Change the way you think about ADHD

When I mention ADHD, what immediately comes to your mind?

What gender do you imagine a person with ADHD identifying with?

What are their behaviours?

And are they young or old?

ADHD (or Attention Deficit Hyperactivity Disorder) is a condition you may or may not already be familiar with but it is definitely something that we all should know a bit more about.

This is because having ADHD, particularly undiagnosed, can have a real impact on someone’s day-to-day life and building awareness of this condition is key to people getting the help they need early on in their lives.

It is even more important as much of the information about ADHD in the past has centred on some ideas which simply aren’t true.

In this blog, we will be exploring ADHD, particularly in adulthood, and why some of the common myths can be barriers to diagnosis.

What is ADHD:

ADHD is a neurodevelopmental condition which affects a person’s executive functioning and behaviour. What does that mean? Well, these are functions of the brain which help us carry out important everyday tasks including planning, prioritising, decision making and emotional regulation among others.¹

In the case of ADHD, some or all of these functions can be impacted. A diagnosis looks into if these symptoms are persistent and impairing across different settings of a person’s life (such as home and work). Importantly they need to be present from childhood but unfortunately, this does not mean that diagnosis is always made then (more on that later).

The word ‘impairing’ is important in making the diagnosis. You may have read the functions above and thoughts about times in your life when you have struggled with any one of them. The crucial difference with ADHD is that the symptoms experienced can have a marked and consistent impact on your daily life.²

Types of ADHD:

Did you know ADHD can fall into different categories? As with many conditions, there is not a ‘one size fits all’ presentation which is why things can get a bit confusing. You can find that people experience:

1. Hyperactive Type: This can include some of the most common symptoms linked to ADHD such as talking or moving lots and fidgeting as well as impulsivity like interrupting people multiple times in a conversation. This can be tricky in more rigid environments like the classroom or workplace.

2. Inattentive Type: This can present in different ways - including struggling to focus on things which don’t interest you, difficulty finishing tasks or being easily distractible.

3. Combined Type: This is when you can have traits of both.³

What myths make ADHD diagnosis so variable?

Across the world, the number of people diagnosed with ADHD (and the way it is diagnosed) can vary but there are some universal myths which can act as barriers to diagnosis.

This is why we are tackling them head on:

1. “ADHD only affects boys”:

You can identify as any gender and have ADHD.

However, there appears to be a gender gap in the actual diagnosis of ADHD. This may be due to a combination of factors but one key one is that it can present differently for different people. For example, symptoms of hyperactivity may more commonly show up in individuals assigned male at birth. This historically has been a more commonly associated symptom of ADHD, meaning a higher historical diagnosis rate which can lead to the assumption that it is more common in these individuals.

Equally symptoms like inattention may pass by more unnoticed in the classroom or be reframed as someone ‘daydreaming’.⁴

2. People with ADHD cannot focus:

No! The ‘attention deficit’ part of the name really does not capture the nuance of this condition. Attention is better described as ‘dysregulated’ rather than deficient.

By this, we mean that the voluntary attention (that is, the attention which is applied by the individual) can be very well directed on a subject which interests them (whatever that subject may be!) but when asked to focus on other more mundane tasks, this focus can be more elusive.

This is really tricky in a workplace or school where repetitive or boring tasks can be part of your routine.

It can also come into difficulty when involuntary attention comes into play. This describes external stimuli, like a loud noise from a colleague or a flashing slideshow on someone’s screen, which can be more likely to distract attention in someone with ADHD than without.⁵

3. “You grow out of ADHD”:

Symptoms may evolve in adulthood but many people continue to experience symptoms later in life.

However, humans are very adaptable and you may find that as adults, it is not the symptoms which have reduced, but how someone has learnt to hide them that has. These can be referred to as “masking”.

It is important to pick up on these as unchecked they can put a lot of pressure on the person at hand. Masking can be exhausting and isolating and someone may only realise they are doing this when they are diagnosed with ADHD.⁶

4. “I don’t have ADHD, I have {insert alternative medical diagnosis here}”:

ADHD can often be misunderstood or misdiagnosed as another medical diagnosis.

This can be because there are crossover symptoms with other medical conditions or because ADHD itself can cause you to feel a number of different ways. For example, you may experience anxiety as a result of your ADHD symptoms but be diagnosed with anxiety in the first place before discovering that ADHD is the root of your symptoms.

Furthermore, you can have a number of conditions where ADHD and other neurological developmental differences can go hand in hand, for example, Autism and ADHD.⁷

5. “ADHD will stop me coming top in the class”:

You can have ADHD and achieve great things.

However, it is important to tackle the belief that someone who did well at school cannot have ADHD.

It is amazing how early adaptive techniques can develop and not be a barrier to achieving more conventional markers of success, like a string of top grades. However, this does not mean that the journey there has been a simple one and it’s important not to take them at face value if someone has experienced ADHD symptoms along the way.

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ADHD is an important and evolving condition which presents differently in everyone. If you think you or someone dear to you may have ADHD, your first appointment with a clinician is only a few steps away.

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References:

1. ADHD in Adults, Royal College of Psychiatrists, December 2021, https://www.rcpsych.ac.uk/mental-health/problems-disorders/adhd-in-adults
2. DSM-5 Diagnostic criteria, QA ADHD, Accessed May 2022, https://www.qandadhd.com/diagnostic-criteria#:~:text=DSM%2D5%C2%AE%20DIAGNOSTIC%20CRITERIA%20FOR%20ADHD%20IN,1&text=Five%20or%20more%20symptoms%20of,social%20and%20academic%2Foccupational%20activities.
3. What is ADHD, CDC, September 2021, https://www.cdc.gov/ncbddd/adhd/facts.html
4. ADHD in girls and women, Psychiatry UK, May 2020, https://psychiatry-uk.com/adhd-in-girls-and-women/
5. Linking ADHD to the Neural Circuitry of Attention, PMC, June 2018.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497785/
6. .Experienced consequences of being diagnosed with ADHD as an adult – a qualitative study, BMC Psychiatry, February 2015, https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-015-0410-4
7. The nature and nurture of ADHD and its comorbidities: A narrative review on twin studies, Neurosci Biobehav Rev.February 2020, https://pubmed.ncbi.nlm.nih.gov/31838192/