ADHD in men: symptoms and treatments

Attention-deficit/hyperactivity disorder, or ADHD, is difficult to live with for people of all sexes and gender identities. But research shows that males are up to 3 times more likely to be diagnosed with ADHD than females. Although many experts believe that this discrepancy is partly due to provider bias, it’s still important to understand the unique ways that ADHD in men can present and how to get help if you’re struggling.

In this guide, we unpack the facts about ADHD in men, including symptoms and effective treatment methods. We also talk about why and how ADHD presents differently in men vs women. 

If you’re a man who’s grappling with the symptoms of ADHD, there’s no need to face this journey alone. Find an ADHD treatment provider on Klarity Health today to get the support you need.

ADHD symptoms in adult men

Understanding the nature and range of ADHD symptoms in men is crucial to effectively identifying and managing the condition. It’s important to note that while these symptoms can be present in anyone, they’re often more pronounced in people with ADHD. Common symptoms like mood swings, poor organizational skills, and even substance misuse are often overlooked. 

If you or someone you know are experiencing one or more of the symptoms discussed below, you should speak to a mental health professional about a possible ADHD diagnosis. Below, we examine 3 common symptom categories associated with ADHD in men: 

• Hyperactivity
• Impulsivity
• Inattentiveness.

Hyperactivity 

For many, the term ADHD conjures up images of a young child who can’t sit still. While hyperactivity is a prominent symptom of childhood ADHD, adults, specifically men, can also experience it — although it may not be as conspicuous. In men, hyperactivity often manifests as restlessness, a constant need for stimulation, or the tendency to talk excessively. 

They might fidget, have difficulty relaxing, or feel an ongoing sense of under-stimulation. Hyperactivity in men with ADHD can also lead to feelings of internal chaos, making them seem impatient or having difficulty waiting their turn in conversations or activities.

Impulsivity

Impulsivity refers to a tendency to act without thinking about the consequences. Men with ADHD might struggle with impulse control, leading to abrupt decisions or actions. This could be seen in various aspects of life, including financial decisions, career choices, and personal relationships. 

Impulsive behavior can range from interrupting others during conversation and making hasty life-changing decisions to engaging in risky behaviors. The consequences of such impulsivity can lead to significant turmoil in your personal and professional life.

Inattentiveness

Inattentiveness is another common symptom of ADHD in men. This doesn’t necessarily mean a lack of focus or concentration but rather an inconsistent ability to focus. Men with ADHD might struggle with maintaining attention on tasks that they find mundane or that lack immediate rewards. It can look like forgetfulness, disorganization, or lack of motivation. 

The same men can exhibit hyperfocus, or intense concentration, on tasks they find particularly engaging or stimulating. Having an inconsistent attention span can be an indication that you’re struggling with ADHD.

Other symptoms of ADHD in men

In addition to the 3 official ADHD symptoms listed above, there are other signs of ADHD in men you might notice, including:

• Substance misuse: Although abusing drugs and alcohol isn’t an official symptom of ADHD, studies show that men with ADHD are more likely to experience substance use disorder than those without. This can be traced back to different factors, including the impulsivity and mood swings that can often come along with ADHD.
• Angry or emotional outbursts: Many men with ADHD experience emotional dysregulation, or difficulty calming or regulating their own emotions. Because of this, men with ADHD may have ADHD rage, which is characterized by angry or emotional outbursts when they aren’t able to calm themselves down.
• Relationship problems: ADHD can present many unique challenges for relationships, including impulsive behaviors, difficulty sustaining attention during important conversations, and forgetfulness. This can lead to partners of men with ADHD feeling frustrated or like they need to walk on eggshells.
• Lack of follow-through: Men with ADHD often lack follow-through and feel like they’re not making do on their promises. This isn’t due to a lack of caring; ADHD makes it a challenge to remember details, and men may either forget to follow up or find it challenging to get motivated to follow through. This often leads men with ADHD to feel like they’re not meeting their full potential.
• Starting (but not finishing) new projects: Men with ADHD often get very excited about new interests and projects. At the same time, they may find that they quickly become bored with new interests, leading to a cycle of starting but not finishing tasks and projects.

How do you know if you have adult ADHD? 

Recognizing the signs of adult ADHD can be challenging, as the symptoms can often resemble those of other mental health conditions or could be attributed to general life stressors. If you consistently experience difficulties with attention, impulsivity, and hyperactivity that interfere with your life across multiple settings — work, home, and social relationships — you might have ADHD.

Keep in mind that everyone can experience these difficulties from time to time, but in adults with ADHD, they’re more severe and persistent. If you suspect you might have ADHD, it’s important to seek a professional evaluation. Self-diagnosis can be inaccurate and potentially harmful, as other conditions can mimic ADHD symptoms. A medical professional will evaluate your symptoms, family medical history, and personal medical history to make an accurate ADHD diagnosis. 

ADHD in men vs women

ADHD presents differently across genders and developmental stages, a dynamic that still isn’t fully understood. During childhood, boys are diagnosed with ADHD more frequently than girls. However, this gender gap narrows in adulthood. Studies suggest that ADHD persistence into adulthood is more common in women.

Gender also plays a role in how ADHD symptoms manifest. Adult men with ADHD are often more prone to combined symptoms, including heightened hyperactivity and impulsivity, while signs of ADHD in women tend toward inattentive symptoms. For women, over time, hyperactive and impulsive symptoms generally decrease, while inattentive symptoms persist.

The gender divide also extends to the prevalence of comorbid disorders. Males with ADHD are more likely to experience “externalizing” disorders, such as substance abuse, antisocial personality disorder, or conduct disorder. Females, on the other hand, are more prone to “internalizing” disorders, including anxiety, depression, somatic symptoms, or bulimia. This pattern of comorbidity can often lead to misdiagnosis, particularly in women with ADHD.

How ADHD affects men’s lives

Boys are more likely to be diagnosed with ADHD than girls, which means that many men are getting the diagnosis and treatment they need at an early age. But this doesn’t make ADHD any easier to live with, and men with ADHD often feel that their diagnosis has had lasting effects in every area of life.

Being diagnosed with ADHD can mean that boys are judged or labeled from an early age. Many men with ADHD feel like they never reached their full potential due to their diagnosis and the stigma it represents. The stigma also often leads to a lack of self-esteem and a sense of shame around living with this condition.

As adults, men with ADHD can struggle in every area of life, including in relationships and at work. For example, in relationships, men may be forgetful and impulsive, which can lead to arguments and frustration. Men with ADHD may also feel like they’re not meeting their full potential at work because of their symptoms.

On the other hand, ADHD and other forms of neurodiversity have also been linked to greater creativity in the workplace and beyond. Many men with ADHD are great leaders and innovators and inspire people around them to think outside of the box.

What causes ADHD in men?

The causes of ADHD in adult men are multifaceted and not attributed to any single factor. Genetics play a substantial role, as ADHD often runs in families, suggesting that inherited traits are involved. Certain genes, particularly those related to dopamine regulation, have been linked to ADHD.

Brain structure and function are also involved. Neuroimaging studies indicate differences in the brains of men with ADHD, particularly in areas governing attention, impulses, and self-regulation.

Environmental factors can contribute to the development of ADHD as well. Exposure to tobacco smoke or alcohol during pregnancy, lead exposure in early childhood, low birth weight, and premature birth are linked to an increased risk of ADHD.

How ADHD in men is diagnosed

ADHD is diagnosed the same way in men and women. There’s currently no universal test or assessment used to diagnose ADHD. Diagnosis typically includes:

• Clinical interviews, questionnaires, and self-reporting of symptoms
• Observation
• Interviews with other people, like parents and teachers, especially when diagnosing children
• Comparing observed symptoms to those listed in the Diagnostic Statistical Manual (DSM), the text that mental health professionals use to make diagnoses
• Computerized neuropsychological assessments, including continuous performance tests (CPTs)

Males are more likely to be diagnosed with ADHD as children, at least partly because adults tend to find childrens’ symptoms of hyperactivity more “disruptive” in settings like the classroom. This means that often, men may have entered adulthood already diagnosed with ADHD, while women may need to seek out assessment and diagnosis as adults.

What does ADHD treatment look like for men?

The primary aim of ADHD treatment is to manage symptoms, improve quality of life, and promote better functional performance in life. Treatment plans for men with ADHD tend to be individualized, taking into account their specific symptoms, co-occurring conditions, and personal circumstances. Therapies often involve a combination of medication and behavioral interventions. 

Keep in mind that while medication can play a critical role in managing ADHD symptoms, it’s typically most effective when combined with behavioral therapies, lifestyle modifications, and supportive counseling. The decision to use medication and the choice of medication should always be made in consultation with a healthcare provider who is familiar with ADHD and its treatment.

Non-stimulant ADHD medications

While stimulant medications are often first-line treatments for ADHD, non-stimulant ADHD alternatives benefit certain men. These medications work differently than stimulants and might be considered for men who haven’t responded well to stimulants, who have a history of substance misuse, or who have certain co-existing conditions. (Learn more about stimulant vs non-stimulant ADHD meds.)

Atomoxetine (formerly Strattera), a selective norepinephrine reuptake inhibitor (SNRI), is one such medication. By selectively inhibiting the reuptake of norepinephrine, Atomoxetine enhances the concentration of these brain chemicals called neurotransmitters. This increase in norepinephrine can significantly improve focus and reduce impulsivity and hyperactivity in men with ADHD. 

Atomoxetine’s non-stimulant nature means it has a lower risk of abuse or dependency, and it provides continuous symptom control throughout the day, unlike some stimulant medications, which may wear off after a certain number of hours. 

On the other hand, Guanfacine and Clonidine are alpha-2 adrenergic agonists, which work differently from both stimulants and SNRIs like atomoxetine. These medications bind to alpha-2 receptors in the brain, which inhibits the release of norepinephrine. This, in turn, has a calming effect on certain parts of the brain, reducing hyperactivity and improving impulse control. 

Guanfacine and Clonidine can be particularly beneficial for those struggling primarily with impulse control and hyperactivity, and these medications can also help improve sleep in those with ADHD, a common problem area. 

Additionally, bupropion (brand-name Wellbutrin) can effectively treat ADHD in adults. It’s classified as an atypical antidepressant. It inhibits the reuptake of both norepinephrine and dopamine, 2 neurotransmitters involved in attention and focus. Like other non-stimulant medications, Bupropion is less likely to be abused than stimulant drugs. Some people may find it helpful for managing co-occurring conditions like depression or anxiety.

The choice of ADHD medication always depends on your specific needs, medical history, and individual response. As such, these decisions should always be made in close collaboration with a healthcare provider well-versed in ADHD treatment.

Stimulant ADHD medications

Stimulant medications are the most commonly prescribed treatments for ADHD. They work by increasing the levels of certain chemicals in the brain that help with thinking and attention. There are 2 main types: methylphenidate-based (like Ritalin and Concerta) and amphetamine-based (like Adderall and Vyvanse).

Methylphenidate-based medications primarily increase dopamine levels in the brain, whereas amphetamine-based ones increase both dopamine and norepinephrine. Both types of medication are effective in reducing adult ADHD symptoms like inattention, impulsivity, and hyperactivity.

Key takeaways

• Although people of any gender can experience ADHD, studies show that men are up to 3 times more likely to be diagnosed than women.
• ADHD in men can present as hyperactivity, impulsivity, or inattentiveness. However, men are more likely to experience hyperactivity and impulsivity than women.
• Men with ADHD are also more likely to experience “externalizing” comorbid disorders, including conduct disorder and substance use disorder.
• ADHD can be treated successfully in men and people of all genders. Some effective treatment options include stimulant and non-stimulant medications and therapy.

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