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Our understanding of and diagnostic criteria for autism, a lifelong condition, have evolved considerably over the last 50 to 60 years. One fall-on effect of this awareness: Many autistic adults overlooked or misdiagnosed in childhood are finally pursuing an evaluation. This population is sometimes called “the lost generation.”

Today, there remains a significant lack of information and understanding about the unique needs, supports, and challenges of autistic people in midlife and at older ages. This webinar will highlight autism and aging as a rapidly advancing and important area of research, and it will provide approaches to help autistic adults live full and happy lives.

In this webinar, you will learn:

• About the historic changes to diagnostic criteria that resulted in some 90 percent of autistic people receiving diagnoses at and after age 50 worldwide
• How complementary conceptual approaches can be used to examine aging in autism (i.e., dimensional trait-based approaches and categorical diagnosis-based approaches)
• What recent empirical research findings tell us about aging as an autistic person, covering a range of studies related to cognition, health, wellbeing, and life experiences
• How the information gained from these studies can be pieced together to create a broad picture of where support can be provided to improve the quality of life and outcomes of older autistic adults to ensure they live long and happy lives

Have a question for our expert? There will be an opportunity to post questions for the presenter during the live webinar.

Autism in Adults: Resources

• • • Free Download: The Truth About Autism in Adults
    • Read: AuDHD: ADHD and Adult Autism Symptoms, Diagnosis & Interventions for Both
    • Read: Q: How Can I Get Evaluated for Autism as an Adult?
    • Read: ADHD, Autism, and Neurodivergence Are Coming Into Focus

Meet the Expert Speaker

Gavin Stewart, Ph.D., is a senior postdoctoral research fellow at King’s College in London. He is an expert in autism and aging, and his research takes a multifaceted approach to explore the life experiences of autistic people across adulthood and as they age.

Certificate of Attendance: For information on how to purchase the certificate of attendance option (cost $10), register for the webinar, then look for instructions in the email you’ll receive one hour after it ends. The certificate of attendance link will also be available here, on the webinar replay page, several hours after the live webinar. ADDitude does not offer CEU credits.

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Click on each image below to explore the science, expert insight, lived experiences, and camaraderie that surrounds women with ADHD.

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ADHD is not a disorder of willpower; it is a condition of dysregulation. Decades of neurobiological research demonstrate that altered signaling in key neurotransmitter systems — particularly dopamine, norepinephrine, and serotonin — contribute to the core features of ADHD. These chemical messengers in the brain shape how we focus, prioritize, feel motivated, regulate emotions, and experience reward.

Dopamine is central to motivation, pleasure, reward processing, and goal-directed behavior. When dopamine signaling is adequate, individuals feel calm, satisfied, and capable of sustained engagement. When dopamine tone is reduced or dysregulated, as often observed in ADHD, the brain compensates by seeking novelty, urgency, or high stimulation. This contributes to distractibility, procrastination on mundane tasks, and the pursuit of immediate rewards over long-term goals.

Norepinephrine supports sustained attention, executive functioning, working memory, and impulse control. In the prefrontal cortex, the brain’s executive control center, dopamine and norepinephrine work together to optimize cognitive performance. When these systems are underactive, individuals may experience task initiation difficulties, emotional reactivity, sensory overwhelm, and mental fatigue.

While not traditionally viewed as a “core” ADHD neurotransmitter, serotonin plays a critical modulatory role in mood, sleep, emotional stability, and behavioral inhibition. Serotonergic imbalance can amplify irritability, anxiety, mood swings, impulsivity, and sleep disturbance, complicating the ADHD clinical picture.

In this engaging and scientifically grounded webinar, you will learn:

• About the neurochemical basis for ADHD and understand what is beneath the surface of symptoms
• How ADHD brains differ structurally and functionally from neurotypical brains, including altered activity in the prefrontal cortex, differences in reward circuitry, variations in cortical maturation and connectivity, and dysregulation within the networks that aid cognitive control
• Gain insight into how these neural systems interact dynamically, and how neurotransmitter balance influences real-world behavior
• How excess hormones and neurotransmitters can lead to over arousal, anxiety, and irritability while insufficient signaling affects executive function, procrastination and motivation
• How serotonin modulates emotional regulation, impulsivity, and sleep stability, with clinical examples to illustrate how neurochemical dysregulation translates to everyday functional difficulties

About evidence-based interventions and how they restore brain function, including:

• Stimulant medications that enhance dopamine and norepinephrine signaling
• Traditional non-stimulant treatments that target norepinephrine
• New and novel nonstimulants that modulate serotonin
• Behavioral interventions that leverage reward systems
• Sleep, exercise, and lifestyle strategies that support neurotransmitter balance

Have a question for our expert? There will be an opportunity to post questions for the presenter during the live webinar.

Webinar Sponsor

ADHD isn’t a lack of effort. It’s rooted in differences in how your brain regulates motivation, reward, attention, and emotions. When dopamine and other key brain chemicals fluctuate, it can affect everything from focus and consistency to mood and impulse control. Inflow gets it. Our science-backed program helps you better understand your ADHD brain and apply practical strategies to improve follow-through, emotional balance, and daily functioning. Take the free ADHD traits quiz to get started.

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

ADHD & Brain Health: Resources

• • • Free Download: Unraveling the Mysteries of Your ADHD Brain
    • Read: ADHD Neuroscience 101
    • Read: Everything You Never Knew About the ADHD Brain
    • Read: Using a Dopamine Menu to Stimulate Your ADHD Brain
      
      

Meet the Expert Speaker

Gregory W. Mattingly, M.D., has been a psychopharmacology Instructor for more than 20 years at The Washington University School of Medicine in St. Louis, Missouri. He earned his medical degree and residency at Washington University, where he received a Fulbright Scholarship. Dr. Mattingly has been a principal investigator in more than 500 clinical trials and his research has been published in numerous national and international journals. He is the CMO for ACCUMIN Neuroscience, a research insights and analytics company. In addition to his clinical and research practice, Dr. Mattingly has worked as a mental health consultant and evaluator for both the National Football League and Major League Baseball. Dr. Mattingly is the Past President for the American Professional Society of ADHD and Related Disorders, serves on the Scientific Program Committee for the World Federation for ADHD and is Co-Chair for the U.S. Psych Congress.

Certificate of Attendance: For information on how to purchase the certificate of attendance option (cost $10), register for the webinar, then look for instructions in the email you’ll receive one hour after it ends. The certificate of attendance link will also be available here, on the webinar replay page, several hours after the live webinar. ADDitude does not offer CEU credits.

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Reserve your spot in this free webinar, and get the event replay link plus a 15% discount to ADDitude magazine

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Emotional distress includes feelings of anxiety, low mood, worry, rumination, and self-criticism. For people with ADHD, as well as those facing chronic stress, it can stem from changes in relationships, work, caregiving demands, health problems, or challenges to life satisfaction. When we feel prolonged uncertainty, our distress can become self-perpetuating. Heightened emotional reactions lead to overthinking and avoidance, which ultimately limit meaningful action and personal growth.

In this webinar, Doug Mennin, Ph.D., introduces ideas aligned with emotion regulation therapy, a research-based approach designed to help people better understand and respond to emotional distress. Rather than trying to erase difficult emotions, this approach focuses on changing how we relate to them so that we can move forward with greater clarity, flexibility, and purpose.

In this webinar, you will:

• Understand emotional distress through a motivation and emotion-regulation lens, including why anxiety and depression often feel so hard to shift
• Recognize common patterns like worry, rumination, and self-criticism that keep distress going
• Build mindful awareness of emotions, body sensations, and internal conflicts without becoming overwhelmed by them
• Develop practical skills to step back from intense thoughts and feelings and see them more clearly
• Use emotion-regulation strategies to support meaningful actions, even when emotions are uncomfortable

Have a question for our expert? There will be an opportunity to post questions for the presenter during the live webinar.

Webinar Sponsor

Emotional dysregulation can make everyday triggers feel bigger and harder to manage. Play Attention, inspired by NASA technology and backed by Tufts University research, strengthens executive function and self regulation so adults can respond with greater calm and control. With a personalized plan and expert coaching, Play Attention supports lasting change. Take our ADHD assessment or schedule a consultation today.

www.playattention.com

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

Emotional Dysregulation in Adults: Resources

• • • Free Download: Emotional Regulation & Anger Management Scripts
    • Read: Everything You Never Knew About the ADHD Brain
    • Read: Does ADHD Emotional Dysregulation Ever Fade?
    • Read: After the Shame: How to Re-Center Your Bruised Emotions

Meet the Expert Speaker

Doug Mennin, Ph.D., is a Professor of Clinical Psychology and Director of Clinical Training of the Clinical Psychology Ph.D. Program at Teachers College, Columbia University. He earned his Ph.D. from Temple University in 2001 and has previously held positions in the Department of Psychology at New York University, Yale University, and CUNY Hunter College, where he was Co-Director of the Health Psychology and Clinical Science PhD training program. In his academic role, Professor Mennin has trained numerous graduate students and post-baccalaureate research assistants on diagnosis, assessment, and treatment of anxiety and mood disorders. He has published more than 150 articles, chapters, and books and is the developer of Emotion Regulation Therapy (ERT). He regularly leads workshops to help people better understand and respond to their struggles with anxiety, worry, and depression. He currently serves on the editorial board of six journals and has been on the executive boards of the APA Division of Clinical Psychology, the Society for a Science of Clinical Psychology, and is the former Chair of the Scientific Council of the Anxiety and Depression Association of America (ADAA).

Certificate of Attendance: For information on how to purchase the certificate of attendance option (cost $10), register for the webinar, then look for instructions in the email you’ll receive one hour after it ends. The certificate of attendance link will also be available here, on the webinar replay page, several hours after the live webinar. ADDitude does not offer CEU credits.

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Women with ADHD who report significant negative mood symptoms just before and during menstruation tend to experience similar-magnitude increases in ADHD symptoms at this time, found a new study in Journal of Attention Disorders.¹ Building upon a modest foundation of previous research that found ADHD symptoms vary across the menstrual cycle, the researchers studied women of reproductive age with ADHD treated with amphetamine salts, the most commonly used medication among members of this demographic, 60% of whom use Adderall of Mydalis.²

The 30 study participants were required to complete daily surveys measuring their ADHD symptoms as well as the severity of 17 mood symptoms. Participants reported their total daily dose of amphetamine salts, as well as use of other medications, alcohol, tobacco, or cannabis.

The study found:

• ADHD symptoms were most severe in the menstruation phase of the monthly cycle
• Negative mood symptoms were most severe in the menstruation and luteal phases
• The magnitude of increase in ADHD symptoms and negative mood was similar, leading researchers to conclude that mood and ADHD symptoms co-vary between menstrual cycle phases

These findings validate the anecdotal experience of many women with ADHD.  “Fluctuating estrogen and progesterone across the menstrual cycle invariably impact ADHD symptoms, emotions, and functioning. We know this to be true, but there is almost no research validating this relationship,” explained Lotta Skoglund Ph.D., in her recent ADDitude article, “The Menstrual Cycle Impacts ADHD Symptoms in Disparate Ways.”

“The entire week leading up to my period is where my ADHD symptoms get even more intrusive than usual,” says Chloe, an ADDitude reader. “My executive functioning dips even lower, distractibility and difficulty focusing is increased, and my mood/energy level is much lower, causing me to feel badly about all the things I’m not being successful at that week.”

Charlie, a reader in Australia, echoes this experience: “A week before I am due for my period, my brain goes to complete peanut butter. It is an utter mission to focus and stay on task. Sensory overload is at its peak. Impatience rules the days, and I get so overwhelmed.”

In addition, many women report lower efficacy of ADHD medication during the luteal and menstrual phase. One ADDitude reader shares “My ADHD meds are significantly less efficacious for about 10 days per month; two days before menstruation I am a barely functional zombie.” Norma, an ADDitude reader in Wisconsin, describes a similar experience, “The week leading up to my cycle, I might as well not even take my ADHD meds. It’s like my body overrides them.”

Based on similar anecdotal reports, the study’s researchers sought to uncover whether women with ADHD were exploring cycle syncing, increasing their dose of stimulants during the late luteal and menstruation phases to address intensified ADHD symptoms. They found, however, that women maintained constant daily medication dosing throughout their menstrual cycles.

“This may reflect prescribing practices for stimulant medications, which often do not encourage ‘flexible’ or ‘symptom-based’ dosing regimens, as well as potential inexperience of providers or patients regarding the effects of menstrual cycle phase on medication metabolism and efficacy,” the researchers reflect. The authors refer to an earlier study that found many women with ADHD were hesitant to ask doctors about the effect of their menstrual cycle on ADHD medication and often reported invalidating responses from their practitioners when they did inquire.³

Skoglund advises women to use a menstrual cycle tracking log to record and report specific data to aid these conversations with doctors: “Tracking your cycle will give you powerful insights into how hormonal fluctuations influence your ADHD symptoms, medication effectiveness, and overall functioning. With this data, you’ll be in a better position to talk to your doctor about enhancements to your treatment plan to improve your health and wellbeing.”

The study had several limitations, including its small sample size; 16 of the 46 initial participants were excluded for failure to complete daily surveys, leaving 30 participants, and the authors note it is possible the individuals who successfully completed the surveys had milder ADHD symptoms. In addition, unlike other studies,⁴ the researchers did not measure ovarian hormone levels, relying on participants’ reporting of menstruation for this information. Individuals who were taking other psychiatric medications were excluded, thus excluding women who receive medication for mood disorders and/or Premenstrual Dysphoric Disorder, both of which are significantly more likely in people with ADHD.

Sources

¹Zaritsky, R., Reed, S. C., & Evans, S. M. (2025). Changes in ADHD Symptoms and Mood Across the Menstrual Cycle in Females Treated With Stimulants: A Pilot Study. Journal of Attention Disorders, 0(0). https://doi.org/10.1177/10870547251400038

²Anderson K. N., Ailes E. C., Danielson M., Lind J. N., Farr S. L., Broussard C. S., Tinker S. C. (2018). Attention-deficit/hyperactivity disorder medication prescription claims among privately insured women aged 15-44 years – United States, 2003-2015. Morbidity and Mortality Weekly Report, 67(2), 66–70. https://doi.org/10.15585/mmwr.mm6702a3

³Bürger I., Erlandsson K., Borneskog C. (2024). Perceived associations between the menstrual cycle and attention deficit hyperactivity disorder (ADHD): A qualitative interview study exploring lived experiences. Sexual & Reproductive Healthcare, 40, Article 100975. https://doi.org/10.1016/j.srhc.2024.100975

⁴Roberts B., Eisenlohr-Moul T., Martel M. M. (2018). Reproductive steroids and ADHD symptoms across the menstrual cycle. Psychoneuroendocrinology, 88, 105–114. https://doi.org/10.1016/j.psyneuen.2017.11.015

At a medical appointment, have you ever felt that the doctor dismissed your or your child’s symptoms? Ever felt your provider was asking the wrong questions or implying that you were overreacting? Ever been sent home with advice to reduce stress or weight, only to learn you were suffering from a condition or illness requiring a more informed diagnosis and more effective treatment?

Exciting research is revealing compelling new evidence regarding ADHD’s lesser known co-occurring conditions — co-diagnoses unfamiliar to many physicians, some of whom may not be open to learning more. It’s important to know when a provider is gaslighting you — when they say that your symptoms are all in your head; blame your age, weight, or gender for your concerns; or refuse relevant testing. It is also important to understand why ADHD brains tend to be more susceptible to gaslighting, and what you can do if this happens to you.

In this webinar, you will learn:

• Why ADHD brains are more susceptible to gaslighting
• How to distinguish between gaslighting and honest provider error or lack of knowledge
• Examples of how gaslighting can effectively manipulate intelligent, educated targets
• Pro-active approaches to work with your physician, not against them
• Ways to train yourself and your child to minimize the risk of gaslighting
• Strategies to keep yourself and your child clear and informed when gaslighting does occur

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Medical Gaslighting: Resources from ADDitude

• Download: How to Talk to Your Doctor About Medical Research
• Read: 9 Questions to Ask Your Doctor Before Deciding on ADHD Medicine
• Read: “Medical Gaslighting Convinced Me That I Didn’t Have ADHD”
• Read: “You Couldn’t Possibly Have ADHD”

Obtain a Certificate of Attendance

If you attended the live webinar on February 24,, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Jennifer Fraser, Ph.D., is the founder of The Bullied Brain and an award-winning educator of 20 years, author of five books, and international presenter. She has a Ph.D. in Comparative Literature from the University of Toronto.

Her latest book is The Gaslit Brain: Protect your Brain from the Lies of Bullying, Gaslighting, and Institutional Complicity. (#CommissionsEarned) She consults with organizations and governments on ways to apply neuroscience to normalized abuse cultures in order to transform them into healthy, happy, high-performing ones. With a focus on neurodiversity, written about in her publications since 2011, she is highly attuned to the diverse and remarkable ways in which brains interact with their environment and with others. She writes a series, “The Bullied Brain,” for Psychology Today.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

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A wealth of detailed, data-driven information on the efficacy and side effects of ADHD interventions now exists in a free, interactive platform called Evidence Based Interventions-ADHD (EBI-ADHD), the product of a massive umbrella review published in the British Medical Journal.¹

EBI-ADHD was created to satisfy the need for accessible information about a wide array of ADHD interventions, and its findings were drawn from 221 meta-analyses of randomized controlled trials that explore ADHD treatments in adults and kids, as well as from the ADHD community itself.

“The platform is made to be user-friendly, and to help people make informed choices about what they really care about,” said Samuele Cortese, M.D., Ph.D., senior author on the study, in a recent ADDitude webinar titled “Heart Health and ADHD Treatment: Implications of Stimulant Use for Adults.” “It is based on a huge analysis of the literature — we analyzed data from more than 50,000 people — but it is also based on the experience and the recommendation of people with lived experience.”

Information on the EBI-ADHD platform is extensive and can be sorted according to various filters, including the following:

• Age group
  • Preschoolers
  • Children
  • Adults
• Treatment type
  • Medication (12 types, including stimulants and non-stimulants)
  • Psychosocial (8 types)
  • Lifestyle (9 types)
  • Brain stimulation (3 types)

The platform contains data on the impact of the various treatment types on ADHD symptoms, as rated by:

• Clinicians
• Teachers
• Parents
• Patients
• A combination of the above

The database also contains information about side effects such as:

• Sleep disruption
• Appetite suppression

Also included are measures of:

• Acceptability (discontinuation for any reason)
• Tolerability (discontinuation due to side effects)

For each measurement, evidence quality (very low to high) is given.

Most Effective ADHD Medication: Findings

Most Effective ADHD Medication for Children

The researchers found moderate- to high-certainty evidence that the following medications had medium to large effect sizes for ADHD symptoms in children:

• Alpha-2 agonists
• Amphetamines
• Atomoxetine
• Methylphenidate
• Viloxazine

On average, methylphenidate was found to be the most tolerable for children (better than placebo). Amphetamine showed worse tolerability than placebo, with moderate-certainty evidence.

This finding was supported by another recent study which focused on the efficacy and mechanism of action of methylphenidate.² Participants were stimulant-naïve 8- to 12-year-old children with ADHD. They received an MRI while completing tasks that measured attentional control and impulsivity — once without medication and once after a dose of methylphenidate. The MRIs revealed that methylphenidate decreased variability and increased stability in the brain.

“We found that whole brain flexibility decreased on methylphenidate,” the study’s authors wrote. “Further, individuals with greater decreases in whole brain flexibility on methylphenidate exhibited greater improvements in task performance.”

According to the most recent ADDitude treatment survey, which recorded responses from more than 11,000 participants:

• 52% of children taking medication for ADHD use methylphenidate, and their caregivers rate it 3.09 out of 5 for efficacy
• 34% take a form of amphetamine and their caregivers rated it 3.06 out of 5

Most Effective ADHD Medication for Adults

The researchers found moderate-certainty evidence of medium effect sizes for the following ADHD treatments for adults:

• Atomoxetine
• Methylphenidate

Though other medications, including alpha 2 agonists, showed large effect sizes, the evidence was low or very low certainty.

The ADDitude treatment survey found that, among adults taking medication for ADHD symptoms:

• 30% take a form of methylphenidate, and they rate it 2.96 out of 5 for efficacy
• 62% take a form of amphetamine, and they rate it 2.96 out of 5

Most Effective Non-Medication Interventions

Only one non-medication intervention, cognitive behavioral therapy, had moderate-certainty evidence of efficacy in managing ADHD symptoms in adults, according to clinicians.

The ADDitude survey found that 46% of adults have tried cognitive behavioral therapy, and 81% of those recommend it to others.

Acupuncture, mindfulness, and physical training showed large effect sizes on both ADHD symptoms and secondary outcomes, such as academic performance and quality of life, however the evidence certainty was low or very low, because of small sample sizes, trial limitations, and lack of data on acceptability, tolerability, and side effects. Mindfulness was the only intervention to show large effects at extended follow-up; the efficacy of all other interventions was short term.

Effect of Interventions on Other Outcomes

In children and adolescents, moderate-certainty evidence found that

• Amphetamines showed medium improvements in academic performance
• Atomoxetine showed small to medium improvements on quality of life

In adults, moderate- or high-certainty evidence found that:

• Atomoxetine showed small improvements on emotional dysregulation
• Methylphenidate showed small improvements on executive functions

The international team of researchers behind EBI-ADHD hopes the free, user-friendly tool will empower patients with information about the diverse breadth of treatment options available today, so they can actively participate in shared decision making with their providers.

“Long waiting lists for mental health services are a major issue. Having incorrect information about treatments can make people’s journeys even more difficult, by wasting time and money on non-evidence-based approaches,” said Corentin Gosling, Ph.D., an associate professor at the Paris Nanterre University and first lead author of the study, in a press release. “Taking the time to review all treatment options within a shared decision-making process using the web app we developed can empower people with ADHD, leading to better treatment adherence, improved outcomes, and an overall better patient experience.”

Sources

¹Gosling C J, Garcia-Argibay M, De Prisco M, Arrondo G, Ayrolles A, Antoun S et al. Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making BMJ 2025; 391 :e085875 doi:10.1136/bmj-2025-085875

²Nugiel, T., Fogleman, N.D., Lyons, M.G. et al. Methylphenidate stabilizes dynamic brain network organization during tasks probing attention and reward processing in stimulant-naïve children with ADHD. Transl Psychiatry 15, 488 (2025). https://doi.org/10.1038/s41398-025-03694-9

Self-regulation difficulties are a strong predictor of both hyperactive-impulsive and inattentive ADHD in adulthood, according to a new study published in the Journal of Attention Disorders.¹

The study challenges the dual-pathway model of ADHD, which proposes that separate, independent traits explain the two main sets of ADHD symptoms. That model proposes that inattention links to low effortful control (e.g., difficulties with emotional regulation, inhibitory control, and focus), while hyperactivity/impulsivity links to reactive traits, such as high surgency (increased activity levels, impulsivity) and negative affect (strong negative emotions, such as fear, frustration, or discomfort).²

This theoretical framework does not fully account for ADHD that persists into adulthood. For example, it suggests that effortful control should exclusively explain the variance in inattentive symptoms in adults. However, when researchers analyzed the results from the German Adult Temperament Questionnaire of 158 adults (79 with ADHD and 79 controls), they found that low effortful control predicted both inattentive and hyperactive-impulsive symptoms in adults with ADHD.

Likewise, while reactive traits reliably predict ADHD in childhood, they become less relevant for the persistence of ADHD symptoms in adulthood. In the dual-pathway model, high surgency and negative affect exclusively explain the variance in hyperactive-impulsive symptoms in childhood and adolescence, but the study found no significant group differences in surgency in adults. A one-unit increase in negative affect was associated with a twofold increase in the odds of belonging to the ADHD group. However, the negative affect’s predictive value for hyperactive-impulsive symptoms was strongly reduced once effortful control was added to the model.

“When considered alongside research on ADHD in childhood and adolescence, our findings suggest that elevated restrictive traits (surgency and negative effect), although considered central risk factors for the development of ADHD in childhood, may be less relevant for the persistence of clinically significant ADHD symptoms into adulthood,” the researchers wrote. “In contrast, self-reported deficits in effortful control appear to be strongly associated with sustaining a clinical diagnosis of adult ADHD. However, this strong association does not imply that effortful control and ADHD should be equated.”

Cumulative Effects of Low Effortful Control

The researchers also found a strong reciprocal relationship between low effortful control and high negative affect. In this case, deficits in effortful control may intensify negative affective states, which, in turn, impair an individual’s use of self-regulation strategies.

“The emotional consequences of impaired effortful control may become more pronounced with age, as cumulative exposure to adverse life events increases self-perceived negative affect,” the researchers wrote.

A recent study, published in the Journal of Child Psychology and Psychiatry, supports this idea. The study found that the risk of autistic and ADHD children developing comorbid depression or anxiety in adulthood is driven largely by emotional exposures in childhood and how intensely they are experienced. ³

Temperament-based assessments could help clinicians better understand and individualize treatment plans for adult patients, according to the researchers. Interventions focused on strengthening regulatory skills, such as mindfulness, cognitive behavioral training (CBT), or executive function training, may improve executive function and reduce emotional distress in adults with ADHD.

Several limitations of the study exist, including the cross-sectional design and use of self-reported data. The researchers recommend future longitudinal studies spanning various developmental stages.

Sources

¹Teuchert, C., Kerner auch Koerner, J., Daseking, M., & Heinze, H. (2025). How does adult temperament relate to ADHD symptom domains? Testing the dual-pathway model. Journal of Attention Disorders. 0(0). https://doi.org/10.1177/10870547251393062

²Sonuga-Barke EJ. (2003). The dual pathway model of AD/HD: an elaboration of neuro-developmental characteristics. Neurosci Biobehav Rev. https://doi.org/10.1016/j.neubiorev.2003.08.005

³Lukito, S., Chandler, S., Kakoulidou, M., Griffiths, K., Wyatt, A., Funnell, E., Pavlopoulou, G., Baker, S., Stahl, D., & Sonuga-Barke, E. Emotional burden in school as a source of mental health problems associated with ADHD and/or autism: Development and validation of a new co-produced self-report measure. Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.70003

Perimenopause begins up to 10 years earlier in women with ADHD, who report more severe perimenopausal symptoms than do women without ADHD.

This finding comes from a new population-based study published in European Psychiatry¹ that found the highest prevalence of severe perimenopause symptoms occurred between the ages of 35 and 39 among women with ADHD and between the ages of 45 and 49 among women without ADHD.

Slightly more than half (54.2%) of women with a self-reported ADHD diagnosis experience debilitating symptoms during perimenopause (the period of years before menopause) compared to one-third of women without ADHD, the study reported.

“Our findings suggest a considerably higher symptom burden, including impairing psychological and somatic symptoms, among women with ADHD, compared to those without ADHD,” the researchers wrote. “These differences were most pronounced at age 35 to 39 years, suggesting an onset of perimenopause up to 10 years earlier in women with ADHD than in the average.”

The study examined data from 5,392 women, aged 35 to 55 years, who participated in the Icelandic Stress-and-Gene-Analysis (SAGA) cohort in 2018 and a follow-up survey in 2024. The researchers assessed perimenopausal symptoms using the Menopause Rating Scale (MRS). They found that women with a self-reported ADHD diagnosis encountered more physical symptoms, such as headaches and digestive problems, compared to women without the disorder. Women with ADHD also had higher MRS measurements in all perimenopausal symptom categories, including:

• somatic (hot flushes/sweating, heart discomfort, sleeping problems, and muscle and joint problems)
• psychological (depressive mood, irritability, anxiety, and tiredness)
• urogenital (sexual problems, bladder problems, and vaginal dryness)

Given the cross-sectional nature of measurements, the researchers could not confirm a causal relationship between ADHD and more severe perimenopausal symptoms.

“However, since ADHD develops in childhood, we could assert that the symptoms of the disorder precede perimenopausal symptoms in time,” the researchers wrote.

Impact of Hormonal Fluctuations During Perimenopause

Hormonal fluctuations in perimenopause could exacerbate existing ADHD symptoms or could lead to a diagnosis of previously unrecognized ADHD, the researchers also noted. In the study, about 8% of women without diagnosed ADHD, aged 35 to 44 years, reported having severe ADHD symptoms that decreased as they aged.

“We were unable to determine whether the women who had not been diagnosed with ADHD, but reported severe ADHD symptoms, had impairing ADHD symptoms in childhood, whether the symptoms emerged in later years, or what caused severe ADHD symptoms in these age groups,” the researchers wrote.

This is the first study assessing the differences in perimenopausal symptoms among women with and without ADHD. Emerging research and anecdotal reports have suggested that women with ADHD are more vulnerable to challenges before and after menopause.^{2, 3} “As estrogen vacillates wildly in perimenopause, many women find that their ADHD symptoms grow significantly worse,” says Lotta Borg Skoglund, M.D., Ph.D., an associate professor at Uppsala University in the Department for Women’s and Children’s Health and leader of the pioneering research group GODDESS ADHD.

In an ADDitude survey of nearly 5,000 women with ADHD, 63% of respondents aged 45 and older said ADHD had the greatest impact on their lives during perimenopause and menopause. (In contrast, less than 6% said ADHD had the biggest impact before age 20.)

More than 93% said they noticed a difference in the severity of some ADHD symptoms during perimenopause and/or menopause.

“Everything flared up in perimenopause. I feel the worst I have ever felt, and my life is in disarray,” wrote one respondent. “I am unemployed, without a fixed address, lonely, anxious, depressed, and can’t think straight. I’ve turned my life, which appeared to be running well enough, into a blazing dumpster fire.”

“In perimenopause, the brain fog and memory, inattention, distractibility, perfectionism, hyperactivity, and restlessness issues become progressively worse,” wrote a 52-year-old woman diagnosed with ADHD at age 50. “I have always had these symptoms, but I was able to manage them with systems that I created for myself. My ability to manage them has declined significantly, and this makes these symptoms seem like they are the worst they have ever been.”

More recently, a systematic review published in Frontiers in Global Women’s Health found that hormonal fluctuations significantly impact the way ADHD symptoms present and progress across the female lifespan.⁴

More Research Needed on Perimenopausal Women with ADHD

The Frontiers in Global Women’s Health study also highlighted six significant gaps in scientific research that are crucial for improving the diagnosis and treatment of ADHD in women. It concluded that women with ADHD remain underdiagnosed, under-researched, and undertreated despite growing awareness of their unique challenges during hormonal changes across the lifespan.

“We need research investigating the role of hormones in ADHD symptom expression in girls and women,” says Julia Schechter, Ph.D., of the Duke Center for Girls and Women with ADHD. “This research should examine hormonal levels across the reproductive lifespan, including puberty onset, menstrual cycle, pregnancy, postpartum period, and menopause, and post-menopause.”

“Whether it’s ADHD or perimenopause or ADHD and perimenopause, the impact of perimenopause and menopause on presentation of ADHD symptoms is an enormously unrecognized and important topic in global female health,” said Jeanette Wasserstein, Ph.D., during her 2023 ADDitude webinar “Hormonal Fluctuations and ADHD.” “We’re half the world, and this is a significant issue, and it should be recognized and addressed.”

Findings from the European Psychiatry study echoed the demands of other ADHD experts for more research on the impact of hormonal replacement therapy and/or stimulant treatment on the connection between ADHD and perimenopausal symptoms. The study also underscored the importance of developing guidelines for the treatment and care of perimenopausal women with ADHD.

Sources

¹Jakobsdóttir Smári, U., Valdimarsdottir, U.A., Wynchank, D., de Jong, M., Aspelund, T., Hauksdottir, A., Thordardottir, E.B., Tomasson, G., Jakobsdottir, J., Lu, D., Nevriana, A., Larsson, H., Kooij, S., Zoega, H. (2025). Perimenopausal symptoms in women with and without ADHD: A population-based cohort study. Eur Psychiatry. https://doi.org/10.1192/j.eurpsy.2025.10101
²Weber, M.T., Maki, P.M., & McDermott, M.P. (2014). Cognition and mood in perimenopause: A systematic review and meta-analysis. The Journal of Steroid Biochemistry and Molecular Biology. https://doi.org/10.1016/j.jsbmb.2013.06.001
³Dorani, F., Bijlenga, D., Beekman, A.T.F., van Someren, E.J.W., Kooij, J.J.S. (2020). Prevalence of hormone-related mood disorder symptoms in women with ADHD. J Psychiatr Res. https://doi.org/10.1016/j.jpsychires.2020.12.005
⁴Kooij, J.J.S., de Jong, M., Agnew-Blais, J., Amoretti, S., Bang Madsen, K., Barclay, I., Bölte, S., Borg Skoglund, C., Broughton, T., et al. (2025). Research advances and future directions in female ADHD: the lifelong interplay of hormonal fluctuations with mood, cognition, and disease. Frontiers in Global Women’s Health. https://www.frontiersin.org/journals/global-womens-health/articles/10.3389/fgwh.2025.1613628

How does long-term ADHD medication use impact heart health, and do potential risks outweigh treatment benefits?

Medications (including stimulants and non-stimulants) are an important component of a comprehensive management strategy for ADHD. While these medications have demonstrated clear benefits, concerns remain about their possible side effects — among them, potential cardiovascular problems. Extensive research has probed this relationship and asked: How important is dosing and duration of treatment with ADHD medication? What are the risk-benefit ratios associated with ADHD medication use for different patients?

In this webinar, Samuele Cortese, M.D., Ph.D., professor at the University of Southampton, United Kingdom, and New York University (NYU), will explain the results and implications of the most relevant studies on this topic.

In this webinar, you will learn:

• The latest research on the relationship between cardiovascular problems and ADHD medication use, including considerations for older adults.
• The relationship between ADHD itself and cardiovascular problems, regardless of medication effects.
• The importance of medication use for many individuals with ADHD and the consequences of not receiving treatment.
• Strategies to help people mitigate or prevent cardiovascular disease from a lifestyle perspective.

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation

Heart Health and Stimulant Use: Resources

• Free Download: What You Need to Know About ADHD Medication
• Read: Change of Heart: Understanding Cardiovascular Disease in Women with ADHD
• Read: Who’s Afraid of ADHD Stimulants?
• Watch: How ADHD Affects Life Expectancy
  
  

Obtain a Certificate of Attendance

If you attended the live webinar on December 2, 2025, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Samuele Cortese, M.D., Ph.D., is the National Institute for Health and Care Research (NIHR) Research Professor, Professor of Child and Adolescent Psychiatry at the University of Southampton, Honorary Consultant for Hampshire and Isle of Wight Healthcare NHS Foundation Trust, UK, and adjunct professor at NYU. Prof. Cortese’s main research interests are around neurodevelopmental disorders. He has published more than 450 peer-review papers. He has secured funding as main/co-applicant for more than £ 23 M. Since 2022, he has been included in the top 1% of scientists in the field of psychiatry/psychology (Web of Science). Since 2022, he has ranked number one worldwide in terms of expertise on ADHD (Expertscape). He is the Chair of the European ADHD Guidelines Group.

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Because it brings fewer behavior-management problems, Inattentive ADHD is not always recognized and diagnosed in childhood, and this under-recognition can persist into adulthood. This is particularly true for girls with ADHD, who are more likely than boys to have the inattentive subtype. Research and clinical experience show clearly, however, that difficulties with attention — even when not accompanied by impulsivity or hyperactivity — can lead to significant functional impairment and distress in higher education, the workplace, and in social interactions.

In this hour-long webinar, you will learn about:

• The prevalence of predominantly inattentive ADHD in children and adults
• The most common symptoms and distinctive features of inattentive ADHD
• How predominantly inattentive ADHD is recognized and diagnosed
• The daily-life difficulties of people with inattentive ADHD
• Effective treatments for predominantly inattentive ADHD

The intersection of ADHD, hormones, and menopause is more nuanced than previously understood and requires more research, according to two new studies. A systematic review published in Frontiers in Global Women’s Health found that hormonal fluctuations significantly impact the way ADHD symptoms present and progress across the female lifespan.¹ At the same time, women with ADHD do not report more severe symptoms of menopause than women do without ADHD, according to a recent study published in the Journal of Attention Disorders.²

Both studies emphasize that women with ADHD remain underdiagnosed, under-researched, and undertreated despite growing awareness of their unique challenges during hormonal changes across the lifespan, particularly during menopause.

According to an ADDitude survey of nearly 5,000 women with ADHD, 63% of respondents aged 45 and older said ADHD had the greatest impact on their lives during perimenopause and menopause. More than 93% said they noticed a difference in the severity of some ADHD symptoms during perimenopause and/or menopause.

The authors of the Frontiers in Global Women’s Health study analyzed data collected from the ADDitude survey as well as other existing literature to “identify what we know and what we need to know about people assigned female at birth having ADHD.”

Their findings suggest that:

• Hormonal transitions exacerbate ADHD symptoms and mood disturbances, yet pharmacological research and tailored treatments are lacking.
• Executive function deficits manifest differently in girls and women with ADHD.
• Diagnostic practices and sociocultural factors contribute to delayed diagnoses, increasing the risk of comorbidities, impaired functioning, and reduced quality of life.
• Undiagnosed women are at an increased risk for premenstrual dysphoric disorder (PMDD), postpartum depression (PPD), and cardiovascular disease during perimenopause.

The review also highlighted six significant gaps in scientific research that are crucial for improving the diagnosis and treatment of ADHD in women.

Research Gap #1: Executive Function

What’s Missing: Large, inclusive, long-term studies tracking the impact of changing estrogen and progesterone levels in females with ADHD across puberty, pregnancy, and menopause.

Research Needed:

• longitudinal cohort studies including diverse gender and hormonal profiles
• studies timed to menstrual cycle phases or accounting for ovulation suppression
• brain imaging and neuropsychological testing across hormonal changes to better understand symptom variability in women and girls with ADHD

Research Gap #2: Puberty, Hormones, and Pharmacological Treatment

What’s Missing: Research on how puberty and hormonal changes impact ADHD symptoms and stimulant medication effectiveness in girls. Also unclear is how stimulant use may affect physical or hormonal changes during adolescence.

Research Needed:

• longitudinal case-control studies on puberty’s effects on ADHD symptoms and treatment, and the impact of stimulant use on pubertal development in girls
• studies (including brain imaging) assessing how hormonal changes influence medication metabolism in both sexes
• mixed-methods research exploring societal expectations and gender norms shaping adolescent ADHD experiences

Research Gap #3: Sexual Health and Risky Behaviors

What’s Missing: Research exploring the role of co-occurring conditions (e.g., autism, substance use) and environmental factors, or how treatment might reduce the risks that girls and women with ADHD face for risky sexual behaviors.

Research Needed:

• long-term studies investigating sexual health outcomes among diverse ADHD populations
• trials assessing how hormonal birth control methods affect ADHD symptoms, mood, and quality of life
• studies exploring the effectiveness of non-pharmacological and pharmacological interventions in reducing risky sexual behaviors and their consequences
• comprehensive studies that address both reproductive health and mental health aspects of contraceptive use

Research Gap #4: Maternal ADHD in the Peripartum Period

What’s Missing: The peripartum period is under-researched for women with ADHD, despite potential heightened risks of postpartum depression and anxiety.

Research Needed:

• studies on pregnancy and birth outcomes in women with ADHD
• research on pregnancy and birth complications, peripartum anxiety, and depression in women with ADHD
• trials of safe, effective perinatal pharmacological and psychological interventions
• research identifying potential targets for prevention and early intervention to mitigate adverse outcomes associated with perinatal and early infancy risk factors in children with a genetic predisposition to ADHD

Research Gap #5: Hormonal and Gynecological Disorders in ADHD

What’s Missing: Substantial research is needed to bridge the gaps in the understanding of hormonal and gynecological disorders in female ADHD. Limited evidence exists about the relationship between ADHD and coexisting conditions like polycystic ovary syndrome (PCOS), endometriosis, or premenstrual dysphoric disorder (PMDD). These conditions may influence how ADHD presents and is treated.

Research Needed:

• epidemiological studies exploring whether women with ADHD are at greater risk of hormonal or gynecological disorders
• investigations into how inflammation and hormonal dysregulation intersect with ADHD symptoms and comorbidities
• research into how these disorders may explain individual differences in ADHD presentation and outcomes

Research Gap #6: Menopause, Cognitive Decline, and Late Diagnosis

What’s Missing: ADHD symptoms may change or intensify during menopause, but research is lacking on neurocognitive outcomes during this transition. Additionally, many women are diagnosed late in life, often after years of misdiagnosis or masking.

Research Needed:

• longitudinal cognitive and neuroimaging studies of women with and without ADHD across menopause stages
• trials testing the impact of menopausal hormone therapy on ADHD symptoms and cognition
• research investigating why girls and women are still underdiagnosed or diagnosed late, and what symptoms of female ADHD should prompt proper diagnostic measures and improve early identification
• mixed-method longitudinal studies involving women with lived ADHD experiences

The Journal of Attention Disorders study addresses some of these research gaps.

Menopause May Not Be Worse Than Expected

That study compared the menopausal experiences of 656 women aged 45 to 60 with and without ADHD between October 2023 and June 2024. Findings reveal that women with diagnosed ADHD did not report worse menopausal symptoms than women without ADHD at any stage of menopause. This suggests that, while hormonal changes can worsen ADHD symptoms, this doesn’t necessary translate into a perception of aggravated menopause. That said, ADHD symptoms did correlate with poorer quality of life during menopause, with medication potentially influencing these correlations.

“Arguably, these findings are unexpected because ADHD is associated with several difficulties that overlap with menopausal complaints,” the study’s authors wrote.

One potential explanation for the results, the researchers suggest, involves how women interpret their symptoms. Women with ADHD may attribute memory problems and concentration difficulties to their existing condition rather than to menopause, leading to different reporting patterns. They may also be more accustomed to these symptoms than are other women experiencing them for the first time in menopause, thus skewing their self-reports.

Medication Doesn’t Significantly Change the Picture

In addition, the study did not find a significant difference in menopausal experiences between women with ADHD who use stimulant or non-stimulant medication and those who do not. The researchers explained that current ADHD treatments may not specifically address menopause-related symptom changes and may need to be adjusted. Women may also need additional support during hormonal transitions.

The study sample included 245 women with existing ADHD diagnoses (107 on medication, 138 not on medication) and 411 women without ADHD. (Women currently using menopausal hormone therapy or contraceptive pills were excluded from participating.)

Similar to the Frontiers in Global Women’s Health study, the authors of the Journal of Attention Disorders stressed the importance of more research.

“Much more research is needed to understand the relationships between ADHD and menopausal symptoms and explore other methods to support valid assessments, such as comprehensive clinical interviews or objective evaluations by clinicians,” the study’s authors wrote.

Sources

¹ Kooij, J.J.S., de Jong, M., Agnew-Blais, J., Amoretti, S., Bang Madsen, K., Barclay, I., Bölte, S., Borg Skoglund, C., Broughton, T., et al. (2025). Research advances and future directions in female ADHD: the lifelong interplay of hormonal fluctuations with mood, cognition, and disease. Frontiers in Global Women’s Health. https://www.frontiersin.org/journals/global-womens-health/articles/10.3389/fgwh.2025.1613628

² Chapman, L., Gupta, K., Hunter, M. S., & Dommett, E. J. (2025). Examining the link between ADHD symptoms and menopausal experiences. Journal of Attention Disorders. https://doi.org/10.1177/10870547251355006

To the ADHD brain, a behavioral addiction may feel like a quick escape from reality that slowly transforms into a suffocating trap.

Gambling, Internet use, gaming, sex, pornography, and social media can provide short bursts of relief or excitement, but they demand more and more over time while making us feel less satisfied.

Why does ADHD make us more vulnerable to behavioral addictions? Because we’re individuals who crave novelty, abhor delayed gratification, and juggle dopamine dysregulation.

A behavioral addiction starts as a distraction or a coping mechanism that becomes a chronic condition over time. They affect daily living, erode workplace performance, undermine relationships, and contribute to depression and anxiety.

Without recognition and intervention, these conditions can progress in severity and compromise long-term functioning. What felt like a solution in the moment often creates deeper problems in the long run.

This webinar will explore the science linking ADHD and behavioral addictions, explain the toll these behaviors take on daily life, and highlight strategies that promote recovery. Attendees will learn how to recognize warning signs, reduce risks, and support long-term resilience and healthier coping.

In this webinar, you will learn:

• Why people with ADHD face elevated risks for behavioral addictions.
• About the signs that a distraction or coping mechanism is becoming an addiction.
• About the behavioral addictions that are most common in people with ADHD.
• How these addictions affect daily living, jobs, relationships, and mental health
• About treatment challenges, and evidence-based strategies and interventions to overcome these addictions.
• How to foster resilience through ongoing support and monitoring for lasting change.

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Behavioral Addictions and ADHD: Resources

• • • Free Download: Your ADHD Dopamine Menu Template
    • Read: ADHD and Addiction: The Truth About Substance Abuse
    • Read: Video Game Addiction: Signs, Risk Factors, and ADHD Links
    • Read: Never Enough? Why ADHD Brains Crave Stimulation
      
      

Obtain a Certificate of Attendance

If you attended the live webinar on October 21, 2025, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Todd Love, Psy.D., JD, LPC, CSAT, BCC, is a licensed professional counselor who has focused his career on the intersection of ADHD and behavioral addictions. In addition to his clinical work, he has presented at many national conferences and published several scholarly articles and book chapters on behavioral addictions. He has also delivered webinars and podcasts on ADHD and addiction and developed a continuing-education program to help mental health clinicians working with adult ADHD. Before becoming a therapist, he both practiced law and worked in technology, experiences that inform his direct and practical approach.

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ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

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