large number of people who have ADHD weren’t diagnosed in childhood, especially women, high performing individuals, and those with inattentive tendencies. What was designed to capture ADHD was an environment where children came across as disruptors, and many individuals didn’t fit the profile.
There are years that come before a late diagnosis. That provides them with context, however. Laziness was simply a lack of executive functioning. The feeling was a kind of anxiety but it was true that many times it was a constant cognitive strain where the person with undiagnosed ADHD managed without any structure. The diagnosis provides a new context for the past – and significantly, for the future, too.
Why So Many Adults Were Never Diagnosed
There are a number of reasons why diagnosed ADHD adults may have had their ADHD for years overlooked:
Symptoms were not as they had been anticipated. What the public thinks of when they think of ADHD is a hyperactive boy who can’t sit still. Often, adults with ADHD, and especially females, are inattentive: forgetful, disorganized, regularly late, and have difficulty maintaining attention on tasks that aren’t engaging. These signs and symptoms are not difficult to overlook, and it’s not difficult to shrug them off as character problems.
It was well hidden by a high-performance. Adults who were high school students, or high achievers, and went undiagnosed as children compensated. For years, ADHD symptoms can be masked by intelligence and/or a structured environment, as well as a person’s willpower. However, compensation comes at a price and can begin to fall apart if demands increase, such as when a new job is in prospect, when children are born, or when there is a significant life change.
Comorbidities were the emphasis. No one has ADHD by itself. Often there are also anxiety, depression and sleeping problems. People who go to the doctor for help with anxiousness receive treatment for their anxiousness – but not for their underlying ADHD. One of the most frequent causes for not being diagnosed with ADHD is treating the symptoms without understanding the underlying issue.
Diagnostic error due to gender bias. There is an unusually high likelihood of late diagnosis of ADHD among women. Girls’ inattentive symptoms are often ignored and childhood diagnostic rates for ADHD are much lower for women than for men. Many women don’t get a proper diagnosis until they grow up and years of believing their issues stemmed from anxiety, stress and emotional sensitivity have passed.
This is often seen as a story of endless frustration-women constantly running at full speed and yet always getting further behind. This isn’t a character flaw. This is the ADHD that goes untreated in a woman.
Symptoms of ADHD in Adults That Often Go Unrecognized
If you’ve been wondering if ADHD is the cause of your problems, these may be signs of ADHD in adults:
- Failure to respond to or maintain attention on tasks with attention demanding instructions
- Persistent disorganization for lack of effort or intent to keep up with it
- Losing things often, missing appointments or underestimating the amount of time things take
- Beginning projects enthusiastically, but only fully completing a few of them
- Please note that needing to prioritize time or keeping to schedules is challenging, such as routinely being late or underestimating/overestimating time requirements
- Emotionality and inability to manage frustration and/or criticism
- Racing thoughts, difficulty relaxing,mental restlessness
- Takes an overly intense focus on intriguing topics rather than common duties
- A history of job under-performance as opposed to appraisal of work performance
- Relationships that have been affected by forgetfulness, poor attention span, and/or impulsivity
For adults with a diagnosis of ADHD these symptoms are really perceived as a lack of inner control over themselves for most of their lives, as a personal failing. When people are finally given an accurate evaluation, the one thing they have in common is that it gives them a lot of relief to know they aren’t doing anything wrong.
The Emotional Reality of a Late Diagnosis
It’s not often a clear moment of insight a diagnosis of ADHD is given to a person who is older. It evokes a myriad of emotions that are complex and challenging – not something to be ignored – for most adults.
The relief is usually the first reaction – that there is finally an explanation, a reason that explains years of striving. But relief is often followed by grief. A Bereavement for the past of self-blame, for the reasons you could not be as good as people, for the assistance you missed when you were in need.
So too, is anger – that this important is being overlooked or ignored: anger at the system that overlooked or ignored; anger at the people who told you you were lazy or unfocused; anger at the years that went by while you coped and found some level of satisfaction with what you did but what you truly wanted was even more. These are all normal emotions when impacted by late diagnosis and are all valid.
What’s essential to remember is the following: Diagnosing something is not the end game. This is where it all starts to become about working with your brain as opposed to against it.
Who Can Diagnose ADHD in Adults in New Jersey?
After all, one of the most frequently asked search queries from adults is: ADHD – who can diagnose it? This is important because you may not be able to diagnose or misdiagnose if the evaluation is incomplete.
The below professionals are allowed to make an official diagnosis of ADHD in adults in New Jersey:
- Psychiatrists – Doctors qualified to make a full psychiatric assessment who could prescribe medicine. A psychiatrist for ADHD in adults is usually the best place to begin treatment for complex cases, especially when treatment for anxiety or depression are necessary, too.
- Psychologists – May conduct evaluations and assessment of neuropsychological skills for ADHD but not prescribe medication.
- Neurologists – Be able to evaluate ADHD especially when excluding neurological causes.
- Primary care physicians – May diagnose and prescribe in clear cut cases but are not optimal if there are comorbidities.
For late-diagnosed ADHD adults, a psychiatric evaluation is generally the most thorough and appropriate starting point – especially when anxiety, depression, or sleep problems are also in the picture. A qualified psychiatrist can evaluate the full clinical picture, make an accurate diagnosis, and build a treatment plan that addresses everything at once.
Getting Diagnosed with ADHD in New Jersey: What the Process Looks Like
New Jersey ADHD evaluations usually consist of the following process for the adult:
Step 1: Initial consultation
You provide information on challenges you are experiencing, your past experiences and why you are seeking an evaluation. The first step is to commence mapping your symptom pattern by your psychiatrist.
Step 2: Comprehensive clinical interview
It’s more than just a checklist. An assessment is comprehensive, looking at your childhood experiences, how you have manifested your symptoms across life contexts, what things could be exacerbating or overlapping and how this is affecting how you function.
Step 3: Eliminating other causes
Chronic anxiety, sleeping disorders, thyroid and depression can all mimic symptoms of ADHD. These are ruled out by a qualified psychiatrist or are found to be associated with another condition that needs to be treated first.
Step 4: Diagnosing and treatment planning
Once diagnosed, you receive a diagnosis and a customized treatment plan (which can include managing medications, developing behavioral strategies, therapy, and/or a hybrid approach).
Step 5: Continuing treatment for medications
Follow-up visits track your reaction to medicine, further lower your dose and make care of side effects.
By providing telehealth services, this process is available across New Jersey without needing a face-to-face evaluation, thus eliminating one of the most prominent barriers to evaluation.
Where to Start in New Jersey
The first step in seeking help for adolescents who think they could have a case of ADHD is to visit a psychiatric professional for a consultation who has experience in the treatment of ADHD in adults.
Dr. John C. Shershow, M.D. is an adult ADHD psychiatrist practicing in New Jersey, NY. His emphasis is on adults since each evaluation is tailored to what ADHD is like in adult life – and not what addiction was like in childhood, as that left many children untouched. Telemedicine is offered statewide in New Jersey
Let a little time pass and you will see that you aren’t unhappy any longer. The evaluation time is relatively short. When you get the answers it changes everything.
Make an appointment for an evaluation for adult ADHD right NOW. Call (212) 265-4310.
Frequently Asked Questions (FAQ)
Q. So what does it mean to be a late diagnosis adult ADHD?
It indicates that you had ADHD your whole life but didn’t receive the diagnosis when you were a child. Many adults are first diagnosed in their 30s, 40s or beyond when they have long noticed that dealing with focusing, organizing, and regulating their emotions has long been a challenge for them, but they had no idea why.
Q. What are the signs and symptoms of ADHD are in grown-up young adults?
Chronic disorganisation, problems maintaining attention, time management difficulties, impulsiveness, emotional regulation issues, hyperfocus (inability to focus for a prolonged period on other interests); pervasive sub-optimal functioning compared to ability.
Q. In New Jersey, who is able to diagnose ADHD in adults?
Experts such as a psychiatrist, psychologist or neurologist are able to make a formal diagnosis of ADHD in adults. When some other condition, such as anxiety disorder or depression is also present, an ADHD psychiatrist for adults is the most comprehensive option for those clients facing an ADHD diagnosis.
Q. Can ADHD be diagnosed without hyperactivity?
Yes. Mental fog, forgetfulness and trouble with focus are a part of the inattentive presentation of ADHD in adults but it is one most commonly missed.
Q. So many females are diagnosed late for ADHD, why?
Most symptoms of ADHD are do not include an excess of disruptive behavior, such that inattentive symptomology is more typical in girls. Women’s socialization also contributes to underdiagnosis of ADHD, causing women to feel compelled to regulate their symptoms.
Q. What happens after an ADHD diagnosis as an adult?
For most adults, there’s a combination of relief, sadness and clarity. This is followed by a specific treatment plan tailored to that patient that may involve medication management, cognitive behavioral therapy, and learning to live differently.
Q. Can I see a doctor for ADHD for a telehealth appointment in NJ?
Yes. You can have a telemedicine evaluation for adult ADHD in New Jersey, and get the entire diagnostic workup done at home. Dr. Shershow sees patients from New Jersey and New York via telehealth.
Q. Is there a possibility of having ADHD and anxiety together?
Yes. Anxiety is common in people with ADHD. For many of the late diagnosed adults, anxiety had been treated for years before ADHD was finally diagnosed. A thorough psychiatric evaluation will help assess both conditions and formulate a treatment plan that will treat them simultaneously.s.