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Hyperactivity & attention deficit disorder in adults.
Unveiling the invisible impact and overcoming strategie

HPA Magazine 23 // 2025

Attention Deficit Hyperactivity Disorder (ADHD), although currently more easily recognized in children, is often overlooked or misunderstood in adults, especially women, who sometimes deal with a quieter and underdiagnosed version of the disorder.
This article explores the specific challenges faced by adults with ADHD, highlighting their characteristics, coping strategies, and the intersection with comorbidities such as anxiety and depression.

ADHD in adults: a reality little talked about
When thinking about ADHD, it is common to associate it with childhood, usually with children with attention and/or behaviour difficulties. However, ADHD also persists into adulthood and can have a significant impact on professional, academic, and personal life.
In Portugal, it is estimated that the prevalence of ADHD in adults is around 2.5% to 5%, but many cases remain undiagnosed.
Lack of knowledge about ADHD in adults often results in late or non-existent diagnoses. Many individuals spend years feeling "different" from their peers, who are unable to understand the additional difficulty in everyday tasks that seem simple to them. Adults with ADHD sometimes face criticism, both at work and in personal relationships, being labelled as "lazy," "disorganized," or "irresponsible."
In reality, these difficulties result from a neurodevelopmental disorder that affects the ability to regulate attention, impulsivity, and organization.
Furthermore, the transition from childhood/adolescence to adulthood brings additional challenges that could overwhelm the adult. Without adequate support, ADHD symptoms become more evident as the demands of adult life increase: studies, demanding careers, financial and family commitments. The difficulty in reconciling, balancing, and dealing with all these demands leads to a cycle of frustration and a feeling of failure that is often misinterpreted.

While in children’s symptoms such as hyperactivity or even attention/concentration deficits are more evident, in adults ADHD can manifest itself in more subtle ways, such as:
• Difficulties in the ability to concentrate for long periods of time;
• Frequent forgetfulness and disorganization;
• Constantly postponing important tasks (procrastination);
• Increased sensitivity to stress and difficulties in time management;
• Difficulty maintaining stable interpersonal relationships;
• Low productivity in the work context;
• Abuse and/or dependence on substances (tobacco, alcohol, drugs) or activities (video games, gambling);
• Tendency to frequently change jobs or projects.
These symptoms not only impact self-esteem but can also lead to the development of other conditions, such as anxiety and depression. Many adults with ADHD report constant feelings of "being behind" or "always falling short." This self-inflicted pressure, coupled with a lack of external understanding, makes life as an adult with ADHD particularly challenging.
Another significant obstacle is the lack of information and training of health professionals. Many adults report seeking professional help, only to be misdiagnosed or told to "better discipline." It is essential to promote greater knowledge about ADHD in adults, enabling early diagnoses and effective interventions that transform the lives of these individuals.

ADHD, anxiety, and depression: A complex relationship
There is a clear link between ADHD and conditions such as anxiety and depression. As adults, the difficulty in meeting daily demands and the constant feeling of failure can contribute to the development of these conditions.
ADHD and Anxiety:
• Excessive worry: The inattention and impulsivity associated with ADHD can create a cycle of excessive worry, especially in social and professional settings.
• Difficulties Managing Tasks: A lack of organization can generate a constant feeling of being overwhelmed, which can lead to symptoms of anxiety.
ADHD and Depression:
• Low Self-Esteem: Repeated failure to meet deadlines, achieve goals, or maintain relationships can result in a negative self-image and depression.
• Social Isolation: The difficulty in interacting socially and the feeling of "being different" can also contribute to isolation, a risk factor for depression.

Studies indicate that more than 50% of adults with ADHD have some type of associated mood disorder, such as generalized anxiety or major depression. This comorbidity is not a mere coincidence but rather the result of a cycle of emotional and functional difficulties that reinforce each other.

Practical Strategies for Dealing with ADHD
From Assessment to Intervention
For adults with ADHD, small changes in everyday life can make all the difference. Below, we present some simple and effective strategies that could be applied taking into account the challenge:

Synergy between psychologists, psychiatrists and/or neurologists is essential for an integrated and effective approach to treating ADHD in adults. While psychologists offer support in specialized assessment and development of behavioural and cognitive strategies, psychiatrists and/or neurologists can provide appropriate medical monitoring, with the prescription of medications when necessary. This interdisciplinary collaboration not only ensures accurate assessment but also maximizes the positive impact of treatment, promoting lasting improvements in individuals' quality of life.

Female ADHD: Invisibility and Challenges
Female ADHD is an area that has only recently received more attention. Studies show that women tend to present a different pattern of symptoms, with a lower incidence of hyperactivity and more signs of inattention. This contributes to underdiagnosis, as behaviours are often attributed to other causes, such as stress, anxiety or personality, perpetuating the invisibility of ADHD in females.
The impact of ADHD on adult women manifests itself in a complex way, affecting multiple spheres of life. Social pressure to balance professional, family and personal responsibilities intensifies feelings of overload. Women with ADHD often report difficulty maintaining an organized routine, which leads to a constant cycle of frustration and guilt. This experience contributes to high levels of anxiety and increases the risk of burnout.
In terms of prevalence, it is estimated that around 3% of adult women have ADHD, but the numbers may be higher due to the complexity of the condition and the difficulty in making the diagnosis. Common features include:
• Forgetfulness and chronic disorganization;
• Constant feeling of overload;
• Anxiety related to productivity and performance;
• Higher incidence of professional burnout;
• Difficulties in managing deadlines and commitments;
• Relationship problems due to impulsivity or distraction.
Lack of adequate treatment can result in long-term complications, such as emotional exhaustion and greater vulnerability to mood disorders. It is essential to increase awareness about female ADHD, promoting more accurate diagnoses and personalized interventions that consider the specificities of adult women with this disorder.

Conclusion
ADHD in adults, especially in women, is a condition that is often overlooked but presents significant challenges for those who face it. Early diagnosis and implementation of appropriate strategies can provide substantial improvements in the quality of life of affected individuals. Furthermore, understanding associated comorbidities, such as anxiety and depression, is essential to offer more effective and comprehensive treatment, promoting psychological and emotional balance.