Risks of undertreating – consequences for adults
- Lars Lien
- Dec 8, 2020
- 6 min read
Updated: 2 days ago
Undertreating ADHD (Attention-Deficit/Hyperactivity Disorder) can have significant and far-reaching effects on mental health, relationships, and overall quality of life. While treatment (including medication, therapy, and lifestyle modifications) is not a cure, it can significantly mitigate the symptoms and help individuals lead more productive, fulfilling lives. Addressing ADHD early and appropriately reduces the risk of developing many of these secondary issues, allowing adults with ADHD to better manage their symptoms and reach their full potential.
There are both minor and major life-threatening concerns with untreated ADHD in adults and I will start with the more minor issues though these might be important enough for the person that experience the problem. Minor might be concerns at job, in the family, comorbid somatic and psychiatric diagnosis. The major concerns are increased suicidality, traffic and other accidents, drug abuse and involvement in criminal behavoir.
In Norway patients might complain about their treatment or lack of such and get compensated. One the fasted growing reason for people to complain is that they get the diagnosis and treatment too late. On the other hand, there are also young adults who often due to specific job seeking (police, military) want their ADHD diagnosis to be reconsidered and removed. Speaking to many people who got the diagnoses as adults a frequent statement is that the most important is to be diagnosed as they then know they were different from siblings or friends during childhood and adolesces.
From both a political and patient perspective many mental health disorders lead to reduced productivity. The case of ADHD is no exception as individuals with untreated ADHD often struggle with time management, staying organized, and meeting deadlines, leading to decreased performance at work. People with ADHD symptoms often encounter job instability due to forgetfulness, poor impulse control, and difficulty with focus that can contribute to problems with job retention or frequent job changes. Untreated ADHD can prevent individuals from reaching their potential, as they might miss opportunities for growth due to distractions or inefficiencies in their work.
Persons with ADHD are at increased risk of anxiety and depression. There might be several reasons for this, but chronic struggles that come with untreated ADHD - like feeling overwhelmed, failing to meet expectations, or experiencing constant self-criticism - can lead to anxiety, depression, and feelings of inadequacy. Many with ADHD also reports of low self-esteem and adults with undiagnosed or undertreated ADHD may internalize their difficulties and develop poor self-worth, believing their challenges are due to laziness or personal failings, rather than recognizing the neurobiological factors at play. Also, everyday tasks like managing household chores, paying bills on time, or keeping track of personal items may become overwhelming or chaotic without proper treatment. Procrastination is a hallmark of ADHD, and when untreated, it can lead to unfinished projects and chronic feelings of frustration or guilt and extreme frustration in the family.
The higher stress levels with constantly battling symptoms like distractibility, forgetfulness, and impulsivity might also result in heightened stress and burnout. Often these problems also lead to relationship issues and interpersonal conflicts. ADHD symptoms like impulsivity, forgetfulness, and difficulty staying focused during conversations can lead to misunderstandings and frustration in relationships. Partners or family members may feel neglected, misunderstood, or that the adult with ADHD isn't "trying hard enough." In the end this might end up in social isolation. Difficulty maintaining relationships and following social norms can result in social withdrawal, making the individual feel increasingly isolated.
Without proper treatment, ADHD may lead to neglect of personal health, including poor diet, lack of exercise, risky sexual behavior and irregular sleep patterns. Additionally, untreated ADHD has been linked to a higher risk of substance abuse as individuals may self-medicate with drugs or alcohol. The ongoing stress of managing untreated ADHD can have physical health repercussions, including elevated blood pressure, gastrointestinal issues, and other stress-related conditions. ADHD often makes it harder to stay focused and organized when trying to learn something new, which can limit educational and personal growth opportunities and the possibility to engage in lifestyle changes.
Moving now to the more major problems with untreated ADHD and we start with the increased accident risk. Many studies have shown that adults with ADHD have a higher risk of encounter traffic accidents and any accidental injuries. This may be due to the difficulty of maintaining attention while driving, higher impulsivity leading to taking risky decisions such as driving recklessly or engaging in risky behavior that can result in dangerous situations. The increased use of alcohol and drugs might also be an important factor connected to traffic accidents.
Research has shown that adolescents with untreated ADHD are more likely to engage in delinquent behavior. They are also more likely to be involved with the criminal justice system at an early age. Children with ADHD may struggle to succeed in traditional educational settings due to issues with attention, organization, and following instructions. This can result in academic failure, which in turn may lead to feelings of frustration, anger, and alienation from peers and authority figures. Children and adults with ADHD may have difficulty forming and maintaining healthy social relationships due to symptoms like impulsivity, distractibility, and inappropriate behavior. Peer rejection and social isolation can contribute to feelings of low self-worth, which might lead some individuals to seek acceptance in deviant or criminal subcultures.
Some statistics show that half of inmates in prisons might have ADHD. The relationship between ADHD and criminality is complex and multifaceted. While ADHD itself does not directly cause criminal behavior, certain symptoms of ADHD-such as impulsivity, inattention, and poor self-regulation-can increase the risk of engaging in behaviors that may lead to criminality. One of the core symptoms of ADHD is impulsivity-acting without thinking about the consequences. This can lead individuals with ADHD to engage in risky behaviors, including criminal acts, without fully considering the legal or personal consequences.
The impulsivity and emotional volatility common in ADHD can make young people more likely to act on suicidal thoughts, especially if they feel overwhelmed by academic pressures, peer rejection, or family conflict.
Adults and adolescents with ADHD may struggle to regulate their emotions, leading to sudden outbursts, irritability, and aggressive behavior. In certain contexts, this emotional dysregulation can manifest as violence or aggression, which might result in legal problems. People with ADHD may have difficulty following rules or adhering to societal norms, particularly in environments with rigid structures like school, work, or the justice system. This can lead to conflicts with authority figures, increasing the risk of involvement in criminal or disruptive behavior.
Adolescents with ADHD are particularly vulnerable to suicidality, as adolescence is a time of heightened emotional and social challenges. The impulsivity and emotional volatility common in ADHD can make young people more likely to act on suicidal thoughts, especially if they feel overwhelmed by academic pressures, peer rejection, or family conflict. ADHD symptoms such as impulsive behavior, hyperactivity, or difficulty focusing can make adolescents more susceptible to bullying and social exclusion, both of which are major risk factors for suicidal ideation in youth.
One of the most significant risk factors for suicidality in people with ADHD is the co-occurrence of depression. Studies have shown that individuals with ADHD are more likely to develop mood disorders, particularly depression and anxiety, which are strongly linked to suicidal thoughts and behaviors. The feelings of frustration, failure, and hopelessness that often accompany ADHD can contribute to the development of depression. Adults with untreated ADHD may face difficulties in their careers, leading to chronic job instability or underachievement. The resulting financial or professional difficulties can be a source of ongoing stress, which may increase vulnerability to suicidal thoughts.
Individuals with ADHD are at higher risk of developing substance use disorders, which can serve as a form of self-medication to cope with the symptoms of ADHD or the emotional pain associated with it. Alcohol and drug use can increase impulsivity and lead to self-destructive behaviors, including suicidal attempts. Those with ADHD who abuse substances may be at risk of accidental overdose or engaging in reckless behavior that could lead to self-harm or fatal outcomes. Substance abuse often worsens underlying mental health conditions like depression and anxiety, further increasing suicidality risk. □
