Accounting for ADHD in Military-to-Civilian Transitions and Support Structures

This article was submitted by SIOP Military and Veterans Inclusion Committee member and MVI Publications Sub-Committee Lead Grace Winder.

While all service members encounter challenges when transitioning to civilian life, those with attention-deficit/hyperactivity disorder (ADHD) may experience even greater difficulties. With ADHD affecting 7.6% to 9% of soldiers aged 25-29, the service member prevalence rate is higher than the general U.S. adult population (4–5%) (Kok, Reed, Wickham, & Brown, 2019), indicating that ADHD is common and may be often overlooked in the military (Sayers, Hu, & Clark, 2021). Service members with ADHD also face unique risks after discharge. This includes increased emotional and identity stress during transition, higher chances of psychiatric issues due to disruptions to care, and unemployment. Understanding transition challenges in the context of ADHD is essential before exploring effective management strategies for mitigating these unique risks.

Context for Transition Challenges
Adapting to new norms and managing relationships and emotions presents additional challenges, all of which contribute to transition stress – the emotional and psychological impact of moving from military to civilian life. It involves losing military identity, struggling to adapt to civilian norms and expectations, and feeling disconnected from peers, familiar structures, and a sense of purpose. Furthermore, veterans may experience existential distress from losing their strong identity as “soldiers.” This phase can be harder for those with ADHD because of their tendency for emotional dysregulation, low frustration tolerance, and reactive thinking.

ADHD in soldiers is closely linked to post-traumatic stress disorder (PTSD), with research showing how soldiers with ADHD before deployment are more than twice as likely to experience PTSD after returning (Howlett, Campbell-Sills, Jain, Heeringa, Nock, Sun, Ursano, & Stein, 2018). The likelihood of having major depressive or generalized anxiety disorders increases significantly with co-occurring ADHD. The combination of effects raises the risk of unemployment and strained relationships after military discharge, particularly without structured support. Furthermore, they often experience inconsistent care because there are no standardized systems for treating and monitoring their symptoms after they leave service.

Lastly, these veterans experience reduced job performance and an increased risk of unemployment, with those showing the highest adherence to ADHD medication having poorer job outcomes, likely reflecting greater ADHD severity rather than treatment failure. This emphasizes that medication alone does not address the work challenges associated with severe ADHD. Although guidelines recommend combining medication with behavioral therapies and workplace support, real-world practice often omits these, leaving key vocational needs unmet. As a result, veterans are at greater risk of underemployment, unemployment, and long-term financial difficulties without personalized accommodations, job training, and continuous support.

Mitigation and Management
To tackle these unique challenges, it is essential to provide structured support that emphasizes mental and physical health alongside employment outcomes. Veterans need ongoing integrated care systems, with treatment focused on managing symptoms while also providing support for education or career goals, such as the VA’s VITAL Program. Studies show that following treatment plans leads to better results in work and daily activities, but this needs regular monitoring and support.

Practical vocational guidance provides additional support. Veterans with ADHD frequently experience executive dysfunction, which can hinder their decision-making and job-hunting efforts. Coaching in resume preparation, job searching, and utilizing GI Bill benefits can offer straightforward, step-by-step support, and creating structured routines can be another priority. Many veterans with ADHD struggle when the predictable structure of military life disappears, which exacerbates problems with time management, planning, and task completion. Establishing clear routines with defined goals and flexible scheduling can mitigate these challenges.

Finally, vigilance is critical, especially during the initial months of transition. Veterans with ADHD face a higher risk of substance use, suicidal ideation, and impulsive actions, which can complicate the reintegration process. The aim is to bring back a sense of purpose and organization in civilian life, while also tackling the specific challenges that can arise during transition.

Get involved or learn more here.

• See the MVI article in TIP (632, Autumn 2025) introducing the committee and its efforts Fostering Engagement, Service, and Integration of the Military and Veteran Community Across SIOP and Beyond.
• Edit your My Account – Profile on SIOP.org to include Additional Information on your interests and to identify your Veteran Status* to receive distributions from SIOP on military, veterans, and the MVI.
• *The SIOP team will create MIL/VET and MVI distributions from members who have selected veteran, actively serving, or neither actively serving nor a veteran from the veteran status drop-down options (fifth input in the last tile). “Neither” would include all supporters of the military community, including spouse, dependents, DoD, and beyond.
• Contact MVI directly to submit a request for engagement or further collaboration.

References:
Howlett, J. R., Campbell-Sills, L., Jain, S., Heeringa, S. G., Nock, M. K., Sun, X., Ursano, R. J.,

Stein, M. B., (2018). Attention Deficit Hyperactivity Disorder and Risk of Posttraumatic Stress and Related Disorders: A Prospective Longitudinal Evaluation in U.S. Army Soldiers. Journal of Traumatic Stress, 31(6):909-918. https://doi.org/10.1002/jts.22347

Kok, B.C., Reed, D.E., Wickham, R.E., Brown, L.M. (2019). Adult ADHD Symptomatology in Active Duty Army Personnel: Results From the Army Study to Assess Risk and Resilience in Servicemembers. Journal of Attention Disorders, 23(9):968-975. https://doi.org/10.1177/1087054716673451

Sayers, D., Hu, Z., Clark, L. L. (2021). The Prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) and ADHD Medication Treatment in Active Component Service Members, U.S. Armed Forces, 2014-2018. Medical Surveillance Monthly Report., 28(1):9-14.