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Estimates suggest that somewhere between five and seven percent of the adult population in the United States has ADHD. However, only about 20% of those individuals are ever treated for the condition.

While some with ADHD may choose to go without treatment, many adults who have the condition simply don’t recognize that they even have it.

The three types of ADHD are the inattentive type, hyperactive/impulsive type, or the combined type. While children experience the same symptoms, they often look different in adults. In kids, symptoms of hyperactivity, inattention, and impulsivity tend to be more disruptive and apparent in classroom settings.

This can create a wide variety of problems in a person’s life, ranging from academic struggles to relationship conflicts. To better understand the condition and its effect on an individual’s life, it can be helpful to look at what undiagnosed ADHD might look like in adults.

Restlessness

Hyperactivity is often a major symptom of ADHD. Where in children, this symptom often manifests as an inability to sit still. In classroom settings, kids might fidget or squirm in their chairs, talk excessively, interrupt others, and always seem to be in motion. 

On the positive side, this means that they always seem to have almost boundless energy. However, it can also make it difficult to sit through work meetings or other activities. 

Disorganization

Adults with undiagnosed ADHD often seem disorganized or even scattered. These organizational struggles can affect many areas, from prioritizing tasks to keeping track of personal items.

Common signs of organization problems include:

• Always looking for items they can’t find 
• A haphazard approach to projects, where tasks are often left incomplete
• Clutter and messiness in their home, office, car, and other areas under their control
• Difficulty putting things in order
• Dropping things where they are and not sorting them
• Losing important bills, papers, documents, or bank statements
• Misplacing items
• Sorting objects into visible piles instead of putting them where they belong
• Storing things in locations that don’t make sense

This disorganization also affects speech and thought. Adults with undiagnosed ADHD may have problems organizing what they want to say or may lose track of what they are saying as they are speaking. It also affects their ability to stick to a routine, remember appointments, and complete projects in an orderly fashion.

Problems With Motivation

Another common sign of undiagnosed ADHD in adults is a tendency to struggle with what feels like poor motivation. ADHD causes deficits in executive functioning, which are the mental skills needed to plan, organize, initiate, and sustain activity. 

In other cases, a person might start a task but struggle to stay focused on it. And not knowing how to organize the project into manageable, sequential chunks can make it that much more difficult to stick with it. This means they might start a project only to abandon it. 

Unfortunately, this often leads to adults with undiagnosed ADHD being labeled as lazy, unmotivated, and uncaring. Such labels aren’t just hurtful; they can also impact a person’s self-image and self-esteem.

An adult with ADHD might look at the lost list of projects they never started or tasks that were abandoned halfway through and think that it must be a sign that they are lazy. 

Lack of Focus

Adults with ADHD may struggle to focus on tasks that they find boring, repetitive, or uninteresting. However, what may seem confusing to many is that these individuals may also get lost in projects that interest them. 

A person without ADHD may be just as bored, but they can marshall their motivation and focus for long enough to slog through it. An adult with undiagnosed ADHD may simply lack that focus.

This lack of focus is the most noticeable for time-consuming, predictable, or repetitive tasks. Reading books, completing daily household chores, or managing a checkbook are a few examples of these activities. Projects that take a long time to pay off, like learning a new language or how to play an instrument, can also lead to problems with focus.

However, undiagnosed ADHD in adults is also often characterized by periods of hyperfocus. People will become extremely engrossed in one thing, often for hours at a time. They may neglect other important tasks in order to focus on the thing that is currently holding their attention.

Forgetfulness

Forgetfulness is a common theme among adults who have ADHD, but these symptoms can seem particularly confusing for those who have received a diagnosis. This symptom can lead to problems like:

• Starting a tasking and forgetting what they were doing
• Losing things, even if they were just using them
• Forgetting important dates or appointments
• Retelling a story that they’ve already told someone because they don’t remember telling it to them
• Momentarily walking away from a task and then forgetting that they were working on it

An adult who has ADHD may often not realize that they have forgotten something until they get a call from their dentist’s office about missing their appointment or come across a partially-completed project they forgot they were working on. 

Like other ADHD symptoms, research suggests that forgetfulness stems from differences in how the brain works in people who have the condition. People with ADHD are less able to filter out irrelevant distractions so they can focus on what’s important. This negatively impacts the ability to both encode new memories and retrieve old ones.

Time Management Issues

Adults with undiagnosed ADHD often struggle with time management. They may always seem to be late, unsure of what needs to be done when, and unclear about how much time they have left to finish important tasks. 

This may be because people with this condition experience something known as time blindness. They struggle to sense the passing of time, which means that they have a hard time recognizing how much time has passed.

These time problems often result in issues such as:

• Chronic lateness
• Feeling like time is passing too quickly
• Feeling like time is passing too slowly
• Problems making and sticking to schedules
• Problems recognizing how long ago events occurred
• Trouble knowing how much time will be needed to finish a task

Chronic lateness can also negatively affect relationships. And because people often don’t understand the reason why they struggle with time management, it can contribute to feelings of frustration and poor self-image. 

Shifting Emotions

Adults with undiagnosed ADHD may also experience symptoms of emotional dysregulation, which means they may struggle to control their emotional responses. Some of the ways that this might be expressed include:

• Having problems calming down when they are mad
• Overreacting to relatively small stresses
• Becoming very frustrated by minor annoyances
• Difficulty focusing on anything other than their emotions
• Experiencing sudden shifts in mood or outbursts of anger

Unfortunately, these problems with emotional regulation are often misunderstood. It also contributes to the underdiagnosis or misdiagnosis of ADHD.

This also means that the person experiencing these intense and upsetting emotions may not understand why they can’t seem to moderate their feelings. Other people in the person’s life might conclude that they are overly sensitive, temperamental, or aggressive.

Indecisiveness

Indecisiveness is a common problem for many adults, but it can be particularly troublesome for those who have undiagnosed ADHD. It can manifest in a variety of ways, including:

According to one 2021 study, adults with ADHD experience indecision and various other decision-making-related problems.

Other symptoms of the condition, such as memory problems, distractibility, and inattention, contribute to this problem by making it hard for people to focus on the options and information they need to make decisions. 

Challenges in making decisions are also related to the same executive functioning impairments that lead to many other symptoms of adult ADHD. Such functions allow people to plan, organize and prioritize.

Getting a Diagnosis

If you suspect that you might have undiagnosed adult ADHD, talk to your healthcare provider or a mental health professional for future evaluation. For many adults, getting a diagnosis can be both a relief and life-changing. It often helps explain struggles and problems that a person may have been dealing with all their life. 

Intergenerational trauma refers to trauma that is passed from a trauma survivor to their descendants. It can also be referred to as transgenerational or multigenerational trauma.

People experiencing intergenerational trauma may experience symptoms, reactions, patterns, and emotional and psychological effects from trauma experienced by previous generations (not limited to just parents or grandparents).

What Is a Trauma Response?

Humans have survived for thousands of years by evolving the ability to adapt. If you live with chronic stress or have lived through a traumatic event, certain responses activate to help you survive—these are known as trauma responses.

Although these responses are helpful for short-term survival, being in that “survival mode” headspace is harmful to both physical and mental health in the long term. When your brain learns the adaptive behavior necessary to keep yourself and your family safe/alive, these adaptations may be passed on to future generations and can be challenging to un-learn.

Remaining in “survival mode” can limit one’s ability to thrive, as living in survival mode is founded in response to fear/trauma/scarcity. Thriving is possible when there is a developed sense and lived experience of safety and security, which people suffering from intergenerational trauma may not have a model/cellular knowing or foundation for.

For example, someone may have grown up in a household where there were generations of yelling and shouting at their children in anger, stemming from a place of unresolved trauma and pain. In order to understand intergenerational trauma, it is important to acknowledge the impact of what the parents/grandparents/great-grandparents/ancestors/etc. survived that resulted in their yelling or shouting.

This may have been because yelling or shouting was adaptive behavior for survival or they had their own parents yell at them because those parents and those before them didn’t have the tools, energy, modeling, support, or space to speak kindly/gently/lovingly to their children due to constant stressors and the trauma of historical oppression/struggle.

The impact of intergenerational trauma in this case would be descendants continuing to shout/scream at their own children, from a place of unresolved intergenerational trauma/stress.

What Does Intergenerational Trauma Look Like?

Those affected by intergenerational trauma might experience symptoms similar to that of post-traumatic stress disorder (PTSD), including hypervigilance, anxiety, and mood dysregulation.

However, because the individual did not directly experience the trauma themselves, they will not experience flashbacks or intrusive memories. They experience trauma symptoms and trauma responses from events that did not occur to them; rather, the response is inherited genetically.

Because stress responses are linked to more physical health issues, intergenerational trauma can also manifest as medical issues including heart disease, stroke, or early death.

What Causes Intergenerational Trauma?

Intergenerational trauma occurs when the effects of trauma are passed down between generations. This can occur if a parent experienced abuse as a child or Adverse Childhood Experiences (ACEs), and the cycle of trauma and abuse impacts their parenting.

Intergenerational trauma can also be the result of oppression, including racial trauma or other systemic oppression. The effects of intergenerational trauma have been documented in descendants of refugees, residential schools, and Holocaust survivors, demonstrating that this type of trauma continues to impact populations for generations after a collective traumatic event has occurred.

Genetics and Intergenerational Trauma

Although research differs and a definitive number is not presently known, it is estimated that human beings have more than 25,000 genes present in our DNA.The way that our genetic material manifests in our bodies, or the way that our genes determine everything from how we look to what diseases we may be predisposed to, is called epigenetics.

Some genes are dormant when we are born but activate based on our environment. This is one way that we adapt to our environment and survive.

When someone experiences trauma, their DNA responds by activating genes to help them survive the stressful time. Genes that prime us for things like a fight, flight, freeze, or fawn response will activate to help us be ready for future dangerous situations. We then pass these genes onto our offspring in order to prepare them for possible traumatic events.

Our genetics do a great job of keeping us safe even if this does not mean keeping us happy. When genes are primed for stressful or traumatic events, they respond with greater resilience to those events, but this constant state of anticipating danger is stressful. The trade-off of being constantly prepared to keep us safe increases our body’s stress levels and impacts our mental and physical health over time.

If your parents or grandparents experienced trauma, their DNA coded itself to have a survival response that helped them get through those events, which then passed down through generations. This “survival mode” remains encoded and passed down for multiple generations in the absence of additional trauma.

Treatment and Coping for Intergenerational Trauma

As noted above, intergenerational trauma persists for multiple generations if additional trauma is not present. However, research shows that children of parents with higher ACEs scores are at higher risk for their own adverse childhood experiences.

If you experience intergenerational trauma, trauma-informed interventions and therapy treatment can help you cope with your own symptoms, understand the impact of intergenerational trauma, and equip you with tools to help change deeply embedded patterns and heal yourself and generations after you.

Even if you do not have your own memories of the trauma, a trauma-informed approach to care can help you manage your body’s physiological response to intergenerational trauma.

There are many resources available to those dealing with trauma, both personal and intergenerational. Recognizing trauma symptoms, even if they are inherited rather than related to a personal trauma, is vital in coping and seeking support for intergenerational trauma.

Healing Intergenerational Trauma

Because intergenerational trauma is inherited across generations, it can be fully healed by creating an environment where additional trauma does not occur for multiple generations. It can be healed even in the context of continuing stressors with the tools, inner resources, and support needed to care for symptoms and heal the root cause of the intergenerational trauma on physical/somatic, emotional, mental, cellular, and ancestral levels.

This means both providing education about trauma, trauma responses, and intergenerational trauma to providers, teachers, and parents, as well as addressing systemic issues that perpetuate trauma in minoritized populations.

It also means acknowledging how intergenerational trauma impacts those who have not personally experienced a traumatic event. This understanding is the first step in treating intergenerational trauma in individuals as well as preventing future intergenerational trauma.

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If you are experiencing the effects of intergenerational trauma, please know that therapy can be a helpful tool to help you overcome and navigate trauma responses. A therapist can also teach you healthy coping mechanisms that you can employ if you encounter a trigger. Please remember that you are not alone and that there’s no shame in reaching out to a professional.