A Busy Life Linked to Remission of ADHD Symptoms: Study

ADHD symptoms may experience periods of partial or full remission, particularly when patients engage in demanding work or school activities.

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Symptoms of attention-deficit/hyperactivity disorder (ADHD) can significantly improve or resolve for many people if they stay engaged in demanding work or school activities, a recent study suggests.

Over 11 percent of American children aged 3 to 17 have been diagnosed with ADHD, and the rate of diagnosis in U.S. children has steadily increased in recent years.

Severity Can Vary Over Time

Research published in The Journal of Clinical Psychiatry in October found that environmental factors, such as school, work, and obligations to others, can positively influence symptom fluctuations for people living with ADHD.

The study builds on research from 2022 that described ADHD as a condition characterized by intermittent periods of remission and found that approximately 30 percent of children with ADHD experienced complete remission at some point during a 14-year follow-up period.

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Margaret Sibley, lead author of both studies and professor of psychiatry and behavioral sciences at the University of Washington School of Medicine, said she was surprised by the association between living a demanding life and improved symptoms.

“We did find a robust relationship, but it was the opposite of our hypothesis,” she stated in a press statement. “We found that, in the years that people were doing better, they seemed to actually be living much more demanding lives.”

Periods of Complete ADHD Remission

The study reviewed the cases of 483 patients across six locations in the United States and Canada who had participated in the study for at least 16 years, starting at an average age of 8.

Researchers found the following:

• 64 percent experienced fluctuations, including partial to complete remission.
• Remission began emerging in early adolescence, around age 12.
• Two types were identified: complete remission with minimal symptoms and partial remission, meaning the person still experienced milder issues.

Complete remission is where a person has almost no symptoms or impairments and has completed all of their treatment, Sibley said. Partial remission is where patients get better to the point that they technically no longer meet the criteria for ADHD but still have some milder problems that are meaningful in life, she said.

Sibley characterized the fluctuating group as individuals moving between complete remission, partial remission, and complete ADHD diagnosis. The study also identified three additional patient subgroups:

• Nearly 11 percent were “stable persistent” and met the criteria for ADHD every year of the study.
• 15.6 percent were categorized as “stable partial remission,” with one classification change from persistent ADHD to partial remission that continued until the study’s conclusion.
• 9.1 percent achieved complete remission that lasted through at least two consecutive assessments without subsequent episodes of recurrence.

According to Sibley, the rich dataset allowed researchers to create a “moving image” of how those with ADHD experience the condition rather than a clinical “snapshot” of one person’s future based on a single assessment.

Factors That Influence ADHD Symptoms

The findings suggest that patients may experience both positive and challenging years while living with ADHD, highlighting the importance for doctors to convey this message.​

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“If you’re a doctor talking with a patient who is first getting diagnosed with ADHD, it’s a huge help for that person to hear the message that ‘You’re going to have good years and you’re going to have not-so-good years, but things can go really well for you if you can get the right factors in place,’” Sibley stated.

People with ADHD need to identify personal factors that contribute to their periods of remission to manage their condition better, she said.

“A person with ADHD needs to learn what factors they need to put in place in their life in order to be their best,” she said.

Although science continues to uncover the specific factors that help individuals with ADHD, Sibley noted that patients could reflect on their own lives or work with therapists to identify successful strategies. She said patients can ask themselves: “When I’ve had those periods of remission, when I’ve been doing really well, what was it that made me do well? Can I replicate that in my life?”