Adult ADHD ranks in the top ten for mental health searches鈥 for good reason.
According to recent statistics reported by (August 2023), more than 8.7 million adults in the U.S. have been diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). The rate has increased over the last two decades, from 6.1% of American adults to 10.2%. Since 2020, there has been a significant increase in adults seeking treatment for ADHD.
While it is clearly a hot topic in 2024, experts say it is important to look for the right explanation鈥攏ot just the easy one.
Braun Tueller, PA-C, MS, a physician鈥檚 assistant at Huntsman Mental Health Institute, has seen the rise firsthand. 鈥淚n the past two weeks alone, more than half of the outpatient patients I have treated have had ADHD as a chief complaint or as a co-occurring diagnosis,鈥 he says. 鈥淭hat鈥檚 an enormous number of people who are struggling with focus and concentration.鈥
Is COVID-19 to blame for the rise?
In 2024, it鈥檚 convenient to blame everything on a national pandemic. However, with a tidal wave of new adults presenting with symptoms of ADHD, Tueller considers the merit of three of COVID-19鈥檚 biggest impacts.
- Loss of structure. Having structure can be a coping strategy for those who live with undiagnosed ADHD. Office-bound adults and college students used to the rigidity and supervision of a formal work environment may have felt a profound loss of guardrails. Temptations and distractions aplenty, those dependent upon a formal routine have found it difficult to stay focused and honor work-life boundaries.
- Cognitive dysfunction. Those diagnosed with COVID-19, and particularly long COVID, have struggled with new onset and exacerbated cognitive dysfunction, says Tueller, who has examined the well-established and growing data on the subject.
- Social media awareness. The explosion of ADHD-related content on social media has resulted in increased awareness of the disorder. This has prompted more people to ask questions about their own lack of attention or impulse control. This was so common that for a while, Tueller was asking patients directly if they had identified their ADHD through social media sources. The answer was usually 鈥測es.鈥
Societal tendencies to consider
Tueller considers all theories to explain this rise in ADHD diagnoses, from food additives and genetics to a simple increased recognition of the disorder. Additionally, he believes a disconcerting societal tendency may be contributing to the trend. 鈥淲e鈥檙e moving towards a society driven by instant gratification,鈥 he says. 鈥淏eing patient, postponing gratification, future planning, and boredom tolerance are disappearing from our behavioral repertoire. In the absence of these things, ADHD symptoms will naturally manifest across the age spectrum.鈥
A holistic approach to diagnosis
More awareness and conversations naturally lead to more diagnoses. However, Tueller cautions, the increased attention is a confounding factor regarding diagnostic clarity.
Tueller aims to holistically learn about his patients. Much of his screening takes place via the patient鈥檚 history. ADHD is a neurodevelopmental disorder present in childhood, so he asks adult patients questions about early behavioral issues and academic performance to extract clues related to control and attention. When warranted, neuropsychological testing is conducted to better identify the disorder.
The importance of research
Tueller and others at Huntsman Mental Health Institute have working theories about the relatively new disorder, formally recognized by the American Psychiatric Association in the 1960s:
- Abnormalities related to frontal-subcortical function directly impact a person鈥檚 executive function and memory consolidation. From a neurotransmitter standpoint, the monoamine dopamine signaling seems to play a large role in all these functions. When the signaling is decreased or disrupted, an individual is more likely to struggle to focus attention and to encode stimuli into short-term memory.
- Amphetamines and methylphenidate increase signaling of the critical neurotransmitters. Unfortunately, rolling national shortages of ADHD medications create new challenges and require providers to spend time calling around to pharmacies and trialing alternate drugs. Patients are encouraged to plan ahead for refills. Medications alone, however, aren鈥檛 Tueller鈥檚 only option. He customizes a treatment plan for each patient, utilizing cognitive behavioral therapy for enhanced patient outcomes.
Worldwide, more brain research is needed, and funding for complex brain studies is decades behind research for other organs and disorders.
鈥淲e are just beginning to have 鈥榣ifers鈥 in the field鈥攑eople who were diagnosed and treated for ADHD from a young age. These patients provide opportunities to follow the data longitudinally over a lifetime, which can further inform researchers and offer additional hope for patients.鈥