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Have you ever had a “Well, that explains a lot!” moment? This happens to countless adults being diagnosed for the first time with ADHD in their 30s and 40s. In many cases, ADHD (attention deficit hyperactivity disorder) goes undiagnosed in childhood; this is particularly true for females.1 Research also tells us that a majority of children diagnosed with ADHD continue to experience symptoms into adulthood, although presentations may look different.2
In this article, we will look to genetics to understand the causes of ADHD, variations in the degree or number of symptoms, and their severity and persistence.
Genetic Foundations of ADHD
ADHD is a complex condition affected by genes and their interaction with the environment. It is highly heritable (74%), with many childhood cases persisting into adulthood due to underlying genetic factors. Current thinking is that no single gene has a big impact; rather, many different tiny genetic changes, each with a small effect, combine to increase someone’s risk and symptom profile.
For instance, certain genes control how your brain uses chemicals like dopamine and serotonin, which are important for focus, mood, and self-control. Changes (called variants or SNPs [single-nucleotide polymorphisms]) in these genes can lead to differences in the functioning of that chemical system, resulting in problems with attention, impulse control, or emotional regulation. Studies show that a large amount of ADHD’s genetic risk comes from many common SNPs acting together.3
Key SNPs Linked to Adult ADHD Symptoms
SNPs, such those of COMT and HTR2A genes, influence the functioning of body systems, particularly neurotransmitter systems. Others interact with the environment (e.g., diet, sleep, stress, etc.), triggering differences in the severity or frequency of symptoms.
Research shows that such SNPs seem to have the biggest impact on hyperactivity and impulsivity symptoms, as well as overall ADHD scores. This suggests that these types of symptoms, especially when they continue into adulthood, are strongly influenced by genetics.4
How could understanding your genetics and SNP profile help you?
| Key SNPs Linked to ADHD Symptoms | Function/Implications |
| COMT (rs4680) | Affects dopamine breakdown in the prefrontal cortex, contributing to ongoing challenges with focus, impulse control, and working memory in adults. |
| MAOB (rs1799836) | Alters monoamine oxidase activity, potentially exacerbating dopamine/norepinephrine imbalances linked to hyperactivity and emotional dysregulation. |
| HTR2A (rs6313) | Impacts serotonin receptor function, influencing emotional reactivity and comorbid anxiety/depression in adults with ADHD. |
| SLC6A4 (rs1042173) | Modulates serotonin transporter efficiency, associated with mood instability and impulsivity. |
| TPH2 (rs4570625) | Affects serotonin synthesis, potentially worsening emotional regulation and stress response. |
| MAO-A (rs6323) | Interacts with environmental stressors (e.g., chronic stress) to amplify or mitigate ADHD traits in adulthood. |
Managing Adult ADHD Symptoms
If you or someone you care about has ADHD, understanding personal ADHD-related genetics can provide actionable insights, such as:
- Personalized Interventions: Genetic insights could guide tailored therapies, such as targeting dopamine/serotonin pathways with medications or nutraceuticals or using stimulant versus non-stimulant medication.
- Comorbidity Awareness: SNPs may explain common adult ADHD overlaps with anxiety, obsessive compulsive disorder, substance use, and other conditions. Recognizing shared genetic risks could help you and your healthcare practitioner develop an integrated treatment plan.
- Lifelong Adaptation: Understanding your genetic risks can empower you to develop personal interventions that may include dietary changes, specific coping strategies, and skill building to manage symptoms.
What Might Future Treatment Directions Look Like?
Nutrigenomics and precision medicine are two areas that will undoubtedly have larger roles in ADHD treatment in coming years. Nutrigenomics is a field devoted to the intersection of nutrition and genes to understand how certain foods may increase or decrease ADHD symptoms. There is also building research on dietary supplements that influence SNP expression and can mitigate some of the effects of SNPs. For instance, tyrosine and omega-3s, to support normal dopamine production and neurotransmitter balance. Precision medicine or "personalized medicine" is another innovative approach to tailoring disease prevention and treatment. It accounts for differences in your genes, environment, and lifestyle.
Thanks to growing interest in the field of ADHD and advances in genetic research, scientists are uncovering how multiple SNPs contribute to ADHD risk and how their combined effects influence symptoms and their severity. With insight into your own genetic makeup, you and your healthcare practitioner will be better equipped to create a more personalized treatment plan that works for you.
FAQs
Is ADHD hereditary?
ADHD is highly heritable. It’s thought to be the result of the combined effects of many common genetic variants, each having very small effects.
Why is my ADHD getting worse as I get older?
ADHD can feel worse in adulthood because life becomes more demanding and less structured, making it harder to manage symptoms related to time management, organization, and focus. Without the built-in structure and support systems of childhood, everyday responsibilities can overwhelm executive function and amplify ADHD challenges. Using genetic information to get a more personalized treatment plan may help.
References
- Attoe DE, Climie EA. Miss. Diagnosis: A systematic review of ADHD in adult women. J Atten Disord. 2023;27(7):645-657. doi:10.1177/10870547231161533
- Abdelnour E, Jansen MO, Gold JA. ADHD diagnostic trends: Increased recognition or overdiagnosis? Mo Med. 2022;119(5):467-473.
- Faraone SV, Larsson H. Genetics of attention deficit hyperactivity disorder. Mol Psychiatry. 2019;24(4):562-575. doi:10.1038/s41380-018-0070-0
- Bidwell LC, Gray JC, Weafer J, et al. Genetic influences on ADHD symptom dimensions: Examination of a priori candidates, gene-based tests, genome-wide variation, and SNP heritability. Am J Med Genet B Neuropsychiatr Genet. 2017;174(4):458-466. doi:10.1002/ajmg.b.32535