Much of the research on ADHD risk factors focuses on genetics, which have been found to be a strong contributing factor to ADHD. However, some research suggests there are environmental causes of ADHD [1], which can involve both biological and social factors.

What is ADHD?

Before discussing ADHD environmental factors, it’s helpful to have some background information on ADHD. ADHD is a neurodevelopmental disorder that causes symptoms of inattention and/or symptoms of hyperactivity and impulsivity.

ADHD symptoms often begin during childhood, but they can continue to impact a person during adolescence and then adulthood. Other ADHD cases may not begin until adulthood. Symptoms of ADHD, like inattention, hyperactivity, and impulsivity, can make it difficult to be successful at school or function in formal settings like the workplace [2].

ADHD symptoms are divided into symptoms related to inattention and those linked to hyperactivity/impulsivity. Some symptoms of inattention include [2]:

  • Making careless mistakes at school or work.
  • Losing focus easily.
  • Struggling with organization and meeting deadlines.
  • Avoiding mentally taxing tasks, such as homework or writing reports.
  • Failing to follow through on assignments or chores.
  • Being easily distracted.

On the other hand, ADHD symptoms related to hyperactivity and impulsivity include [2]:

  • Constant fidgeting and squirming.
  • Leaving one’s seat when remaining seated is expected.
  • Appearing as if one is driven by a motor due to constant motion.
  • Talking excessively and interrupting others’ conversations.
  • Running or climbing when it’s inappropriate to do so, which may present as restlessness in adults.
  • Struggling to wait one’s turn in line.

A mental health professional will diagnose ADHD by looking for the symptoms above. Researchers believe that these ADHD symptoms are largely a result of genetics. However, it can also be helpful to consider environmental causes of ADHD, as some factors can be modified to improve functioning [2].

Environmental Causes of ADHD

There is plenty of evidence that genetic factors are linked to ADHD [3], but environmental influences also play a role. Below, some of the top ADHD environmental factors are discussed in more detail.

Prenatal Factors

It turns out that the environmental risk factors for ADHD begin before birth during the prenatal period. For example, researchers have found that ADHD risk is higher in children whose mothers had a poor diet during pregnancy. More specifically, a lack of key vitamins and minerals in the pregnant mother’s diet can interfere with brain development and increase ADHD risk [4].

Diet is not the only prenatal factor linked to ADHD; maternal weight gain and obesity can also elevate the risk of ADHD. Excessive weight gain during pregnancy can lead to inflammation, which can negatively affect neurodevelopment in the fetus [4].

In addition, infection during pregnancy can harm brain development and increase the risk of ADHD in offspring. The Zika infection, in particular, is linked to an increased risk of neurodevelopmental problems. Bacterial infections can also elevate the risk of ADHD [4].

Elevated stress levels during pregnancy are also linked to ADHD in offspring. Children of mothers who experienced extreme stress during pregnancy show more severe ADHD symptoms. High levels of stress hormones can impact brain development and lead to abnormalities in brain circuit development [4].

Finally, prenatal alcohol exposure increases the risk of ADHD in children. Maternal alcohol consumption can lead to fetal alcohol spectrum disorder, and ADHD is often diagnosed alongside this disorder [4].

Problems During Birth

In addition to pregnancy-related problems, risk factors that occur during and immediately after birth can lead to ADHD. Birth complications, like premature birth and umbilical cord incidents, can interfere with brain development and increase ADHD risk [4].

Being born at a low birth weight and experiencing a lack of oxygen after birth can also contribute to ADHD risk. Lack of oxygen can occur in cases of prolonged labor or when a baby aspirates meconium. The use of assistance devices, such as a vacuum during birth, can also elevate the risk of ADHD [4].

Other Environmental Factors

Environmental factors linked to ADHD are not limited to those that occur during the prenatal period or during birth. For example, the larger living environment can increase ADHD risk. Research has shown that being exposed to lead within the environment increases the risk of externalizing disorders, including ADHD [5].

Air pollution can also predispose a person to developing ADHD. Researchers have found that living close to agricultural areas, industrial estates, and major roadways increases the risk of ADHD. This increased risk occurs because living in such an area leads to higher exposure to pesticides, organochlorine compounds, and air pollutants from traffic [6].

Diet during childhood is another environmental factor that can increase the risk of ADHD. For instance, diets high in sugar may contribute to ADHD risk. Food allergies, iron deficiency, and deficiencies in minerals (like zinc and iodine) may also be linked to ADHD [4].

Psychosocial Stressors Affecting ADHD

While environmental factors like pollution can increase the risk of ADHD occurrence, sometimes psychological stressors exacerbate existing ADHD. ADHD stressors may precede the onset of ADHD or simply make symptoms worse for those who already have an ADHD diagnosis. Some of these psychosocial stressors are discussed below.

Low Socioeconomic Status

Living in poverty or having a low socioeconomic status can be an ADHD stressor. One study found that in children whose parents did not have ADHD, the risk of ADHD was 6.2 times higher for low-income compared to high-income children. Study authors concluded that in children without genetic risk factors for ADHD, environmental factors, like the stress of low income, become more important [7].

Maternal Mental Health

Poor mental health in mothers has been identified as an important ADHD risk factor. A review of 11 different studies found that depression in mothers was linked to ADHD in children. The relationship between maternal depression and ADHD occurred for both prenatal and postnatal depression [8].

General Stressors

Researchers have identified general ADHD stressors, such as chronic illness, disabilities in the child or family members, household and neighborhood problems, high pressure at school, unemployment, financial problems, and conflict with family members. These stressors can worsen ADHD symptoms; therefore, developing a supportive environment is essential for those with ADHD [9].

How Sleep and Lifestyle Can Influence ADHD Symptoms

Several lifestyle factors, including sleep, can affect ADHD symptoms. Research has found that sleep issues, such as insufficient sleep, insomnia, and frequent nighttime awakenings, are linked to worsening ADHD symptoms [10]. On the other hand, sleep hygiene interventions can improve sleep habits and, thus, ADHD symptoms [11].

Additionally, diet and exercise habits can affect ADHD symptoms. A nutritious diet containing plenty of omega-3 fatty acids and zinc, and limited in sugar and artificial ingredients, can be beneficial. Making time for regular physical activity can also improve symptoms [12].

How to Manage Environmental ADHD Stressors

So, is ADHD environmental? There is a significant amount of evidence showing that environmental factors can contribute to ADHD or worsen symptoms. Based on this knowledge, individuals with ADHD can reduce the severity of symptoms by addressing environmental stressors and risk factors. Some important tips include:

  • Follow healthy lifestyle habits: Engaging in healthy habits, like following a regular sleep schedule, exercising regularly, and maintaining a healthy diet, are essential for ADHD symptom management. A nutritious diet that emphasizes whole foods can reduce symptom severity. It’s also important to develop a regular exercise routine to alleviate common symptoms, like hyperactivity and restlessness [12]. A consistent sleep schedule with a cool, dark sleep environment and a calming bedtime routine can reduce sleep complaints and improve ADHD symptoms [11].
  • Practice healthy stress management: Life stressors like school pressures, family conflict, and financial problems can make ADHD symptoms more difficult to manage [9]. Therefore, healthy stress management is essential. Take time for rest, relaxation, and self-care, and make sure to talk to supportive people. For parents managing ADHD symptoms in children, it’s helpful to teach and model healthy stress management and offer a listening ear when children are feeling stressed. It can also be necessary to protect children from the stressors of daily life, such as by not discussing finances or family conflict in their presence.
  • Develop a regular routine: A regular routine can make it easier to cope with ADHD stressors. Routines create predictability, allowing a person with ADHD to know what to expect [2]. This can be comforting and can reduce stress levels. For children, a consistent bedtime and evening schedule is essential. Adults also benefit from following routines, using planners, and having lists to keep themselves organized.

Adults with ADHD can implement the tips above to improve symptoms and quality of life. On the other hand, parents of a child with ADHD can provide guidance and suggest the strategies above for ADHD symptom management. By taking steps to improve the environment and reduce stressors, families can reduce the severity of ADHD symptoms. This, in turn, reduces the effects of ADHD on daily functioning.

While stress management can be beneficial for reducing the effects of ADHD environmental factors, sometimes professional support is needed. Talking with a therapist or taking medication may be necessary. Families may also benefit from attending counseling together to learn coping strategies and to develop strong plans for managing behaviors related to ADHD [2].

References
  1. Nigg, J. (2020). Recent perspective on genetics and environment and implications for health-related complementary approaches for ADHD. The ADHD Report, 28(2). Available at: https://guilfordjournals.com/doi/10.1521/adhd.2020.28.2.1
  2. National Institute of Mental Health. (2024). Attention-deficit/hyperactivity disorder. Available at: https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd
  3. Brikell, I., Kuja-Halkola, R., & Larsson, H. (2015). Heritability of attention-deficit hyperactivity disorder in adults. American Journal of Medical Genetics Part B, 168(6), 406-413. Available at: https://onlinelibrary.wiley.com/doi/10.1002/ajmg.b.32335
  4. Al-Gailani, L., & Al-Kaleel, A. (2024). The relationship between prenatal, perinatal, and postnatal factors and ADHD: The role of nutrition, diet, and stress. Developmental Psychobiology, 66, e70004. Available at: https://onlinelibrary.wiley.com/doi/10.1002/dev.70004
  5. Symeonides, C., Ponsonby, A.-L., Vuillermin, P., Anderson, V., & Sly, P. (2013). Environmental chemical contributions to ADHD and the externalising disorders of childhood – A review of epidemiological evidence. Journal of Environmental Immunology and Toxicology, 1, 92. Available at: https://www.researchgate.net/publication/265511229_Environmental_Chemical_Contributions_to_ADHD_and_the_Externalising_Disorders_of_Childhood_-_A_Review_of_Epidemiological_Evidence
  6. Saez, M., Barcelo, M. A., Farrerons, M., & Lopez-Casasnovas, G. (2018). The association between exposure to environmental factors and the occurrence of attention-deficit/hyperactivity disorder (ADHD): A population-based retrospective cohort study. Environmental Research, 166, 205-214. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0013935118302494?via%3Dihub
  7. Rowland, A. S., Skipper, B. J., Rabiner, D. L., Qeadan, F., Campbell, R. A., Naftel, A. J., & Umbach, D. M. (2018). Attention-deficit/hyperactivity disorder (ADHD): Interaction between socioeconomic status and parental history of ADHD determines prevalence. Journal of Child Psychology and Psychiatry, 59(3), 213-222. Available at: https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.12775
  8. Tucker, J. R. D., & Hobson, C. W. (2022). A systematic review of longitudinal studies investigating the association between early life maternal depression and offspring ADHD. Journal of Attention Disorders, 26(9), 1167-1186. Available at: https://journals.sagepub.com/doi/10.1177/10870547211063642
  9. Hartman, C. A., Rommelse, N., van der Klugt, C. L., Wanders, R. B. K., & Timmerman, M. E. (2019). Stress exposure and the course of ADHD from childhood to young adulthood: Comorbid severe emotion dysregulation or mood and anxiety problems. Journal of Clinical Medicine, 8(11), 1824. Available at: https://www.mdpi.com/2077-0383/8/11/1824
  10. Soehner, A. M., Bertocci, M. A., Levenson, J. C., Goldstein, T. R., Rooks, B., Merranko, J., Hafeman, D., Diler, R., Axelson, D., Goldstein, B. I., Hickey, M. B., Monk, K., Phillips, M. L., & Birmaher, B. (2019). Longitudinal associations between sleep patterns and psychiatric symptom severity in high-risk and community comparison youth. Journal of the American Academy of Child & Adolescent Psychiatry, 58(6), 608-617. Available at: https://www.jaacap.org/article/S0890-8567(19)30175-3/abstract
  11. Nikles, J., Mitchell, G. K., de Miranda Araújo, R., Harris, T., Heussler, H. S., Punja, S., … Senior, H. E. J. (2020). A systematic review of the effectiveness of sleep hygiene in children with ADHD. Psychology, Health & Medicine, 25(4), 497–518. Available at: https://www.tandfonline.com/doi/full/10.1080/13548506.2020.1732431
  12. Fotoglou, A., Morati, I., Diamantis, A., Stergios, V., Gavriilidou, Z., & Drigas, A. (2022). Nutritious diet, physical activity and mobiles: The game changers of ADHD. Technium BioChemMed, 3(2), 87-106. Available at: https://techniumscience.com/index.php/biochemmed/article/view/6916
Dr. Jenni Jacobsen, PhD
Author Dr. Jenni Jacobsen, Ph.D. Medical Reviewer, Writer

Dr. Jenni Jacobsen, PhD is a medical reviewer, licensed social worker, and behavioral health consultant, holding a PhD in clinical psychology.

Published: Jan 6th 2025, Last edited: Jan 29th 2025

Medical Reviewer Dr. Jennie Stanford, M.D. MD, FAAFP, DipABOM

Jennie Stanford is a dual-board certified physician in both family medicine and obesity medicine, holding an MD, FAAFP, and DipABOM. She has experience in both clinical practice and peer-quality reviews.

Content reviewed by a medical professional. Last reviewed: Jan 6th 2025
Medical Content

Our Medical Affairs Team is a dedicated group of medical professionals with diverse and extensive clinical experience who actively contribute to the development of our content, products, and services. They meticulously evaluate and review all medical content before publication to ensure it is medically accurate and aligned with current discussions and research developments in mental health. For more information, visit our Editorial Policy.

About MentalHealth.com

MentalHealth.com is a health technology company guiding people towards self-understanding and connection. The platform provides reliable resources, accessible services, and nurturing communities. Its purpose is to educate, support, and empower people in their pursuit of well-being.