When I was unexpectedly diagnosed with ADHD last year, it turned my entire identity upside down. At 37, I’d tamed my restlessness and fiery temper, my obsessive reorganization of my mental to-do list, and my tendency to write and rewrite the same sentence for hours. Being this way was exhausting, but that was just who I was, or so I thought. My diagnosis reframed these quirks as symptoms of illness—importantly, ones that could be managed. Treatment corralled my racing thoughts in a way that I’d never before experienced.
But knowing that I have ADHD, short for “attention-deficit hyperactivity disorder,” has also opened my eyes to a new issue: Apparently, I am at risk of an early death. According to a study published last week that analyzed the deaths of more than 30,000 British adults, ADHD is linked with a lifespan that’s nearly seven years shorter for men, and about nine years shorter for women. Nine years! The findings suggest that the life expectancy of people with ADHD is nearly on par with that of smokers, and about five years shorter than that of heavy drinkers. When I sent the study to my husband, who also has ADHD, he texted back: “Damn.”
The findings are foreboding for many Americans. As of 2022, about 7 million American children ages 3 to 17 had at one point received an ADHD diagnosis as of 2022—1 million more than that same age group in 2016. And although ADHD may bring to mind kids bouncing off the walls, the number of adults with the condition has surged in recent years. ADHD’s rising prevalence has been met with some dismissiveness. As I wrote in 2023, questions have been raised about the validity of the recent spate of adult diagnoses, some of which were offered through dubious telehealth services that haphazardly doled out prescriptions. And ADHD is widely seen as mild, even mundane: Struggling to focus is hardly the same as say, schizophrenia, which has been linked to declines in life expectancy. But ADHD is “not as innocent as some people think it is,” Margaret Sibley, a psychiatry professor at the University of Washington School of Medicine who is not associated with the new study, told me.
No one dies from ADHD itself. Rather, symptoms such as concentration issues, emotional instability, memory issues, and impulsivity can touch nearly every aspect of life. Researchers have long known that people with ADHD are more likely to engage in risky behaviors, including substance abuse, unsafe sex, gambling, criminal acts, and dangerous driving. They are at a higher risk of depression, anxiety, and suicide. Difficulties keeping up with healthy lifestyle habits, such as eating well and exercising, lead to higher rates of obesity. All of these risks can chip away at a person’s life: Around the world, having ADHD is associated with lower socioeconomic status.
Some of the most life-threatening impacts of ADHD may be the least conspicuous, experts told me. Missing doctor appointments, forgetting to take medications, and struggling to navigate the health-care system can make existing illnesses worse. What leads children to be scolded for poor behavior can snowball into difficulties keeping a job, maintaining healthy relationships, and even staying out of prison. Forgetting to pay rent can lead to eviction; the sudden urge to race down a freeway could end in a crash.
The new study points to these sorts of risks to explain how ADHD can cut someone’s life short. Besides the shocking findings, what makes the research so notable is that it is the first to directly quantify years lost to ADHD. By matching diagnoses with death records, the authors calculated the mortality rate of people with ADHD, which they used to estimate life expectancy. A previous study quantified the effect of a childhood diagnosis on lifespan by extrapolating the effect of known risks and came to similar findings. The new research shows that “we have data related to the mortality of individuals—true data,” Sibley said.
The calculations aren’t definitive. The top-line life-expectancy numbers are part of a range that incorporates a margin of error: 4.5 to 9.11 years lost for males, and 6.55 to 10.91 years lost for females. “The estimate is not super precise,” Joshua Stott, an author of the paper and a clinical-psychology professor at University College London, told me. Nevertheless, even the most optimistic scenario discussed in the paper—a reduction of 4.5 years for men—is “still a big difference” in lifespan, Stott said.
Another caveat, he added, is that the study population may have been skewed toward people with additional health issues, possibly inflating the mortality risk. ADHD underdiagnosis is common in the United Kingdom, so it’s possible that those who had a diagnosis had sought it and were overall more in touch with health services. Perhaps the biggest limitation of the study, however, is that it doesn’t show whether treatment helps. Good data on who in the study was treated just weren’t available, Stott said.
Among the researchers I spoke with, there was no question that treatment would help. In fact, the diagnosis alone is even more important—an idea that transformed my fears into hope. Once people are aware of their condition, they can learn about the risks and adjust their lifestyle accordingly, David Goodman, an ADHD expert and a psychiatry professor at the Johns Hopkins University School of Medicine, told me. If ADHD can be diagnosed and managed, “a lot of this would disappear,” Stott said. Certainly, research suggests that drugs like Adderall can reduce ADHD’s effect on life expectancy. That should provide solace for many Americans: In 2023, two-thirds of American adults with ADHD were on medication or in behavioral therapy, or both.
The earlier a person knows about their disorder and the risks associated with it, the better. In a way, ADHD is like diabetes, Goodman said. When it’s treated early, living a relatively healthy life is doable. The longer it isn’t treated, the more the comorbidities pile up: heart disease, vision problems, nerve damage, kidney disease, and so on. With ADHD and diabetes, treatment can involve both drugs and lifestyle changes.
At first, my diagnosis brought relief. Then anger and remorse—that I had spent nearly four decades feeling drained and frustrated with myself when I could have managed my disorder all along. When I shared this with Goodman, he replied: “You and everyone else who gets diagnosed in their adult years.” Underdiagnoses aren’t limited to the U.K.; globally, they are common, particularly among girls and women. Underdiagnosis partly accounts for the growing number of adult cases. Given Stott’s findings, the uptick in adult diagnoses is a positive thing: It means those people have a chance to claim the years they might otherwise have lost. With diagnosis, “the goal is to diminish the regret that you have in the future, given the information and decisions you make in the present,” Goodman said.
But that requires a new perspective on ADHD. Although it has long been classified as a mental-health disorder, it is often seen as a stage that can be outgrown; eventually, the hyperactive child learns to sit still. The notion that ADHD is a serious lifelong disorder remains underappreciated; it’s relatively new, even in the research community. The condition has a dubious reputation among the general public: Just yesterday, Senator Tommy Tuberville lamented the bygone days when, to manage their child’s ADHD, “parents didn’t use a drug, they used a belt.” It is sometimes seen as a path to the recreational use of stimulants. Some scientists still contest the validity of adult ADHD itself, Sibley said: One recently framed ADHD as a false epidemic sparked by an overmedicalized society and self-diagnosis. Indeed, during the coronavirus pandemic, TikTok creators self-diagnosing ADHD led their followers to do the same; whether their assessments were right is anyone’s guess.
At times, I still question my own diagnosis, wondering whether my attention span is just victim to a maelstrom of forces: Texts, social-media alerts, email notifications, and the endless onslaught of news can make anyone feel chronically discombobulated. But I know now that ADHD is more than just a problem of attention; the relief I experience with treatment—from impulsivity and recklessness, angry outbursts, and frantic thoughts—is undeniable. For people with ADHD, the hope is that diagnosis can help disentangle a serious condition from the frenzied realities of modern life. Both are exhausting, but one, at least, can be controlled.
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