Not getting treatment for attention deficit hyperactivity disorder (ADHD) can affect more than just a child’s ability to sit still.
In some cases, it can have long-term effects on things such as substance abuse, driving ability, and eating habits.
“An interesting thing happens when people are considering whether or not to treat ADHD,” says Ari Tuckman, psychologist and author of “More Attention, Less Deficit: Success Strategies for Adults with ADHD.” “They will often focus on the potential risks and side effects but ignore the potential benefits. In other words, they ignore the risks and side effects of not treating ADHD.”
In many cases, the risks of not treating ADHD outweigh the potential side effects of stimulant medications, which can include loss of appetite, potential slowing of growth in childhood, and increased blood pressure or heart rate.
“For kids, [not treating ADHD carries] all the risks that parents worry about,” explains Tuckman. “Doing badly in school, having social struggles, greater substance use, more car accidents, less likely to attend and then graduate college. For adults, untreated ADHD also affects job performance and lifetime earnings, marital satisfaction, and likelihood of divorce.”
That’s because untreated kids sometimes don’t learn impulse control, emotional regulation, and social skills.
As adults, they can sometimes fall behind the curve and don’t always catch up. Children who receive ADHD treatment can slow down and focus enough to participate in therapy and learn critical skills and coping strategies to manage ADHD into adulthood.
Potential Risks of Not Treating ADHD
Studies have recognized a number of potential problems that can develop out of untreated ADHD.
One is substance abuse. Stimulant medication commonly used to treat ADHD is a controlled substance, which indicates a possibility of addiction. However, in the doses prescribed for ADHD, these stimulants are not addictive.
Studies have actually shown that individuals with untreated ADHD are more prone to use and abuse alcohol and illegal drugs.
In a 2003 study published in The Journal of Clinical Psychiatry, the author noted, “Findings included confirmation that, in fact, stimulant therapy protected medicated ADHD patients against substance use disorder, which occurred at rates that were 3 to 4 times greater among people with untreated ADHD.”
Another potential risk is criminal activity. Studies have shown about 25 percent of individuals behind bars in the United States have ADHD.
Experts mainly contribute this fact to impulsivity and poor self-regulation, two symptoms that can be improved with ADHD treatment. Researchers compared rates of antidepressant and stimulant prescriptions to the rate of violent crimes in the United States from 1997 to 2004. They said that as rates of antidepressant and stimulant use rose, the rate of violent crime dropped.
Driving abilities can also be affected. A 2009 examination of the literature on ADHD and driving injuries found that stimulants used to alleviate ADHD can reduce symptoms such as inattention, distractibility, and impulsiveness that have implications on driving skills.
Linda Roggli, founder of the ADDiva Network, knows all too well the dangers of driving with untreated ADHD. She learned the hard way when she rushed out the door forgetting to take her ADHD medication one morning.
The panic of brushing one car against the other in her garage created enough cognitive confusion to lead her to use the wrong pedal and cause $12,000 worth of damage.
“Driving is a complex task,” explains Roggli, “involving paying attention to the road, the people and cars on either side, planning ahead to turn off on the correct exit, and changing lanes. All of which are impacted by my distractibility.”
Eating, Studying, and Job Performance Are Also Affected
Another potential risk of untreated ADHD is binge eating.
A study published last month in the International Journal of Eating Disorders found children with ADHD are 12 times more likely to have loss of control eating syndrome (LOC-ES) than kids without ADHD. The researchers found that the worse a child’s impulse control, the more likely they were to have LOC-ES.
Untreated ADHD also impacts academic achievement. Improvement in both achievement tests and academic performance outcomes have been noted when comparing untreated ADHD patients to treated ADHD patients, although achievement test scores improved more than academic performance.
Academics affect more than grades on a report card. One study found, “Adults with self-reports of diagnosed ADHD in the community were significantly less likely to have graduated high school (83% vs. 93%) or obtain a college degree (19% vs. 26%).”
Job performance is another issue. Individuals with ADHD have increased difficulty getting jobs and keeping them. As well, they make $8,900 to $15,400 per year less than non-ADHD workers.
Adults with ADHD were less likely to be currently employed (52% vs. 72%), and had more job changes over a 10-year period (5.4 vs. 3.4 jobs). Poor time management and organizational skills can also lead to poor workplace performance. Treated or not, experts say it’s crucial for people with ADHD to seek careers that play to their strengths.
Finally, there’s divorce. Adults with untreated ADHD are nearly twice as likely to get separated or divorced from their spouses. According to Melissa Orlov in her book, “The ADHD Effect on Marriage,” untreated ADHD can cause an unsuccessful parent-child relationship between partners.
“[It] can translate into a lot of extra work for a non-ADHD spouse,” Orlov wrote. “If workload distribution inequities aren’t addressed, the resentment and feelings of ‘being a slave’ that the non-ADHD partner often feels can result in divorce.”
Determining the Problem First
Both Tuckman and Roggli say treatment for ADHD adults is essential if ADHD is impacting one’s ability to function well in life, but it all starts with diagnosis.
“When you know what you're dealing with you can actually change the trajectory of your life, in all areas,” says Roggli.
Tuckman added one final thought: “There is a price paid in additional suffering from withholding a treatment that research shows is beneficial.”
A self-described "veteran" parent of a son with ADHD, Penny Williams is an award-winning blogger and author of the Amazon best seller, "Boy Without Instructions: Surviving the Learning Curve of Parenting a Child with ADHD." Her second book, "What to Expect When You're Not Expecting ADHD," is now available.