Question: Hello professor,
  
  my ADHD was considered atypical because I got diagnosed at 30y/o after what others perceive a great career. I suffer greatly from ADHD, but my higher IQ along with genuine curiosity and drive carried me through. I could have achieved much much more.
  
  Anyway, my question would be if you have seen any atypical development of the disorder over time. To me it seems like it keeps getting worse significantly (which could also explain why it wasn't obvious at earlier age); alternatively I'm just getting old and running out of energy to keep fighting. Shouldn't the effects ADHD remain mostly stable?
  
  Thank you and have a nice day! :)
Answer: That's a good point.  For most patients, symptoms of hyperactivity and impulsivity tend to get better as they age. Symptoms of inattention tend to stay the same.  But in some cases, the disorder seems to worsen.  When that happens, the clinician must determine if the symptoms are actually getting worse or if the impairments caused by the symptoms are getting worse.   For example, if one's ADHD leads to an accumulation of life stress, then that accumulating stress will  make one feel worse, even though the symptoms don't change.  Also keep in mind that the severity of ADHD symptoms can worsen when the challenges life throws at us become more difficult.  So, when a person gets a promotion at work, that's a happy event, but the new position may be more challenging and stressful leading to a breakdown in functioning.
content: Q: Hello professor,
  
  my ADHD was considered atypical because I got diagnosed at 30y/o after what others perceive a great career. I suffer greatly from ADHD, but my higher IQ along with genuine curiosity and drive carried me through. I could have achieved much much more.
  
  Anyway, my question would be if you have seen any atypical development of the disorder over time. To me it seems like it keeps getting worse significantly (which could also explain why it wasn't obvious at earlier age); alternatively I'm just getting old and running out of energy to keep fighting. Shouldn't the effects ADHD remain mostly stable?
  
  Thank you and have a nice day! :)
   Ans: That's a good point.  For most patients, symptoms of hyperactivity and impulsivity tend to get better as they age. Symptoms of inattention tend to stay the same.  But in some cases, the disorder seems to worsen.  When that happens, the clinician must determine if the symptoms are actually getting worse or if the impairments caused by the symptoms are getting worse.   For example, if one's ADHD leads to an accumulation of life stress, then that accumulating stress will  make one feel worse, even though the symptoms don't change.  Also keep in mind that the severity of ADHD symptoms can worsen when the challenges life throws at us become more difficult.  So, when a person gets a promotion at work, that's a happy event, but the new position may be more challenging and stressful leading to a breakdown in functioning.