A Silent Struggle… For People Suffering From Attention Disorder

It was a typical Monday morning for Rishi Tandon (name changed), a 29-year-old graphic designer living in Bengaluru. Like most days, he sat at his desk, determined to get through his task list. He had emails to reply to, client work to finish and a presentation due by the afternoon.

But somehow, as the hours slipped by, he found himself jumping between browser tabs, watching unrelated videos and staring blankly at his screen. His mind wouldn’t stay calm.

When his manager called to check on the presentation, Rishi panicked — he hadn’t even started it. He apologised, blaming it on a bad night’s sleep, but deep down he knew this wasn’t new. It happened all the time. Friends would call him “scattered” or “easily distracted,” and he would laugh it off. But lately, it felt like he was losing control of his own brain.

What Rishi didn’t know is that he wasn’t alone. He was living with undiagnosed adult attention-deficit/hyperactivity disorder (ADHD),  a condition that has been viewed primarily as a childhood disorder, often associated with hyperactive young boys who can’t sit still in classrooms.

But the reality is far more complex. ADHD is a common neurodevelopmental disorder that affects children and often continues into adulthood. A World Health Organization report says roughly 5 percent of children globally are diagnosed with ADHD.

A systematic review analysed global ADHD prevalence and incidence among children and adults from 2020 onward, revealing wide variations largely driven by differences in diagnostic methods and study quality. Survey-based studies, particularly in Asia, often showed inflated prevalence rates due to reliance on self-reports and less rigorous methodologies.

Conservative estimates

However, studies using medical records or clinical interviews, more common in North America and parts of Europe, reported more conservative estimates. Only a few studies were considered low-risk, and these found ADHD prevalence in children ranging from 3.2 percent in Sweden to 10.5 percent in the US.

Evidence suggested higher rates among older children compared to younger ones, with slight increases in recent years. The COVID-19 pandemic caused temporary disruptions in ADHD diagnosis and treatment, such as a dip in prescription rates in 2020 followed by a rise in 2021, reflecting healthcare access issues rather than true prevalence changes.

Despite increasing demand and reports of long waiting lists for ADHD assessments, reliable data on referrals, private assessments and diagnosis conversion rates (percentage of individuals who, after being initially diagnosed with one condition, are later diagnosed with a different condition) remain scarce.

A 2024 research study in India indicated that prevalence rates range from 1.3 percent to 28.9 percent, with higher rates among males, but many cases — especially among females and minority groups — go undiagnosed due to cultural and systemic barriers.

Diagnosis and treatment vary widely across regions, largely due to gaps in healthcare, research and professional training. Although national mental health policies exist, their implementation is inconsistent. Improving diagnosis and support in India requires more trained professionals, better school support, and culturally sensitive interventions.

Another systematic review found that adult ADHD is quite common in India, with prevalence rates ranging from 5.48 percent to 25.7 percent across various population groups.

Adult ADHD often presents differently from its childhood counterpart. People such as Rishi may not exhibit classic hyperactivity. Instead, they may silently battle chronic inattention, forgetfulness, impulsivity and emotional dysregulation. It’s not about lack of willpower or motivation — it’s a neurological condition.

Adults with ADHD were significantly more likely to experience job instability, relationship difficulties and mood disorders compared to non-ADHD peers. They also reported more frequent legal troubles and financial struggles.

ADHD affects multiple areas of life: projects go unfinished, daily routines fall apart, appointments are forgotten and conversations are hard to follow. This can cause frustration and embarrassment, leading to a cycle of low self-esteem and chronic anxiety.

Emotional impact

The emotional toll of untreated ADHD can be devastating. Adults often feel like they are constantly underperforming, no matter how hard they try. Many describe a sense of internal chaos or frustration at not being able to control their thoughts. Over time, this may lead to comorbid conditions like depression, anxiety and even substance abuse.

It’s not just the individual who suffers. Partners, friends and family members are often affected too. Caregivers may feel overburdened or resentful. Without understanding what’s going on, ADHD behaviours are often misinterpreted as laziness, irresponsibility or lack of care. Over time, this can strain relationships and lead to caregiver burnout.

With a 70-80 percent heritability rate for ADHD, genetic factors are significant. The rearing family and social environment do not significantly contribute to the remaining 20-30 percent variance. This positions it among the most strongly inherited psychiatric conditions. Genes involved in dopamine transmission, including DRD4 and DAT1, are commonly associated with the disorder.

People with ADHD often have smaller brains and delayed brain maturation, particularly in areas like the amygdala, hippocampus and frontal cortex. These regions are involved in emotion regulation, memory and cognitive functions such as attention and planning.

The motor cortex matures faster in ADHD, possibly contributing to restlessness. Delays in the maturation of the frontal lobe, particularly the premotor and prefrontal cortex, affect attention, impulse control and social behaviour. However, brain size does not impact intelligence.

While ADHD is not caused by diet, certain lifestyle choices may influence symptoms. But diets high in sugar and low in essential nutrients can exacerbate symptoms in genetically predisposed individuals. Similarly, poor sleep, high stress and lack of physical activity can all impact symptom severity.

However, popular beliefs — such as “sugar causes ADHD” — are largely unsupported. A meta-analysis concluded that sugar does not cause ADHD, though it might affect behavioural responses in some children.

For someone like Rishi, understanding his condition can be transformative. A diagnosis isn’t a label — it’s a roadmap. It offers validation and opens doors to effective treatments, which may include cognitive behavioural therapy (CBT), medication (stimulants like methylphenidate or non-stimulants like atomoxetine) and environmental or behavioural modifications.

Cognitive-behaviour therapy is structured, time-limited psychotherapy that helps individuals identify and challenge negative thought patterns and behaviours. It focuses on improving emotional regulation and developing coping strategies for dealing with life’s challenges. CBT tailored for adults with ADHD significantly improves executive functioning and reduces symptoms.

Once equipped with the right tools, many adults with ADHD discover untapped potential. They often possess high levels of creativity, intuition and energy, especially when working in environments that allow flexibility and autonomy.

What’s most important is to shift how ADHD is viewed. It’s not about being lazy or undisciplined — it’s about having a brain that works differently and needs different kinds of support. For both children and adults, compassion, awareness and proper intervention are far more effective than judgement or criticism.

Asking for help is not a weakness; it’s the beginning of clarity. Understanding ADHD is not just about naming a disorder — it’s about finding hope, building strategies and realising that success and wellness are still within reach.