ADHD Questions
ADHD Questions
Can ADHD disappear naturally?
Charles Li, MD
April 20, 2023
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For most children, ADHD tends to get better as they age, though it doesn’t go away completely. ADHD symptoms can return from time to time.
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In some cases, ADHD can persist into adulthood. These cases have been linked with difficulties at home and work.
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Fortunately, ADHD is readily treatable for children and adults. Lifestyle factors, such as getting enough sleep, and exercising, have also been linked with better outcomes in ADHD.
ADHD tends to get better naturally in some ways as we get older. However, the improvement process can be slow and challenging. Based on the evidence, ADHD doesn’t naturally go away entirely for most people.
A study tracking ADHD over time found that most individuals with ADHD end up with fluctuating symptoms, showing improvement but continuing to have ADHD symptoms return from time to time.
Most with ADHD will experience some periods of improvement over time. However, recurrence is common.
According to the DSM, a professional manual in psychiatry, some symptoms of ADHD tend to change or become less evident as we age.
However, they also state that for many, ADHD symptoms will continue into adulthood.
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In most individuals with ADHD, symptoms of motoric hyperactivity become less obvious in adolescence and adulthood, but difficulties with restlessness, inattention, poor planning, and impulsivity persist. A substantial proportion of children with ADHD remain relatively impaired into adulthood.
DSM-5
Risk factors for persistent ADHD
Given that ADHD can go away naturally for some people but not for others, are there factors linked to ADHD going away or not going away?
One study found that the best predictor of whether ADHD will go away naturally is the severity of the symptoms.
Children with severe ADHD symptoms, and ADHD symptoms requiring medication, were around twice as likely to have ADHD stick around into adulthood.
Children with other mental health disorders, such as conduct disorder and major depression, along with their ADHD, were also less likely to have ADHD go away naturally.
A meta-analysis found that severe ADHD, ADHD treatment, conduct disorder, and major depressive disorder were all factors linked to someone having ADHD persisting into adulthood.
Researchers also looked at other potential factors and found that IQ, socioeconomic status, and gender were not linked with ADHD persistence.
A second study, looking at ADHD persistence, found similar results.
In addition to the factors above, this study also found that the parent's mental health could help predict whether ADHD goes away naturally.
Childhood Factors Affecting Persistence and Desistence of Attention-Deficit/Hyperactivity Disorder Symptoms in Adulthood: Results From the MTA
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As seen in previous studies, childhood ADHD severity predicted a risk for adult symptom persistence. Similarly, the effects of parental psychopathology and childhood psychiatric comorbidity on persistence are in line with previous studies. Parental mental health problems, and in particular maternal psychopathology has been shown to predict ADHD persistence in adolescence and young adulthood.
Consequences of persistent ADHD
Having ADHD continue into adulthood isn’t just inconvenient; it’s also correlated with higher risks of adverse outcomes.
Children in whom ADHD doesn’t go away have 6x the risk of difficulty in their relationships, 5x the risk of an anxiety disorder, and 3x the risk of difficulty at school and work.
These are only correlations. We don’t yet know whether persistent ADHD is causing these effects. As seen above, children with the most severe symptoms are also the most likely to have persistent ADHD, in which case these figures could represent only correlation, not causation.
Correlation and Causation
Can you prevent the negative effects of persistent ADHD?
Fortunately, some studies have shown that it is entirely possible to improve outcomes with persistent ADHD.
Exercising, getting enough sleep, not smoking, and graduating high school were significant protective factors in those with persistent ADHD. The study found that adults with ADHD who fit these criteria did not have many of the negative effects associated with persistent ADHD.
While ADHD was associated with a lower life expectancy, those with the following factors were significantly healthier than the typical ADHD patient.