How ADHD affects health by middle age

Living with ADHD as an adult can mean years of working overtime to keep up with everyone else. Because of challenges with executive function and focus, you might struggle with ADHD burnout, staying connected with friends, and parenting or caregiving responsibilities. By the time you land in middle age — between ages 40 and 65 — the stress can take a real toll on your mental well-being and physical health.

That’s the takeaway from new research out of the United Kingdom. Two studies, published in JAMA Psychiatry and Nature Mental Health, measured the mental and physical health of 17,000 people born in England, Scotland, and Wales in 1970 and tracked it over time.

ADHD wasn’t as well understood in the 1970s as it is now. So instead of only including kids with official ADHD diagnoses, the researchers looked through questionnaires to find people with a high number of ADHD traits. These include being easily distracted, talking excessively, and making careless mistakes in schoolwork. The researchers then analyzed how the responses to those questions would fit into the DSM criteria for assessing ADHD that clinicians use now.

They found that once kids with high ADHD traits reached 46 years old, 27% showed signs of mental distress. The rate was only 18% among those who didn’t have high ADHD traits.

That distress can contribute to physical health problems, too. The research shows that 42% of the group with high ADHD traits had more than one medical problem, like migraines, back pain, high blood pressure, diabetes, or cancer. The rate was 37.5% among those without high ADHD traits.

“ADHD is not something that is limited to childhood,” Amber John, Ph.D., an author of both studies and a psychology lecturer at the University of Liverpool, tells Understood. “It can carry lifelong health risks.”

But that doesn’t necessarily mean you’re destined for poor health if you have ADHD, John points out. Emotional support, feeling included, and healthy habits can all make a real difference when it comes to living well later in life. “Improving those things can help to reduce or minimize later health inequalities,” says John.

ADHD and mental health

ADHD affects more than just executive functioning and focus. Many people with ADHD report issues related to self-esteem, burnout, and stress. Plus, ADHD often occurs alongside other mental health conditions, like anxiety, depression, eating disorders, and bipolar disorder.

John and her team wanted to better understand the mental health of people with high ADHD traits over time. So they tracked their “psychological distress” from childhood to middle age. They looked for times when participants reported things like feeling isolated from friends, losing a job, and experiencing depression.

What they found reveals a great deal about how ADHD affects mental health. On average, people with high ADHD traits had more distressing experiences that built up over time, from ages 26 to 46, compared to their neurotypical peers. That was true even after the researchers considered how factors like sex, socioeconomic class, and race affected their experiences.

People with high ADHD traits were more likely to be excluded from society, which led to more distress. The types of exclusion they experienced included:

• Relational exclusion: Feeling like you have no social network or people in your circle who you can trust.
• Economic exclusion: Experiencing unemployment or carrying debt.
• Services exclusion: Not being able to access public services like policing, schooling, and health care.

These findings highlight why strong relationships, community, and accessibility can be so important for people with ADHD. “Making more accessible workplaces and education, and creating more inclusive environments where people with ADHD are able to thrive — this can have a [ripple effect] in terms of improving long-term health outcomes in people with ADHD,” John says.

ADHD and physical health

Research shows that ADHD impacts physical health at all ages. In fact, people with ADHD are more likely to develop or experience:

• Heart-related issues, like high blood pressure or heart disease.
• Sleep disorders or disrupted sleep schedules.
• Inflammatory conditions, like allergies, autoimmune disorders, and hypermobility problems.

John’s research found that people with high ADHD traits were more likely to have multiple physical health problems. This is partly because they were more likely to smoke, have a high body mass index (BMI), and experience mental distress. All of these have been linked to heart disease, high blood pressure, diabetes, and other health issues.

Why does ADHD affect health in middle age?

There are a number of reasons why people with ADHD can experience more or multiple health issues in midlife. For one thing, middle age is a life stage often filled with changes. And challenges with executive functioning and focus can make it more difficult to navigate those changes, points out Mariely Hernandez, Ph.D., a licensed clinical psychologist in private practice.

“By midlife, you might have family responsibilities, which can be very boring and can lead to burnout in a way,” she says. “It makes it harder for us to take care of ourselves, because we’re taking care of tiny humans. Also in our jobs, we may be getting promotions and [experiencing] job changes.”

Some adults may not even realize their ADHD is a cause of their physical or mental distress until they hit their 40s or 50s, says psychologist Justin Barterian, Ph.D., an associate professor at The Ohio State University Wexner Medical Center. In fact, many of Barterian’s patients come to him in their 40s for help managing stress or self-doubt related to work — and then get support to help manage other parts of their health.

“A lot of what we focus on is building strategies to help reduce the impairment caused by the ADHD symptoms,” Barterian says. That includes building routines around taking medication and making health care appointments. “If they’re prescribed medications for heart conditions or diabetes or weight conditions, we work on finding ways to reduce barriers to remembering to take the medication.”

How to improve midlife health with ADHD

Does having ADHD as a child or adult mean you’ll have poor health later on? The short answer is no. Many factors contribute to health, such as genetics, where you live, and your access to health and social services. There’s also lifestyle — the way you eat, exercise, use substances, and choose to live every day.

That said, having ADHD can make certain healthy habits harder to keep up with. And kids with ADHD are more likely to develop long-term physical and mental health conditions. But research shows that getting kids early support for ADHD and other health needs can set them up for better lifelong health. For example, offering sleep therapy to kids with ADHD and insomnia will lower their chances of having a sleep disorder later on. This could improve their ADHD symptoms and reduce their risk for health issues like heart disease.

And diagnosis, for all ages, is key. “Diagnosing ADHD, or at least identifying it, and leading people to help is a big part of combating some of these negative outcomes that we see,” Barterian says.

4 healthy habits for ADHD

Here are some practical strategies to start now that could have a real impact in middle age and beyond.

1. Don’t forget annual checkups.

Many people with ADHD have a hard time scheduling or remembering appointments. It can be easy to let a year go by without getting an annual checkup or regular teeth cleanings. But research shows that people who stay on top of their preventive health visits are less likely to develop bigger health problems later on.

2. Listen to your body, especially if you have “time blindness.”

Many people with ADHD experience time blindness. This is when you lose track of time or tend to underestimate how long tasks will take. You can get so absorbed in a task that you don’t notice when your body tells you to eat, drink water, or go to the bathroom, Hernandez says.

Over time, ignoring your body’s needs can add up to bigger health issues. For example, holding your bladder too often can lead to kidney problems. And delaying your bedtime can lead to sleep issues and related heart disease. “For people with ADHD, we know we can be capable of really incredible feats of productivity, but that cannot be your standard,” says Hernandez. “Leave room to take care of yourself so you can live long enough to reap the benefits of all your hard work.”

3. Set up routines for practical things.

If you have ADHD challenges with working memory or executive function, it can be hard to keep up with healthy daily routines. You might not always remember to take your medications or brush your teeth before bed. Setting alarms and other reminders can keep you on track, especially if your schedule changes.

4. Find support now.

It’s common to experience heightened emotions when you’re diagnosed with ADHD. And living with it can bring up feelings of self-doubt, frustration, low self-esteem, and other negative emotions. A trusted psychologist, psychiatrist, or other mental health professional can help you navigate those feelings. They may suggest you try treatments like cognitive behavioral therapy, medication, or other types of therapy for ADHD-related stress.

Barterian says that some of his patients with ADHD are afraid to ask for help because they’re worried about “being found out” by coworkers or facing judgment from friends. But working with a therapist or ADHD coach can help you find ways to manage your mental and physical health.

For example, you might find that working in an office can be distracting. Or that your natural sleep schedule makes it hard to keep up with your work schedule. Working with a trusted advisor can help you strategize to find options that work for you.

“Reach out to professionals to help address [health] problems sooner rather than later, so that the negative effects don’t compound and the distress doesn’t persist longer than it has to,” Barterian says.

This story was produced by Understood and reviewed and distributed by Stacker.