Blue Monday: ADHD can be predictive of poor mental health outcomes in adults

girl at night suffering depression
© Marcos Calvo Mesa

Adults with high levels of ADHD are more likely to experience poor mental health than adults with high levels of autistic traits

According to new research led by psychologists at the University of Bath, poor mental health including more symptoms of anxiety and depression are likely for adults with high levels of attention-deficit hyperactivity disorder (ADHD).

ADHD is a neurodevelopmental condition characterised by inattention and/or hyperactivity and impulsivity. The condition is estimated to affect between 3% and 9% of the population.

The effects of Blue Monday

On Blue Monday, the 16th of January – supposedly the saddest, gloomiest day of the year – a UK study shows that ADHD is more predictive of poor mental health outcomes in adults than other neurodevelopmental conditions, like autism.

With a severe lack of information on the effects of ADHD on poor mental health, there is far more research focusing on the impact of autism on depression, anxiety and quality of life.

Because of this, people with ADHD have often struggled to access the clinical care they need to cope with their symptoms.

“The fact that more people are willing to talk about it is to be welcomed”

When speaking on Blue Monday, lead researcher, Luca Hargitai, said: “Scientists have long known that autism is linked to anxiety and depression, but ADHD has been somewhat neglected.

“Researchers have also struggled to statistically separate the importance of ADHD and autism for mental health outcomes because of how frequently they occur together.”

Ms Hargitai, a PhD Researcher at Bath, added: “Our aim was to precisely measure how strongly ADHD personality traits were linked to poor mental health while statistically accounting for autistic traits.”

“The condition affects many people – both children and adults – and the fact that more people are willing to talk about it is to be welcomed.

“The hope is that with greater awareness will come more research in this area and better resources to support individuals in better managing their mental health.”

Computerised simulations with a 100% ‘reproducibility rate’

The study used a large, nationally representative sample of adults from the UK population, asking all participants to complete gold standard questionnaires – one on autistic traits, the other on ADHD traits.

Participants responded to statements such as “I frequently get strongly absorbed in one thing” and “How often do you feel overly active and compelled to do things, like you were driven by a motor?”

These results were replicated in computerised simulations with a 100% ‘reproducibility rate’. This showed, with great confidence, that ADHD traits are almost certainly linked to poor mental health outcomes, like more severe anxiety and depression symptoms in adults than autistic traits.

Funding for ADHD research – particularly psychological research – is lacking

Ms Hargitai said: “Our findings suggest that research and clinical practice must shift some of the focus from autism to ADHD. This may help to identify those most at risk of anxiety and depression so that preventative measures – such as supporting children and adults with the management of their ADHD symptoms – can be put in place earlier to have a greater impact on improving people’s wellbeing.”

According to Dr Punit Shah, senior author and associate professor of Psychology at Bath, another important aspect of the new study is that it advances scientific understanding of neurodevelopmental conditions.

“By addressing the shortcomings of previous research, our work provides fresh information about the complex links between neurodiversity and mental health in adults – an area that is often overlooked.

“Further research is now needed to delve deeper into understanding exactly why ADHD is linked to poor mental health, particularly in terms of the mental processes that might drive people with ADHD traits to engage in anxious and depressive thinking.

“At the moment, funding for ADHD research – particularly psychological research – is lacking. This is especially pronounced when you compare it to the relatively high level of funds directed at autism.

“As the evidence becomes clear that ADHD isn’t just a childhood condition but persists throughout life, we must adjust our research agendas to better understand ADHD in adulthood.”

“This is a step towards recognising the broader impact of unmanaged and untreated ADHD”

Commenting on the new findings, Dr Tony Floyd, CEO of ADHD Foundation, The Neurodiversity Foundation, said: “This research demonstrates clear evidence of the increased risks of mental health comorbidities associated with adult ADHD. This is a step towards recognising the broader impact of unmanaged and untreated ADHD.

“We hope this research will lead to more research being commissioned in this area. We also hope it will result in changes to the design and delivery of health services.

“The cost implications to the NHS of leaving ADHD untreated, and the need to better train health practitioners in both primary and secondary care, are now more apparent. And of course there are other costs too that need to be considered – to the health of UK citizens with ADHD and to their family life, employability and economic wellbeing. These costs are often hidden but they are considerable.

“This research from Bath University will add to the growing national debate and the business case for a national review of health services for ADHD across a person’s lifespan.”

The authors of the study hope their findings will trigger new research into ADHD and ultimately improve the mental health outcomes for people with the condition.

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