Ryan S. Sultan, MD
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85% of adults with ADHD are undiagnosed and untreated, representing millions of people struggling with executive dysfunction. Most cases are inattentive-type ADHD, easily missed without hyperactivity. |
By Dr. Ryan S. Sultan, MD | February 13, 2026
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Key Takeaway: Research shows that approximately 85% of adults with ADHD are undiagnosed and untreated. Many adults with ADHD struggle for decades with symptoms mistaken for anxiety, depression, or "just their personality" before getting the help they need. |
Jordan, a 30-year-old professional, was only diagnosed with ADHD in their late twenties. Despite being an excellent problem-solver and innovator at work, Jordan had always struggled with time management, restlessness, and difficulty in following through with tasks.
They frequently forgot about meetings, and always seemed to be running late. Their colleagues made jokes about "Jordan time" — the unspoken expectation that Jordan would arrive 15-20 minutes after everyone else. At home, bills piled up not because Jordan couldn't afford them, but because they simply forgot to pay them until reminder notices arrived.
Jordan had tried multiple organizational systems — planners, apps, sticky notes covering their desk. None of them stuck for more than a week or two. Their apartment was cluttered with half-finished projects: books started but never completed, hobby equipment bought with enthusiasm but barely used, important documents in disorganized piles.
Finally, after years of feeling like they were constantly playing catch-up, Jordan sought help for what they initially thought was just stress and anxiety. They assumed everyone struggled this much with basic organization and time management.
The diagnosis came as a shock — and a relief.
"I always thought I was just lazy or disorganized," Jordan later shared. "Finding out there was an actual neurological reason for my struggles changed everything."
Jordan's story illustrates a troubling statistic: an estimated 85% of adults with ADHD are undiagnosed and untreated. But why do so many adults go decades without recognizing they have ADHD?
Many people picture ADHD as a hyperactive child who can't sit still in class. But in adults, ADHD often manifests more subtly:
Because these symptoms don't match the stereotypical image of ADHD, both patients and doctors often miss the diagnosis.
Many adults with ADHD, like Jordan, initially seek help for what seems like anxiety or depression. And it's no wonder — the symptoms overlap considerably:
| ADHD Symptom | Often Mistaken For |
| Difficulty focusing on tasks | Anxiety, stress, depression |
| Restlessness, fidgeting | Generalized anxiety disorder |
| Chronic procrastination | Laziness, poor motivation |
| Emotional outbursts | Mood disorder, personality issues |
| Sleep problems | Insomnia, stress |
| Forgetfulness | "Just being absent-minded" |
The critical difference: Treating anxiety or depression alone doesn't resolve the underlying ADHD symptoms. Many adults try multiple antidepressants or anxiety medications without significant improvement before finally receiving an accurate ADHD diagnosis.
Research suggests that males are diagnosed with ADHD about 3 times more often than females in childhood. However, this ratio doesn't reflect the true prevalence — it reflects diagnostic bias.
Why women are missed:
Many women don't receive an ADHD diagnosis until their 30s, 40s, or even later — after decades of believing there was something "wrong" with them.
Some adults with ADHD — particularly those with high IQs — manage to compensate for their symptoms through sheer cognitive ability. They get through school and early career by:
However, these compensation strategies become less effective as demands increase. Many high-achieving adults seek diagnosis in their late 20s or 30s when they "hit a wall" — when career advancement, family responsibilities, or life transitions overwhelm their coping mechanisms.
For decades, ADHD was considered a childhood disorder that people "grew out of." It wasn't until the 1990s-2000s that the medical community began recognizing adult ADHD as a legitimate diagnosis.
This means:
Going undiagnosed with ADHD for years or decades isn't just inconvenient — it has real consequences:
Adults with untreated ADHD are:
Untreated ADHD impacts work performance:
Adults with untreated ADHD have significantly higher rates of:
Untreated ADHD is associated with:
If you recognize yourself in Jordan's story — or in the symptoms described above — here's what to do:
Ask yourself these questions:
If you answered "yes" to several of these, it's worth pursuing a formal evaluation.
Important: Not all mental health professionals have expertise in adult ADHD. Look for:
In New York City: Dr. Ryan Sultan is a board-certified psychiatrist specializing in adult ADHD at Columbia University. Schedule an evaluation.
A comprehensive ADHD evaluation typically includes:
The evaluation typically takes 60-90 minutes and may span multiple appointments.
The good news? Treatment for adult ADHD is highly effective. Research shows that when on the right medication and dose, nearly 9 out of 10 people with ADHD will have the majority of their symptoms disappear.
Six months after starting treatment (a combination of medication and cognitive-behavioral therapy), Jordan reports:
"I didn't realize how much energy I was spending just trying to function," Jordan reflects. "Now that energy goes toward actually living my life."
Effective adult ADHD treatment typically includes:
1. Medication
2. Psychotherapy
3. ADHD Coaching
4. Lifestyle Modifications
For more details, see the Complete ADHD Guide.
If you're reading this and recognizing yourself in these descriptions, know that you're not alone — and you're not "broken."
Adult ADHD is common:
Getting diagnosed and treated for ADHD can be life-changing. Many adults describe it as finally understanding themselves, getting access to tools that work, and being able to live up to their potential.
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Ready to Take the Next Step? If you recognize these symptoms in yourself, consider scheduling an ADHD evaluation with a specialist. Dr. Ryan Sultan is a board-certified psychiatrist specializing in adult ADHD in New York City (Columbia University). He understands the unique challenges of adult diagnosis and provides comprehensive, evidence-based treatment. |
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