Is it worth it getting an ADHD diagnosis in your 40s?
February 21, 2023 12:12 PM   Subscribe

In my forties, live a thriving life, my child is showing ADHD-adjacent traits and I have a lot of them too. Would getting formally diagnosed for ADHD help me at all?

I'm a 42 year old guy with a 4 year old kid. The kiddo has short attention span challenges and sensory seeking behavior like constant climbing and jumping that is much different from his peers the same age. He's been diagnosed with sensory processing disorder and is getting occupational therapy; his symptoms and behavior don't really align with the autism spectrum but line up closely with ADHD. We're working with him on that, so it's not my concern at the moment. But his behavior makes me wonder if I have ADHD.

I've been told by my wife and many people in my life that I probably have ADHD and don't know it. I grew up in a family where my parents were very hostile to discussing mental health at all so never got diagnosed as a kid. I've always had problems with attention span, focus and being organized. I ended up finding ways to manage this as an adult. I run a small business and can only do this by setting lots of guardrails I'm obsessive about following (timeblocking every day even when I don't have meetings, setting a ton of reminders online, using a very detailed record keeping system for when things skip my brain, etc).

My business does well but I lose things in the house and forget to do chores all the time unless I write them down in a very visible place. I'm very good at organizing and doing chores when I have a way of writing down to-do lists, but am hopeless otherwise.

Here's the thing: I found coping tools over time for the attention span issues I have, I function pretty decently in day to day life and have zero interest in medication.

My question: Would actually getting a diagnosis to see if I have ADHD or not be useful at all besides as self-knowledge that's interesting but not useful for everyday life?
posted by allthethings to Health & Fitness (25 answers total) 22 users marked this as a favorite
If you don't want a prescription, you could probably do just as well by reading through accounts of ADHD-specific coping strategies if you need anything (including just solidarity.) My wife got diagnosed in her early 30s and getting meds somewhat unexpectedly fixed a large part of her anxiety, because, as it turned out, anxiety was one of her main strategies for making things feel intense enough that she could focus on them, but other than that, she hasn't had any medical interventions for it.
posted by restless_nomad at 12:15 PM on February 21 [13 favorites]

I am hopeless in similar ways. I asked my doctor about this a while back and they said that I could probably get a positive diagnosis if I wanted to based on what I was describing. But also that unless the diagnosis itself was important for some reason, for instance medication or insurance stuff, there was no real reason to. Like you, I have identified these issues and worked with them, as I'm sure your kid will too with your support.

In your case I would only say that it might be nice if your kid is likely to get a diagnosis, that you have one too. That may help them understand that it is a trait and one that runs in the family, not a personal failing they need to correct.
posted by BlackLeotardFront at 12:32 PM on February 21 [1 favorite]

A surprisingly large number of my friends tell a story that goes like mine, which is, I'm a high-achieving professional in a very challenging career, and it turns out I've had ADHD the whole time. I have skills and strategies and systems and coping mechanisms and they worked great until sometime in my forties and, then... they... stopped working.

Could be a change in life circumstance, an illness, a hormonal shift (hellloooooo perimenopause!), or just having less energy because of growing older.

Running a small business seems like one of those professions where having ADHD can be a great asset, and you have the kind of flexibility that lets you work around a lot of the ADHD disadvantages, so it's not surprising that you are doing pretty well!

It's a great thing that you have recognized ADHD as a possibility. If seeking a diagnosis right now doesn't feel right, and your systems are keeping your life on the rails, then I don't think you need to get diagnosed. But keep an eye on things, and if you feel like you're working harder and harder just to stay afloat, or frequently finding yourself overwhelmed and burning out, then it might be time to see if your medical professionals think you can benefit from some meds and/or therapy.
posted by BrashTech at 12:33 PM on February 21 [15 favorites]

Being diagnosed with ADHD is a watershed moment for a lot of people. My ADHD diagnosis helped a lot in my twenties. But that's because I was younger and still struggling to find the coping skills I needed, which you... are not.

However, I'm in my forties now and I find myself going around on a similar question with autism. Based on reading and conversations with friends with autism and an OT who is a close friend specializing in autism, I'm about 95% sure I'm autistic. But given that my life is going pretty well personally and professionally these days, I'm not sure what a formal diagnosis would change. I think I've decided to blow it off for at least a while and just let it influence my reading. I mean, it's been very cool to learn things like how not being able to picture my loved ones in my head doesn't mean I'm dead inside, it just means I have face blindness, which is super common for autistic people..

Similarly, if you don't feel like pursuing medical treatment for this and are already dealing with your life pretty well, yeah I think you can skip the formal diagnosis. But I think about all of the elements of being ADHD that it's helpful to be able to put on a name on and I think there's definitely value in that. You should totally read say, Driven to Distraction by Hallowell or whichever other books appeal to you (though everyone starts with Hallowell for a reason). Go get a guided tour of your brain. Get a sense for where ADHD has insinuated itself into your life. It's self-knowledge you may take comfort in or gain benefit from later. Either way, totally worth it to learn about yourself in a new light.

Honestly, stop and read some books first is my advice for people who do want to get a formal diagnosis. Find out what you can about what it's all about.
posted by DirtyOldTown at 12:38 PM on February 21 [5 favorites]

Why not, I guess is the question? At the very least you'll be interacting with a medical professional who can give you some guidance regardless of the final diagnosis.

You grew up with a family resistant to discussing mental health, and having "zero interest" in medication is absolutely your choice, but I encourage you to open that door just a crack and see what's on the other side. Modern treatment for adult ADD (i think they've removed the H) is effective and nuanced. I'm like restless_nomad's wife - basic low-dose medications did wonders for my anxiety and focus. When I didn't have to work so gosh darn hard at all the tiny things just to keep functioning, my work/family/personal life improved dramatically.
posted by nkknkk at 12:38 PM on February 21 [2 favorites]

I've been told by my wife and many people in my life that I probably have ADHD and don't know it.

You say that you function well in your life, but what does your wife think? Folks with ADHD tend to have much higher divorce rates. It’s easy to think you’re functioning well, but have your partner disagree. I think this is especially true for situations where the man is the one with ADHD, since there is already a built in dissonance in chores and division of labor.

You mentioned that your business runs well due to the coping mechanisms you’ve put in place, but lose things around the house and have trouble keeping on top of chores. There have been times when I felt like I was on top of things, but was actually burning all of my executive function at work. This left very little of my focus available for chores, focusing on my relationship, and enjoying hobbies and other self care. Once I recognized this (due to my husband pointing it out!) I was able to adjust my meds to give me better afternoon/evening coverage. I share this to point out that it may still be worth exploring how well you’re actually doing, across all areas of your life. Are you just making it through, white knuckling your way through each day? Or are you actually thriving?
posted by bluloo at 12:57 PM on February 21 [21 favorites]

I was diagnosed in my 40s, and it helped me a bit at work (it helped me understand some big pictures things), but you know where it really helped? Home. You said you are forgetting chores at home sometimes and that your wife thinks you have ADHD. Since you are a man, married to a woman, with a kid, I suspect that your wife is mentioning this because she is taking on some of the burden of you forgetting your chores. And around your age is when some women start to get really fed up with this sort of thing. (In my marriage, it was my husband who was home more who would get so frustrated that I couldn't remember to clean up the dishes after dinner, for example. So I don't mean to suggest that this is always gendered in stereotypical ways.)

Work is fine, but is home fine?

Also, getting a formal diagnosis doesn't mean you have to get medicated. You could do a lot by reading up on ADHD even without a diagnosis. But I would suggest setting a time to have a real and sincere conversation with your wife about this, and the balance of things in your house, and where she feels like she might be picking up the pieces you miss. Good luck.
posted by bluedaisy at 12:58 PM on February 21 [13 favorites]

I know a few people close to me (including my husband) who got diagnosed as adults in the past couple of years and the general sense has been relief. What happened, uniformly, is all of them were very on top of things, had all of their coping mechanisms, were doing fine...until all of a sudden, some combination of things, usually involving now having a small child, was the straw that broke the camel's back, and the whole thing just fell apart. They got diagnosed, got on meds/in therapy, and it made a huge difference in their overall well being.

So, even if things are going OK now (and, echoing the comments to check in with your wife, please, having been on that side of things), having a diagnosis in place, and potentially, some support (a psychiatrist, a therapist) there if you need it in the future, is probably a good idea.
posted by damayanti at 1:03 PM on February 21 [7 favorites]

Came here to say what bluloo did - if people are pointing out that you might have ADHD, you may not be "functioning well" to their specifications. If it's coming from your partner, that's a potential red flag.

I've wondered for a long time whether I might have ADHD, but hadn't pursued it until recently. I spoke to my doctor and am trialing an ADHD medication. Too early to tell, but early signs seem hopeful.

So - getting diagnosed would be helpful, especially if you aren't limiting your options. But even if you're 100% opposed to medication, there are other things you can do that might be even better coping strategies than what you have in place, or are otherwise helpful for folks with ADHD.
posted by jzb at 1:13 PM on February 21 [1 favorite]

If you do decide to skip the diagnosis, remember you can still using the coping strategies, both at home and at work.

I'm probably nonneurotypical in some way, but not really aligning that well with any particular diagnosis. I find some of the strategies that autistic people use, and some of the strategies that ADHD people use, work well for me. So I use those strategies. A formal diagnosis would give you access to a few other options (medication, formal accommodations if you were in a corporate workplace, etc), but many of the options are available either way.
posted by nat at 1:30 PM on February 21 [2 favorites]

Thanks for asking this question because I've thought same about "is there a point in getting diagnosed at my age if I literally can't choke pills down my throat and meds are not an option?" My impression is that the only treatment is meds, meds, meds, so I wasn't really into getting diagnosed for that reason. I did try to get my HMO to pay for my out of pocket therapy (hahahahah nooooooooooo), which is why I did end up getting an "official evaluation" in which they made me fill out a survey and do some Zoom with some woman for a half hour.

I note that when I was officially getting evaluated by my HMO, which is notorious for not wanting to provide mental health care whatsoever, they said I was undiagnosable with anything. I probably have ADHD tendencies at the very least, but since I honestly answered that my ability to function throughout the day wasn't hampered (also I didn't indicate being outright suicidal/alcoholic/cutting myself/in dire distress right this minute...), I didn't count as having anything. So getting diagnosed with anything may not be as easy as you think if you can function through daily life without being completely incapacitated by your brain.
posted by jenfullmoon at 1:45 PM on February 21 [1 favorite]

A lot of your story sounds familiar to me. If I don't have a written to-do list I tend to forget stuff, and the only way I've recovered from having ruined my credit score years ago is by having reminders pop up for literally every bill I have to pay. And often I can hyper focus on stuff up until the point I absolutely can't, and in fact can't even sit still, which is a big ADHD thing. I was seeing a neurologist for my sleep issues and during one visit I asked him who I would see to talk about ADHD. He asked like two or three questions and said, "me. You'd see me." He gave me a test prescription of Ritalin on the spot, but I had to stop taking it almost as soon as I started because it made my heart race and gave me chest pains.

Since you have zero interest in medication and you're already self employed, it's not like a clinical diagnosis would give you access to any new accommodations. If you think a formal diagnosis would give you some valuable peace of mind, then sure, go get one. Otherwise I'm with everybody else saying that if you think finding some new coping strategies will help you, try the coping strategies.
posted by fedward at 1:52 PM on February 21 [1 favorite]

+1 you should ask your wife this question. A friend who's your age almost certainly has ADHD and it's a significant problem in his marriage, especially as his kids get older and have more activities / friends / stuff (they're older elementary age now). He was working with a "time therapist" for a while, if that's something that sounds like it might be helpful to you.

I've also found some helpful coping strategies for ADHD (I probably do not have it, but have some overlapping symptoms) on the internet, including this very site. Might be worth finding a new technique or tool to try for an area you have trouble with, and see if the benefits are bigger than you expected. Maybe you and kiddo can use related strategies and support each other in being consistent with them?
posted by momus_window at 2:36 PM on February 21 [2 favorites]

> A surprisingly large number of my friends tell a story that goes like mine, which is, I'm a high-achieving professional in a very challenging career, and it turns out I've had ADHD the whole time. I have skills and strategies and systems and coping mechanisms and they worked great until sometime in my forties and, then... they... stopped working.

This is exactly what I, a person diagnosed with ADHD in my 30s, came to say. Having a formal diagnosis means that you can more easily get medication or set up for therapy in the future if you find that you need it. If also gives you a right to disability accommodations from an employer if you need them -- you run your own business now, but what if you don't do that forever? It's also frankly just a relief to be validated -- which I say as the child of parents who handwaved my problems in school as "laziness" because I was "so smart." They also have a poor attitude about getting treated for mental health issues.
posted by desuetude at 4:44 PM on February 21 [3 favorites]

I just turned 43 and got diagnosed a little over a year ago. As others have suggested, I think asking your wife if she thinks it's worth it is a good idea but I'd like to address this specifically.

I found coping tools over time for the attention span issues I have, I function pretty decently in day to day life...

So did I. I work in the post-production industry on TV and movies and in my early/mid-thirties I went back to school to study computer science while still working. I graduated with a 4.1 GPA before being diagnosed. Thing is, I had rock solid routines. Always in bed by the same time. Always got up at the same time. Out the door to work at the same time. Monday means the bathroom gets a good thorough scrub. Timers and reminders for everything. Etc. etc. etc. I was doing just fine and dandy. When I finished school my wife (who was also diagnosed as an adult about 10 years ago) started noticing that I was having more problems with getting things done and focusing just because of the loss of that part of my routine. And then the pandemic hit and I started working from home. Suddenly I didn't have any particular reason to be out the door at 6 am. Or to spend a few hours unwinding browsing the internet at a coffee shop after work. I could browse the internet all day long! And I did!

I lost all my routines and that was....not good for me. And this seems to be a common theme with ADHD people diagnosed later in life: all the coping strategies work great, right up until they don't and life goes sideways. And when that happens it can be really hard to get things back on track. You've spent years getting all your systems in place and if they were to suddenly blow up in your face, like they did for me through no real fault of my own, you can end up completely lost and struggling to put those systems, or new ones, back in place and that can place a lot of strain on you and your family.

Now, I'm not here to push meds on you. That's your choice. Meds help me but, as my wife is fond of saying, "pills don't teach skills." Meds don't fix us and they wouldn't mean you'd no longer need your systems and reminders and so on. ADHD is an executive function disorder so we have trouble focusing and prioritizing and meds can help with that and doing the things that need to be done but you still have to actually do the work. And if you're coping okay right now, then maybe you don't need them and that's great!

The one thing that I will say about meds though is this: the first line of treatment for ADHD is stimulants. Finding the right one can take some time and not everyone responds to them. But stimulants aren't like anti-depressants. You take them and they're out of your system by the next day. You don't have to take them continuously if you don't want to and you don't have to wean off. You can just stop if you don't think it's for you. So trying them if you and your doctor think it's worth it doesn't have to be a big deal and you can get an idea of whether they're working or not fairly quickly.
posted by Mister_Sleight_of_Hand at 4:45 PM on February 21 [8 favorites]

I was diagnosed as an adult, but a few years into a career very much affected by it. I used to take meds and found them helpful but can't currently due to other medical issues. But more generally, I found the definitive diagnosis from an experienced psychiatrist very validating even compared to the "likely" answer I'd received from another doctor before. It has helped to break down some of the internalized self-shaming surrounding manifestations of ADHD symptoms. It's also made me more confident in mentally characterizing things that way and employing strategies based on ADHD specifically, which I find are very different and more effective than mainstream productivity advice.

Even if you don't though, I think you should continue to explore this idea and try out strategies that ADHD people find helpful. My favourite source is the Something Shiny podcast by two therapists with ADHD. There also lots of great Ask Metafilter threads about ADHD you can search for.
posted by lookoutbelow at 5:27 PM on February 21 [1 favorite]

Another mid-40s person here who looks on the outside like a very high-performing person and who got diagnosed about 5 years ago. I cannot tell you what a relief medication has been for me--how profoundly it has changed my whole life. I was in therapy for what I thought was some combination of depression, anxiety, and imposter syndrome. But then my therapist saw my "system" for keeping track of my tasks, and she pursued exploring the possibility I had ADHD. My depression and anxiety and all of it turned out to be largely symptomatic. And when she said, "you know...I think you may have been running on the hamster wheel with a veritable weighted backpack on you for lord knows how many years (i.e. making everything work with and against the ADHD)" oh how I wept.

My college-age son has also recently been diagnosed with ADHD; on the form for his accommodations at his university, his doctor indicated that I had a similar diagnosis, which partly helped the doctor to make the case for my son's own diagnosis and the accommodations he needs. It's since been productive for me to be able to talk to my son candidly about my condition and the strategies I've used to manage it.
posted by pinkacademic at 6:02 PM on February 21 [5 favorites]

My coping strategies broke down right as I moved to a new state/started a new job/lost my entire social circle. Also I mostly worked from home. I was spending more and more time in bed, pushing deadlines back, retreating into my Zone of Oblivion and honestly feared I might fuck up and get fired.

Meds didn't make that all go "poof!" but they did allow me to set up new routines, and not get the "frozen deer in headlights" problem that was keeping me from just doing what needed doing.

It's also helped me spot some things in my kid that may need help further down the road.

So fuck yeah, get diagnosed!
posted by emjaybee at 7:59 PM on February 21

Another fuck yeah! It's so worth it. 48 year old who got a diagnosis and began getting treatment about a 8 months ago. Has been a game changer. My general level of anxiety is so much lower, because now I can actually reliably engage with and accomplish tasks. I get shit done now, and it feels great.
posted by armoir from antproof case at 9:43 PM on February 21 [4 favorites]

Yes, of course. There’s no age at which a better quality of life is meaningless. I’m in my early 50: and only got my diagnosis two years ago; I’m now doing coaching which is absolutely revelatory, and found a non-stimulating medication that has absolutely shocked me in its ability to make concentration and productivity much easier, reducing my stress level overall and making me much more present in relationships. The question “is it worth it?”can only be answered with “would you like the opportunity to have more presence i your own life, reduced stress levels, an easier time using your coping mechanisms, and stronger interactions with others?” Even if I were 80 now I’d say yes. I wish I’d done it all sooner, but better now than never.
posted by Miko at 10:05 PM on February 21 [8 favorites]

Self-knowledge is useful for everyday life. And at the very least, there are a number of quite unusual co-occuring conditions which are often present with ADHD and go undetected. I would speak to a professional.
posted by mani at 12:18 AM on February 22 [1 favorite]

Don't get a diagnosis... Until you decide if you need it.

*Do* pursue knowledge and understanding about adhd, for all the reasons said above, but also because understanding executive function and disfunction will improve your relationships with your family, yourself, and your work.
posted by rebent at 5:36 AM on February 22

The diagnosis isn't the most helpful part, the treatment is. Getting effective help (e.g. working with a coach, getting work accommodations if you have that kind of job) can make an incredible difference in your quality of life and professional potential. If the diagnosis helps you get that, then it is absolutely worth it. But not more helpful than self-diagnosing, if you were to get the same amount of help either way.
posted by epanalepsis at 9:27 AM on February 22 [2 favorites]

Assuming you have access to mental health care that won't bankrupt you, I'd get the evaluation. For a couple of reasons. First, if you ever do want assistance--whether that's behavioral support, accommodations at work, therapy, meds--having a pre-existing diagnosis in your record makes that much easier. Second, you may find as you get older that your coping mechanisms don't works as well (that happened to me when I was about a year older than you are now). But finally, at least for me, getting a diagnosis was emotionally validating in a way I hadn't expected. I'd always thought I was likely ADHD. But having someone officials say so, say that I wasn't just lazy or messy or dumb, that there was a medically recognized reason why things are harder for me that other people find easy, was such a relief. I cried when I got my diagnosis, just because it lifted such a weight of guilt and self-criticism off my shoulders. So yeah, I'd do it if you have access to the resources.
posted by decathecting at 10:50 AM on February 22 [1 favorite]

My question: Would actually getting a diagnosis to see if I have ADHD or not be useful at all besides as self-knowledge that's interesting but not useful for everyday life?

I have ADHD. Formal diagnosis is necessary in some circumstances:

1. Your ADHD is causing problems in day-to-day life at work, at home, in your relationships relationships, with your kid (the whole catastrophe) and you've reached the end of what you can effectively do on your own to resolve/improve those problems.

2. Medication management is in on the table to help with that

3. Insurance covered talk therapy is on the table to help with that

4. You need to ask for some sort of workplace accommodation under the ADA

5. (maybe?) You need some professional guidance on how to help your kid carve a path in life that isn't as hard for them as it was for you.
posted by space_cookie at 9:26 PM on February 22

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