Does ADHD hyperactivity improve with age?

Generally, ADHD symptoms tend to get better over time.

Of all the ADHD symptoms types, hyperactivity symptoms are the most likely to improve first.

One study found that most participants still had inattention symptoms at age 18. In contrast, most had recovered from their hyperactivity symptoms to the point where their hyperactivity no longer met the criteria for ADHD.

A detailed look at hyperactivity symptoms over time shows that the majority of children with ADHD will experience syndromatic remission by the time they reach age 18, meaning that their hyperactivity symptoms no longer qualify for ADHD. As a whole, teens with hyperactivity get better each year.

However, despite the improvement, most still have some impact from hyperactivity in their lives.

Compared to inattention symptoms, it becomes clear that hyperactivity symptoms are much more likely to improve.

Most teenagers with ADHD will continue to have ADHD-level difficulties with attention in college.

The DSM, a professional psychiatry manual, confirms this finding with its position on ADHD and maturation.

According to the manual, kids typically get better at adapting to hyperactivity. But, difficulties in planning and impulsivity often remain into adulthood.

In general, some kids get better faster than others with ADHD.

There has been some research into risk factors for persistent ADHD, examining factors linked with kids getting better or not getting better from ADHD as they age.

One meta-analysis found four factors linked with a significantly higher risk of persistent ADHD.

Those with severe ADHD, for example, had over twice the risk of continuing to have ADHD as adults. Similarly, those whose ADHD requires medication treatment also have a higher risk, though it’s unlikely that medication is causing ADHD persistence.

Having other conditions in addition to ADHD, such as conduct disorder or major depressive disorder, is also a risk factor for having ADHD continue into adulthood.

As with most symptoms of ADHD, improvements in hyperactivity are typically not all or nothing.

Symptoms of ADHD tend to come back on occasion and impact daily life. One study found that even among kids who fully recovered from ADHD, 60% had their symptoms return at some point during young adulthood.

ADHD symptoms can stick around for a long time. Recovering or learning to live with the symptoms can be a painfully long process. Sometimes it can feel like you are taking one step forward and two steps back.

Fortunately, when it comes to hyperactivity, the evidence shows that most will show improvement.