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Surprising 16-year-long ADHD study proves researchers' hypothesis completely wrong

The findings from first-of-their-kind, long-term ADHD studies keep rolling in and surprising researchers along the way.

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Scientists continue to be surprised by the findings of long-term ADHD studies.

Our understanding of ADHD has come a long way in just a few short years. Though it wasn't even formally recognized as a medical condition until the 1960s, by the time the 90s rolled around, diagnoses and stimulant prescriptions were extremely prevalent. (Raise your hand if you grew up in the era of "Anyone who struggles in school gets Ritalin!") Today, diagnoses and treatment are a lot more thoughtful and individualized, and there are more options for treatment and therapy including but not limited to stimulants like the well-known Ritalin. Even with all these advancements, though, we still have more to learn.

A new long-term study published in the Journal of Clinical Psychiatry has proven to be an excellent next step in getting a better understanding of the disorder, showing that a lot of what's commonly believed or assumed about ADHD is incomplete or just flat-out wrong.

Researchers studied 483 participants who were diagnosed with ADHD in childhood and continued to assess them for a period of 16 years. The study's authors wanted to get a sense of how ADHD symptoms might change over time.

What the researchers found surprised them. In most participants, symptoms of ADHD fluctuated greatly over the years rather than staying consistent. What surprised them even more were the environmental factors that seemed to play a role in those fluctuations.

adhd, children, kids, mental health, neurodivergent, brains, psychology, medicine, research, medical studies ADHD brains work in mysterious ways, but we're starting to get a clearer picture. Photo by BUDDHI Kumar SHRESTHA on Unsplash

Researchers expected that greater life demands—like more responsibility at work, a heavier workload at school, major life changes, etc.—would exacerbate ADHD symptoms. What they found was the opposite.

It makes sense that a person that struggles with inattention or hyperactivity might have more trouble focusing when they have more "going on" and more distractions to pull them in different directions. It was a huge surprise to the researchers that, actually, people's ADHD symptoms seemed to ease up when life got hectic.

“We expected the relationship between environmental demands and ADHD symptoms to be the opposite of what we found,” study author, professor, and clinical psychologist Margaret H. Sibley explained. “We hypothesized that when life demands and responsibilities increased, this might exacerbate people’s ADHD, making it more severe. In fact, it was the opposite. The higher the demands and responsibilities one was experiencing, the milder their ADHD.”

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I have a 4-year-old with ADHD and the findings totally track for me based on what I've witnessed in our own life.

We find it's actually easier to be in perpetual motion sometimes—out running errands, doing activities, visiting friends and family—versus staying put too long. When we're just relaxing at home, that's when she tends to start bouncing off the walls! Her ADHD tendencies come out strong in these quiet periods, including what we sometimes playfully refer to as her "hoarding" dozens of coloring sheets or surrounding herself in giant piles of toys, blankets, and stuffed animals; thereby making a huge mess in the house.

Doing nothing or doing very little is not often a restful state for people with ADHD. Typically, people with ADHD experience more background noise than neurotypical brains—so a quiet, seemingly restful environment can sometimes amplify racing thoughts, negative self-talk, and impulsive behavior versus dampening it. You know how kids sometimes act out in school not because they're not smart, but because the material is actually too easy for them and they're bored? Something similar is at play in both of these scenarios.

Of course, as always in science, you have to be careful assuming causation from the findings.

adhd, children, kids, mental health, neurodivergent, brains, psychology, medicine, research, medical studies The results show that staying busy may actually help relieve some ADHD symptoms. Annie Spratt/Unsplash

It's important to note that the results of the study don't definitively prove that being busy causes a decrease in ADHD symptoms.

“This might mean that people with ADHD perform their best in more demanding environments (perhaps environments that have stronger immediate consequences, like needing to put food on the table for a family or pay rent monthly). It also might mean that people with ADHD take more on their plate when their symptoms are relatively at bay," Sibley says. Either way, the correlation is certainly strong and worthy of more study.

In the meantime, the study's authors think the results could be viewed in a hopeful light for people just learning to manage their ADHD. “If you’re a doctor talking with a patient who is first getting diagnosed with ADHD, it’s a huge help for that person to hear the message that, ‘You’re going to have good years and not-so-good years, but things can go really well for you if you can get the right factors in place,'” Sibley said. As a parent, I can imagine how reassuring that would have been to hear early on in our own process.

adhd, children, kids, mental health, neurodivergent, brains, psychology, medicine, research, medical studies We still have so much to learn. Photo by Europeana on Unsplash

With ADHD diagnoses on the rise, more and more research is being conducted. For example, a recent long-term study out of Sweden was just published linking use of ADHD medication with a reduction in traffic crashes, general injuries, and criminal behavior. That's a strong argument for continuing to hone in on accurate diagnoses and treatment for people who need it, as it clearly benefits society as a whole when done properly!

We're learning more and more about what the factors that affect positive ADHD outcomes are—what might exacerbate symptoms and what types of things can help—and we're starting to get a clearer picture of how people can manage this challenging disorder.

This article originally appeared last year. It has been updated.

Family

Dad's simple advice for avoiding after-school tiffs with kids is surprisingly spot on

This is a great tip for dealing with kids who just want to shut down after school.

@thecalmparentingpodcast/TikTok

Everybody needs to decompress

School can be physically, emotionally, and mentally draining for kids. After a day full of rigid structure, oftentimes the only thing they want to do is veg out and decompress. And this can cause some friction at home when parents expect them to immediately be present.

But one dad, who just so happens to host a parenting podcast, has a great bit of advice to avoid those afterschool conflicts. And while his tips were geared towards parents of neurodivergent kids, it’s easy to see how this could help any family have more peaceful afternoons.

“So many of you have strong-willed, neurodivergent ADHD kids who are tapped out mentally and emotionally and socially at school, probably by like noon or 2 p.m. every day,” Kirk Martin, host of The Calm Parenting Podcast, begins in a TikTok clip.

The main culprit behind the fatigue? A lack of autonomy.



“Everything is out of their control at school. They don't really control what they do, where they go, where they sit, and people are telling them what to do all day.”

With this in mind, the solution is rather simple, Martin notes. Instead of asking questions or getting onto them about thenings, give kids a sense of control.

Martin then shares how he came about this revelation, saying “We used to do these after-school camps for kids, and they'd come in, they'd be really bossy with me. And so my initial response inside was, ‘Well, you're a bossy little jerk. No wonder you don't have any friends.’ But that was just me being a jerk.”

Martin then switched his approach. For example, he’d tell his kid “in the basement, there's a broom that's broken. Do you think you can find some duct tape down there and fix it for me?” which gave them an opportunity to do something tactical that was within their control.

“That is very, very settling for your kids,” Martin points out.

Ideally, Martin suggests offering something that doesn't require sitting in front of a screen, and doesn’t feel like more school. “Give them an adult-type job, not a homework-type thing. Do a treasure hunt outside. Bet you can't find this. I hid it in the backyard. They get fresh air. All those things are really, really cool for your kids after school because it just calms them. It's a nice introduction to the afternoon and evening,” he says.

Down in the comments, viewers shared how spot on they felt this advice was

“Thank you for the reminder,” one mom wrote. “ADHD makes homework and chores feel PAINFUL for both of us (and takes forever) so the desire to start the second he’s home is strong..”

“Love this,” wrote another.” My ADHD daughter takes hours to recoup from school!”

Others pointed out that simply allowing kids to have that decompress time can work wonders. After all, that is still a version of them exercising control.

“Giving them a space when they get home does incredible things! Veg and alon time is magic,” one person shared.

“My children just like me needed some alone time doing absolutely nothing,” added another.

Bottom line: no human can be “on” all the time.We all know how overwhelming it feels to be burnt out and in need of a break…and how reenergizing it is to have complete freedom once in a while. When we remember this simple truth, it becomes easier to extend a little grace, and find solutions that benefit everyone.