ADHD, or Attention-Deficit/Hyperactivity Disorder, is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. People with ADHD often describe difficulties with maintaining attention, working memory, and executive function, the brain’s ability to prioritize and manage thoughts and actions. The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics plays an important role.
“People with ADHD tend to live in the moment and have difficulty with executive functioning such as planning, task initiation, task completion, and having a dual focus such as remembering where they parked their car or something they needed to do at the end of a workday,” said Yechiel Benedikt, a NYC therapist and MyWellbeing community member.
ADHD is one of the most common neurodevelopmental disorders of childhood. While it is usually first diagnosed in childhood, it often lasts into adulthood and the estimated lifetime prevalence of ADHD in U.S. adults aged 18 to 44 years is 8.1%. Still, many adults with ADHD aren’t aware that they have it.
We asked our community of therapists to answer some of the most common questions surrounding ADHD—here’s what they had to say.
“ADHD is caused by a lack of dopamine and norepinephrine in your brain,” said Anya Lukianov, a NYC therapist and MyWellbeing community member. “As long as a medication is taken to address this imbalance, ADHD can be very manageable to live with. Often a therapist that you are already seeing can determine if ADHD is present and can refer you to a psychiatrist for a second opinion (as well as medication management). Seeing a psychiatrist only for medication is beneficial, however, also seeing a therapist is highly recommended to manage all biological, psychological and social aspects of having ADHD.”
There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, sleep problems, and certain types of learning disabilities, can have similar symptoms, which is why it’s important to speak to your healthcare providers if you suspect you might have ADHD.
While “only a mental health provider (psychotherapist, psychologist, psychiatrist) should be providing a formal diagnosis of ADHD, you can take a brief online quiz that will help you determine if (and where) you fall on the ADHD spectrum,” said Anya.
Many adults with ADHD feel like it’s impossible to get organized, stick to a job, or remember to keep appointments. Daily obligations like getting up in the morning, getting ready to leave the house, arriving at work on time, and being productive on the job can be especially challenging. They may also have a history of academic problems, problems at work, or failed relationships—but ADHD has nothing to do with a lack of intelligence.
“Many individuals with ADHD have average or high IQs,” said Anya. “Often, their untreated symptoms of ADHD disrupt their ability to learn and perform in a way that demonstrates their true intelligence. This is why a formal diagnosis and proper treatment is necessary to live a more fulfilling life with an ADHD diagnosis.”
“Although it is quite common for ADHD to be misdiagnosed as anxiety, it's also the case that anxiety can impair our ability to do things in a way that looks and feels a lot like ADHD,” said Joanne Davies, a MyWellbeing community member who offers coaching and hypnosis that is complementary to ADHD treatment.
It’s also possible to have both. “Anxiety can make ADHD symptoms worse just like ADHD symptoms can make anxiety worse,” Joanne said. “For example we may be struggling with something like managing our time on a project at work, and we can feel really anxious about the consequences of that for us and others. It can feed into a general anxiety we already had. We might also find that if we are feeling anxious, we don't have enough headspace to access our time management coping skills. Without proper support, it's common for people with ADHD to develop coping strategies that are anxiety-provoking, such as only managing to wrap up that project at the very last moment. This reliance on stress to manage ADHD can create a lot of anxiety over time.”
For a long time, ADHD was considered a children’s condition, but we now know this is not true—ADHD is a neurobiological disorder that affects individuals across their lifespan.
Still, “ADHD symptoms can lessen over time with proper lifestyle changes,” said Michael Shawe, a NYC therapist and MyWellbeing community member. “If you're spending hours of your day sitting and anxious and you instead learn to exercise daily in the morning and you see your symptoms improve, then you'd be wise to continue with your exercise routine. Brain health is very much like physical fitness. If you stop caring for your mind it will atrophy and you'll re-experience your struggle to focus and stay organized. The good news is that ADHD care is part of a healthy lifestyle and you get many whole-body benefits from attending to your brain health.”
In many cases, ADHD is best treated with a combination of behavior therapy and medication, which is why it’s so important to seek the guidance of a mental health professional who will be able to help.
People with ADHD will have symptoms of inattention, hyperactivity-impulsivity, or both. The symptoms of inattention are things like a failure to pay attention to details or sustain attention during tasks, difficulty listening when spoken to directly or organizing tasks and activities, losing things like keys and wallets, or being easily distracted or forgetful.
Symptoms of hyperactivity-impulsivity are things like fidgeting or tapping, feeling restless and unable to sit still, excessive talking or the inability to remain quiet when expected, and difficulty waiting to answer a question before it has been completed or to speak before another person is finished talking.
Many of these difficulties are simply a part of life, but for those with ADHD, they significantly impair life at work and home.
“In children, the most effective treatment for ADHD is medication along with developing their weaker skills and organizational strategies,” said Yechiel. “The main challenge for children with ADHD is conforming to the school system which subjects them to lots of criticism which negatively impacts their self-image. Therefore, building self-esteem is an important aspect of the treatment.”
“In adults, ADHD presents as a lack of structure and stability as well impulsivity and risk-taking. People with ADHD also have strengths in their risk tolerance and ability to brainstorm. A major component of ADHD treatment is embracing the strengths while managing the weaknesses,” said Yechiel.
“Remember that ADHD is a neurological style which is most often determined by genetics, like your eyesight,” said Jenny Starosta, a clinical psychologist with a specialty in working with children, adolescents and families. “Most people do not feel ashamed if they do not have 20/20 vision because they know that it is not their fault. They do know that there are things that they can do that may help them function better, like wear glasses or look at things closer, bigger, or in better light.”
“ADHD is not a personal problem, weakness, or evidence of an individual failure. However, because ADHD impacts how you think, focus and act, it can impact you in all facets of your life, and many people attribute those negative impacts to themselves and feel ashamed or frustrated. You should not feel ashamed of the symptoms of ADHD; it is just as much in your control as your visual acuity. A therapist can help you understand how your symptoms are impacting you and what you can do to cope with them.”
Here are some strategies Jenny suggested:
Some people who have ADHD are not diagnosed until adulthood because it was not recognized by teachers or family at a younger age, the person has a mild form of ADHD, or they developed enough coping strategies to manage some of their symptoms, so if you think you have ADHD but you’re not yet receiving treatment, talk to a mental health provider.
“A therapist will probably take a history of your symptoms and this history will likely help you understand things that were ‘hard’ or frustrating to you when you were younger,” Jenny said. “Once you understand what was causing you the difficulty, it is easier to know what to do to address it. As people with ADHD get older, they tend to get less hyperactive, but often continue have difficulty focusing and sustaining their concentration. The therapist will explain the ways in which your ADHD symptoms are impacting you now. You may also spend some time learning about the ways that you can use your neurological style to your benefit, instead of just focusing on the negative ways it might be impacting you. There are strengths to this neurological style as well.”
“After working with you to understand how ADHD is impacting your life, the therapist will help you find some strategies that will target the most problematic symptoms or problems. This may be new ways of tackling tasks and concrete coping strategies that help train your brain in new patterns, different ways of approaching how you see yourself and your behavior (cognitive/behavioral strategies), and ways that you and people around you can help to make your difficult tasks easier,” Jenny said.
It is never too late to recognize, diagnose, and treat ADHD and any other mental health condition that can commonly occur with it. Effective treatment can improve the lives of many adults and their families. Even those adults who have learned to cope with some symptoms of ADHD deserve treatment if they choose to pursue it, and a mental health provider can help you get the diagnosis and treatment you need. Remember, you deserve support and care. We hope this insight from our therapist community has helped—we’re here for you every step of the way.
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Caitlin is MyWellbeing's Content Lead, a writer, speaker, communication coach, and the founder of Commcoterie, a communication consultancy. She teaches teams how to use professional coaching communication techniques in their everyday conversations, helps leaders engage their teams with effective and inclusive communication, and partners with service providers to activate their programs and offerings with their own clients through inspiring communication strategies. Find out more, including how to work with her, at www.commcoterie.com.