Written by

Dr James J Mulvany

The Myth of “Outgrowing” ADHD

A common misconception is that ADHD is something children “grow out of” as they mature. While hyperactive symptoms often decrease with age, ADHD is a lifelong neurodevelopmental condition, not something that simply disappears.

Rather than outgrowing ADHD, individuals tend to adapt to their symptoms over time, often developing coping mechanisms that help them function in daily life. However, the core challenges; difficulty with attention, executive functioning, and impulse control, often persist well into adulthood.

How ADHD Symptoms Change Over Time

Children with ADHD often display high levels of hyperactivity, impulsivity, and inattentiveness. As they enter adolescence and adulthood, hyperactivity typically decreases, but difficulties with focus, organization, emotional regulation, and task initiation remain.

Many adults with ADHD find that their symptoms manifest differently; instead of running around the workplace, they might struggle to sit through long meetings, meet deadlines, or manage daily responsibilities. This shift can make it seem like ADHD has “gone away,” when the symptoms have just evolved.

Compensatory Strategies, Masking, and Maladaptive Coping

Many adults with ADHD learn to mask their symptoms by adopting compensatory strategies. Some find ways to channel their energy into structured environments, choosing high-stimulation jobs, setting rigid routines, or using digital tools to stay organized. While these strategies can be effective, they do not eliminate the underlying challenges of ADHD.

For those who are undiagnosed or lack adequate support, maladaptive coping strategies can develop. Chronic procrastination, avoidance, perfectionism, or overworking can become default ways to manage tasks.

Some individuals turn to substance use, including caffeine, nicotine, alcohol, marijuana, and other illicit drugs, to self-medicate their symptoms. Stimulant-like substances (such as nicotine and caffeine) may provide temporary relief by enhancing focus, while depressants (such as cannabis or alcohol) may be used to quiet racing thoughts or reduce anxiety.

Research has shown that individuals with ADHD are at a significantly higher risk of developing substance use disorders compared to the general population. The impulsivity associated with ADHD can make people more likely to experiment with substances, while the executive dysfunction makes it harder to regulate use.

Cannabis is particularly common among adults with ADHD, as some report it helps with relaxation or sleep; however, excessive use can worsen motivation, working memory, and executive function. Illicit stimulant use, such as cocaine or methamphetamine, can also be a risk for those seeking to improve focus without access to proper ADHD treatment.

Recognizing these patterns is crucial. ADHD does not just “go away,” but early diagnosis and appropriate interventions can prevent harmful coping mechanisms from taking root.

The Role of Hormones

Hormonal fluctuations can significantly impact ADHD symptoms, particularly in women. During puberty, pregnancy, and menopause, shifts in estrogen levels can influence dopamine regulation, exacerbating issues with attention and emotional control.

Many women with ADHD report worsening symptoms during certain phases of their menstrual cycle, and those who were undiagnosed in childhood may only seek evaluation later in life when hormonal changes make their symptoms more apparent. This underscores the importance of individualised treatment approaches that consider hormonal influences.

Impact on Work and Relationships

While school-related difficulties may lessen with age, new challenges arise in adulthood. Workplace expectations such as meeting deadlines, managing projects, and handling administrative tasks can be particularly difficult for those with ADHD.

Additionally, interpersonal relationships may suffer due to impulsivity, forgetfulness, or difficulty regulating emotions. Many adults with ADHD struggle with maintaining stable employment or relationships, not because they lack intelligence or ability, but because their executive functioning deficits create obstacles that neurotypical individuals may not experience.

The Importance of Early Diagnosis and Support

ADHD is not just a childhood disorder, and the earlier it is identified, the better the long-term outcomes. Without a diagnosis, many individuals spend years blaming themselves for struggles they cannot control, often internalizing the idea that they are lazy, unmotivated, or not trying hard enough.

Early intervention whether through medication, behavioural strategies, therapy, or coaching can dramatically change this trajectory.

Supportive interventions in childhood and adolescence can help individuals develop healthier coping mechanisms and prevent issues such as chronic underachievement, low self-esteem, or mental health comorbidities.

Even if an individual does not require medication long-term, having access to the right tools early on allows them to build effective habits and strategies for managing their symptoms, reducing the risk of substance misuse and other maladaptive behaviours later in life.

Late Diagnoses in Adults

A significant number of adults receive their ADHD diagnosis later in life, often after years of struggling with unexplained challenges. This is particularly common among women, who are more likely to have been overlooked as children due to their symptoms presenting as inattentiveness rather than hyperactivity. Many adults only seek an evaluation after recognizing their struggles in professional or personal life, or after their child is diagnosed, leading them to see similar patterns in themselves. Late diagnosis can be both validating and overwhelming, as it sheds light on past difficulties while also presenting new treatment options.

Medication and Treatment in Adulthood

ADHD is highly treatable, and stimulant medications such as methylphenidate and amphetamines remain some of the most effective options for symptom management. However, treatment in adulthood often requires a more holistic approach, combining medication with therapy, coaching, and lifestyle adjustments. Cognitive-behavioural therapy (CBT) can be particularly beneficial in helping adults develop practical strategies for organization, time management, and emotional regulation. Additionally, exercise, mindfulness, and proper sleep hygiene can significantly impact ADHD symptoms.

Do Children Treated with Stimulants Need Lifelong Medication?

One of the most frequently asked questions from parents is whether children who take stimulant medication for ADHD will need to continue treatment for life.

The answer varies depending on the individual. Some children who receive early intervention with medication and behavioural therapy develop strong coping skills and may no longer require medication in adulthood. Others find that their symptoms persist, and that ongoing pharmacological support significantly improves their quality of life.

Rather than viewing medication as a temporary or lifelong requirement, it is more useful to think of it as a tool; one that can be adjusted or discontinued based on an individual’s needs at different stages of life.

For some, structured support in childhood allows them to build skills that eventually reduce their reliance on medication. For others, stimulant or non-stimulant medications continue to provide substantial benefits well into adulthood. The key is flexibility. Treatment should evolve with the person’s needs, rather than being seen as an all-or-nothing approach.

Executive Dysfunction Doesn’t Disappear

Many adults with ADHD continue to struggle with executive function, including planning, prioritisation, and motivation. While some individuals develop external supports such as structured schedules, accountability partners, or digital reminders these strategies are not a cure.

The underlying neurological differences that cause executive dysfunction remain present, which is why ongoing management is essential. Some adults find that they can manage their symptoms without medication by relying on structured systems, while others benefit from a combination of medication and behavioural interventions.

ADHD and Coexisting Conditions

It is common for adults with ADHD to also experience coexisting conditions such as anxiety, depression, or sleep disorders. These conditions can complicate diagnosis and treatment, as some symptoms overlap.

For example, chronic procrastination in ADHD can be mistaken for depression, and restlessness can resemble anxiety.

A comprehensive treatment plan that addresses both ADHD and any coexisting conditions is crucial for optimal symptom management.

Thriving with ADHD

Despite its challenges, ADHD is not a barrier to success.

Many adults with ADHD possess unique strengths, such as creativity, hyperfocus, adaptability, and resilience.

With the right support whether through medication, therapy, ADHD coaching, or lifestyle adjustments individuals with ADHD can thrive in their careers, relationships, and personal pursuits. Rather than focusing solely on deficits, a strengths-based approach can empower those with ADHD to harness their abilities and build fulfilling lives.

At Pandion Health, our team of experienced child and adolescent psychiatristsbehavioural paediatricianspsychologists , therapists, and ADHD coaches are here to support you.