Untreated ADHD is a costly affair
ADHD can be a lifelong condition and have a significantly negative impact on life. However, maturity plays a role in this context. Approximately half of those diagnosed as children continue to have pronounced ADHD symptoms into adulthood.
Text by: Annika Lund, first published in Medical Science No 3 2024
How ADHD affects those diagnosed varies. Some adults live a well with their ADHD, while others struggle with very serious challenges.
“This is a difficult message to convey in an area so burdened with strong opinions. ADHD should not be reduced to immaturity that one outgrows, but it is also not something that is permanent in all individuals. Our research shows that ADHD can have lifelong, serious consequences,” says Henrik Larsson, Professor at Örebro University and affiliated researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.
The studies he refers to show that people with ADHD, as a group, have significant comorbidities. The occurrence of autism is so common that the term AuDHD, the simultaneous occurrence of ADHD and autism, is becoming established. Other common psychiatric diagnoses include depression and anxiety, but comorbidity with somatic illnesses is also common. For example, certain autoimmune diseases, as well as obesity and type 2 diabetes, are more common in people with ADHD.
How well a person does at school n can also be affected by ADHD, which later reflects in job market opportunities. People with ADHD can struggle in the labour market regardless of their level of education - unemployment and difficulty maintaining employment are more common among both highly and less educated individuals with ADHD compared to those with a similar education level without the diagnosis. This affects income levels.
The risk of being convicted of a crime is also higher among people with ADHD than in the general population. So is the risk of developing an addiction to tobacco, alcohol, drugs or gambling.
ADHD costs - in suffering and money
Overall, this shows that ADHD can cause significant personal suffering ‒ and be extremely costly for society. Numerous studies confirm this. According to Danish research, the average cost to society for an individual with ADHD is around 16,000 euros per year. This includes healthcare and employment losses. If social benefits are also included, the figure rises to an annual 23,000 euros per individual.
Many of these risks decrease with treatment, where medication is an important part for severe ADHD. However, medication should be combined with other interventions, according to national guidelines updated in March 2024. Psychoeducation, i.e. education about your own or a loved one's disability, is emphasised. Other interventions can include various psychological interventions, which can help people with ADHD with planning or emotional management, for example. There are also various aids that can be used to improve, for example, time perception and daily structure.
Tatja Hirvikoski, a researcher at the Department of Women's and Children's Health, investigates various support measures for adults with ADHD. She is one of those who developed the Swedish website Föräldrar med ADHD (Parents with ADHD), which is hosted on the website of the patient organisation Attention. It consists of interviews with researchers and people with ADHD telling their stories, built around three major themes: anger regulation, daily chaos and acceptance.
“The information on the website is evidence-based. We know from conversations with parents and also from research that material on these topics is requested by the target group. We also know that there is value in listening to other who share their experiences. It increases confidence in your own abilities and reduces stigma,’ says Tatja Hirvikoski.
She thinks that work is the least inclusive area of society for people with ADHD.
“It is a huge waste of resources. There are many people with ADHD who have so much to offer. There is energy and drive and creativity and brainpower but less ability to manage time and plan. These are things that can be overcome. We need employers who want to and dare to understand this. Anything else is socioeconomically stupid and leads to suffering for people with ADHD,” says Tatja Hirvikoski.