Untreated ADHD in Adults: How it Affects Job

Leetal Platt had been working in film for several years when she decided to make the switch to fashion. She studied the field in programs in the U.S. and Europe, then began picking up assistant designer and sewing jobs in 2016.

But the switch was a sharp one, and between the new 9-to-5 schedule and the hours of menial tasks ― assistant designers do a lot of data entry ― she found herself floundering.

“I kept messing up at work,” she says. Challenges included prioritizing tasks and hyper-focusing on some while missing others. Time management was suddenly difficult. “I just couldn’t be relied on to get to work on time. I was always late for everything.”

She knew she could sew and design beautiful apparel, and she’d excelled in film. Suddenly, though, in this new environment, she couldn’t function. “I would literally get fired for not showing up on time,” she says.

As she tried to piece together what was happening, Platt, who is in her 30s and based in Boston, started noticing friends post Facebook updates about getting diagnosed with attention-deficit/hyperactivity disorder. After spending some time researching it and getting tested shortly before the pandemic, Platt’s suspicions were confirmed: She was diagnosed with ADHD.

Her story is not unusual. Adults with untreated ADHD “change jobs or lose jobs more frequently” than those without it, says Dr. Lenard Adler, a psychiatrist and director of the Adult ADHD Program at NYU Langone Health. The disorder impairs the very abilities adults need to succeed in the contemporary workplace.

‘It is a paralyzing sort of distraction’

ADHD is a neurological disorder that impairs the executive functions in the brain that enable you “to filter distractions, prioritize tasks, set and achieve goals, and control impulses,” according to Harvard University’s Center on the Developing Child.

The disorder is not “an episodic thing,” says J. Russell Ramsay, associate professor and co-director of the Adult ADHD Treatment and Research Program at the University of Pennsylvania. It’s a chronic condition that’s “probably with you from early on.”

How ADHD plays out in adulthood can differ from person to person. At work, it could display as regularly missing deadlines, procrastination, and impulsivity, like interrupting your boss during a meeting.

“For me it is a paralyzing sort of distraction,” said New York Times bestselling author Jenny Lawson. “Sometimes it feels like I’ve literally been drugged. When it’s bad I often struggle to remember simple things, including things as basic as my zip code. I start a project and then drift off to another one I suddenly remember is late and then forget to go back to the first one.”

This behavior can have significant financial and career consequences. “Adults with untreated ADHD are more likely to have a lower educational attainment, earn less money in the job, change jobs, or lose jobs more frequently” than other adults, says Adler.

ADHD is the ‘second most common neuropsychiatric disorder’ but often goes undiagnosed

An estimated 4.4% of adults in the U.S. have ADHD, according to a 2006 University of Michigan survey of 3,199 adults ages 18 to 44, which experts still cite today. People often think of the disorder as one afflicting children, but its rate among adults “makes it the second most common neuropsychiatric disorder after depression,” says Adler.

Most of the 8 to 9 million adults who have it “are undiagnosed and untreated,” he says. The reasons why vary.

As a child, your symptoms might not always have been glaring. “If you’re just having trouble paying attention and underperforming and not interrupting in the classroom or getting out of your chair,” says Adler, the adults around you might not pick up that something is wrong.

As undiagnosed children become undiagnosed adults, and “as the life gets more complex, the symptoms and impairments tend to come forward,” he says.

Another reason ADHD may go undiagnosed in adults is that, among clinicians, “it’s still a niche specialty,” says Ramsay.

“As many as 80% of adults with ADHD have at least one coexisting psychiatric disorder, including mood and anxiety disorders,” according to a 2017 article published in the journal BMC Psychiatry. Anxiety and depression are “like the common cold in clinical training,” says Ramsay, and clinicians are well trained to assess for them. “ADHD, frankly, it is trickier.”

Platt had a history of depression, for example, and had been prescribed antidepressants. But after several years of treating her depression as she tried to make it in the fashion industry, “things just weren’t moving forward and [my therapist] was having difficulty understanding why,” she says.

She and her therapist ended up doing research on ADHD separately and eventually agreed Platt should get tested.

‘The first step is getting an accurate diagnosis’

Beyond the immediate, practical challenges of losing a job, undiagnosed and untreated ADHD can take a toll on self-image and what adults who have it believe they are capable of.

“One of the early popular books on adult ADHD,” says Ramsay, “was titled, ‘You Mean I’m not Stupid, Lazy or Crazy?!’ And I think that captures the essence of self-attribution” and how people with ADHD might see themselves before they understand that their brain chemistry is a little bit different.

Luckily, the disorder can be treated. “The first step is getting an accurate diagnosis,” says Adler.

Medications such as Adderall “can really be helpful for the primary symptoms of ADHD and somewhat for the executive function deficits,” says Adler. If even with the medication, you find you’re still having residual symptoms and executive function problems, Adler recommends cognitive behavioral therapy.

“CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way,” according to the Mayo Clinic.

Various organizational habits can help keep people on track, too.

Lawson uses a pink noise video she found on YouTube to drown out distracting noises and track intervals of work. “The pink noise video only lasts about 20 minutes, so when it ends I know I’ve actually worked for 20 minutes straight,” she says. “It can be really helpful to be able to see concrete accomplishments like that.”

Platt, who moved back home with her parents to focus on rebuilding her life after her diagnosis, is working on her own organizational habits. “I use the Pomodoro Technique nowadays, which is 20 minutes on, five minutes off, in order to get myself interested in tasks that I don’t want to do,” she says. She’s also started taking medication and is considering future career paths.

For Adler, it’s important to emphasize that adults are not at the mercy of their ADHD.

“If individuals are out there that they think they may have ADHD, be it from work-related issues, but also at home or in social settings, [go out] and talk to your health care provider,” he says. “There’s good treatment available.”