Reduced Life Expectancy in Untreated ADHD
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- Опубліковано 17 вер 2024
- This video discusses the results of my own research and many other studies on the impact of untreated ADHD on reduced life expectancy. My study found that cases having hyperactive child syndrome, or ADHD-C, in childhood manifested a 9.6 year reduction in estimated healthy life expectancy (ELE) in remaining years, a 1.2 year period of greater unhealthy life expectancy in remaining years, and an overall 8.4 year reduction in total life expectancy than did control children by young adulthood. Moreover, the persistence of ADHD to adult follow-up was associated with an even worse impact on these ELE measures, with a 12.7-year reduction in healthy life expectancy and an 11.1-year reduction in total ELE than was seen in control cases. Persistent cases had a 5.3-year reduction in healthy life expectancy and a 4.6-year reduction in total ELE than nonpersistent ADHD-C cases. And both persistent and nonpersistent ADHD cases had significantly lower ELEs by adulthood than did control cases. The magnitude of such reductions in life expectancy can be appreciated by understanding that such reductions are far greater than those associated with smoking, obesity, alcohol use, high cholesterol, and high blood pressure either individually or combined! These findings in the context of the other research noted above on increased mortality by mid-life argue for ADHD being viewed as a public health and not just a mental health disorder. They should also give impetus to efforts to try to reduce those first order factors that are predisposing to reduced life expectancy, such as obesity, smoking, excess alcohol use, poor diet, poor sleep, limited exercise, etc. in children and adults with ADHD. After all, estimated life expectancy is malleable - change the adverse health and lifestyle factors affecting it and one can improve quality of life as well as life expectancy. But our results also suggest that without efforts to address the background trait of poor inhibition specifically and ADHD symptoms more generally, trying to improve only those first order factors may have only limited success. Adding ADHD medications and evidence based psychosocial treatments to address the background traits predisposing those with ADHD to engage in these first order adverse activities is also likely to be necessary. Research on large populations now shows that treating ADHD in adulthood, especially with medications, reduces these various risks and thus would be expected to improve life expectancy
Barkley, R. A. & Fischer, M. (2019). Hyperactive child syndrome and estimated life expectancy at young adult follow-up: The role of ADHD persistence and other potential predictors. Journal of Attention Disorders, 23, 907-923.
Dalsgaard, S., Ostergaard, S. D., Leckman, J. F., Mortensen, P. B., & Pedersen, M. G. (2015). Mortality in children, adolescents and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet, 385, 2190-2196
This needs to be talked about more, there is too much ‘ADHD is a super power,’ and not enough ‘this is a deadly illness, that needs to be treated (hopefully one day cured)’
Agreed!
thank you so much, i totally agree. i'm really tired of the cutesy posts saying adhd isn't so bad and it's a superpower :(
@@russellbarkleyphd2023 wow, Dr. Barkley replied to me, even with one word, I am glowing.
I do like the article/essay that you and Dr. Hallowell put out from your joint session, on ‘super power v deadly illness’ debate. Apologies, I am abbreviating it and not using the proper title, but it is a beautiful comparison and common ground of two brilliant minds with some different approaches to ADHD.
@@patrickkelly737 THANK YOU. Too many people are selling this superpower thing. It's not funny and it's not helpful.
@@patrickkelly737 Could you please add the link to that, for those who might read your comment but not know what you're talking about?
Dr Russel, please always remember - you are great person and you are helping a lot of people.
Thanks ever so much.
You helped us so much as parents, sir, although we are both physicians! You made it so much easier, more bearable and understandable. Greetings from Croatia, Europe and thank you for sharing precious knowledge.
I'm an adult with untreated ADHD, and honestly I find being alive absolutely horrible. I'm constantly exhausted. I am also in perimenopause. It's terrifying. I wish I could put it into words.
Can you get treatment?
@@forisma I'm on a waiting list for exactly that. Have been on it for three years :(
@@pandemoniumgrey 3 years is weird...
@@pandemoniumgreyAre you in England?
@@forisma I'm British. Our healthcare is overwhelmed
Yes, absolutely. I’m 63 and was undiagnosed and untreated until last year. ADHD is not the only thing I have going on, but that and stress responses that generally fall under the heading of GAD are among the biggest reasons I struggled with frustration, irritability, impulsivity and impatience most of my life. Over the course of my fifties, a variety of factors, some new but most lifelong issues, caught up with me and I disintegrated. I’m a bit better now - even modest amounts of meds provide a capacity to manage myself that I have never experienced - but by this time, my life is largely in shambles, and much of it is not stuff that can be recovered from. I’ve been aware that I didn’t want to live as long as possible since I was in my single digits; in part because I always kind of looked forward to the day that my brain would shut down and I would have peace. Amazingly, the first day I tried meds was the first time I stopped feeling that so much.
Based on my own experiences and some family history, the findings you describe do not surprise me at all. What I would emphasize is that yes, the cost does go far beyond how long an untreated adult may live. I lay some of the blame for this on a DSM that still refuses to consider emotional dysregulation as a component of ADHD. I’ll go so far as to say that if, as you have commented, that inclusion in DSM 5 was vetoed by higher ups who did not want to do anything that would impact prevalence, that they bear some responsibility for certain deaths “by intent.”
I realize this is fairly harsh and angry. I’m regulating somewhat better, but as I suggested, the “ADHD tax” has caught up with all aspects of my life. And I increasingly grieve for what my whole life might have been.
Hi there, @jimwilliams3816 . I’m 63 also. Some of your life sequence sounds like mine, so I’m just here to chime in and say there must be a lot of us with lifelong struggles.
You’re a lot closer to having gotten a diagnosis than I was, but I still felt terribly alone through the past 20 years after an official diagnosis. Diagnosis didn’t equate to help, & I never got any good med help until recently (even with it now, I wish I could say I felt the same type of relief you felt on your first med day - they don’t do enough for me).
And it’s only been in the last 2 years that I discovered how many challenges are shared by ADHDers because of UA-camrs & regular people talking about all the messed up things they/we do. I was reading Neuropsychology journals for 40 years, trying to find studies and articles that reflected what I knew about my deficits, and it rarely happened that I found anything remotely relevant. It wasn’t until regular people started talking in social media platforms about their everyday experiences that I found my experience reflected.
That’s been so helpful, actually. A little soothing balm for the battered soul.☺️
It doesn’t change how screwed I am for this remaining part of my life, but I know others out there understand.
So I hope you can mourn the loss of all your potential undeveloped & possibly mis-spent. Then you’ll probably adapt, like many of us, to our new reality. The biggest thing for many is self-forgiveness. Keep trying, & love yourself even when you aren’t.
Meds definitely have their limits. I’ve been on a variety of things in recent years, and have found a reasonable balance of anxiety and ADHD meds, but I can’t handle too much of anything. As near as I can tell, my prefrontal cortex could use more noradrenaline, but my nervous system has too much. That neurotransmitters are used all over complicates the use of reuptake inhibitors. Still, right now I have some ability to tell myself no, and that everything doesn’t have to happen right now. It’s a big improvement, I actually feel human.
I try my best to be kind to myself, though it’s never been my habit. Unfortunately, a lot of things hit critical mass in recent years, and things have gotten screwed up in ways that can’t be fixed. I can think more clearly though, and steer myself at least somewhat, which counts for a lot.
Hope things go as well as possible for both of us.
@@jimwilliams3816 - Cheers. 🫶☺️
I'm 61 ... I've been where you've have been
My only consolation after 43 years of a mostly miserable life undiagnosed, is that Dr Russ Barkley is here, educating the next generation on his and other science, so that those children can at least somewhat avoid the misery.
So good to see an evidence based discussion on this topic. One hopes we'll see healthcare policy take this into account.
I survived a heart attack two months ago, age 57. Being 2 stone overweight with high blood pressure and high cholesterol were significant contributors to the heart attack. All of these factors are related to poor dietary and exercise choices, which I have no doubt ADHD contributed to. I have tried so many times to start and stick to exercise regimes, and I ate for comfort and boredom.
Happy to say my prospects for recovery are good, and I've lost a stone already and am excercising and have changed my diet. However I'm worried I'll relapse I to bad habits once the novelty and enthusiasm wears off.
For short periods of time in the past, I Was able to control my diet long enough to make better nutrition choices. But I kept over-eating all the time.
Started taking ADHD Meds and suddenly I was able to stop myself from eating. I started losing weight.
I now eat mostly meat/cheese, and vegetables from my garden. Between the diet, and the not over-eating I feel so much better even without the medication. But with it. I'm exercising like I never used to(recommend bike rides, very stimulating compared to walking).
Totally worth getting treated. It helps
In some countries like Germany even doctors complain about the lack of professionals in the field f.ex. Ärzteblatt - Kritik an lückenhafter Versorgung von Erwachsenen mit ADHS, Expertenrat ADHS,
In my experience it is quite hard for a female adult to get appropriate help after hard years with clear symptoms- the diagnosis was only as an adult (but didn't find any evidence like a study about this).
Creating more awareness might help the next generation to hopefully have better and much needed early help.
Wow, this is so informative! I was dxd with combined type ADHD last year at 55. I had a road traffic accident at 16 which nearly cost me my life - ended up having 16 surgeries as a result. I have been in recovery from alcoholism for over 8 years and had weightloss surgery in 2013. My medication is being titrated currently, but my impulsivity remains. My temper has reduced since starting Concerta and then Elvanse, but my attention is still very poor. I am praying that the self-knowledge I am gaining in addition to perhaps a different medication and some therapy, I can beat the trend evidenced here. Thank you so much, Dr
just finished the video, thank you so much for this. it really helps strengthen my conviction to be kind to myself and take my adhd seriously.
Just started strattera now at 23yrs old... This year I knew I have adhd and marfan syndrome(with major heart problems)...
Knowing is key to maintain the situation.
Thank you doctor russel for your content, it helps with adhd and also the more I know the less become my depression and my overwhelming feeling lessens.
I don't have Marfrans but I have a dilated aortic valve root, which often occurs with Marfrans. I'm reading that Strattera is the worst medicine for heart issues because of the blood pressure and pulse rate increase. The thing my doctor gave me shows that the stimulants increase blood pressure and heart rate, but way less than Strattera.
@@rpheckenkamp ohh thank you for telling me, I didn't know! I think I'm going to tell both my doctors about strattera.
Even the slightest increase in blood pressure can harm me cause I also have white wolf parkinson's syndrome.
Thank you again🫡
Yet, when there is a government created stimulant shortage and when doctors regularly underdiagnose, it's treated as a non issue. I had what could have been a fatal car wreck before stable treatment, but happened to live. Yes, I lived, but now I'm in pain every day. I've been suicidal most of my life. For some, stimulants reduce suicidality more than anything - JAMA studies show. The president of ADDA, Duane Gordon, used to be about a hundred pounds heavier and had numerous car wrecks before treatment. This is a serious issue - don't forget with the high comorbidities, people with untreated ADHD are also complicating their medical care. Recent article pointed out how sickle cell patients have a much higher risk. I have type 1 diabetes - the care for which has incredible need of proper executive function. I just want us to be seen.
I don't think the government created the shortage. Can you provide any proof?
@@SkodaUFOInternational - I can. The government creates allotments that can be made and regulates the factories. This is the US government, but the US has a large population of patients and has a large impact on supply by their regulation of production - even overseas production. The US also has various international agreements to influence drug production and prescriptions internationally. There are likely similar laws in other countries. If you haven't been watching for when the FTC and other agencies have taken commentary on investigation of production issues, you should - and if American, also look online and contact your representative - the shortage started at the beginning of their current term and it's still going at the end, partially because they have said it's not a big "life or death" deal like other health conditions (Representative Abigail Spanberger, and she's not the worst). The DEA is largely responsible, which isn't run by medical professionals, but by prosecutors, and the head of the agency was under investigation from the DOJ for corruption, though I can't find follow up. I've been planning on doing a number of videos, but I have several health conditions, including ADHD, and it has made it hard to get together, but please subscribe as it helps encourage me. I am an attorney that once worked in practitioner regulation. The shortages also get worse in the latter part of the year in the US because that is when the contracted allotment has usually been filled and used already - and there are numerous paperwork issues to deal with if one factory cannot satisfy their allotment and another company wants to step in. The government wants to address this by putting pressure on doctors not to prescribe stimulants any more - and there are numerous ways they do that - but obviously, if you need them, that's a punishment for having a health problem as Professor Barkley so clearly describes.
This is about the largest generic Adderall factory on the east coast of the United States being shut down due to minor paperwork errors (crossouts without proper signature) in the middle of the shortage:
nymag.com/intelligencer/article/adderall-shortage-adhd-medication-ascent-pharmaceuticals.html
Here is Reason magazine discussing the government role in the overall US shortages:
reason.com/2023/08/25/government-continues-to-deny-its-role-in-adderall-shortage/
This is about DEA chief Milgram's "no bid contracts" - if you know much about New Jersey politics (their Senator is under investigation for putting gold bars given to him by Egypt into his coat pocket - ideally the next Senator will be Representative Kim who is a much better man.) you will know that a corrupt New Jersey politician is not out of the ordinary - it's how things get done typically. Curiously, much of the pharmaceutical companies in the US are based around New Jersey, so even the best politicians there are highly under their thumb, but most stimulants are generic, and thus not a significant profit for them. But those medications do compete with other drugs that are a profit source for them.
apnews.com/article/dea-corruption-fentanyl-cocaine-drugs-contracts-milgram-7fd24fe46c4b664f285773798357d418
Here is a link to your representative's contact information - I find the phone is best, as they rarely answer letters, and emails get you put on a spam mailing list. It's a small impact, but they do track it - not in the way that they pay attention to donors - that's how they spend their whole day, but if enough people contact them, they see it endangers their job. Make sure they know you vote - this is an election year for every representative:
www.house.gov/representatives/find-your-representative
I'm at the hospital now whit broken back, because mostly I'm not able to plan my medecine path (I have many affection like auto immune problem and else)
If I was able to organise my life I would never been in such a situation, all I have is amplified because of late / unplanned treatment that are directly linked to my lack of global organization
The worst is I KNOW what should be done, but my super low capacity to keep track of things and my global lack of organization due to late discovered/ realized ADHD (in my mid 40s) bring me to this point were my life and body fall to a really dangerous and concerning point
I have medication now since on year, it bring a few problems, but overall it give a WAY better mental stability, push the depression away, reduce my anxiety a lot (still really anxious but at a better level)
But I have a mountain to hike now because all those decades without any necessaries health care, so I have lost years if not decades to struggle and I have the health of someone 30 years older than me because of this
That been say it's all positive in the sense that now, I can understand why all this
And just try to focus to improve my life the best Incan but knowing how to do this time
I will probably not aging well / long, but at least I will be able to manage this better now, wich is cool and give me more desire to survive and maybe who know, have a better life in the future maybe that I have never really experienced all those years since childhoods
So yep untreated ADHD is a REALLY SERIOUS concern, kids with it should received the needed treatment and support because it will be life changing for them, it is really important to take this seriously to help them to grow an autonomous that I never have all my life
Have a nice day everyone
@@SkodaUFOInternational- I left a comment, but UA-cam removed it, presumably because I actually tried to give links to back up what I was saying. But the government is probably most responsible and if you want to know more, look up the Intelligencer article about the factory shut down and the Reason article about how allotments of production are assigned. How this affects overseas is more complicated than I want to retype.
I believe I also had a comment removed some months ago. I was warned about misinformation. Granted, I did make one error, but...I was citing an opinion piece by the NYT which can probably still be found. It layed out a somewhat he said/she said situation with manufacturing regulation. If you are Googling this subject, you will also find a press release by a government agency stating that supply problems are absolutely NOT their fault. According to the NYT piece, that’s unclear.
I would say more, but I’m trying to phrase this in a way that passes the filters. That this isn’t talked about more may have to do with the flagging system. To the extent that they are catching true misinformation, okay. If it is suppressing legitimate discussion of possibly problematic policies...not so good.
I was just talking about this with my partner. Thank you for going in more depth on this topic
Where I live (Brazil) doctors and 'anti-psychiatry' activists made up a whole new and bureaucratic process for diagnosing ADHD.
It's called neuro-something (I forget the word) assessment.
Then you go back to the 'original' psychiatrist and he'll assess the assessment.
ADHD is treated like it was a made-up condition, and the patients are treated as if they were asking for duurrgs (!!!).
We don't have adderall here, only methylphenidate (and vyvanse), and even psychiatrists seem to think it's c... an illegal drug for a non-existent condition.
And there are waves of shortage of methylphenidate, the current one started last year (!!!).
Oh no! That’s terrible that the problem is so prevalent, & they cannot stay up-to-date with the science !! I’m sorry! 😢
Possibly it’s a neuropsych evaluation, which is basically what I had. It’s used in the states, but not exclusively. I did it because my psych was leery of prescribing and pushed me to. It was pricey and yes, the clinical psychologist can’t prescribe meds, so the report went back to my psych, who did. I ended up with multiple diagnoses, including ASD, so at least I got a more comprehensive evaluation for the money.
Being disconnected from almost everyone else, from early on in life, is already a half death-sentence. I only learned very recently that what I have is ADHD. Medicines help some. But in no way enough to compensate all the hardship of life-long missed opportunities and way underdeveloped social skills, a somewhat chaotic demeanor and bad short-term memory.
The 9 factors that were used to calculate ELE is helpful. Now I can identify which factors I should improve.
Listening to this and thinking, I must definitely change my lifestyle… once I get old.
😂😂 . Funny. Except it WILL become harder & harder to change your habits as each year goes on, just so ya know.
Thank you as always Your work and videos have helped me support my son growing up with ADHD, it’s very appreciated.
Hi Russell, just letting you know it sounds like your microphone is a stereo mic and needs to be turned 90 degrees anti-clockwise to be facing you straight on. The side with the badge and controls if it has them that are the front and should face you. If it is facing straight on, perhaps make your audio mono so it doesn't have that bias to the side that the last few vids have had.
thanks!
I'm convinced my dad has ADHD (and autism) and anosognosia, and it could have killed him last month. He hurt his forehead with a rusty concrete steel latice and forgot to check if he was still protected against tetanus.
He said "I'll go tomorrow", then forgot, and then said "it's ok I'm not sick".
Probability was low that he'd contract tetanus (the steel was not dirty, stored in the open air and he may still have been protected by the shots he had when he was not yet retired and working in the construction industry), but still, with a disease like tetanus you don't take any chances, but his ADHD/anosognosic mind was too "lazy/blind" to drive 2km to the nearest pharmacy.
I'm thankful for your research and your perspective on ADHD Dr Barkley. So many advocates get hung up on not saying sad things about us that it becomes impossible to explain why ADHD is a problem.
I have ADHD as a comorbidity along with autism level 1 support, so yeah, it's really hard,
managing both disorders at the same time is really complicated. I usually comment on neurodivergent audhd communities, if I could choose I would definitely get rid of the ADHD, it's so hard to manage things when you literally have an impairment in the management part of your brain. Even managing your treatments and therapies is extremely hard.
For better context I am late diagnosed in both conditions only in adult life.
For me most of my life feels like working in circles, one step forward, two backwards in a constant loop. So yeah, I am mostly expecting the low life expectancy for my life, like it is a very real reality for me. I am technically in the beginning of it but it feels but my body and mind feel so tired already like i imagine people start feeling when they are 50 years or up.
Thank you once again for these wise words, Dr Barkeley. You are a beacon of light for those with ADHD. Thank you!!
Once again increasing my man love for you sir (I wanted your Hawaiian shirt last time, this time, I'm thinking of a russell poster!) Once again, thankyou, and acknowledging your brother, even more! Can I thankyou presumptive on his behalf! Can you see any similar and future reports on the horizon for AuDHD?
The one thing I have to say about my ADHD is this I have combined type ADHD features of hyperactive and non-hyperactive I have attention death disorders. I have poor working memory, good long-term memory, especially things that interest me but I also have autism level one high functioning. It’s a strange mixture having both of these disorders combine oh wait I forgot. I’m also dyslexic also does affect more than just reading I also have audio processing disorder. So the way I think see the world hear the world is much different than the normal average person. I have a high IQ around 140 in the range. And shockingly enough despite all my deficits, I have an extremely high EQ with emotional delay takes about three days to finally let emotion settle in. Separate from extreme masking scoring on the cat Q test 146. Everybody thought I was normal, but nobody could see past the mask I suffered from extreme depression all my life as well as anxiety. Everybody would say I look and act normal and I’m an outgoing person. There’s a reason why I’m saying all this to give you a bit of information before I give you the real substance.
I took anti-depression medication SRI they helped my ADHD symptoms shockingly enough because of the reduced impulsivity, but it also leveled out the emotional impulsivity issues, but it did not help with any memory problems. That’s where I took Adderall for the first time in my life, I took Ritalin as a child, but I was a zombie on it didn’t like it as an adult, I finally see help Adderall.
Now that I finally got everything within the picture, I can explain why I’m saying all this.
Adderall does indeed assist in being able to remember stay focused commit to finishing a task.
The antidepressant also assisted a little bit with ADHD impulsive issues which would distract or diss regulate emotionally .
The point I’m getting at is I realize now I can live without the antidepressant, but my emotions are three times more quick to change with extra strong feelings. I’ve learnt how to control this but only after seeing the difference between medication of the SRI medication and seeing how I was afterwards and really introspection and being perceptive of my own issues Takes a lot of work then I realized how much more scatterbrained and forgetful. I am without Adderall. I wish to go back on Adderall, but the dosage I was originally on was nowhere near strong enough. I unfortunately believe I might have to take the high dose didn’t give me any type of buzz happy feeling I didn’t get energy from it or any of the things that they said it would boost other than my capability of being able to focus on a task to the point of completion, I wish it gave me an uplifting energy boost like apparently other people get but I guess my ADHD is a bit more severe but when I was a child, they did say I suffered from some pretty strong deficits in memory and attention, but they also didn’t know I was autistic back then as well But then was still poorly, studied and misunderstood. Now that I got the full picture of how I am with years of experience if I did not learn that I was ADHD combined type and autistic high functioning level one I would not have made the life choices that would’ve been right for me, knowing this information, I changed my entire lifestyle right now. I’m trying to acclimate and yes, it’s very much agreeable that my life expectancy would’ve been a lot worse if I didn’t seek to get Adderall and I didn’t go through anti-depression medication.
💊
the uplifting boost may be a high from adderall that will quickly fade as you get used to a higher dose. if your focus issues are being treated, you're probably good to go, but since you're probably gonna talk to a doctor anyways, you might as well mention all of the above
@@jimgorlett4269 i’ve mentioned all these things. The only differences is that I definitely need a higher dose, but I never felt the boost that they say you get from taking Adderall even initially when I first started taking the medication I felt no different other than I started to notice that I am slightly finishing task betterand I’m able to focus and stay on task longer, but I don’t get that feeling of a rush or any type of boost of energy. Nothing like that.
I think I have ADHD but I can't focus long enough to watch the vid. Can someone summarise?
I saw the title and thought of several reasons that might contribute.
Thnak you so much Dr. Barkley. ❤
I'm completely sure of that... I'm 61 but struggling with a lot of issues due to ADHD
It's a shame the medication is under massive shortage currently then isn't it!
Total joke 👎 & by design.....
I'm always perturbed by the idea that there is a "rediagnosis", or that someone falls out of diagnosis when they don't meet the DSM* criteria. It either suggests that ADHD is "curable", or that the diagnosis is always predicated on the impairment in a sphere of life at a point in time. The latter suggests then that medication is only necessary when, eg, I'm not performing well at work because my symptoms are manifest?
Yet at the same time we need to treat ADHD to ensure that we live longer - the inference of managing impulsivity could be a behavioural change but you're also talking meds.
Then the contradiction kicks in, if my psychosocial skills improve and I manage my ADHD I fall out of diagnosis which then means that my meds can be discontinued. You see where I am going with this?
Lastly, a question wrt to medication and the recent studies suggesting life expectancy shortening for those on stimulants and CVD - how do we reconcile the medication route as a life expectancy promoter while at the same time its acknowledged as the opposite.
Note: I am on Concerta, so I am not an anti-pharma - my ADHD curse is getting frustrated with, what appear to me, to be obvious contradictions that nobody seems to answer 😁Just parsing thoughts out loud.
*There is an interesting youtube I'm digesting by Dr Duncan Astle on transdiagnostic mapping in neurodevelopmental disorders using AI modelling. At a glance he makes an interesting case for why early intervention matters, but that past of certain point neuroplasticity is not available at hub level - which suggests that late diagnosed may find standard psychosocial skills less effective (and in my experience this is anecdotally true).
I can attest to the idea 100% I was undiagnosed until half a year ago. Before that I have sustained traumatic brain injuries, been stabbed, and Two years ago I got run over by a drunk driver. I've been rehabilitating my spine since.
Incredible ❤️
I am 17 with ADHD, i could not imagine myself driving without inevitability crashing even with all my focus.
Any difference between men & women?
because the study was started in the 70s, the ratio was 6:1 males to females. so our study could not properly evaluate sex differences. there may be some given differences in risk taking and drug use but them binge eating and self harm are more common in the females so maybe not.
Oh wow, this might help to explain why my family tree is literred with people that died much younger than average.
How to treat adhd when part of the 20% that it doesn’t work for?
We have a AuDHD family (f42 and 3 boys) and methylphenidate works wonders for one but not at all for my eldest (more agressif and can’t eat).
He struggles a lots (suicidal tendencies, addiction, etc) and doctors (in Switzerland) don’t know what else to try… 🤦♀️ I m sooo worried and I don’t know how to help.
There are many consequences of poor decisions stemming from avoidance or impulsivity that are not fatal and potentially result in a miserable old age. As if life wasn't tough enough.
Respect also to DrB who lost a brother.
Does the financial costs , especially unemployment , maybe impulsive spending reduce life expectancy ? The anxiety and stress caused by financial problems ?
Late diagnosis ADHD, with other neurodivergent conditions , even if the person finishes a 4 year college degree etc , maybe stuck in a cycle of unemployment/underemployment causing a loss of income.
I hope someone studies the aspects you mention some day,
but I’m sure those of us who have lived many adult years before diagnosis & help
will all chime in and say, “Yes, all of the above!” contribute to shortened life expectancy for undiagnosed $ untreated ADHDers.
Yes, this study was limited to the factors that the insurance risk assessments use. They do not take into account all the other aspects of life “mismanagement” and struggles we have.
Relationship problems aren’t getting quantified here, but there’s another big one, for example.
Insurance risk assessments, & thus this study, do not take into account our basic inability to keep life & space organized, meet deadlines (I haven’t filed my taxes in 5 years. I don’t owe taxes, but I don’t collect mine back!), remember birthdays, have trouble getting ourselves to write back to friends, etc., etc., etc. Many lose friendships over the years.
We just can’t do life very well, and the stress accumulates.
I never bought a house, and I am about to retire! I can’t get a loan at my age.
The problems can be enormous, and they take a toll.
But the studies don’t know about all these details yet.
Is it possible to feel the benefit of the meds in some aspects but not so much in the focus? Is it a question of the right dose or medication? Or is it residual cognitive mess?
12.5 years is a big eye opener. Dr Barkley, what is the difference in L.E. if we include accidents/suicidality?
Likely it is far greater because this study doesn’t look at such forms of early mortality which I discuss in the lecture on health outcomes of ADHD.
Ouch. I was thinking that the statistics did factor that in. It doesn’t have to only look at early mortality either. I’m reasonably certain that one of my parents ended their own life in their 70s - I am not certain they had ADHD, but they certainly had executive functioning issues. I had periods of active ideation in my late fifties. Life failures can add up, and emotional dysregulation can make that outcome more likely.
When you say treatment do you just mean with medication or also through psychotherapy??? I can't get medication on the nhs as an adult with ADHD, only privately but this is unaffordable for mecin the long term. I do access psychotherapy though. Can this by itself bring up life expectancy again for us to more in line with NT people?
If you get ADHD meds privately in the UK, once you've found a med that works you can then most likely change to "shared care" which will bring down the cost enormously.
@Handle8844 yes, I've just got that confirmed by my GP surgery here on Isle of Man too.
Hi, Barkley
What do you think about TMS therapy for adhd? Is it a treatment for adhd? And how it works for adhder's , it would be really helpful, if you make a video on adhd.
I am looking into a video on this but it remains experimental as the evidence base is small and not very rigorous with no longer term follow-ups.
Criticism: correlation is not causation, this would've been a really important time to reiterate thst ADHD is comorbid with autoimmune conditions, psychological conditions, and genetics involved with that lifetime life expectancy. I have far more life threatening conditions than the ADHD, to be fair. Diabetes, fibromyalgia, MS, mdd, OCD and colitis are far worse to live with, for example.
imho, this is as spurious a conclusion as any other you'd normally warn us from extrapolating far too much from.
Just found this site. What can / should you do to treat ADHD, beyond Adderall? My adult son with adhd since childhood is suffering , major depression and im scared for him. Is there a specific treatment program to get someone on a track? Groups?
Dear Dr. Russell,
As a person diagnosed with Adult ADHD I'm intrigued by the statistics presented, but I seek clarification. Are you indicating that the mean life expectancy for the general population (control group) is only 58.9 years? This seems surprisingly low, even when considering historical data.
The study mentions a young adult follow-up using 131 hyperactive and 71 control cases, leading to the calculation of Estimated Life Expectancy (ELE). Were the control cases representative of the general population, or did they share similar risk factors with the ADHD group, influencing the lower life expectancy?
Thank you for your insights.
Regards,
Michas Richter
PS: Upon further reflection, I noticed that the mean age of participants at the start of the study was 27 years.
Does this mean that the control group's life expectancy is actually 27 + 58.9 = 85.9 years, which aligns with historical life expectancy data (e.g., ~85.6 years in 1970)? Similarly, would the H+ADHD group have an expectancy of 74.8 years and the H-ADHD group 79.4 years?
I’d appreciate your thoughts on this interpretation.
I think the life expectancy is to be accounted for the group they analyzed, which in average had been already survived 27 years....
yes, that is how you use the estimate. it is added to the current age. while the mean age was about 27 at follow-up the range was 24-32.
How bout life expectation after 27 years on amphetamines?
What is the y-axis? Those numbers seem too low for life expectancy; maybe life expectancy past 20 years old?
You add the life expectancy estimate to their current age, which 27-32 years of age approximately.
Therapy doesn't seem to have an effect on my ADHD, and I'm immune to all of the stimulants/non-stimulants for some reason. So f*ck me I guess 😂
😂
I haven’t had good success either with meds.
The only real help has been with Guanfacine. It tamps down my hyperactivity, which is a big deal these days (I didn’t use to have that symptom), and seems to help with motivation for some reason.
However (there’s always something!), it really screws up my sleep. 😭
@@sfstucco I've tried them all, I didn't notice anything, like at all. I tested my liver enzymes and found out that I'm a hyper-metabolizer. But even when I took 2 times, and then 3 times the max dose, I felt nothing. Super fun 🙃
@@sebben13 - Damn.
Well, I’m not far off from your situation (except I’m the opposite of a super metabolizer… I have low basal metabolism), in that the Guanfacine mainly puts me back at my older baseline (ADD without hyperactivity). I still am functioning terribly.
I feel the stimulants, but they’re not helpful. They just make me go into my mental tunnel more intensely.
I feel driven to follow every single effing idea that pops into my head, no matter how many hours I’ve been at it (24 hours? Sure, why not!). Do I get anything practical done in those sessions? Heck no.
What was the sample size?
158 with ADHD and 81 typicals. but the related studies used entire populations.
Hmmm.... 83-94% male? So how does this look for female kids?
we don’t know yet but most of the factors involved in prediction apply to them just as much.
Well, for the better. Sorry I know its morbid, but life life isn't worth it with ADHD and all the fun add-ons it brings. Even 'treatment' is only barely adequate.
That’s unfortunately very true. In addition to what you just said the disorder is extremely destructive to the lives of the people close to you. That makes it even more tragic. It doesn’t only destroy your life, it also disrupts the lives of the people that are loyal enough to stay close to you 😞
It’s actually better for us and for them if we die early.
Yeah, I wish I wasn't even born...
But I like the saying that if life gives you lemons make lemonade...
But what are my ingredients? I can't even function... 4:55
Absurd victim mindset. Do as you can without comparing yourself, fight and live. Habit creation is not a part of your brain affected by this. Start slow and create momentum. Go do sports, socialize, do anything that helps you focus better. Learn about habit creation, research nicotine pills and other forms of medication, including cardio and meditation
65 year old make. Diagnosed in early 60’s (ya, that severe). Untreated until 7 years ago. It has definitely had its challenges and struggles, but that’s just the way it is. Family and friends all take it into account. Though I’ve lost touch with many friends over the years (time blindness), I still stay in close touch with two I’ve had for over 45 years. Of course, it helps they are both related by marriage now.
@@fabius_bileincorrect. Sometimes people get to the end of their rope and need compassion and help.
Dad, do u have instagram ?
That is so timely. I was JUST saying how i divide gen-z into two grousp..."youtube/tiktok/twitter" vs "instagrammers"...and how only the instagrammers have any sense or humor or hormones..and there you go making an instagram joke about daddy!! Perfect.
@@stoneneils since i have ADHD, and currently taking on Concerta i was going to repost this youtube in my instagram story thats why i asked for Dr Russell’s insta Lol
In Indonesia no one talk about this concerning facts zzzzzz