Sarah is 48. A senior project manager. Reliable and intelligent — but chronically overwhelmed. For years, she has been treated for anxiety and depression with only partial improvement. She procrastinates until deadlines become crises and tells herself she just needs to “try harder.”
Carlos is 42. A talented professional repeatedly passed over for promotion because of “inconsistent follow-through.”
Ms. Johnson is 66, a retired teacher who spent decades believing she was simply disorganized and undisciplined.
All three share something in common.
They have ADHD (Attention Deficit Hyperactivity Disorder).
Their diagnosis was not missed because ADHD is rare. It was missed because no one thought to look for it.
“With a diagnosis of ADHD, a lifetime of unexplained struggle suddenly becomes coherent. What people once blamed on lack of discipline turns out to be a treatable neurodevelopmental condition.” — Dr. Guy Maytal, Chief Medical Officer, Forge Health
ADHD Often Goes Undiagnosed in Adults
Many adults live for years with ADHD symptoms without realizing it. They struggle with poor focus and pervasive disorganization. They wonder why everyday tasks feel harder than they should, or why anxiety and stress never fully improve despite appropriate treatment. In these situations, ADHD may be an unrecognized part of the picture.
Instead, they may receive treatment for anxiety, depression, burnout, or chronic stress. These conditions can coexist with ADHD, but when the underlying attentional and executive functioning challenges are missed, treatment often helps only partially.
Often, the possibility of ADHD simply isn’t considered.
How ADHD Is Diagnosed
ADHD is a clinical diagnosis, meaning it is identified through a careful assessment by a trained clinician.
A comprehensive assessment typically includes a detailed clinical interview and a review of lifelong patterns of attention, organization, and executive functioning. Clinicians may also use screening tools such as the Adult ADHD Self-Report Scale (ASRS) to identify individuals who should receive a more thorough evaluation.
In some cases, objective testing can provide additional information about focus, impulsivity, and activity levels. These tools help supplement clinical judgment and provide a clearer understanding of how attention and executive functioning affect daily life.
Why ADHD Is Often Missed
ADHD does not always look the way people expect.
Much of the early research on ADHD focused on young boys with disruptive behavior, which shaped how clinicians are taught to recognize the condition. But many adults experience ADHD very differently.
Women, for example, are more likely to experience internal symptoms such as chronic overwhelm, restlessness, perfectionism, and executive functioning challenges. Because these symptoms may not appear disruptive in school or work settings, many women are diagnosed years — or even decades — later.
ADHD Rarely Occurs Alone
ADHD frequently occurs alongside other mental health conditions. Research suggests that about 70% of adults with ADHD have at least one additional psychiatric condition, including anxiety, depression, Post-Traumatic Stress Disorder (PTSD), or substance use disorders.
This overlap can make diagnosis more complicated when clinicians assume that a patient has only one diagnosis. If ADHD is not identified, people may be treated repeatedly for other conditions while an underlying attentional disorder remains unaddressed.
Effective Treatment Can Be Life-Changing
When ADHD is accurately diagnosed, treatment can significantly improve daily functioning.
Treatment often includes medications combined with psychotherapy and practical strategies that strengthen organization, focus, and emotional regulation. Addressing ADHD can also make treatment for related conditions such as anxiety or depression more effective.
Once ADHD is properly treated, many patients experience meaningful improvements in work performance, relationships, and overall quality of life.
ADHD Evaluation and Testing at Forge Health
Forge Health offers ADHD evaluation and testing as part of our psychiatric services.
Our clinicians provide:
- Comprehensive ADHD assessments
- Screening and diagnostic tools
- Objective attention testing when appropriate
- Medication management and integrated mental health care
Appointments are available in person or by telehealth, allowing patients to access care quickly and confidentially.
When to Consider an ADHD Evaluation
You may want to consider an ADHD assessment if you frequently experience:
- Difficulty focusing or completing tasks
- Chronic procrastination
- Disorganization affecting work or home life
- Feeling constantly overwhelmed
- The above, combined with anxiety or depression that hasn’t fully improved with adequate treatment
An evaluation can provide clarity — and a path forward.
