I have ADHD, and I am certain that most of the reduced life expectancy is from chronic stress- a well established killer. With ADHD you frequently don’t have the executive control to do what you decided to do, and needs to get done. This leads to constantly being terrified of failing at everything, and letting everyone in your life down. Often calling yourself (and being called by others) lazy, unreliable, disorganized, etc. even when you care deeply and are doing everything you can to succeed.
It would be nice to figure out what can be done about this. I’ve found I usually have dangerously high blood pressure, but a few minutes of slow exhale breathing exercises and a short walk brings it down to normal. Which I usually feel I am too stressed and busy to do.
This is so hard to explain, especially to people dear to you. Like, how many times can you say I‘m sorry, I didn’t ignore your messages on purpose, I just… couldn’t before they grow tired of it? And at the same time you notice how you desperately long for the contact, but the guilt and shame for letting people wait indefinitely makes it ever harder to actually reach out. It’s a devious cycle, and constant source of ever-increasing stress.
Don’t have energy cause I fucked things up, fuck things up because I don’t have energy.
Substance abuse, suicide, and impulsive behavior are also likely contributors[1]. There are multiple studies that have found medication is associated with a significant reductions in unnatural deaths [2][3].
It really is underappreciated IMO that ADHD medications are some of the most effective pharmacological interventions in all of psychiatry. There are risks and concerns but by and large they are figuratively and literally life-saving.
Yep. Immense stress can also be a learned proactive tactic. You build up stress via procrastination until the level is high enough to overcome any disfunction.
Stress is certainly a killer, but it's a facet of a broader factor.
Society has built up a lot of systems to support people, to protect us from our environment and ourselves, and they've been incredibly successful; average lifespans have increased dramatically... literally by decades.
For the most part, these systems are built in response to and designed around how "we" expect peoples' brains work. If your brain doesn't work those ways, many of those support systems are unnecessary, ineffective, or worse still: harmful. There's also no doubt a bunch of systems that could be designed & built that could to help support & protect people with challenges that are largely non-existent for people whose brains work as we expect.
That the combined consequence of this is less that a decade of life expectancy for people with ADHD is actually quite remarkable, but let's not kid ourselves: we could be doing so much better.
Simplify your life, go cheap and use extra time to both reduce stress and spend less time in stressful situations.
I’m probably an undiagnosed ASD and that’s what I ended up doing and plan to take to more extreme level as life situation allows. Fancy stuff and „fitting in“ is not worth it.
I find that stress leads to this endless cycle of drinking at night to clam the brain (otherwise I spend half the night panicking and ruminating over every little thing), followed by energy drinks the next day to keep focused without taking proper medication. I ended up having to quit most of it when the toll on the body was too much after years and years.
The ugly possibility, which this (good) study is too shallow to surface, is that a lifetime of pharmaceutical treatment might be at play.
While amphetemines and adjacent drugs may provide critical relief of symptoms and may be experienced differently by sufferers than non-sufferers, they're still deeply unkind drugs to the body, and years or decades of daily use might have inconvenient consequences that show up in data like this, once someone starts looking.
It's not directly implicated by the results, as no particular causitive factors are, but it's an unfortunately possible factor that the authors chose not to suggest in their discussion.
This is what I'd hoped to find when I clicked on the link.
Just today I had a discussion with a friend of mine, who is diagnosed with ADHD and currently trying out Elvanse (kind of similar to Adderall), and he was adamant about not wanting to stay on it in the long term. He insisted that it can't be the correct answer, because of how much it 'removed' him from feeling like himself, plus all the negative side effects (e.g. higher risk of cardiovascular diseases).
I countered that for some 'conditions', medication just is the correct way to handle it, and so I wouldn't be so quick to rule out the possibility that long-term use of these medications is actually the best way forward (though don't get me wrong, I wouldn't push anyone to use this stuff either-- I'm just hesitant when it comes to blanket statements like 'this can't be the answer').
But that's precisely where more data would be needed. What has the better outcome, for most people? Treating your ADHD with amphetamines, (temporarily) raising your quality of life, but risking damaging your body or brain? Or trying to make due without it, if the situation is at least somewhat manageable with other means such as yoga, meditation etc, and going easier on your body, but possibly never reaching the level of 'focused functioning' and presumably associated lower levels of stress that you might have with the medication?
That has been extensively studied, and all cause mortality is much lower for people on ADHD medication than untreated. There is a slightly higher risk of cardiovascular issues from stimulants, but that is tiny compared to the much larger risks of a bunch of other causes of mortality with untreated ADHD.
One study cited by the paper looked at long(er) term cardiovascular risk (most likely concern for stimulants) and found that while people with ADHD had significantly higher risk of cardiac events there wasn't a significant difference between medicated and unmedicated individuals (11.8 year average follow-up).
IMO its definitely possible there are increased risks but its unlikely they overshadow the associated significantly reduced risk of unnatural mortality for most people with ADHD. More research, better risk screening, and non-stimulant medication options are all still great directions to move in though.
After decades of providing treatment for ADHD adults I've come to the conclusion that ADHD is one of the most disabling mental health disorders. In some ways ADHD can be as devastating to a person's life as bipolar disorder or schizophrenia. While ADHD is highly prevalent among adults its manifestations are typically subtle. As a result, symptoms are attributed to incidental factors and the nature of the person's condition remains hidden.
The article does a good job of addressing factors that contribute to ADHD-linked disability, and ways to deal with them. Clearly underdiagnosis sums up the primary issue. Solving a problem starts with recognizing the problem exists. However the article didn't discuss an important reason ADHD is overlooked, that is, widespread tremendous bias against recognizing the realities of adult ADHD.
Reducing the burden of ADHD via social approaches faces a major challenge: how to inform or educate the public about realities of ADHD throughout the life cycle. While there has been marginal improvement over the last 25 years, prejudice or misunderstanding remain predominant.
IMO the place to start is with the provider community. Healthcare practitioners need training to recognize ADHD among comorbidities and participate in its management. Once providers are actively advocating appropriate treatment for ADHD patients, family members, et. al., will likely follow clinicians' lead, become more amenable to helping ADHD individuals.
Economic costs of ADHD are substantial. Reports give estimates that of $143 to $246 billion/year in the US alone.[0] If nothing else these figures illustrate the potential benefits of providing proper care to adults with ADHD.
Our culture demands that you just do the unpleasant activity and suck it up. Often. It's a lifestyle. School, work etc.
Normies just say "ok" and get on with their life.
ADHDers can't really do that. They can't eat it and get on with their life. They get stuck at the threshold. It's a choice between eternal stress or rejecting society. Both deliver a shortened lifespan.
These results sadden me when I know there is such a stigma about treating it. From the doctors to the pharmacist you get treated like crap trying to seek the most effective medication for this disorder, stimulants.
There are so many legal hurdles and shortage BS you gotta go through as well.
> The apparent reduction in life expectancy for adults with diagnosed ADHD relative to the general population was 6.78 years (95% CI: 4.50 to 9.11) for males, and 8.64 years (95% CI: 6.55 to 10.91) for females.
It's not clear to me that there is a difference. It looks like the confidence intervals overlap.
This is just pure (somewhat informed) speculation.
ADHD is diagnosed roughly twice as often in men than women, and when diagnosed in women it is much more likely to be of primarily inattentive rather than hyperactive type compared to men. Many suspect ADHD may not actually be rarer in women, but just that the inattentive type is harder to diagnose, and more often never diagnosed- mostly because it is less disruptive to others in school settings.
I speculate that the women that are diagnosed are much more enriched for severe inattentive type ADHD, and I also speculate that inattentive type has a shorter life expectancy than hyperactive type. Just judging from myself, and other adults I know with ADHD: the hyperactive type ones tend to remain really physically active even into old age- unusually so, and the inattentive type tend to have a lot more depression, anxiety, and stress.
I might be missing something but I think this may just be because women live longer on average. If we assume an equal increase in risk between men and women then women would automatically have a higher reduction in life expectancy.
Women typically live longer, so I was curious if this was a similarly proportional reduction in life expectancy for each group. Current life expectancy in the UK:
78.6 years for males, so 6.78 years is 8.6% of the average life expectancy
82.6 years for females, so 8.64 years is 10.4% of the average life expectancy
I think this is a relatively small difference in effect between the two, but I can't say for certain.
There is a difference in life expectancy in general so it would be remarkable if these are nonzero and the same. (I.e. exact same increase in risk of death at any pre-retirement age for both populations means higher change to life expectancy for women.)
Copy pasting the article: The aim of this study was to provide the first estimate of life expectancy for UK adults diagnosed with ADHD. We found that adults diagnosed with ADHD are living shorter lives than they should: the apparent years of life lost for males was around 7 years, and for females, 9 years, compared with the general population. We believe that this is unlikely to be because of ADHD itself and likely caused by modifiable factors such as smoking, and unmet mental and physical health support and unmet treatment needs. The findings illustrate an important inequity that demands urgent attention.
They establish that people with ADHD live shorter lives by about 6-9 years on average. They speculate on, but do not directly investigate possible reasons for this.
Title: Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: matched cohort study | The British Journal of Psychiatry | Cambridge Core
ADHD is a neurodevelopmental disorder affecting attention and impulse control, often persisting into adulthood for about 90% of diagnosed children.
The global prevalence of adult ADHD is estimated at 2.8%, yet many adults in the UK remain undiagnosed and unsupported.
Individuals with ADHD face significant social and economic challenges, including educational underachievement, unemployment, and increased risk of substance abuse and mental health issues.
Adults diagnosed with ADHD have a higher likelihood of experiencing various health problems, including cardiovascular diseases and mental health disorders, as well as a greater risk of suicide.
A meta-analysis indicates that individuals with ADHD are twice as likely to die prematurely compared to the general population.
The study estimated that adults with ADHD in the UK experience a loss of approximately 6.78 years of life for males and 8.64 years for females compared to their non-ADHD counterparts.
The research utilized a matched cohort study design, analyzing data from UK electronic health records to assess mortality and life expectancy.
Adults with ADHD often have comorbid conditions that complicate their health outcomes, leading to increased mortality rates.
The findings emphasize the urgent need for improved support services and interventions for adults with ADHD to address their unmet health needs and reduce health disparities.
The study calls for policy initiatives similar to those addressing the life expectancy of autistic individuals, highlighting the necessity for targeted support for adults with ADHD to mitigate the risks associated with the disorder.
A recent matched cohort study published in the British Journal of Psychiatry analyzed data from over nine million UK adults between 2000 and 2019 to assess life expectancy and years of life lost among those diagnosed with ADHD. The research included 30,039 adults with diagnosed ADHD and compared them to 300,390 matched individuals without the diagnosis. Findings revealed that adults with diagnosed ADHD experienced a significant reduction in life expectancy, losing approximately 6.78 years for males and 8.64 years for females compared to the general population. This disparity is likely driven by modifiable risk factors and unmet mental and physical health needs associated with ADHD and its comorbid conditions. The study underscores the critical need for enhanced support and treatment services for adults with ADHD in the UK to address these preventable health inequalities and improve overall life outcomes.
I have a friend whose son was prescribed Adderall when he was 12-13 years old. She noticed the adverse effects right away, so she discontinued the drug, and took her son out of school for a year. He did much better getting homeschooled, and was able to return to the public school system after a year.
Most of the "mental health" diagnoses have to do with metabolic problems. Emotional stress is one of the drains on the body's energy reserves.
I follow the trail of links, but they lead to nowhere. Also the dosage of cocaine is typically orders of magnitude higher than therapeutic amphetamines/mph. Not saying that there is or is not some truth to this, but the jury is still out on this one.
[+] [-] UniverseHacker|1 year ago|reply
It would be nice to figure out what can be done about this. I’ve found I usually have dangerously high blood pressure, but a few minutes of slow exhale breathing exercises and a short walk brings it down to normal. Which I usually feel I am too stressed and busy to do.
[+] [-] 9dev|1 year ago|reply
Don’t have energy cause I fucked things up, fuck things up because I don’t have energy.
[+] [-] enragedcacti|1 year ago|reply
It really is underappreciated IMO that ADHD medications are some of the most effective pharmacological interventions in all of psychiatry. There are risks and concerns but by and large they are figuratively and literally life-saving.
[1] https://www.adhdevidence.org/evidence#premature-death
[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC10936112/
[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC10901868/
[+] [-] floxy|1 year ago|reply
https://www.publichealth.columbia.edu/news/research-shows-st...
They are also at higher risk for any type of unintentional injury:
https://pmc.ncbi.nlm.nih.gov/articles/PMC10107297/
I believe that people with ADHD are over-represented in first-responder type careers, which also carries more risk:
https://www.ems1.com/ems-products/fitness-mental-health-well...
And are know to engage in more risky behavior in general:
https://neurolaunch.com/no-sense-of-danger-adhd/
And substance abuse among those with ADHD is much higher than the general population:
https://www.webmd.com/add-adhd/adhd-and-substance-abuse-is-t...
[+] [-] seizethecheese|1 year ago|reply
[+] [-] cbsmith|1 year ago|reply
Society has built up a lot of systems to support people, to protect us from our environment and ourselves, and they've been incredibly successful; average lifespans have increased dramatically... literally by decades.
For the most part, these systems are built in response to and designed around how "we" expect peoples' brains work. If your brain doesn't work those ways, many of those support systems are unnecessary, ineffective, or worse still: harmful. There's also no doubt a bunch of systems that could be designed & built that could to help support & protect people with challenges that are largely non-existent for people whose brains work as we expect.
That the combined consequence of this is less that a decade of life expectancy for people with ADHD is actually quite remarkable, but let's not kid ourselves: we could be doing so much better.
[+] [-] amanaplanacanal|1 year ago|reply
[+] [-] mantas|1 year ago|reply
I’m probably an undiagnosed ASD and that’s what I ended up doing and plan to take to more extreme level as life situation allows. Fancy stuff and „fitting in“ is not worth it.
[+] [-] AutistiCoder|1 year ago|reply
[+] [-] giantg2|1 year ago|reply
[+] [-] morkalork|1 year ago|reply
[+] [-] swatcoder|1 year ago|reply
While amphetemines and adjacent drugs may provide critical relief of symptoms and may be experienced differently by sufferers than non-sufferers, they're still deeply unkind drugs to the body, and years or decades of daily use might have inconvenient consequences that show up in data like this, once someone starts looking.
It's not directly implicated by the results, as no particular causitive factors are, but it's an unfortunately possible factor that the authors chose not to suggest in their discussion.
[+] [-] mckirk|1 year ago|reply
Just today I had a discussion with a friend of mine, who is diagnosed with ADHD and currently trying out Elvanse (kind of similar to Adderall), and he was adamant about not wanting to stay on it in the long term. He insisted that it can't be the correct answer, because of how much it 'removed' him from feeling like himself, plus all the negative side effects (e.g. higher risk of cardiovascular diseases). I countered that for some 'conditions', medication just is the correct way to handle it, and so I wouldn't be so quick to rule out the possibility that long-term use of these medications is actually the best way forward (though don't get me wrong, I wouldn't push anyone to use this stuff either-- I'm just hesitant when it comes to blanket statements like 'this can't be the answer').
But that's precisely where more data would be needed. What has the better outcome, for most people? Treating your ADHD with amphetamines, (temporarily) raising your quality of life, but risking damaging your body or brain? Or trying to make due without it, if the situation is at least somewhat manageable with other means such as yoga, meditation etc, and going easier on your body, but possibly never reaching the level of 'focused functioning' and presumably associated lower levels of stress that you might have with the medication?
[+] [-] kqr|1 year ago|reply
[+] [-] UniverseHacker|1 year ago|reply
[+] [-] enragedcacti|1 year ago|reply
IMO its definitely possible there are increased risks but its unlikely they overshadow the associated significantly reduced risk of unnatural mortality for most people with ADHD. More research, better risk screening, and non-stimulant medication options are all still great directions to move in though.
https://pubmed.ncbi.nlm.nih.gov/36073682/
[+] [-] jrapdx3|1 year ago|reply
The article does a good job of addressing factors that contribute to ADHD-linked disability, and ways to deal with them. Clearly underdiagnosis sums up the primary issue. Solving a problem starts with recognizing the problem exists. However the article didn't discuss an important reason ADHD is overlooked, that is, widespread tremendous bias against recognizing the realities of adult ADHD.
Reducing the burden of ADHD via social approaches faces a major challenge: how to inform or educate the public about realities of ADHD throughout the life cycle. While there has been marginal improvement over the last 25 years, prejudice or misunderstanding remain predominant.
IMO the place to start is with the provider community. Healthcare practitioners need training to recognize ADHD among comorbidities and participate in its management. Once providers are actively advocating appropriate treatment for ADHD patients, family members, et. al., will likely follow clinicians' lead, become more amenable to helping ADHD individuals.
Economic costs of ADHD are substantial. Reports give estimates that of $143 to $246 billion/year in the US alone.[0] If nothing else these figures illustrate the potential benefits of providing proper care to adults with ADHD.
[0] https://www.jaacap.org/article/S0890-8567(12)00538-2/abstrac...
[+] [-] viraptor|1 year ago|reply
[+] [-] localghost3000|1 year ago|reply
[+] [-] swayvil|1 year ago|reply
Normies just say "ok" and get on with their life.
ADHDers can't really do that. They can't eat it and get on with their life. They get stuck at the threshold. It's a choice between eternal stress or rejecting society. Both deliver a shortened lifespan.
[+] [-] klipklop|1 year ago|reply
There are so many legal hurdles and shortage BS you gotta go through as well.
[+] [-] chuankl|1 year ago|reply
[+] [-] bhelkey|1 year ago|reply
It's not clear to me that there is a difference. It looks like the confidence intervals overlap.
[+] [-] UniverseHacker|1 year ago|reply
ADHD is diagnosed roughly twice as often in men than women, and when diagnosed in women it is much more likely to be of primarily inattentive rather than hyperactive type compared to men. Many suspect ADHD may not actually be rarer in women, but just that the inattentive type is harder to diagnose, and more often never diagnosed- mostly because it is less disruptive to others in school settings.
I speculate that the women that are diagnosed are much more enriched for severe inattentive type ADHD, and I also speculate that inattentive type has a shorter life expectancy than hyperactive type. Just judging from myself, and other adults I know with ADHD: the hyperactive type ones tend to remain really physically active even into old age- unusually so, and the inattentive type tend to have a lot more depression, anxiety, and stress.
[+] [-] enragedcacti|1 year ago|reply
[+] [-] solid_fuel|1 year ago|reply
78.6 years for males, so 6.78 years is 8.6% of the average life expectancy
82.6 years for females, so 8.64 years is 10.4% of the average life expectancy
I think this is a relatively small difference in effect between the two, but I can't say for certain.
[+] [-] snailmailstare|1 year ago|reply
[+] [-] oth001|1 year ago|reply
[+] [-] yapyap|1 year ago|reply
[+] [-] kanwisher|1 year ago|reply
[+] [-] amarcheschi|1 year ago|reply
[+] [-] UniverseHacker|1 year ago|reply
[+] [-] sillypuddy|1 year ago|reply
[+] [-] ben30|1 year ago|reply
Title: Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: matched cohort study | The British Journal of Psychiatry | Cambridge Core
ADHD is a neurodevelopmental disorder affecting attention and impulse control, often persisting into adulthood for about 90% of diagnosed children.
The global prevalence of adult ADHD is estimated at 2.8%, yet many adults in the UK remain undiagnosed and unsupported.
Individuals with ADHD face significant social and economic challenges, including educational underachievement, unemployment, and increased risk of substance abuse and mental health issues.
Adults diagnosed with ADHD have a higher likelihood of experiencing various health problems, including cardiovascular diseases and mental health disorders, as well as a greater risk of suicide.
A meta-analysis indicates that individuals with ADHD are twice as likely to die prematurely compared to the general population.
The study estimated that adults with ADHD in the UK experience a loss of approximately 6.78 years of life for males and 8.64 years for females compared to their non-ADHD counterparts.
The research utilized a matched cohort study design, analyzing data from UK electronic health records to assess mortality and life expectancy.
Adults with ADHD often have comorbid conditions that complicate their health outcomes, leading to increased mortality rates.
The findings emphasize the urgent need for improved support services and interventions for adults with ADHD to address their unmet health needs and reduce health disparities.
The study calls for policy initiatives similar to those addressing the life expectancy of autistic individuals, highlighting the necessity for targeted support for adults with ADHD to mitigate the risks associated with the disorder.
[+] [-] Wheaties466|1 year ago|reply
[+] [-] tcj_phx|1 year ago|reply
Most of the "mental health" diagnoses have to do with metabolic problems. Emotional stress is one of the drains on the body's energy reserves.
Stimulants like amphetamine 'shred' our mitochondria. It's okay for a short-term boost, but causes deterioration too: https://news.ycombinator.com/item?id=18211048
[+] [-] hirvi74|1 year ago|reply