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ADHD Is Not Just Lack of Focus: The Effects Can Be Dangerous

Sub-optimal judgments are associated with executive function deficits in ADHD.

Key points

  • ADHD can be dangerous, with life-altering addictions, risky behaviors, and even suicide.
  • Dangers of ADHD blunt select treatment protocols, including appropriate medication and a variety of self-help techniques
  • Researchers found that those diagnosed with ADHD as adults are more than four times likely to die prematurely than those not afflicted with ADHD.
Photo by Tara Winstead from Pexels
Source: Photo by Tara Winstead from Pexels

Many fail to understand that ADHD is far more than a benign condition simply challenging one’s learning and organizational skills and ability to focus and concentrate on daily routines and tasks. It is not merely a caricature of the joking remark, “You must be a little ADHD,” directed at someone acting a bit distractedly. Indeed, unchecked, the condition can prove literally dangerous, its victims pursued by their propensity for life-altering addictions, risky behaviors, and even suicide.

A 2015 study published in The Lancet reported an association between ADHD and “excess mortality [due to] deaths from unnatural causes, especially accidents.” (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)6168…) In fact, study investigators indicate that those diagnosed with ADHD as adults – age 18 or older – are more than four times likely to die prematurely than those not afflicted with the disorder. In the recently published book ADHD 2.0, the two psychiatrist authors quote ADHD expert and psychologist Russell Barkley Ph.D. as saying, “Two-thirds of people with ADHD have a life expectancy reduced by up to 21 years” – far greater than the time shaved off by such public health issues as smoking, obesity, and diabetes.

Who Are Those Dangerous ADHD Minions?

Much of the blame for the dangers that lurk can be placed on the tendency of ADHD patients to become distracted, adventurous, and engaged in high-risk behaviors. The scientific literature is awash in studies showing a link between car crashes and ADHD. A 2017 article in JAMA Pediatrics suggests both adolescents and young adults with ADHD “experience an estimated 36 percent higher motor vehicle crash risk than their [non-ADHD] counterparts regardless of [driver] licensure age or sex.” (https://jamanetwork.com/journals/jamapediatrics/fullarticle/2631767) Writers of another study, this one in the online publication PLOS One, conclude that one of ADHD’s significant hallmarks, namely distraction -- both internal (mental) and external, can lead to “attention failures,” which significantly increase an adult driver’s chances for causing a motor vehicle accident. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4275204/)

Scientists reporting in a 2021 edition of Neuroscience & Biobehavioral Reviews concur, indicating that ADHD patients, in general, are “at increased risk of accidents and injury” across the lifespan and that the risk is even greater among those with ADHD and co-existing mental disorders like depression and anxiety. (https://www.sciencedirect.com/science/article/pii/S0149763421000567) Supporting their contention are findings of a 2018 study (published in the Wiley Online Library) suggesting children and young adults with ADHD are at greater risk of suffering fractures, burns, and poisonings. (https://onlinelibrary.wiley.com/doi/10.1111/cch.12591)

Meanwhile, other recent studies describe connections between ADHD and addictions, such as substance abuse and gambling, and ADHD and suicide. In work just published in June 2021 in JAMA Network Open, the Lifespan Brain Institute of Children’s Hospital of Philadelphia and the University of Pennsylvania call for “early diagnosis and treatment of behavioral symptoms with ADHD medication.” (https://www.chop.edu/news/adhd-medications-associated-reduced-risk-suic…) They see the medication as both a method for improving behavior and learning problems and a strategy for decreasing risk of suicide. In their assessment of nearly 12,000 children, the authors determined that those not receiving ADHD treatment, but who showed “severe externalizing symptoms,” were more likely to express suicidal tendencies at one-year follow-up. The Centers for Disease Control and Prevention cite suicide as being the second leading cause of death among those between ages of 10 and 24 during 2018.

Of equal concern is the safety of children, particularly very young children, under care of a parent or parents with ADHD. Authors of a 2015 study in the journal Medicine indicate that fathers with ADHD who may have difficulties recognizing injury risk, “cannot enforce safety rules, and who are more permissive toward their children, may not be able to provide the necessary supervision for preventing possible injuries” to their children. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616671/). These same scientists call such unintentional childhood injuries “a growing global public health problem,” causing an estimated one million deaths annually.

Is It All About Taking Risks?

To ascribe risk-taking and distraction as the primary sources of danger for the ADHD-afflicted would be to underestimate the complexities of the disorder. In two studies appearing in a 2021 edition of the Journal of Attention Disorders, researchers suggest that the underlying mechanism for ADHD-related “bad” or questionable behavior in adults may be less due to “risk-seeking” and more the result of what the authors call “sub-optimal decision-making.” (https://journals.sagepub.com/doi/10.1177/1087054718815572https://journa…) Sub-optimal judgments are associated with executive function deficits in ADHD, lack of motivation, and the difficulties ADHD patients have in investing the necessary mental effort to make the wisest, most advantageous choices, the investigators state.

And the Answer Is…

For those recently diagnosed with ADHD – or who suspect they have the disorder, the next step is to find the right clinician and seek help. Chronic forgetfulness, poor concentration, failure to complete projects or finish tasks, time-management problems, impulsiveness, lack of emotional control, anxiety, and sleep-related problems are all warning signs.

Research has demonstrated that the dangers of ADHD can be blunted through select treatment protocols, including appropriate medication, and a variety of self-help techniques, such as:

· Adding more structure to life by using filing systems, organizers, planners, calendars – even just a wristwatch -- to keep one on task, on deadline, and on time.

· Avoiding the urge to multi-task. Concentrate on one or two projects at a time to ensure they get completed in a systematic – not overwhelming – fashion.

· Investing time in mindfulness meditation to quiet racing thoughts and calm mind and body.

· Exercising regularly. Consider joining a yoga class. Studies have shown yoga can help reduce ADHD symptoms.

· Reaching out for family and friend support and professional counseling if losing control of behavior through addictions like gambling or street drugs or experiencing suicide ideation.

ADHD may have its monsters under the bed, but it does not have to become a premature death sentence.

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