ADHD Life Span: How Long Do Symptoms Last?

ADHD and menopause are making headlines, renewing conversations about how ADHD symptoms can change as people mature. Evidence shows that ADHD symptoms generally decline with age, but for some people symptoms carry over from childhood to adulthood (Vos & Hartman, 2022).  

Because most ADHD research focuses on children, less is known about how symptom profiles change as people move into adolescence and adulthood. What do practitioners need to know about how ADHD looks and feels at different life stages? 

Early Childhood

ADHD is often classified in one of three types:

• hyperactive/impulsive, characterized by high energy, lots of movement, frequent risk-taking, and difficulty staying on task 
• inattentive, characterized by distractibility, trouble remembering, and difficulty following through on long-term or complex tasks 
• combined type, characterized by both inattentive and hyperactive/impulsive symptoms (National Institute of Mental Health, 2021) 

It’s important to note that these characteristics are based on diagnostic criteria. They don’t reflect the strengths and abilities associated with ADHD, including charisma, hyperfocus, and creativity, among others.  

ADHD symptoms can show up as early as the toddler years (Brown & Harvey, 2018). Young children with ADHD often have more externalizing symptoms, meaning those that are outwardly directed and easily observable. These symptoms include 

• being fidgety, restless, or overly active;  
• talking excessively; 
• interrupting or blurting out; 
• behaving impulsively; 
• losing things; and 
• having trouble with organization and follow-through on tasks (King et al., 2018). 

Behaviors like these can disrupt classrooms, which explains why ADHD is often diagnosed once children start school.  

It’s also important to note that sex and gender can affect how ADHD symptoms appear, even at this early stage. Inattention, for example, is more common among those assigned female at birth. Since inattention is less likely than hyperactivity to attract attention in a classroom, ADHD can be easier to spot in those assigned male at birth.  

Teen Years

Evidence explaining the relationship of puberty, hormones, and ADHD symptoms is conflicting. Some studies have linked hormone fluctuations to worsening ADHD symptoms; others don’t show a clear connection between the two.  

It is clear that ADHD symptom profiles shift in the teen years. Inattentive symptoms become more apparent, leading to academic difficulties as schoolwork becomes more demanding. Hyperactivity often declines. In adolescence, ADHD symptoms can lead to

• risk-taking; 
• early, frequent sexual experiences; 
• substance use; 
• anxiety and depression; 
• more frequent auto accidents among those who drive; and 
• higher risk of pregnancy and sexually transmitted infections (Antoniou et al., 2012; Curry et al., 2017;  Özgen et al., 2021; Norén Selinus et al., 2016). 

Learn more: Why It's So Important to Assess Executive Function in Children with ADHD

Adulthood  

ADHD symptoms persist into adulthood for 35%–65% of those diagnosed with the condition (Owens et al., 2016). Even so, in young adulthood, symptoms decrease for many people. When symptoms persist, ADHD can lead to 

• lower income, 
• greater risk of occupational disability, 
• more time lost from work, and 
• less educational attainment (Jangmo et al., 2021). 

Researchers think emotional dysregulation, school and discipline problems, anxiety, depression, and social rejection play a big role in these outcomes (Owens et al., 2016). It’s important to note, however, that people with ADHD often compensate for symptoms in ways that help them to adapt and build new skills (Merkt et al., 2015). 

In a 2018 review of the literature, Franke et al. described symptoms as “internal restlessness, ceaseless unfocused mental activity, and a difficulty focusing on conversation.” Researchers also noted problems with impulse control, attention switching, emotional responses, and problem-solving. 

Few studies focus on the ways ADHD affects people who are pregnant or postpartum. During these periods of intense hormonal change, people may notice

• greater distraction and more trouble focusing; 
• depression, especially as estrogen and dopamine levels drop; and 
• lower self-esteem. 

When a birthing parent has ADHD, it’s 20%–30% more likely they’ll need a caesarean section.  Many women who were incorrectly diagnosed with an anxiety or mood disorder earlier in life finally receive an ADHD diagnosis once their children do (Antoniou et al., 2021).  

Learn More: Lived Experiences—ADHD in Girls & Women

Later Adulthood

Researchers agree that, for many people, ADHD life span symptoms decrease with age. It’s important to understand, however, that research also shows ADHD is “under-recognized and under-treated” in older adults. Some researchers have referred to older adults as the “blind spot” in ADHD research (Vos & Hartman, 2022).  

It’s known that when estrogen levels drop during perimenopause and menopause, ADHD symptoms increase sharply for many women. Researchers think the surge in symptoms may be related to lower dopamine and lower estrogen levels. Trouble with focus or concentration, along with mood disorders, can result (Antoniou et al., 2021).  

Other Factors to Consider

Changing comorbidity profiles. ADHD often co-occurs with other conditions. At varying times, the symptoms of those disorders may also change. Symptoms of other conditions may overshadow ADHD symptoms or cause more functional problems at different life stages.  

Changing responses to treatment. Beginning in school-age children, medication is a first-line treatment, and it is associated with better lifelong outcomes. Even so, ADHD medications may need to be re-evaluated in pregnant or nursing people and in older adults taking medications for other health conditions. 

Key Messages

ADHD symptoms may look more like hyperactivity and impulsivity early in childhood, especially among people assigned male at birth. In the teen years, inattentiveness and risk-taking behaviors may become more prominent. For many, inattentiveness and lack of focus persist into adulthood, when changing hormones can cause symptom surges. Early intervention, treatment, follow-up, and compensatory skills can lead to better outcomes at every age. 

Related Assessments: 

• (CAARS) Conners’ Adult ADHD Rating Scales
• (ADHD-2) Attention-Deficit/Hyperactivity Disorder Test, Second Edition

Further Reading on ADHD

• The WPS In-Depth Guide Autism and ADHD 
• The WPS In-Depth Guide to ADHD
• Understanding the Complicated Interplay of Autism and ADHD
• How Autism and ADHD Can Disrupt Interoception
• How to Create a Sensory-Friendly Classroom

Research and Resources:

Antoniou, E., Rigas, N., Orovou, E., Papatrechas, A., & Sarella, A. (2021). ADHD symptoms in females of childhood, adolescent, reproductive and menopause period. Materia Socio-Medica, 33(2), 114–118. https://doi.org/10.5455/msm.2021.33.114-118 

Brown, H., & Harvey, E. (2018). Psychometric properties of ADHD symptoms in toddlers. Journal of Clinical Child & Adolescent Psychology, 48, 1–17. https://doi.org/10.1080/15374416.2018.1485105 

Curry, A. E., Metzger, K. B., Pfeiffer, M. R., Elliott, M. R., Winston, F. K., & Power, T. J. (2017). Motor vehicle crash risk among adolescents and young adults with attention-deficit/hyperactivity disorder. JAMA Pediatrics, 171(8), 756–763. https://doi.org/10.1001/jamapediatrics.2017.0910 

Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., Cormand, B., Faraone, S. V., Ginsberg, Y., Haavik, J., Kuntsi, J., Larsson, H., Lesch, K. P., Ramos-Quiroga, J. A., Réthelyi, J. M., Ribases, M., & Reif, A. (2018). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. European Neuropsychopharmacology, 28(10), 1059–1088. https://doi.org/10.1016/j.euroneuro.2018.08.001 

Jangmo, A., Kuja-Halkola, R., Pérez-Vigil, A., Almqvist, C., Bulik, C. M., D'Onofrio, B., Lichtenstein, P., Ahnemark, E., Werner-Kiechle, T., & Larsson, H. (2021). Attention-deficit/hyperactivity disorder and occupational outcomes: The role of educational attainment, comorbid developmental disorders, and intellectual disability. PloS One, 16(3), e0247724. https://doi.org/10.1371/journal.pone.0247724 

King, K. M., Luk, J. W., Witkiewitz, K., Racz, S., McMahon, R. J., Wu, J., & Conduct Problems Prevention Research Group. (2018). Externalizing behavior across childhood as reported by parents and teachers: A partial measurement invariance model. Assessment, 25(6), 744–758. https://doi.org/10.1177/1073191116660381 

Merkt, J., Reinelt, T., & Petermann, F. (2015). A framework of psychological compensation in attention deficit hyperactivity disorder. Frontiers in Psychology, 6, 1580. https://doi.org/10.3389/fpsyg.2015.01580 

National Institute of Mental Health. (2021). Attention-deficit/hyperactivity disorder in children and teens: What you need to know. https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-in-children-and-teens-what-you-need-to-know  

Norén Selinus, E., Molero, Y., Lichtenstein, P., Anckarsäter, H., Lundström, S., Bottai, M., & Hellner Gumpert, C. (2016). Subthreshold and threshold attention deficit hyperactivity disorder symptoms in childhood: Psychosocial outcomes in adolescence in boys and girls. Acta Psychiatrica Scandinavica, 134(6), 533–545. https://doi.org/10.1111/acps.12655 

Owens, E. B., & Hinshaw, S. P. (2016). Childhood conduct problems and young adult outcomes among women with childhood attention-deficit/hyperactivity disorder (ADHD). Journal of Abnormal Psychology, 125(2), 220–232. https://doi.org/10.1037/abn0000084 

Özgen, H., Spijkerman, R., Noack, M., Holtmann, M., Schellekens, A., Dalsgaard, S., van den Brink, W., & Hendriks, V. (2021). Treatment of adolescents with concurrent substance use disorder and attention-deficit/hyperactivity disorder: A systematic review. Journal of Clinical Medicine, 10(17), 3908. https://doi.org/10.3390/jcm10173908 

Vos, M., & Hartman, C. A. (2022). The decreasing prevalence of ADHD across the adult lifespan confirmed. Journal of Global Health, 12, 03024. https://doi.org/10.7189/jogh.v