What Is Adult Attention-Deficit/Hyperactivity Disorder?

Attention-deficit/hyperactivity disorder (ADHD) is a mental health condition characterized by symptoms of inattention, disorganization, hyperactivity, impulsivity, or some combination of these. ADHD is commonly thought of as a childhood disorder, but many adults also live with ADHD.

There are different types of ADHD, which can change how it affects employees and their work. The American Psychiatric Association (APA) lists the 3 types of ADHD as follows:¹

• Predominantly inattentive type—meaning the person mostly or entirely displays symptoms of inattention or disorganization
• Predominantly hyperactive type—meaning the person mostly or entirely displays symptoms of hyperactivity or impulsivity
• Combined type—meaning the person displays equal or nearly equal symptoms of inattention or hyperactivity.

Symptoms of inattention or disorganization include:²

• Having difficulty focusing on tasks that require sustained attention
• Overlooking important details in work, school activities, or other tasks
• Failing to follow through on instructions
• Losing track of important items easily
• Becoming easily distracted
• Seeming not to listen
• Displaying frequent forgetfulness in regard to completing daily activities

Symptoms of hyperactivity and impulsivity include:²

• Excessive fidgeting
• Having difficulty sitting still or standing for extended periods or time
• Struggling to wait one's turn (such as while waiting in line)
• Often interrupting others in conversation or intruding during activities
• Talking excessively

It is not uncommon for people with ADHD to not receive a diagnosis until adulthood. To meet criteria for ADHD, the symptoms must occur in multiple settings (e.g., in the workplace, at home) and must be persistent (i.e., symptoms must occur for at least 6 months).²

How Adult ADHD Affects Employees and Employers

Adults with ADHD can experience impairments in many areas of their lives, which can lead to difficulties functioning and reduced quality of life.

Physical Effects

The core symptoms of ADHD are behavioral in nature but there are many links to physical conditions that can compound the behavioral symptoms of ADHD.

ADHD in adulthood has been linked to a wide range of acute and chronic medical conditions, many of which can be debilitating. These include migraine, immune system dysfunctions (e.g., allergies), sleep disorders (e.g., insomnia), digestive disorders (e.g., celiac disease), epilepsy, obesity, and asthma.^2,3

Psychiatric and Functional Effects

Adults with ADHD can experience difficulties with concentration, decision making, regulating emotions, and memory.⁴ As many as 80% of adults with ADHD also have another psychiatric disorder, often a depressive disorder, anxiety disorder, bipolar disorder, substance use disorder, or personality disorder.⁵

ADHD is also associated with an elevated risk of suicide. In a review of 57 studies, ADHD was linked to 3.5 times greater odds of thoughts about suicide (called suicidal ideation), 4.5 times greater odds of making suicide plans, 2.3 times greater odds of suicide attempt, and 6.6 times greater odds of completed suicide.⁶

Work-Related Effects

Distractibility, inattention, and disorganization at work can happen to anyone. However, workers with ADHD are especially vulnerable to these and other symptoms that can negatively affect their occupational functioning.

Consider the following examples of how ADHD can affect the workplace:

• Presenteeism — ADHD results in 21.6 days of lost work productivity per year.⁷
• Absenteeism — People with ADHD are estimated to miss 13.6 days of work per year.¹⁰
• Work productivity loss — The estimated productivity loss associated with ADHD is $28.8 billion.¹⁰
• Cost to employers — ADHD costs employers between $209 and $6,699 per person per year in lost wages, presenteeism, disability payments, and worker’s compensation payments.⁸

How Is Adult ADHD Treated?

The first-line recommended treatment for ADHD is medication, typically stimulants. The recent discovery of nonstimulant medication represents an additional treatment option for people who do not respond well to or cannot tolerate stimulants.⁹

Nonmedication treatment, such as psychotherapy (e.g., cognitive-behavioral therapy), behavioral interventions (e.g., making lifestyle changes like improving sleep hygiene), and social interventions (e.g., anger management, social skills training), plays a critical role in managing ADHD symptoms and is generally recommended in combination with medication.¹⁰

Because adults with ADHD commonly have other psychiatric disorders, treatment should also include management of those co-occurring disorders and symptoms via medication, psychotherapy, or both.

Tips for Employers: How You Can Help Employees with Adult ADHD

Having ADHD does not mean having to give up on career goals and aspirations, and employers play an important role in this by creating a work environment that helps emphasize employees’ individual strengths rather than their unique challenges. Workplace interventions and accommodations can help ensure employees with ADHD get the help they need to optimize their health and functioning, including being better poised to succeed in the workplace.

Employers can help manage ADHD in the workplace through strategies such as:

• Ensuring workers with ADHD receive a diagnosis and access to treatment as needed. Perhaps the most obvious contributor to poor productivity among adults with ADHD is the lack of proper diagnosis and treatment. Employers can help address this need by promoting health insurance coverage and employee assistance programs that make access to mental health services easy and affordable.
• Creating an informed and supportive work environment. Individuals with ADHD may have endured a lifetime of criticism for being perceived as lazy or unmotivated, but for most people, those descriptors simply do not apply. Most workers with ADHD want to succeed, but disparaging attitudes can create a self-fulfilling prophecy in which people feel destined to fail. Employee education can be helpful in dispelling misperceptions that individuals with ADHD are sloppy or incompetent, which contribute to stigma and poor self-esteem. Positive reinforcement from supervisors about their employee’s talents and value to the company can go a long way in building confidence, which may translate to better productivity and greater success for the individual and the company.
• Offering occupational accommodations to help workers stay focused and engaged. For instance, employees with ADHD may benefit from more structured environments, such as regular check-ins from supervisors on the status of assignments to ensure time management is efficient and effective. Allowing employees to wear headphones while working can help reduce distractions from noises and conversations taking place around them. Seating or office arrangements that minimize distractions, such as moving desks away from windows or noisy doorways, can be helpful. Finally, encouraging intermittent breaks can help reduce restlessness.
• Thinking outside the box. Although medication is often tremendously helpful, individuals with ADHD still have to adopt their own particular learning and working style to prevent their symptoms from decreasing productivity. Employers can help them accomplish this by utilizing the Job Accommodation Network as a resource for additional ideas for workplace modifications. Simple strategies, such as helping people divide larger tasks into smaller, more manageable assignments and providing them with a checklist of current responsibilities, can empower employees by giving them the tools they need to succeed.

Resources

Managers, supervisors, and other employers can learn more about adult ADHD in the workplace through the following resources.

• The Job Accommodation Network is a federally funded resource center for employees, employers and others. They offer consultation, resources, and information on job accommodations.
• Economic Impact of ADHD in the United States: A study published in the Journal of the American Academy of Child and Adolescent Psychiatry found a substantial economic impact of ADHD in the United States.