“A constant feeling that something is wrong.” The number of adults diagnosed with ADHD is increasing

You can also listen to the article in audio version.

“Until recently, I didn’t believe in ADHD and basically belonged to those who dismissed it,” begins the forty-four-year-old Tomáš Kundrát. He was diagnosed with attention deficit hyperactivity disorder only a year ago.

He was restless since childhood, did not like frontal teaching and took notes away. “The whole time I kind of fought my way through life with the fact that I’m simply a mess, chaotic and often forgetful. I took it as part of my personality, that it just is,” he states. Around the age of 30, with marriage and own business came the promise of a certain anchoring.

But that didn’t happen. Instead, he continued to experience stress, setbacks, and feelings of failure. According to Tomáš, all of this took an even faster turn during the pandemic. “Covid gave it a blow, with which I ended up in the hospital and then I didn’t even climb the stairs. But mostly it blew my mind. I stopped working, I couldn’t concentrate on anything, I started doing crazy tricks and I was able to spend money on complete nonsense just to reward myself somehow,” he describes.

“At that moment I felt that I was responsible for everything. My self-confidence went down, my anxiety started and I didn’t know what I was doing here at all,” Tomáš continues. It was only a friend who pointed out to him that he might have ADHD.

But finding a psychiatrist with whom he could consult his condition was a long-term difficulty. Long waiting times are a problem.

“Just looking for someone to marry me took almost a year before you even got anywhere. And then when I did find a contact for someone to take me on, it took another four months before a position became available. And what’s more, you often don’t even know if the specialist will have an understanding for it, if he even takes ADHD into account,” Tomáš describes his journey in seeking professional help.

Everything I did had to be extreme, but at the end there was no joy, as it is with ordinary people, there was only absolute emptiness, like when you drain the bathtub, feelings at zero and then you wondered why he was here and what he was doing here. The meaning of life disappeared at that moment. Now it’s starting to show up occasionally, but it’s still not the same.

The psychiatrist finally confirmed the diagnosis and medication was put on him. “It was a huge bunch of feelings all mixed together. In the end, relief prevailed that something could be done about it and that one now knows what one is fighting against. But there was certainly also frustration from why no one noticed it or what life could have been like if I had known it since childhood,” Tomáš explains the feelings with which he left the doctor’s office.

According to data provided to Seznam Zprávám by the Institute of Health Information and Statistics (ÚZIS), in 2022, over 46,000 people with a primary or secondary diagnosis of ADHD were reported, of which 38,500 were children and 7,500 were adults. But as ÚZIS analyst Tomáš Májek points out, mere suspicions of ADHD appear in the register, not just actually diagnosed patients. Whether their number is increasing in the adult population cannot be said with certainty.

However, the high interest in diagnostics is also confirmed by experts in practice.

“I don’t have personal experience like it was 20 years ago, but in general and worldwide the data shows that there is an increase in the number of diagnoses in adults because there is generally more knowledge about it and patients themselves are suspicious after reading information about ADHD on the Internet and they feel that it suits them,” says psychiatrist Jitka Holčapková from the Outpatient Psychiatry and Psychology Clinic. According to her, the disorder is very underdiagnosed in the Czech Republic.

More telling in terms of the number of clinical cases may be the number of reported diagnoses combined with reported reimbursements for medications used to treat ADHD. In 2010, there were nine thousand patients, by 2022 the number will almost double to 17 thousand. At the same time, however, it is necessary to take into account that not all patients who have a diagnosed disorder are simultaneously taking pharmacotherapy.

“It is true that, based on empirical experience, there are more and more people who meet the criteria for attention deficit disorder in adulthood, but the problem is that there is not a completely unified diagnostic procedure, moreover, many people, based on greater general awareness, self-diagnose the disorder, while not they always meet the diagnostic criteria,” Pavel Mohr, head of the clinic of the National Institute of Mental Health (NÚDZ), told Seznam Zprávy.

“Increased awareness also results in ADHD in adulthood being given more attention, more thought, which creates the optical impression that the number of people with this disorder is increasing. In fact, the incidence is probably still the same as in the past, only these symptoms were not labeled as a mental disorder or were attributed to other mental illnesses, which also often occur simultaneously with ADHD,” adds Mohr.

The prevalence of the disease is slightly higher in children and ranges between six and seven percent. In the adult population, the number decreases, as the human brain continues to develop during childhood and adolescence, and the prevalence of the disorder in the population decreases to three to four percent. “It is similar in the Czech Republic, as shown by one of the few domestic epidemiological studies,” confirms psychiatrist Mohr.

According to this information, tens of thousands of adults in the Czech Republic should be affected. However, as the data shows and experts confirm, most of them do not know their diagnosis yet.

Until recently, 39-year-old Robert was among them, who only started to think about the fact that he might have ADHD through his son. “During my youth, it wasn’t addressed at all, but I was a very hyperactive child, I was always flying somewhere, and I see that my son is exactly the same now,” he explains, explaining where the first impulse came from.

This was followed by an examination by a psychologist and then a psychiatrist, who confirmed the diagnosis. “When they told me I really did have ADHD and that I was going to be put on medication, I finally found out why I function the way I do. Finally, I will be able to work with it somehow, and perhaps medication will help me in this,” hopes Robert, who is also being treated for multiple sclerosis.

However, he is not yet sure how much he will communicate his diagnosis with those around him. He believes that it is still a big stigma in society. “Even at my son’s school, when I talked about it with one of the teachers – even before it was definitely confirmed to me – I told him about my suspicion that I and my son have it, and he told me not to go anywhere with it , that he has ten similar children like him in his class,” he says.

Although, unlike Robert, his son does not yet have confirmed ADHD, the probability that he inherited the disorder is between 70 and 80%, according to experts.

While in children ADHD is often a problem mainly in the school environment, in adults it can complicate relationships and work engagement.

“It’s uncertainty and a permanent feeling that something is wrong and you don’t know what. And you feel completely incompetent because you don’t remember your anniversaries or the births of your children and everyone looks at you like you’re crazy. Or maybe you feel that you did something, but it was just a thought, in the end you didn’t do it, for example paying bills. For others it’s a completely normal activity, for me it’s a difficult thing to keep in my head,” Tomáš Kundrát describes the problems he encounters in his life with ADHD.

ADHD

“What I enjoy, I do two hundred percent. What I don’t enjoy, I don’t do at all and I can’t force myself to do it. And I always think it’s just my laziness, but when I see other people with ADHD, it’s exactly the same experience,” adds Robert.

Psychiatrist Holčapková also points out that associated anxiety and depression are also common in patients with ADHD. Some use the depressant effects of alcohol or marijuana as part of “self-medication”.

“Because ADHD is associated with a more vulnerable psyche, there is a high risk – around 75 to 80 percent – that these people will also develop another psychiatric diagnosis during their lifetime, whether it’s anxiety or depression, but often it’s addiction or compulsive disorders. Often they were being treated for some secondary disorder and were not aware that there could be something else behind it,” he adds.