- Structure disappears. School, parents and routines can hold ADHD in check. Moving out, starting a demanding job or becoming a parent removes that scaffolding, and symptoms that were always there become obvious.
- Demands increase. A job with competing deadlines, or running a household with children, asks far more of attention and organization than school did.
- Coping strategies wear out. Bright people often compensate for years with over-preparation, late nights or anxiety-driven effort, until it stops working.
- It was missed. The inattentive presentation, without obvious hyperactivity, is easily overlooked in childhood, especially in girls.