Last month’s newsletter included part one of an article entitled “ADHD Goes to College – Part 1“.

But what happens to those students who are unaware of their diagnosis?  Freshman are the most at risk because while attending high school and living at home with their parents, they may have had a lot more structure and support from both teachers and parents.  If this is their first time living away from home, they will need to self-regulate and structure their time in ways that are far more difficult for them than for other students.   According to Dr. Stephanie Sarkis, “The reality is that young adults with ADHD tend to function at a younger emotional age than their peers.”  Their parents have likely spent years monitoring their child’s academic and social activities and although being away at school may be exciting for these students, being on their own, can also be overwhelming.

The areas of concern to most be aware would be in comorbid disorders that are present in approximately 25 to 50% of people with ADHD. (Fischer et al., 2007; Sarkis et al. 2005) These would include depression, anxiety, eating disorders, sleep problems, and drug alcohol abuse. Sometimes symptoms are missed because of the ADHD and it has been determined that only 36% of students with ADHD who meet the criteria for depression actually sought medication or counseling while on campus.  

Eating disorders among college students with ADHD was the highest of any comorbid disorder. (Mattos et al., 2004.) This is most probably in response to a heightened sense of loss of control over their environment and ability to be successful, which makes this population (particularly in girls) almost 4 times more likely to develop an eating disorder than non –ADHD girls. (Biederman et al, .2007)

Sleep is another area that is negatively impacted in that freshman students are now in an environment for the first time in which they have no parental authority regulating what time they go to bed.  Handling this new found freedom is not always easy for these individuals. In addition, many individuals with ADHD are not always alert first thing in the morning and may not do well with early classes.

With a tendency to self-medicate, as well as the need for social acceptance, students with ADHD have a greater propensity toward drug alcohol abuse.  In fact, one in five adults with ADHD will experience a drug alcohol abuse problem.   (Wilens & Updhyaya, 2007)

In conclusion, college presents very significant challenges to students with ADHD, especially in their freshman year.  Students need to avail themselves of the resources on campus that can provide support services, such as the Office of Disability Services as well as the Counseling Center.  Seeking support and asking for help when needed is essential to their success.  Although most universities do not provide neuro- psychological batteries on campus, the Office of Disability Services can direct students on where to get the appropriate testing to determine a diagnosis.  Faculty can help in sustaining this vulnerable population by redirecting students to the necessary resources on campus and by further educating themselves about how to identify and support these students.


Leslie Rouder, LCSW is a therapist and ADHD coach, as well as a university consultant and trainer.  To receive her free newsletter or to read additional articles, you may visit her website at