Mar 2

ADHD 101:

Answering the most frequently asked questions

Myths, misconceptions, and straight-up misinformation abound in the world of ADHD- from ADHD and neurotypical brains alike! And while these myths may seem innocent, each one has to potential to hurt the many brave and creative brains that live with ADHD each day.

So, let’s clear some of them up:

What's up with the name ADHD? I thought it was ADD.

Names of diagnoses are created (and changed) as our understanding of them evolves. The people who most often dictate these changes are the team of psychologists and psychiatrists who author the Diagnostic and Statistical Manual (DSM). This manual is commonly referred to as "the bible" of mental disorders.

Officially, the name was changed in 1987 from Attention Deficit Disorder to Attention-Deficit/ Hyperactivity Disorder to take into consideration the increasing understanding that people with ADHD can have inattention and/or hyperactivity as their primary symptoms but that no matter which primary symptom you had the disorder had the same roots..

The ADHD terminology has taken greater hold when talking about kids than when talking about adults- partially because kids are more likely to have visible (and often disruptive) hyperactivity. Adults, however, struggle more often with symptoms of inattention and less obvious hyperactivity. This, in combination with the fact that most adults that were diagnosed as kids were diagnosed at a time when ADD was still a more common vernacular, has made the ADD terminology harder to turn over.

So there are different types of ADHD? What are they?

Yes, right now 3 types of ADHD have been classified, each identified by how many symptoms you have in the 2 categories of symptoms: inattention and hyperactivity/ impulsivity.

Inattentive Type ADHD

Inattentive type ADHD is identified by 5 or more of the following symptoms:

Failing to pay close attention to details or making careless mistakes
Having trouble holding attention on tasks or activities
Having difficulty listening when spoken to directly
Struggling to follow through on instructions and failing to finish tasks
Having trouble with organizing tasks or activities
Avoiding or disliking or feeling reluctant to do tasks that require mental effort over a long period of time
Losing things necessary for tasks or activities
Being distracted
Being forgetful in daily activities

Hyperactive/ Impulsive Type ADHD

Hyperactive/Impulsive type is identified by having 5 or more of the following symptoms:

Often fidgeting with or tapping hands or feet or squirms in the seat
Often leaving their seat in situations when remaining seated is expected
Often running or climbing in situations where it is not appropriate (in adults this may be limited to feeling restless)
Often being unable to take part in leisure activities quietly
Is often "on the go" acting as if "driven by a motor."
Often talking excessively
Often blurting out an answer
Often having trouble waiting their turn
Often interrupting or intruding on others

Combined Type ADHD

Combined type ADHD is identified for people who experience 5 or more symptoms of both groups of symptoms.

*It is important to note that ADHD is a neurodevelopmental disorder, and therefore these symptoms must have been present before the age of 12 to qualify for the diagnosis.

Neurodevelopmental disorder? What's that?

Neurodevelopmental disorders are a group of disorders that are believed to be the result of differences in the development and functioning of the nervous system. This means that a person's development impacts how the disorder shows up.

For example, it is hard to differentiate a child with ADHD from a neurotypical child at the age of 3- because the executive control abilities involved in ADHD don't begin to develop until later. Therefore very young children all look similar on executive control tasks. However, as those 2 children age- the differences in abilities become more stark and apparent.

The neurodevelopmental aspect of ADHD also describes the fact that ADHD symptoms change over the course of someone’s life- symptoms may be more obvious to outsiders when someone is younger but less apparent as they age.

Does that mean that you can grow out of ADHD?

It used to be thought that everyone with ADHD (what was then known as Hyperkinetic Disorder of Childhood) would grow out of the disorder. In later conceptualizations of the disorder, it was hypothesized that most people would outgrow it.

We now know that about 60-70% of adults with ADHD will have symptoms that wax and wane, particularly during times of increased stress or life change.

We also know that the way ADHD shows up in adulthood changes significantly from how it shows up in kids. Adults with ADHD often experience a lessening in symptoms that are easily visible to others. (That doesn’t mean they feel a lessening necessarily but they are more able to hide and accommodate for them.)

For example, adults often find themselves more able to restrain themselves from acting inappropriately in public. They may still struggle to attend to a conversation or have a hard time settling down or staying seated for long periods. But, they are less likely to run or climb on the furniture in a boring meeting or blurt out inappropriate comments during a lecture.

Adults also often find some relief from a combination of skills training, therapy, medication, exercise, lifestyle management, and external support, which helps them present with less significant symptoms.

What does ADHD look like in adults?

ADHD is a disorder of regulation. Because people with ADHD don't always have a deficit of attention or an over-abundance of energy- in fact, sometimes they struggle with overfocus, and sometimes they struggle to get going. ADHD causes the brain to struggle to regulate attention, concentration, energy, emotion, and impulses. So sometimes it gives too much, sometimes too little, and with very little consistency.

Because of this lack of consistency, adults with ADHD can struggle with employment, relationships, and self-care. They also often struggle with depression, anxiety, and substance abuse as a result of their symptoms. Other issues that adults with ADHD struggle with include:

Organizing and prioritizing tasks
Completing tasks
Starting tasks- particularly if there is no pressure to do so
Remaining consistent with work performance or attendance
Lateness
Interrupting people in conversation
Remembering daily tasks or items
Maintaining relationships that are not seen daily
Routinely completing tasks for daily living (i.e.: washing dishes, doing laundry, paying bills)
Remaining focused on tasks
Attending to details of tasks
Difficulty paying attention when someone is talking
Frequently losing things

Doesn’t everyone have a little ADHD?

No.

While every person can relate to the struggles of ADHD either from moments when we have been overtired, stressed, overwhelmed, or just not at our best. The experience of dealing with these challenges every day, all day is unique and particularly challenging for those with ADHD.

Most people with ADHD have a lot of experience hearing from neurotypicals that they too have struggled with (lateness/ procrastination/ difficulty organizing/ etc.) and that if just tried (enter pat solution here) it would make it better.

These suggestions are well-meaning but can also be crazy-making and demoralizing. People with ADHD understand what they should do but they have a hard time doing it. So it’s not a matter of just knowing the proper management strategy- it’s how to implement that strategy when you have a brain that doesn’t stimulate the neurotransmitters that it needs (dopamine and norepinephrine) consistently.

I think I might have ADHD- what do I do now?

Check out the ADDept online quiz to see if you have some of the symptoms that people with ADHD most often struggle with. It is important to note that this is not intended for diagnostic purposes. But only to give more information.

It is therefore important to get a formal diagnosis. There are numerous factors to be considered when diagnosing ADHD, and it requires significant training and experience to do so. Only a trained professional can give you an accurate diagnosis. For more information on what type of testing to get check out my post on how to get tested for ADHD.

Ok, I just found out I have ADHD- now what?

It can be overwhelming trying to decide how to best manage your ADHD when you come to the diagnosis as an adult and it can feel like a confusing rollercoaster just wrapping your mind around your feelings about the diagnosis itself.

The good news is that there are a lot of different things you can do to help to manage it and as you build in more and more systems and supports you can experience greater and greater relief.

Now the ADHD brain is likely to say- Great! Let's do all of them at once! I hear that and love the enthusiasm. But if you do too many, it’s likely to get pretty overwhelming and can end up frustrating you in the end.

I usually recommend starting with medication or therapy first. Start to understand how that process works for you, and what impact it has, and then you’ll have some support to start the others. Lifestyle management, while less cost-intensive, is made extra challenging by ADHD symptoms themselves. This, therefore, is best accomplished in conjunction with therapy and/or medication.

What questions do you have about ADHD? What misconceptions have you come across? Let me know and I will add them in an upcoming post.

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