Mental Health Blog

Adult ADHD: A Family Affair

• October 23, 2025
• The REACH Institute
• ADHD, Assessment & screening, Parents

“Most primary care providers aren’t new to seeing adults with ADHD,” explains Kathleen McCoy, DNSc, who specializes in family psychiatric mental health and integrative care. “What’s changing is our understanding of the condition and how to help adults manage it well, often while also supporting their children with ADHD.” 

More than half of the estimated 15.5 million adults in the US diagnosed with ADHD received their diagnosis in adulthood, meaning they missed out on critical early interventions. There are also significant gaps in research on ADHD in adults and gaps in diagnosis, especially for women. This can lead to enduring challenges across all aspects of life, from employment to relationships to family dynamics. 

For adults with ADHD, primary care providers (PCPs) are often their first and only source of recognition and access to treatment. We asked Dr. McCoy to share what PCPs should know about diagnosing and supporting adults with ADHD. 

Identifying Adult ADHD and the Critical Role of PCPs

“ADHD is a family affair,” explains Dr. McCoy. “When a child comes into your office with ADHD, it’s very likely in the family tree and potentially in the parent right there in front of you with the child.” 

Depending on each individual’s coping and management skills, adult ADHD can look similar to or very different from ADHD in children and adolescents. For example, some adults with ADHD might show classic signs such as fidgeting and struggling to sit still, even during a brief office visit. They may struggle to keep a job, maintain relationships, or balance a checkbook.  

In contrast, other adults will have learned to manage and live well with their ADHD, even in the absence of prior diagnosis or treatment. They may lean on organizational tools such as calendars and lists, channel their energy into physical activities or work that interests them most, find workarounds for tasks or activities that exacerbate their symptoms, and have social capital and relationships easily accessed for support. 

Adults with ADHD may suspect they have the condition or they may have no idea until they see themselves in their child’s behaviors. This is where the role of the PCP is so essential. Primary care providers see patients and families over time, enabling such providers to identify patterns that specialists and patients themselves can miss. 

Opening the Conversation About Adult ADHD

“Stigma for ADHD is a dynamic we are still facing today,” explains Dr. McCoy. Adults with ADHD may have struggled in silence for many years, not understanding why aspects of their lives have been so difficult. 

Dr. McCoy advises clinicians to use a slow and gentle approach when talking to adults they suspect may have ADHD and to “look for when the person invites change.” Parents, for example, often become open to considering their own ADHD diagnosis only after they see changes in their child thanks to treatment. 

When working with adults, Dr. McCoy refers to ADHD as a condition, not as a pathology. The goal is to give patients the tools to have a balanced life that protects them from the worst harms of untreated ADHD. Assisting the adult to befriend the condition of ADHD is critical to empower each individual to know how to work with it, rather than allowing the symptoms to continuously disrupt their lives.

Considerations for an Adult ADHD Management Plan

While there are not yet formal guidelines in the US for managing adult ADHD (though guidelines are currently in development, with REACH founder Dr. Peter Jensen as a leading contributor) tools for clinicians to consider include: 

• Medication: The latest data suggests that only a third of adults use stimulant medications for their ADHD. Thus, while medication can be helpful for some, many adults rely on other methods for managing ADHD. 

• Practical Tools: People can use tools, such as calendars, alarms, lists, and other reminders, to keep themselves on track and avoid missing important details. 
• Lifestyle Changes: Learning to support a healthy lifestyle, such as sleeping enough, taking in well-balanced intake and hydration, and getting adequate movement, is even more important for adults with ADHD. Because ADHD already affects the ability to concentrate, simple things such as missing sleep or meals can quickly exacerbate symptoms for people with ADHD.
• Social Capital: Adults who manage their ADHD successfully often have people around them to ask for support and learn to draw on this social capital when needed. If a person is isolated or lacks a support system, clinicians can encourage them to be intentional about joining support groups or programs, either online or in person.
• Workplace Accommodations: The types of accommodations needed from an employer will vary significantly by both an individual’s needs and their type of employment. Some people also intentionally choose not to disclose an ADHD diagnosis to their employer. 

For adult ADHD, Dr. McCoy explains that, “It’s not all a downside. Some people with ADHD learn the right patterns and skills that carry them into a very successful and balanced life.”

The Family System in ADHD Management for Adults and Children

Genetics is not the only reason ADHD is a family matter. For children with ADHD, successful treatment requires a therapeutic alliance between clinicians, pediatric patients, and their parents and other primary caregivers. 

“The family itself is a tool that either works or doesn’t work for managing ADHD,” explains Dr. McCoy. If a parent with ADHD learns to deploy helpful organizational skills in their own lives, children can learn by example. If a parent struggles with their own ADHD, and does not take effective steps to manage ADHD, this will affect the child’s outcomes, as well as the family dynamics.

Today, more support is available than ever for families affected by ADHD. The key is to seek help—for both the individual experiencing symptoms and their loved ones. That process begins with a formal diagnostic evaluation to understand the symptoms and, if needed, move forward with the appropriate treatment options.

RESOURCES: 

For clinicians interested in deepening their understanding of adult ADHD, these evidence-based resources offer a mix of current research, practical tools, and patient supports:

• This review from the Journal of the American Board of Family Medicine summarizes key updates in adult ADHD recognition and treatment, including diagnostic challenges, pharmacological options, and the importance of screening for co-occurring disorders.
• This CDC report, Vital Signs: ADHD Among Adults and Children, covers ADHD prevalence and diagnosis trends, highlighting gender and age disparities and the growing number of adults being diagnosed later in life.
• The REACH Institute’s Adult Behavioral Health in Primary Care program covers the assessment, diagnosis, and treatment of adult ADHD, in addition to other common mental health conditions like bipolar disorder, substance use, and chronic pain. Learn more here.