A new nationally representative study published online in the International Journal of Applied Positive Psychology found two in five adults (42%) with attention deficit hyperactivity disorder (ADHD) were in excellent mental health. To be considered in excellent mental health, participants had to report: freedom from mental illness in the previous year (i.e., substance use disorders, depression, anxiety, suicidality); almost daily happiness or life satisfaction in the past month; and high levels of social and psychological well-being in the past month.

"This finding provides a very hopeful message for both individuals struggling with ADHD and their loved ones," says lead author Esme Fuller-Thomson, professor at the University of Toronto's Factor-Inwentash Faculty of Social Work and director of the institute for Life Course and Aging.

"This research marks a paradigm shift. Most previous research, including my own, has focused on mental illness among those with ADHD so to focus on those who are thriving mentally is refreshing and very heartening."

Investigators examined a nationally representative sample of 480 respondents with ADHD and 21,099 respondents without ADHD from Statistics Canada's Canadian Community Health Survey-Mental Health.

The study identified several factors that were associated with complete mental health among those with ADHD. Individuals who were free from chronic pain and had no lifetime history of depression or anxiety were more likely to be thriving.

"Our findings emphasize the importance of addressing comorbid mental health issues when providing care to individuals with ADHD" says co-author Bradyn Ko, a recent graduate of the Master of Social Work (MSW) program at the University of Toronto. "Those with ADHD who also struggle with depression and anxiety face substantial barriers to achieving complete mental health, and may benefit from targeted care. Cognitive Behavioral Therapy is a very promising intervention that has been shown to be effective for those with ADHD"

Other factors that were associated with complete mental health include being married, being physically active, and using spirituality to cope with daily challenges.

"These results highlight potentially modifiable risk factors to support the well-being of adults with ADHD," says co-author Lauren Carrique, a recent MSW graduate from the University of Toronto "When compared to being sedentary, engaging in optimal levels of physical activity approximately quadrupled the odds of complete mental health. This underlines the potential value of physical activity in helping individuals with ADHD achieve excellent mental health."

The study also identified specific subpopulations of adults with ADHD who may be less likely to be in complete mental health, such as women.

"The finding that female respondents were less likely to be in flourishing mental health highlights the specific vulnerabilities among women with ADHD," says co-author Andie MacNeil, a recent Master of Social Work graduate from the University of Toronto. "This aligns with other research that has found higher rates of depression, anxiety, and suicidality among women with ADHD, which may partially explain this gap in mental well-being."

The prevalence of complete mental health among those without ADHD was 73.8%, which was significantly higher than the 42.0% of individuals with ADHD who were in complete mental health.

"Although we were surprised and delighted to find that two in five adults with ADHD were in excellent mental health, they are still lagging far behind their peers without ADHD, for whom 74% were thriving. There is still a long way to go in closing the mental health gap between those with and without ADHD," says Fuller-Thomson. "This study calls attention to this gap, while also emphasizing potential mechanisms to reduce this discrepancy."