Over the last decade or two, ADHD (or ADD, the old term that many professionals and patients continue to use) has entered the public vocabulary to the point that a layperson is likely to have a general image of its features. When asked to describe ADHD, most people first picture a child, typically a boy, who:
- Is constantly moving, climbing, and fidgeting, even when inappropriate to do so.
- Struggles to stay on task or work quietly.
- Lacks impulse control.
- Has difficulty following rules and waiting his turn.
- Is labeled “disruptive” or “difficult” by teachers and other authority figures.
- Receives poor or inconsistent grades in school.
- Has a volatile temper and low tolerance for frustration.
This may be a decently accurate profile of the one possible presentation of ADHD, but it is a limited – and limiting – understanding of the condition. These symptoms describe the stereotypical childhood presentation of hyperactive-subtype ADHD while acknowledging neither its inattentive subtype nor how symptoms tend to carry into adulthood.
In contrast to hyperactive ADHD, the inattentive subtype is less immediately obvious than its counterpart, and is frequently undiagnosed or even misdiagnosed as anxiety, depression, or simply dismissed as laziness or a deficit of character. While men are more likely than women to have an ADHD diagnosis overall, women and adults are more likely to present with inattentive ADHD and consequently be underdiagnosed. Inattentive ADHD presents symptoms such as:
- Frequently making careless mistakes or missing details at school, work, or home.
- Struggling to stay “tuned in” for lengthy or mentally intensive tasks, even enjoyable ones.
- Difficulties with following through on tasks or assignments, including starting a task but quickly burning out and losing focus.
- Disorganization – frequently losing or misplacing personal belongings, poor time management, messiness and clutter.
- Procrastination, particularly around tasks that require sustained mental effort (schoolwork, preparing reports, cleaning a chaotic space).
- Being easily distracted by noises, sights, smells, and unrelated thoughts.
- Being forgetful in daily activities like chores, errands, paying bills, returning calls, and keeping appointments.
The third and final subtype of ADHD is called combined presentation, and it is defined by the presence of many symptoms of both the hyperactive and inattentive subtypes.
While it is true that ADHD was once believed to be a disorder that only presented in childhood, further research has revealed that approximately 50-80% of those with a childhood diagnosis of ADHD continue to experience symptoms throughout adulthood. This means that while 1 in 5 children do “age out” of symptoms as they mature, the vast majority experience only partial remission or none at all. Adults remain the largest undiagnosed group of those with ADHD, with a mere 10-25% of those with ADHD in the United States ever receiving a diagnosis and treatment.
Although we now understand that ADHD is also prevalent among adults, much of the conversation continues to center around the condition in children; even then, discussions are often tinged with skepticism of the condition’s legitimacy and wariness of overdiagnosis. It’s not uncommon to hear people – including teachers, doctors, and some mental health professionals – express doubt or concerns about overdiagnosis and overmedication. In some regions, schools, and cases, this is true to varying degrees. However, other areas and practitioners are more influenced by the stigma against diagnoses like ADHD than by an epidemic of frivolous prescriptions. There are still many in the medical field who “don’t believe” in ADHD, despite solid evidence yielded by brain scans, genetic studies, and global research; this ongoing invalidation stops many from seeking or receiving the support that they may need.
Further skepticism surrounding ADHD arises from the reality that everyone has forgetful moments or struggles to make themselves do things that they don’t actively enjoy. Most people have varying levels of clutter in their office or living space at least some of the time, and few can honestly say that they have never acted impulsively before. These are symptoms of being human and little else, so the resistance to framing these common experiences as an illness is understandable.
However, just like you can feel sad without having depression, you can feel scattered and restless without having ADHD. Three factors distinguish these normal traits and habits from ADHD: intensity, duration, and pervasiveness. If these symptoms regularly interfere with your functioning in multiple areas of life (e.g., in school, at work, and at home), if your friendships and relationships have been negatively impacted over time, if your symptoms have been present since childhood, and if they cause you significant distress, you are a good candidate for an ADHD assessment. If you are looking for a psychiatrist in Newport Beach or the surrounding area, the clinicians at Mindful Health Solutions now offer 30-minute, in-house ADHD testing. It’s never too late to receive a diagnosis and create meaningful change, and no one is too old to outgrow deserving support.
If you’ve managed to achieve success in academic or professional settings despite having symptoms – and many do, as ADHD also carries common strengths like creativity, wit, energy, and drive – your symptoms may have been dismissed because you didn’t fit the stereotype of disruptive behavior and poor performance. Contrary to common belief, it is possible for many people to do well in school and at work with ADHD; getting good grades or succeeding professionally does not disqualify you from a diagnosis.
Functioning well in these environments with ADHD typically requires a great deal of effort, structure, praise, and double- or triple-checking one’s work; and even those who perform well often receive feedback or express their own feelings of “failing to live up to their potential.” Children, adolescents, and adults with ADHD frequently report constant worry that they have missed something important or live in the shadow of their inevitable next mistake. In addition, the exhaustion of working (and often failing) to disguise or compensate for symptoms, especially when combined with negative feedback and ill-fitting or inadequate support, often results in chronic feelings of incompetence, helplessness, despair, and shame.
It is unsurprising, then, that ADHD is frequently accompanied by other diagnoses, most commonly depression, anxiety, and substance use disorders. This can further complicate the process of building a sufficient treatment plan. One thing is certain: ADHD is never a one-size-fits-all issue, and neither is managing your symptoms. The most successful treatments typically combine multiple approaches (medication, therapy, lifestyle changes, etc.) to build a scaffold of skills and supports in multiple life domains. Some people respond well to medication while others don’t, and some prefer to exhaust all other options before even considering medication. The key is building a system that works for your specific wants and needs.
To access support and explore treatment options, the first step is receiving a formal diagnosis. While ADHD testing can be surprisingly difficult to access, most mental health practitioners and all professionals who prescribe ADHD medication require a diagnosis in order to begin treatment. Fortunately, Mindful Health Solutions recognize the growing demand for more integrated and accessible care that addresses multiple needs at once. This is why Mindful Health Solutions have incorporated in-house testing and treatment for ADHD in addition to providing telepsychiatry, medication management services, and groundbreaking, research-supported treatments like transcranial magnetic stimulation (TMS) and esketamine.