Recognising ADHD in Adults: Signs That Are Often Overlooked

ADHD (Attention Deficit Hyperactivity Disorder) is often thought of as a childhood condition — the restless child who can’t sit still in class, or the talkative student who blurts out answers. But ADHD is not limited to childhood. In fact, an estimated 5% of adults worldwide live with ADHD [2], though many remain undiagnosed.

For adults, ADHD can look very different from the stereotypical hyperactive child. Its symptoms are often subtle, misunderstood, or masked as stress, anxiety, or even personality traits. Recognising these overlooked signs is essential, because untreated ADHD can significantly affect relationships, careers, and mental health.

How Adult ADHD Differs from Childhood ADHD

ADHD symptoms usually begin before age 12, but the way they present changes with age.

• In children, hyperactivity tends to be more obvious — running, climbing, or constant movement.

• In adults, hyperactivity may look like inner restlessness, fidgeting, or difficulty relaxing.

While some adults do remain impulsive or highly energetic, many primarily struggle with inattention and executive function challenges: organisation, time management, planning, and memory. This shift can make adult ADHD harder to recognise.

Subtle Signs of Adult ADHD That Are Often Overlooked

Here are some of the less obvious — but very common — ways ADHD can appear in adulthood:

1. Chronic disorganisation and “time blindness”
   Adults with ADHD often underestimate how long tasks will take, run late to meetings, or struggle to prioritise. This isn’t laziness — it’s linked to the brain’s executive functioning differences.

2. Forgetfulness and working memory struggles
   Misplacing keys, missing appointments, or forgetting details of conversations are common. These memory lapses can be mistaken for carelessness rather than a neurological condition [7].

3. Emotional dysregulation
   Around 30–70% of adults with ADHD report frequent irritability, mood swings, or explosive frustration [9]. These responses are not simply “bad temper” but part of ADHD’s impact on emotional regulation.

4. Hyperfocus
   While distraction is well known, many adults with ADHD experience the opposite: becoming so absorbed in a task they lose all track of time [4]. Though it can be useful, it often disrupts balance in work and relationships.

5. Relationship challenges
   Interrupting others, forgetting important dates, or seeming inattentive during conversations can strain personal connections. These issues are frequently misunderstood as disinterest or irresponsibility rather than ADHD-related difficulties.

6. Restlessness instead of obvious hyperactivity
   Rather than climbing or running around like a child might, an adult may tap their feet, shift in their chair, or feel mentally “on the go” all the time [6].

7. Impulsivity in everyday life
   Adults may overspend, change jobs abruptly, drive recklessly, or speak without thinking — behaviours often misinterpreted as poor judgment rather than a symptom of ADHD [5].

Because these signs overlap with anxiety, depression, or stress, adults often go undiagnosed. This is particularly true for women, who are more likely to present with inattentive symptoms that are easier to miss.

Why Getting a Proper Diagnosis Matters

Without diagnosis, adults with ADHD may spend years blaming themselves for being “lazy,” “forgetful,” or “irresponsible.” In reality, their brains are wired differently. A diagnosis can:

• Provide clarity and reduce self-blame

• Unlock access to therapies, coaching, or workplace adjustments

• Help manage co-occurring conditions like anxiety, depression, or addiction [10]

• Improve relationships and daily functioning

Importantly, ADHD treatment isn’t one-size-fits-all. While stimulant medication and therapy are effective for many, not everyone responds to or tolerates them well. That’s where innovative treatments like Transcranial Magnetic Stimulation (TMS) come in.

How TMS Can Help Adults with ADHD

Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment that uses magnetic pulses to stimulate specific brain regions involved in attention, impulse control, and mood regulation.

At Smart TMS, ADHD treatment involves targeting the prefrontal cortex, an area strongly linked to attention and executive function. Treatment typically consists of 30 sessions across three to six weeks, each lasting around 30 minutes.

Benefits of TMS for ADHD include:

• Non-medication approach: An option for those who cannot or prefer not to take stimulants.

• Improved focus and attention: By enhancing neural connections through neuroplasticity.

• Better impulse control and emotional balance: Supporting self-regulation in daily life.

While TMS is still a newer approach compared to medication or CBT, research shows promising results in reducing ADHD symptoms and improving functioning. For many adults, it offers hope beyond traditional treatments.

Final Thoughts

Adult ADHD often hides behind disorganisation, forgetfulness, or emotional ups and downs. Recognising the subtle signs can change lives — helping people understand their challenges are not flaws, but symptoms of a neurodevelopmental condition.

If ADHD symptoms are affecting your work, relationships, or wellbeing, it’s worth seeking an assessment. Diagnosis opens the door to personalised treatment options, from therapy and medication to innovative approaches like TMS at Smart TMS.

It’s never too late to take that step. With the right support, adults with ADHD can move from frustration and self-blame toward clarity, balance, and confidence.

References

1. Prakash, J., Chatterjee, K., Guha, S., Srivastava, K., & Chauhan, V. S. (2021). Adult attention-deficit Hyperactivity disorder: From clinical reality toward conceptual clarity. Industrial Psychiatry Journal, 30(1), 23–28. https://doi.org/10.4103/ipj.ipj_7_21

2. Ayano, G., Tsegay, L., Gizachew, Y., Necho, M., Yohannes, K., Abraha, M., Demelash, S., Anbesaw, T., & Alati, R. (2023). Prevalence of attention deficit hyperactivity disorder in adults: Umbrella review of evidence generated across the globe. Psychiatry Research, 328, 115449. https://doi.org/10.1016/j.psychres.2023.115449

3. de la Peña, I. C., Pan, M. C., Thai, C. G., & Alisso, T. (2020). Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Subtype/Presentation: Research Progress and Translational Studies. Brain Sciences, 10(5), 292. https://doi.org/10.3390/brainsci10050292

4. Ashinoff, B. K., & Abu-Akel, A. (2021). Hyperfocus: the forgotten frontier of attention. Psychological Research, 85(1), 1–19. https://doi.org/10.1007/s00426-019-01245-8

5. Pollak, Y., Shoham, R., Scheres, A., & Dekkers, T. J. (2023). ADHD and Risk-Taking Behavior: Associations, Mechanisms, and Interventions. Autism and Child Psychopathology Series, 295–332. https://doi.org/10.1007/978-3-031-41709-2_12

6. Son, H. M., Calub, C. A., Fan, B., Dixon, J. F., Rezaei, S., Borden, J., Schweitzer, J. B., & Liu, X. (2024). A quantitative analysis of fidgeting in ADHD and its relation to performance and sustained attention on a cognitive task. Frontiers in Psychiatry, 15, 1394096. https://doi.org/10.3389/fpsyt.2024.1394096

7. Tolonen, T., Leppämäki, S., Roine, T., Alho, K., Tani, P., Koski, A., Laine, M., & Salmi, J. (2024). Working memory related functional connectivity in adult ADHD and its amenability to training: A randomized controlled trial. NeuroImage: Clinical, 103696. https://doi.org/10.1016/j.nicl.2024.103696

8. Minear, M., Coane, J. H., Cooney, L. H., Boland, S. C., & Serrano, J. W. (2023). Is practice good enough? Retrieval benefits students with ADHD but does not compensate for poor encoding in unmedicated students. Frontiers in Psychology, 14, 1186566. https://doi.org/10.3389/fpsyg.2023.1186566

9. Astenvald, R., Frick, M. A., Neufeld, J., Bölte, S., & Isaksson, J. (2022). Emotion dysregulation in ADHD and other neurodevelopmental conditions: a co-twin control study. Child and Adolescent Psychiatry and Mental Health, 16(1). https://doi.org/10.1186/s13034-022-00528-0

10. Choi, W.-S., Woo, Y. S., Wang, S.-M., Lim, H. K., & Bahk, W.-M. (2022). The prevalence of psychiatric comorbidities in adult ADHD compared with non-ADHD populations: A systematic literature review. PLOS ONE, 17(11), e0277175. https://doi.org/10.1371/journal.pone.0277175