What is ADHD? An introduction
Attention Deficit Hyperactivity Disorder (ADHD) has been in the news and social media a LOT over the last couple of years. It seems that ‘everyone is getting diagnosed’.
But the reality is not ‘everyone is a little bit ADHD’ like we hear frequently.
ADHD can be seriously impairing to people in a raft of life domains, and as our scientific knowledge has grown we are now playing catch ups for generations that were missed. I didn’t get diagnosed until just before my 49th birthday.
It was thought until fairly recently that:
children grew out of ADHD in adulthood (most don’t)
females didn’t really get it (it presents differently in women which is not reflected in research mainly done on males)
and - despite it being one of the most well researched mental health/neurodevelopmental conditions out there- many medical professionals really didn’t and still don’t understand it.
This has led to a lot of people being diagnosed with other mental health conditions that can present similarly, or have simply living undiagnosed for a lot of years struggling and not knowing why.
So let’s take a look at ADHD in simple language, to get a basic understanding of what it is and how that shows up in a person’s life.
What is ADHD?
It is a neurodevelopmental disorder that is believe to impact around 3-5% of the adult population. Simply, our brains are different. It’s not a made up condition! Studies of thousands of brain scans comparing ADHD and non-ADHD brains show there are clearly key differences.
ADHD primarily impacts the parts of the brain that drive our executive functioning responsible for organisation, memory, long term goals, attention, self-regulation. You could think of these as the ‘sensible’ parts of brain. This area - the pre-frontal cortex - is physically smaller for us.
There is still a lot that is unknown about ADHD but it is believed that mainly it is as a result of deficencies of the neurotransmitters (brain/body chemicals) dopamine and norepinephrine which ‘normal’ brains have in greater amounts leading to ‘normal’ functioning in memory, attention, impulse control, planning, reward etc.
Attention Deficit Hyperactivity Disorder has three subtypes
Inattentive, Hyperactive and Combined (has both Inattentive and Hyperactive) types.
Inattentive - 47% of people with ADHD-the most common subtype among adults
Think of your attention as a spotlight. For most people, that spotlight can easily focus on one thing for a while, like reading a book or working on a project. But for someone with ADHD, that spotlight is more like a disco ball, bouncing around from one thing to another. It's hard to stay focused on a single task.
It’s not that we have a deficit of attention, we have too much.
We struggle to focus. We’re interested in all the things and we flit from thing to thing. It’s like having 100 tabs open on your computer or a radio channel that keeps continually changing. With the amount of noise going on - either internally or by being distracted externally due to sensory sensitivities - we can’t stay on one thing (unless we are hyperfocussing and then you can’t drag us away).
Hyperactivity
This part of ADHD doesn't always mean bouncing off the walls. It's more about having a lot of energy and feeling restless. You might find it tough to sit still in class or meetings. It's like having a motor that's always running in your body. It can feel like you can never really relax. There is also the cognitive hyperactivity, so the brain that is continually pinging around as described above.
Combined type - the most common subtype in children
This type is characterised by both inattention and hyperactivity/impulsivity
Is ADHD really a disorder or a disability?
ADHD is considered a "disorder" because it can make daily life more challenging. In Australia it is classed as a disability under the 1992 Disability Discrimination Act.
In other words, you’re not making it up or imagining the struggles you face - the research backs this up over and over again about the impact on the lives of people with ADHD.
However, it's essential to remember that it doesn't have any bearing on your intelligence or capability. It can make a difference in how you apply those things however.
You might feel like you are wading through mud a lot of the time.
You can’t grasp how other people make things look so easy and you struggle with them.
Even simple stuff like cooking and shopping, as I was able to reflect post diagnosis:
“When my kids were small things like meal plans seemed almost impossible. Even food shopping with a list. Too many steps!
Think about how many there are: writing the list during the week, forgetting to add things to the list because I got distracted, trying to remember to always put the pen and pad in one spot so that I didn’t lose said thought (it will be forgotten if I have it in the phone), coming up with meal ideas (might require visiting multiple websites), then listing every ingredient you’d need for each recipe), then actually going and getting it all systematically without forgetting anything (requiring a methodical approach), then bringing it back home realising you’d missed something or if something was out of stock and now the whole lot was ruined as you were missing a crucial ingredient with no time to get it elsewhere. It just felt way, way too hard.
And it was always the same; I’d feel like crying with the frustration of it all. Plus, how on earth do people even know what they want to eat in advance? And it’s so incredibly boring (to me).
Same with dealing with insurance companies, or staying organised in day to day life and keeping up with the messages pinging in everywhere on multiple apps and email addresses.
Everything can feel like a jumbled mess; in your head, your calendar, your priorities/responsibilities, and in your environment.”
Who gets ADHD?
ADHD can affect people of all ages, from kids to adults. Anywhere from between 3-5% of the adult population has ADHD.
The majority of people who have ADHD as kids continue to have it as adults. To get diagnosed as an adult you have to have shown signs of the condition before the age of 12.
Common signs and symptoms
Here are some common signs and symptoms of ADHD:
1. Difficulty Paying Attention
People with ADHD might have trouble focusing on tasks, conversations, or schoolwork. They may get easily distracted by things happening around them. This might be because of a sensory issue e.g. noise, we’re bored or because something else feels more interesting or more urgent.
We can’t filter between things that come into our awareness that are not important and things that aren’t. It is all a competing demand for our attention - and all at once and with equal priority.
2. Impulsivity
Impulsivity means acting before thinking. Someone with ADHD might blurt out answers in class, interrupt others, or have a hard time waiting their turn. This leads to a lot of shame, because we often can’t understand why we do this.
We think if we don’t ‘do it now’ we will forget, or there won’t be another chance.
3. Hyperactivity
While not everyone with ADHD is bouncing off the walls, many have a lot of energy and find it challenging to sit still for extended periods. This also presents in fidgeting, leg jiggling, stimming, skin picking, repetitive movements, looking around and appearing distracted.
Paradoxically, unlike neurotypicals, we often actually need to be moving in some way to learn, to engage, to concentrate. You can see why our modern day environments like classrooms and offices rarely work well for people with ADHD.
4. Forgetfulness
Individuals with ADHD often forget everyday things like school assignments, keys, or appointments. Repeatedly. You might have multiple attempts to leave the house, despite your best attempts.
5. Organisation Troubles
Keeping things organised and following a routine can be a huge struggle, almost impossible. It can feel like chaos all of the time. OR we can go to the opposite end and become obsessive about being organised which is being driven by the ADHD also.
This may lead to a lot of time checking and double checking and triple checking everything because we can’t remember what we’ve done or why we’ve made the decisions we’ve made, even if we spent a lot of time on them.
6. Time Management
People with ADHD may have a hard time estimating how long tasks take. Things end up taking much, much longer than we expected (my diagnosing psych says if a tradie with ADHD gives you a quote, you might as well triple it). It’s called time blindness and can contribute to our periods of burn out as we take on way too much without realising how long things will actually take (and no, it doesn’t matter how many times we’ve done it before, we will forget).
We find it hard to grasp time in the linear way that others do. There is either ‘now’ or ‘not now’.
7. Emotional Rollercoaster
Mood swings are not unusual with ADHD. You might go from feeling happy to upset in a short amount of time.
Emotional regulation is a real challenge for us. When we are in a period of intense emotion it can feel like it will never end. We often don’t possess the skills to steady ourselves and spin off our axis. We might need to offload on a lot of people because of what feels like the injustice, or to verbally process.
When we come out of it, we’re quite likely to forget the level of distress we felt while we were in it. This is why so many women got misdiagnosed with Borderline, because ADHD can present similarly to (and overlap with) personality disorders, PTSD, cPTSD, Bipolar etc.
What about all the things you CAN do?
Myths and misconceptions
Let's clear up a few common myths about ADHD:
Myth 1: ADHD is Not Real
ADHD is a scientifically recognised condition - it’s one of the most researched conditions in mental health out there. Brain imaging studies have shown that the brains of people with ADHD work differently. So, no, everyone isn’t ‘a little bit ADHD’ and anymore than ‘everyone’s a bit socially awkward’ is like autism. It is often impairing in some ways for people who have it.
Myth 2: Only Kids Have ADHD
While it's often diagnosed in childhood, many adults have ADHD. It mostly lasts throughout a person's life.
Myth 3: Everyone with ADHD is Hyperactive
Not everyone with ADHD is hyperactive. There are three types of ADHD: inattentive, hyperactive-impulsive, and combined type. Some people only have inattentive symptoms, especially adults, which can present quite differently.
Myth 4: ADHD is Caused by Bad Parenting
ADHD is not caused by bad parenting. It's a complex condition that involves genetic, environmental, and neurological factors - and it’s 80% heritable meaning that one of your parents or your kids are likely to have it.
Myth 5: Medication is the Only Solution
While medication can be very helpful, it's not the only solution, and often not a quick fix. Usually treatment requires a combination of coaching, lifestyle changes, support and education.
Bottom line: ADHD is a real condition that affects how a person pays attention, controls impulses, and manages time, emotions and energy.
It can cause serious challenges for people in various areas of their lives including relationships, study, family life, planning, addiction, parenting, self-management.
If you have ADHD … your struggles are real and they are not your fault! ❤️
Your struggles do not define you - there are LOTS of great things about you to tap into.
If you want to know more about assessment, diagnosis and treatment, go to this blog:
If you’d like to book a session to talk about your ADHD, your symptoms, ways you can better manage life - you don’t need to be diagnosed.
Check out my info on ADHD coaching or how to work with me.
Sources:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC; 2013.
Chen Q, Brikell I, Lichtenstein P, Serlachius E, Kuja-Halkola R, Sandin S, et al. Familial aggregation of attention-deficit/hyperactivity disorder. J Child Psychol Psychiatry. 2017;58:231–9
Del Campo N, Chamberlain SR, Sahakian BJ, Robbins TW. The Roles of Dopamine and Noradrenaline in the Pathophysiology and Treatment of Attention-Deficit/Hyperactivity Disorder. Biol Psychiatry. 2011;69(12):e145-157. doi:10.1016/j.biopsych.2011.02.036
Hoogman M, Bralten J, Hibar DP, et al. Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis. Lancet Psychiatry. 2017;4(4):310-319. doi:10.1016/S2215-0366(17)30049-4
