Are you born with ADHD?
When it comes to health conditions, is it nature or nurture? Some conditions seem purely genetic, others come as a reaction to external factors and experiences. The same can be true for mental health conditions. So which is it for ADHD?
The short answer: Genetic factors do play a significant role. While symptoms may not become apparent until age 3, there is evidence that points to some children having a genetic predisposition to develop ADHD, which is a neurodevelopmental disorder. But that’s just part of the story.
Read on for more information about what causes ADHD and what doesn’t cause ADHD. You’ll also find information about whether this mental health condition goes away and whether you can develop it as an adult.
What are the causes of ADHD?
There’s not one single cause of ADHD (attention-deficit/hyperactivity disorder) but studies have shown that the condition does run in families and that genetics play a major role. In fact, ADHD has a heritability of between 75-91%, which means the genes you inherit from your parents play a significant role in whether or not you’ll have ADHD. (It doesn’t mean that this is the approximate chance you have of developing ADHD). Certain environmental factors are important, too (more on that below) but they are not the only things involved.
The role that genes play in ADHD are complex and not entirely understood. Generally speaking, ADHD isn’t thought to be the result of a single “wrong” gene, but rather to result from small, common variations in a number of genes that add up over time and have a collective impact. The brain activity and structure of people who have ADHD also appears to differ from those of people who don’t, possibly as a result of genetic differences. Scientists are still researching why these changes to brain function and activity happen and how exactly they contribute to ADHD.
In addition to genetic causes, the following may also be causes or risk factors for ADHD:
- Lead poisoning
- Substance use disorders during pregnancy
- Premature birth
- Low birth weight
What doesn’t cause ADHD?
It’s worth restating that, according to current research, ADHD is largely the result of genetic differences. And, despite what many people believe, it’s not caused by things like
- Excessive sugar intake, screentime, or videogames
- Lack of personal discipline or willpower
- Bad parenting
ADHD isn’t the result of a child or adult’s behavior, in other words. In fact it’s the opposite: In certain circumstances, a child or adult’s behavior may be the result of ADHD.
Does ADHD go away?
The short answer is “probably, in some cases.” Studies of ADHD remission—basically, the lessening or disappearance of some or all ADHD symptoms—have pointed to a number of different answers for why some children seem to “outgrow” ADHD. For example, as time goes on, the brain might use different structures to make up for the challenges caused by ADHD. However, we don't fully understand how this happens or have specific numbers to explain it.
Some studies have shown that 55-70% of children with ADHD will experience remission in adulthood, with 25-48% of those adults continuing to experience mild symptoms—not intense enough to be considered clinical ADHD or qualify for an ADHD diagnosis. Other studies have shown that remission can be temporary, and that patients who experience remission may find that their ADHD comes back, goes away, and then comes back again in a zig-zag pattern.
Around 90% of adolescents and young adults with an ADHD diagnosis experience at least some period of time with lessened or no symptoms. Still, other studies have found that just under half of children diagnosed with ADHD will continue to have it in adulthood, with a majority of people having symptoms related to inattention and about a third of people experiencing symptoms related to hyperactivity and impulsivity.
To reiterate, if you do experience remission, you may still experience some symptoms of ADHD. But you may also not experience remission at all, as different people have different experiences of ADHD.
Whatever your particular experience, proper treatment, including therapy and medications, can help alleviate symptoms. If you have ADHD and are seeking care, or if you think you might have ADHD, consider taking Talkiatry’s free online assessment
Can you develop ADHD as an adult?
It’s a common misconception that ADHD only affects children. In fact, plenty of adults live with ADHD. Some of them were diagnosed as children, while others received their diagnoses later in life.
While you can be diagnosed with ADHD as an adult, some researchers have suggested that what can appear to be “adult-onset” ADHD may have been present—but masked or missed, or compensated for by environmental factors—in childhood. Adult ADHD symptoms can be more subtle due to their being more on the inattentive side versus the hyperactive side According to this line of thought, if you receive a diagnosis of ADHD as an adult, that may mean that you had ADHD all along. Still, some studies have shown that a large percentage of adults diagnosed with ADHD did not experience symptoms in childhood.
Generally speaking, though, to receive an ADHD diagnosis in the US as an adult, symptoms must have been present before the age of 12. In practice, however, different clinicians treat the question of adult-onset ADHD differently, and their views may continue to change as new research comes out. Regardless, the number of adults being diagnosed with ADHD is steadily going up. Currently it’s estimated that about 2.5-% of adults have been diagnosed with it.
Adults with ADHD are more likely to experience symptoms related to inattention than hyperactivity, though both are possible. Adults with ADHD may have problems getting good grades, holding a job, or advancing in their profession. They may also make careless mistakes and have trouble comprehending social cues and thus experience difficulties in maintaining relationships. Treatment in the form of stimulant and non-stimulant medications and cognitive-behavior therapy can help alleviate symptoms and improve overall quality of life.
On the other hand, if you’re an adult and think you have recently developed ADHD, you may instead be experiencing stress or dealing with other life factors that can cause symptoms that appear similar to ADHD. Other mental health conditions also share similar symptoms, which is why it’s important to talk to a professional, like a psychiatrist, who can give you a proper diagnosis.
If you think your symptoms might be related to ADHD but aren’t sure, taking Talkiatry’s free online assessment is a good first step toward clarity. Our psychiatrists can help come up with treatment options that work for you.
FAQs
Here are more questions about the genetics of attention-deficit/hyperactivity disorder.
What are the signs of ADHD?
The symptoms of ADHD can be broken down into two categories, inattention and hyperactivity. Symptoms related to inattention may include being easily distracted or not following through on instructions, while symptoms related to hyperactivity include a tendency to fidget and being unable to stay seated.
When does ADHD develop?
ADHD symptoms can manifest in children as early as age 3. In order for an adolescent or adult to be diagnosed with ADHD, symptoms must have appeared before the age of 12 and must be present in two or more environments (like school and home) according to DSM-5 criteria.
Is ADHD hereditary?
ADHD is hereditary, meaning that you’re more likely to have ADHD if biological family members have it. Still, environmental factors present before and after birth can play a significant role.
From a certain point of view, it doesn’t matter for you, as an individual, what causes ADHD. If you’re a person with ADHD who’s seeking treatment, or if you think you might have ADHD and are in search of answers, what matters is that you have access to a clinician who can help you.
If you’re looking for such a clinician now, taking Talkiatry’s free online assessment is a good place to start. We’re an online psychiatry practice that provides in-network care. We’ll make sure we’re the right fit for you and match you with a Talkiatry psychiatrist suited to your needs.
The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.
Dr. Michael Roman is currently a Staff Psychiatrist at Talkiatry. He completed his adult psychiatry residency training at the University of Pennsylvania. Dr. Roman is a board-certified Adult Psychiatrist and a diplomate of the American Board of Psychiatry and Neurology (ABPN).
Dr. Roman’s clinical practice centers primarily around medication management and psychopharmacological treatment approaches. He also specializes in a variety of psychotherapeutic modalities which he utilizes in conjunction with medication management in order to provide patients with the best possible treatment outcomes.
Dr. Roman’s curiosity for the studies of the human mind began with pursuing a bachelor’s degree in psychobiology at the University of California, Los Angeles (UCLA). He was intrigued by the way our mind, body, emotions, and behavior were intertwined to comprise our everyday life experiences. His interest in the intricacy of the human mind was deepened in medical school, and he received his medical degree from the David Geffen School of Medicine at UCLA. He completed his adult psychiatry residency training at the University of Pennsylvania.
Dr. Roman treats a wide spectrum of patients, but his primary clinical focus is treating mood disorders, ADHD, anxiety disorders, and PTSD. Dr. Roman also specializes in treating substance use disorders and possesses clinical expertise in implementing high quality motivational interviewing and motivational enhancing therapy.
