Jyoti Kinghorn 
Attention-deficit/hyperactivity disorder, or ADHD is a developmental disorder that affects an individual’s attention span and causes hyperactivity and impulsivity.
Adult ADHD affects about 5% of Americans (8 million adults). About 60% of children who are diagnosed with ADHD still have it as adults.
Adults with ADHD struggle with many basic aspects of life such as making it to work on time, staying organized, controlling impulsive actions or words, and maintaining self-control.
All adults who have ADHD had symptoms of ADHD as children, but many were not diagnosed. Some may have had mild symptoms that got worse in adulthood when the demands of life and work put increased pressure on staying organized and focusing on the task at hand. Less than 20% of adults who have ADHD know it. Many suffer from the disorder in silence and manage their symptoms the best they can. However, the increased stress and lifestyle changes that occurred due to the COVID-19 pandemic worsened ADHD symptoms for many people.
Reasons for the surge
Adult diagnoses had been sharply increasing even before the pandemic. There was a 123% increase in adult ADHD diagnoses between 2007-2016 compared to previous years. But during the pandemic, ADHD diagnoses and prescriptions went further up. ADHD prescriptions in women appeared to increase exponentially. The numbers went up in men too, though to a lesser degree. Among different age groups, young people between the ages of 20-29 had the greatest increases in ADHD prescriptions.
The reasons for these increases range from lifestyle changes such as not being able to get enough exercise to increased screen time.
1. Reduced fitness
One of the consequences of the COVID lockdowns was the temporary closing of public gyms. Public health advisories to stay at home as much as possible also may have brought down other measures of physical fitness such as the daily step count and flights of stairs climbed. Physical exercise has profound benefits for everyone, but it is especially beneficial to those with ADHD.
In patients with ADHD, the brain experiences low activity of dopaminergic and noradrenergic systems. This results in lower levels of neurotransmitters which are chemical messengers that transmit information from the brain and nerves to the muscles. Stimulant medications increase the availability of dopamine and norepinephrine in the prefrontal cortex, and improve executive functioning and reduce symptoms. Physical exercise increases the release of neurotransmitters and thereby increases the availability of dopamine, epinephrine, norepinephrine, and serotonin in the brain. So physical exercise can have similar effects as stimulant medications, in addition to the other benefits to health.
Losing the ability to work out could have had an adverse effect on the well-being of some people with ADHD or borderline ADHD, and worsened their symptoms.
2. Loss of “structure” in lifestyle
Making routines and sticking to them is very hard for those with ADHD. Yet, once they put in the work and repeatedly follow a routine, the routine becomes a habit that helps ADHD patients cope. People with ADHD often heavily depend on these structures and routines to keep themselves organized. The break in the routine caused by the lockdowns and work-from-home scenarios could have been especially hard for those with ADHD as it required them to make new systems and routines.
3. Increased screen time
Excessive screen time in children has been correlated with an increased risk of developing ADHD. In adolescents, increased screen time in a given year worsened the effects of ADHD for the same person in that year. Television viewing and video gaming were both associated with worsening ADHD symptoms causing attention problems not only in the present but also in the future. Increased social media use was associated with the most severe symptoms (such as worse short-term memory and attention problems) which continued to worsen from year to year.
Due to the lack of socializing and recreational opportunities during the pandemic, many adults also spent significantly longer time on their screens. For those with ADHD, this could have caused a worsening of their symptoms.
4. Recognition of previously undiagnosed ADHD
For many people, the lockdown period of the pandemic was a period of self-reflection. Things that were ignored in the hustle and bustle of daily life were brought to the fore. This may have included paying attention to one’s ADHD symptoms. The topic of ADHD got a lot of attention on social media during the pandemic years. The increased attention may have made people with undiagnosed ADHD realize what is was that they had been dealing with their whole lives.
5. Incorrect diagnoses
ADHD symptoms are not unique and most of us show some symptoms of ADHD from time to time. This makes the condition difficult to diagnose for anyone other than a well-trained psychiatrist who studies a person’s complete medical history.
However, during the pandemic, appointments with psychiatrists had long wait lines and people found faster appointments with primary care medical providers including registered nurses. They may not have been equipped with all the knowledge it takes to correctly diagnose ADHD, which may have led to false ADHD diagnoses.
People also took to self-diagnosing their ADHD based on social media. But this can be misleading. According to researchers and ADHD experts who studied the 100 most popular ADHD videos on TikTok, more than half were misleading.
Spurious online drug companies may also have misdiagnosed ADHD and prescribed stimulants for profit.
Adult ADHD treatment and support
Medications, usually stimulants such as Adderall are used to treat ADHD. Some doctors prescribe non-stimulants or other drugs based on the patient’s symptoms and medical history. A treatment plan for ADHD can also include psychotherapy, including cognitive behavioral therapy. These approaches will not treat ADHD on their own but can help the patient work through their symptoms, better understand the bottlenecks that affect their daily lives, and brainstorm solutions that can make things easier, such as breaking down a task into smaller components and making daily digital and non-digital habits that increase productivity and support relief from symptoms.
The information provided in our blog posts is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.
