ADHD and driving: For many years, Adult ADHD researchers made it a top priority. The evidence is clear: ADHD can impair driving safety. Also clear: Medication can improve driving skills.
As for this cartoon, count on it: Whoever created this “A.D.D. Man!” video also did his research on ADHD and driving. Perhaps first-hand research.
Load up the car with a bag of gallows humor, buckle your seatbelts, and watch out for Road Rage Ralph and Sally Soccer Mom! Click on the center arrow to watch the video below.
Then check the excerpt, below, from Chapter 5 of my book, Is It You, Me, or Adult A.D.D.?
. It explores the various ways in which ADHD-related driving behaviors can sometimes challenge a relationship.
Driving While Distracted: The Roller Coaster Hits the Road
My husband’s driving has improved since
taking medication. He no longer “punishes”
drivers who pass him—by flashing his lights,
making rude gestures, and yelling. I’d be so
embarrassed, I’d slink down in the seat.
— Elizabeth
Carol, married 15 years, says her husband is the absolute best driver ever: “At night, Ken notices little animals on the side of the road and has stopped for moose and deer that I never would have seen.”
Denise’s husband stopped for a moose, too—after he slammed into it at 50 mph. “He says it jumped in front of him,” she says, “but God help me, I wonder if Michael could have avoided the collision had he not been playing with the radio, fussing with the cell phone, adjusting the heat—all the things he does while not watching where he’s going.”
Hubby Michael also doesn’t connect the dots, for example, between speeding citations and higher insurance premiums. What’s more, if he gets one more ticket, he will lose his license and therefore his transportation to work. “But he can’t see the ‘big picture’ in anything,” Teresa says.
“White-knuckling it” is how Rory describes the experience of riding with her husband because, as she explains, “It used to be, if I was going to ride with Clint for more than 15 minutes, I took a nerve pill.”
After a particularly nasty road-rage incident, she put the brakes on riding as his passenger ever again; instead, whenever they rode together, she did the driving. He didn’t like it, but she valued her life too much to care. A few months later, she learned about ADHD, and “That explained a lot.”
Driving: A Most-Studied Area of ADHD
There you have it: Some adults with ADHD drive extremely well, some drive less well, and some downright menace our highways.
None of these stories—or the many others shared in my online support group for partners of adults with ADHD—surprise the researchers who’ve made driving one of the most heavily studied facets of ADHD in teens and adults. These researchers have gathered mounds of data demonstrating that ADHD’s driving-related deficits are real—and even life-threatening. What’s more, they’ve shown that adults with untreated ADHD often remain unaware of their driving challenges.
Consider the results of one 2005 study by a pioneering researcher in this area, psychologist Russell Barkley, and colleagues. Echoing many other studies, the group diagnosed with ADHD showed these outcomes:
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- Had a higher rate of collisions
- Had a higher incidence of speeding tickets
- Had higher total driving citations in their driving history
- Rated themselves lower in the use of safe driving behaviors
- Used fewer safe-driving behaviors in lab simulators
Are Poor Drivers Self-Aware?
Despite their quantifiably poorer performance when compared to a control group, the adults with ADHD in this study thought they did just fine.
Of course, plenty of people with ADHD prove to be excellent drivers, and many dangerous drivers do not have ADHD, cautions Daniel J. Cox, a professor of psychiatry at the University of Virginia Health Sciences Center. Author of more than 170 scientific articles, he has extensively researched driving safety and how disorders such as ADHD, alcoholism, Alzheimer’s, and diabetes affect it.
By and large, though, when it comes to untreated ADHD, the preponderance of evidence suggests critical, even life-threatening, disruption. This is definitely an area worth paying attention to. It can adversely affect relationships and life itself.
The good news: Medication treatment has been shown to vastly improve driving safety in study subjects with ADHD. But it has to be in effect while you’re driving. That means during the morning and afternoon commutes.
How about you?
If you or your partner has ADHD, do you find it’s affected driving safety?
How does it affect your relationship?
—Gina Pera
This post originally appeared December 1, 2008
30 thoughts on “Driving While Distracted: Adult ADHD Hits the Road”
Hi,
Just stumbled upon this. I suspect I have undiagnosed ADHD. I am 46 and have most of the symptoms such as being forgetful, running late, getting any on other drivers etc etc. I have been driving gor 28 years and often under very challenging conditions and long hours. Fortunately I have never been involved in a serious road incident. I drive quite well. Never in my life have received traffic light or speed violation. I take driving very seriously and never use phone when driving regardless of it being legal or not as I know I can only do one thing at a time. So far so good. The thing which seriously made me struggle with long drives was sleep apnoea. Ever since I started CPAP therapy three years ago, I can drive 6-7 hours at a stretch without complaining.
Just sharing my own experience with this.
Hi Vik,
Thanks for your comment. I’m glad you have stayed safe all these years! I’ve seen drivers definitely get more aggressive and “random” over that time.
Yes, I know many good drivers with ADHD. As I wrote in the book (excerpted here in the post):
There you have it: Some adults with ADHD drive extremely well, some drive less well, and some downright menace our highways.
It’s hard to write about the complexity of ADHD, how there’s no “one size fits all”. Especially when much of what we see on the Internet wants us to believe that people with ADHD are clones of each other and that there is an “ADHD Brain’. 🙂
One thing to note here. You say you take driving seriously. That means you give it your attention and avoid distractions.
Some people with ADHD might take it less seriously. They might even get a thrill from speeding and from passing everyone on the freeway, consider their cars a toy.
You mention sleep apnea. That is highly associated with ADHD. So, I’m glad you are finding CPAP useful.
Sleep deprivation, including the type caused by sleep apnea, can resemble “drunk driving” on a very real level.
Best,
Gina
Thanks for the interesting article and discussion!
This was focused on problems driving because of distractability and behavioural issues, but what about problems with motor skills, whether planning or execution?
For instance, the possible inability of a person with ADHD to react to an emergency in traffic requiring very quick and accurate movements? Motor problems seem to be well recognised in other contexts; is there any research on them when it comes to driving?
Hi Inka,
This was a brief recap of my first book’s chapter on driving. You’ll find more in the book.
I think it’s self-evident with ADHD, that reaction and coordination are potential issues with driving. And they can be very much related to distractibility, emotional dysregulation, poor working memory, and other ADHD-related challenges in Executive Functions.
In other words, these challenges directly affect motor skills——planning and executing.
You can read this 2015 review of ADHD and driving research:
https://link.springer.com/article/10.1007/s00702-015-1465-6
I hope this helps.
g
Hi,
Dr Barkley, one of the pre-eminent ADHD researchers, apparently got into the field when his brother, who had ADHD, died in a car accident when they were in his 20s. In one of Dr. Barkley’s Youtube videos, he discusses this incident and the dangers of teens and young adults driving when they don’t have fully matured executive functioning skills.
Yes, Craig. That’s true. And I wrote about it in my 2008 book. 🙂
Hi Gina,
I thought you would be interested in the ongoing research in Sweden on adhd and driving. Preliminary findings here: http://vti.diva-portal.org/smash/get/diva2:1204498/FULLTEXT01.pdf
Thanks, Peter. Very interesting. I’m glad to see Swedish researchers delving into this.
g
Since I’m on the mailing list I ended up reading some of this while checking my email, no wonder I’m always late getting done or being on time. Deciding to comment I swear not to hyper-focus on this.
Driving is overlooked, I also want to mention nodding off —I read that it is sort of a defense from getting bored —had no idea it was related to ADD.
Anyway, I have burned up tea kettles and pans, boiling water for tea etc. while focused on something else, procrastinating about getting to turning off the stove. I need to have the patience to stay with something like that so I don’t get distracted.
There are so many reasons a person needs to be as alert as possible and paying attention. I am accident prone, an accident led to early retirement. That brings me to this. RPN’s are common in a busy Dr’s office, she was writing according to Dr’s instructions but voiced her opinion said “kids need it to study but you don’t even work”
I really got P. O.’d. Since then I have been trying to take an approach when others seem wrong, to just kind of laugh it off. Possibly being denied meds, however, is no laughing matter. Part of the diagnostic guidelines do say symptoms must be affecting performance at work or school. What about personal activities? What do you think?
Hi Terry,
Sorry to distract you — I hope it was worthwhile. 🙂
Yes, as with nodding off being called a “defense from getting bored”, we have all kinds of “alternative explanations” that obscure the realities of ADHD.
That RPN deserved a tongue-lashing. Diplomatic, of course. Or not. lol
Thanks for your comment,
g
Good article. I’m ADD inattentive, medicated 15 years.
I didn’t know I wasn’t a good driver because I didn’t have accidents. Now that I’m medicated I can hear criticisms of my driving without reacting defensively.
Now I use driving as ADD exercise. By that I mean I use it to practice focusing. I drive a car with a manual transmission so I practice smooth transitions. I also practice keeping track of the cars around me and tracking down the middle of my lane. Not all the time, I still drift into dreamland a lot but I’m better.
I’ve said it before but the thing I appreciate about the work that Gina does is that she’s not just focused on money and jobs. ADD affects everything.
Hi Joel,
How clever of you. It’s so easy to get in the car and drive and let our minds drift, ADHD or not. The actions become so automatic over time.
Viewing driving as an “exercise” no doubt fires up those neural pathways and makes you a better driver over time. We should all try it. (But oh….my friend gave me a ride in her Tesla….talk about distractions!)
I am so appreciative of your kind words. Sometimes I feel I have failed in the “marketing” department. Because my work is all over the place. But guess what? So is ADHD!
One of my favorite pastimes is finding the connections between ADHD/dopamine-transmission issues and a whole range of potential physical issues. Because it’s not just about focus—but also breathing, heart rate, reading, swallowing sleeping, and good grief….even singing. A budding professional singer told me that medication helped her to hit the right notes more consistently.
Thanks so much, Joel. I needed a boost today….working 12 hours every day developing this training.
g
My daughter is eighteen. Diagnosed as autistic at four, she has off the charts ADD. Any chance she had for a legitimate academic career has been destroyed by a mother who has refused to even consider medication, for the last fifteen years.
When considering options for her to fulfill her on-line course requirements for her diploma, the ‘guidance’ counselor suggested getting her learner’s permit. When I politely but firmly stated that there was no way she belonged behind the wheel of a moving 4000 pound vehicle, she womansplained – ” Lots of people with disabilities can drive!”
I suppose it is fortunate that I was so stunned by this idiot person’s ‘contribution’ , that I did not respond – I don’t give a flying F about “lots of people” – MY child CANNOT drive a car.
The clueless walk amongst us. Little can be done.
Hi Ian,
I feel your frustration and agree with your assessment.
“Disabilities” covers a lot of ground.
We seem to be experiencing an increasing phenomenon of “You can do anything!” and that, indiscriminately, disabilities are gifts.
I don’t see this as useful or kind. Or, as you point out, safe.
Your daughter is 18 now. I hope that she might make better choices now than her mother has allowed.
With some obvious exceptions, I encourage parents and adults to maximize ADHD medication treatment before even considering the ASD diagnosis. Too many clinicians cannot make a differential diagnosis, and there is a very common tendency to mistake ADHD-related social anxiety, poor ability to focus on social cues, follow conversations, etc. as ASD. Because they do not understand ADHD.
Some parents prefer the ASD diagnosis (to ADHD) because it provides better state services, at least in California.
Good luck to her …and you.
g
I have ADHD-Primarily Inattention. Overall, I’m a very good driver (based on comments by others who have driven with me). Just thinking of how my ADHD relates to my driving.
1. As others have posted here, explicit training in defensive driving has been essential for my driving. Lots of mindfulness and good reflexes going on here. Agreed with above comments that we need to emphasize defensive driving better today.
2. The visual stimulation of the sceneries in front of me during driving has been a boon for me. That does well to keep me alert. But ask me to drive for extended periods of time through monotonous landscapes (e.g., Saskachewan plains), I’d just go stir-crazy.
3. I remember reading articles about the perils of daydreaming while driving. To be frank, my busy mind would just keep on going even while I am driving. So how do I do that without becoming a distracted driver? It’s the quality of daydreaming. During driving, my thoughts usually become automatic and go into streaming mode. No distraction. It’s akin to being able to focus well on your homework while there is ‘white noise/vision’ in the background from the TV, radio or whatever. I feel that it enhances my driving better than if I force my mind to be blank. However, I noticed that when the med effects are at their peak, the ‘daydreaming’ tend to lessen and I can still drive just as well without becoming restless. Now on the other hand, there are certain daydreams/thoughts that can be very distracting. Examples include alluring thoughts (please read between the lines here), dwelling on what has been upsetting me, or trying to keep track of details in my ‘to-do’ list. Those thoughts would not be streaming, but rather be preoccupying. That’s what would distract me. So therefore, I would push aside these preoccupying thoughts during driving.
Thanks for sharing your strategies with us, Jonathan.
Yes, driving is one of those unusual areas….where we must be engaged and ready for anything and yet it’s rather automatic. We can drive while we are thinking about something, listening to a book on tape (my preference on long trips), talking with the passenger(s).
I hate to think of what would happen to me if I just tried to make my mind blank while driving, though, especially on the 101. 🙂
Yes, defensive driving should be taught to all drivers!
g
Thanks, Gina.
I think a huge takeaway from this is not just the importance of getting diagnosed and treated, but the number of people out there who are undiagnosed, untreated, don’t even know they have a problem and think they are good drivers. Like me before diagnosis… My big mistake: thinking anyone coming would be paying attention and slowing down for the red light right next to me.
You have to assume others are not paying attention, no matter where you are. And, especially if you’re young, you could get blamed for something you didn’t cause if somehow ADHD comes up, even if your symptoms are well-treated. If the other driver is undiagnosed and untreated, well the other driver doesn’t have anything wrong with him and you do so you must be at fault, right? That’s how most people see it.
Fortunately, it was BEFORE the accident that I was co-captain of the first team in the history of my high school to ever win a NY state title. Everyone can laugh all they want about bowling being a sport but that was a really big deal and we were cool instead of freaks for like a day lol. The town put up a sign that now has other teams on it but the top one, that’s MY TEAM and that’s the top there’s no nationals. So hey, I have that, right? I had already shown my athletic prowess 😀
I actually have managed to stay fairly active and what I can and can’t do from that injury is SO weird and changes day to day. It’s kind of frustrating though because it tends to be like ADHD where I can do fun things you wouldn’t expect but a lot of routine chores or standing still cause a lot of pain, some days more than others. Sitting tends to make most back injuries worse but helps mine but not if I sit for too long. I managed to end up with an injury that’s just as weird looking to others, yeah I can skateboard (not tricks) but I can’t wash dishes or stand at a bus stop… I just look lazy to people and I’m “using it as an excuse to get out of stuff” when they don’t see the fun things I can’t do (that tandem parachute jump I won in a raffle never happened, kinda sucks). Just like ADHD. Caused by 2 people not really paying attention well, at least one with undiagnosed ADHD in an area where accidents are common.
So if you read this blog, look out for all the people who don’t think they have a problem when you drive!!!! You’re likely not one of them 😉
So well said, Danielle, and I can relate on so many levels!!
1. My mother, who mostly taught me how to drive, drilled it into me to “drive defensively.” Always look both ways at intersections before driving through, etc. Don’t rely on other people doing what they’re supposed to be doing.
I’m old enough to remember the days before Reagan did away with public-service ads. And one of the most powerful ones, to me anyway, was “Drive Defensively.” Maybe we should bring back those campaigns.
2. My father was the citywide bowling champion in Memphis, three years running, in the 1930s. We have a fat scrapbook of newspaper articles. Bowling was a big deal then!
3. I remember, from having double carpal tunnel (meaning in both hands), how I could do big-muscle action — pushing something heavy — but not write a check or brush my hair. When you don’t “look like” you’re sick, people assume you’re just being neurotic, or faking. Perhaps that’s one reason why I empathize with people who have ADHD: Because I know what it’s like to “look normal” but NOT be able to do basic things, seemingly inexplicably.
4. A study showed that most people think they are above-average drivers. Hardly a statistical probability. 🙂
take care and thanks for your comments!
g
Thanks for sharing this. I haven’t driven in years (not due to ADHD these days) but I used to have a psychiatrist who just didn’t get it. I actually started seeing him in his other office farther away so I couch get there using public transit on a different day. He understood that meds last longer in theory than in practice and I was on a long-acting med that gave me like 7 hours and I could take a Ritalin to get another 2, maybe 3 hours if I was lucky. After I was diagnosed, I wouldn’t drive unmedicated. I didn’t know it isn’t supposed to be so hard to filter out the unimportant things and focus on the things I needed to see but wow what a difference! I didn’t even know he had another office with better hours in a place I spend a lot of time for probably a year. The day he was near me, I’d drive to volunteer for a few hours in the morning, drive home, have a gap in structured activities for a few hours, drive to his office for an hour-long appointment, drive home and do volunteer work online at something like 10pm for an hour or two. He wouldn’t let me take an extra short-acting that day, saying it would keep me up even if I took it at 8 for a bedtime of 12. I needed the long-acting for the volunteer job I drove to (and eventually got fired from) and it was gone well before the time I saw him at like 7pm. The online volunteering was more important to me but didn’t give me face to face human contact and it was a scheduled, live event that day and required a lot of focus. I wasn’t covered for that schedule. I had to choose between being able to focus on the thing that mattered to me or not killing someone getting to his office. The short-acting didn’t even really fully cover my appointment and travel time. ADHD doesn’t go away when it’s inconvenient to have and I tried driving there and taking the med when I left and it was crazy scary driving in the dark. I was worried about not seeing people crossing the street. I’m not seeing that guy anymore or volunteering at all. If I didn’t have that volunteer job, he probably would’ve taken away my meds entirely because I “didn’t need to focus.” Um how about remembering to turn off the oven sometime between eating all the cookies I baked and leaving? That’s not important? Turns out I need meds 24/7 and part of my trouble falling asleep was ADHD. I don’t know how I didn’t kill someone all those years I was undiagnosed. After the experience of driving while treated, trying it unmedicated showed me just how dangerous I was and it was scary. I did all the right things to minimize distractions as well but it was my thoughts and not being able to filter out the unimportant things outside the car that caused my issues. I can’t fall asleep without meds. The fact that I was driving without them for so long and didn’t even know I had a problem and didn’t get into more accidents (I looked good compared to my parents and insisted on drivers ed… I didn’t want to learn from them lol so I really thought I was a good driver) or kill someone is truly amazing. And scary knowing I thought I was a good driver. I wasn’t.
I’m glad you included this topic. I’m a poster child for it. It’s every bit as dangerous as you say and I wonder if I would’ve seen the car that hit me when I was 17 if I’d been diagnosed and treated. Neither one of us was really driving well and 20 years later I’m still in pain from my back injury and can’t even keep a volunteer job. My mom was in the same exact accident years later and both times the kid got the ticket despite being in opposite roles. I think it’s just a bad place to be and my mom hurt her back too. But I should’ve looked again before going and the lady who hit me would have rear ended a car not far from me stopped at the red light she should have been slowing down for but never stepped on the brakes. Anyone coming should’ve been going slow enough to stop and I shouldn’t have pulled out assuming others were paying attention and sat there waiting for the other lane to clear, never looking back in that direction. My life changed forever that day.
Never assume others are paying attention, especially if you’re young and have ADHD. You may be right and well treated for your symptoms but you’re probably going to get blamed for something as stupid as being rear ended while stopped at a red light. My mom and I unfortunately proved the age bias where I grew up… And my meds have a warning about driving while on them. Huh? Now I’d never drive without them!
Hi Danielle,
It’s amazing, isn’t it? You and I — and all the top ADHD experts — know that ADHD can severely impair driving safety. And yet, the rest of the world….. not so much.
I’m sorry that you were injured.:-(
best,
Gina
This may explain why some weird sort of stuff happen on the road with so many drivers. Not to be taken wrong hopefully, the thing is there is something that can be done about the condition if only people would be aware.
I sortof wonder if I have ADD, too. I’ve ALWAYS had trouble focusing and paying attention. I was tested for it as a kid but it came back negative. It’s never really been a HUGE (Read: Life-threatening) problem until I started driving. I DON’T even take my cell out of my purse, which sits in the BACK seat, I don’t mess with the radio and AC, make sure everything is in place before leaving my parking spot, and know all the rules because I went to Driver’s Ed. It doesn’t stop me from losing focus and running stop signs, or being late or slow on turns or getting into the right lane, or being able to focus on everything. I do everything I’m supposed to to keep my distractions at a minimum, I know all the rules and try to follow them exactly, but I still make huge mistakes every time I get into a car. It’s been a huge source of frustration for me and I really don’t know what to do.
Hi Reia,
Sounds like it’s time to stop wondering if you have ADHD and start investigating the possibility in earnest. Truly, before you suffer an injury.
While some people with ADHD are of course good drivers, even without medication, many suffer serious impairments.
In fact, a huge amount of research focuses on ADHD-related driving impairments. They are real and quantifiable. Despite trying to do everything by the rules, drivers with untreated ADHD can still pose a risk to themselves (and others) once they get behind the wheel. For these drivers, medication can make a huge difference in driving safety.
I devote a chapter to this in my book, which addresses treatment strategies in full (therapy and medication). I encourage you to read it. It just could safe your life. No kidding.
take care,
Gina
I never even considered the possibility my son was ADD until he turned 16 and I was trying to teach him how to drive. It only took a couple of trips to make me realize something was up.
This turned out to be a good thing. He was diagnosed and treated. Not only did his driving improve, so did his grades. And he’s now doing very well in college too.
– M
Very interesting, Merrill. Lots of studies have been done on ADHD and driving; the effects of untreated ADHD are apparently easy to measure.
Good for you and your son. I’m glad he’s doing well (and driving safely!).
g
What was his treatment?
Hi Val,
Whose treatment?
g
I sometimes think my husband has ADD but has not been diagnosed. He is the one who pays no attention until I shout “James! SLOW DOWN!”. Its an absolute mess.
Oh and I loved the cartoon. Thanks for sharing!
Betsy- My son (ADD Inattentive type) swears that he’s a better driver because he has a manual shift car. He said that he’s less likely to grab the iPod and switch songs because he knows he has to shift soon. Who would have thought?
On the other hand my husband (ADD Inattentive type) is a hyper focus driver. Instead of being distracted he hyperfocuses to the extent that he forgets to turn off the windshield wipers 10 minutes after it’s stopped raining… despite the horrible scraping noises eminating from the windshield!
When I drive with him, I want to reach over and push the gas pedal. He’s such a slow driver that people pass him continually and honk and gesture as they go by. I’m not sure what he’s hyperfocusing on, but I know it’s not the speedometer. His average speed is usually about 10-15 mph below the speed limit. After 23 years of marriage, he understands that I that I have exclusive control of the radio knob. It’s the only thing that helps me to drown out the sounds of honking.
Driving. A woman I know with ADD tells me she is a very good driver but that her driving capability falls apart if she is forced to drive a vehicle with automatic transmission. She says if she has the shifting to do, it provides just enough “to do” that she doesn’t lose her focus.
Not having to actually do anything but steer, accelerate and brake (amazing, that’s three things already; add looking at mirrors and it’s four) causes her to be bored enough that she begins to cast about for something else to occupy her brain.
It underscores what you say — that the ways ADD expresses itself are so varied among individuals. I know someone else with ADD who doesn’t drive because her anxiety about all the split-second decisions she must make create such discomfort she doesn’t even approach the idea much anymore.
One person’s thrill — or even mere pleasure — is another person’s fright (or overstimulation).