It's been a while since we've done a comprehensive, back-to-basics type of post! Our last entry in this category was The Ultimate Beginners Guide To Anxiety. We are also planning an ultimate guide to depression and other mood disorders, with follow-up posts for managing symptoms, including answers to frequently asked questions!
Today, we're tackling ADHD.
Before we get back to basics, here is some background on what inspired this post.
In 2020 (and now 2021), we noticed the following concerns coming up repeatedly in therapy with clients:
- Difficulty focusing on work
- Feeling easily distracted and absentminded
- Struggling with time management
- Not able to stay on task for a reasonable length of time
If any of the above sounds familiar, you are in good company!
Being productive during a pandemic is an ongoing struggle. Most people are experiencing either a major dip in the quality or quantity of work they can produce. Some are able to meet all their pre-pandemic quotas, but are sacrificing their mental health behind the scenes to do so.
Nearly a year into this most bizarre once-in-a-century phenomenon, and we now facing collective exhaustion from trying to maintain SOME level of productivity.
It's no wonder that therapists are hearing more about attention and focus-related issues!
Specifically, clients are coming to us with concerns about ADHD
We want to address this by providing some education around what ADHD is. It's also important to note what ADHD is NOT.
Our heightened concerns about difficulty focusing and paying attention are completely valid! However, it does not necessarily mean we have ADHD.
ADHD is not another way of saying I can't focus. Just like 'bipolar' is not equivalent to being indecisive.
Read on to find out more!
In this post we will cover:
- What ADHD is and who experiences it
- Common signs and symptoms
- Mental health concerns related to ADHD
- A few common myths about ADHD
Now, let's crash this course.
What Is ADHD?
'ADHD' stands for Attention Deficit Hyperactivity Disorder. Sometimes, it is also called 'ADD' or Attention Deficit Disorder. Most of the time, these two acronyms are used interchangeably. In this blog post, we will be referring to it as ADHD.
ADHD is a mental health and brain development condition that causes problems with attention span, concentration, and how impulsive and active the person is (source: CAMH).
Many of us are easily distracted or feel more active and impulsive at times. What makes ADHD different is:
a) These behaviours persist over time
b) The behaviours negatively affect the person's ability to function well in many areas of their life (i.e. family life, social life, school, relationships, work)
Here is a quick and simple explanation of ADHD, if visual engagement is more your thing:
What Is Behind ADHD?
Those with ADHD experience problems in a key area of skills called executive function. This can be considered our brain's management system.
Executive functions skills are responsible for many areas of our functioning, including:
- Paying attention to things
- Organizing, planning, and prioritizing tasks
- Starting a task and remaining focused until it is complete
- Understanding and appreciating different points of view
- Regulating our emotions
- Self-monitoring (keeping track of what you’re doing)
- Inhibiting behaviours (i.e. resisting distractions and temptations)
In general, people with ADHD struggle in many of these areas. Executive function skills usually develop in childhood and continue to grow into our 20's. It's no coincidence that many people begin experiencing ADHD symptoms at a young age, when challenges in executive function development begin to impact behaviour.
Who Gets ADHD?
A common misconception is that ADHD only occurs in children and young people. It's easy to see where this comes from. We know, for example, that ADHD is by far the most common neurodevelopmental disorder in children. Furthermore, many of us grew up knowing kids in our class who had ADHD.
It's important to note that while ADHD usually begins in childhood, the issues tend to carry forward to adulthood as well. The American Psychiatric Association estimates that ADHD affects about 5% of children, and nearly half of them will continue to have symptoms in adulthood.
In fact, it's common for ADHD to remain undiagnosed or be diagnosed for the first time in adulthood, which can be an 'aha' moment for those who struggled with the symptoms throughout school
How is it possible to go years without recognizing a problem?
Well, in the past, children with ADHD in classrooms were often labelled as goofy, slackers, underachievers, etc by parents and teachers. As children, they may even have learned to get by through compensating for the difficulties ADHD can create in a school environment.
Adulthood, however, comes with a greater demand on our ability to plan, focus, and organize our lives. It's more difficult to manage these challenges with ADHD, leading to many people finally seeking help in adulthood.
Signs And Symptoms Of ADHD
So how do you know if you have ADHD?
There is actually a process for getting a formal diagnosis. This process is different for children and adults. The information we are providing here is meant to be used as a guide, and it not a substitute for actual diagnosis of ADHD.
The main symptoms of ADHD can be divided into 2 major categories: inattention and hyperactive or impulsive behaviours. We pulled the most common behaviours in these categories from CAMH:
- Often doesn’t pay attention to details or makes what appear to be careless mistakes in schoolwork or other activities
- Usually has problems staying focused on work or activities
- Often doesn’t seem to listen when spoken to
- Frequently doesn’t follow through on instructions and doesn’t finish tasks
- Often has difficulty organizing tasks
- Usually doesn’t like to do tasks that call for ongoing thinking
- Often loses things
- Is often easily distracted
- Often forgets things
- Often fidgets and squirms in chair
- Often leaves seat when required to sit still
- Frequently runs or climbs excessively (or, for adolescents, feels restless)
- Often talks excessively
- Usually has difficulty playing quietly
- Is constantly in motion
- Usually has problems waiting for a turn
- Regularly blurts out answers before questions have been completed
- Often interrupts or intrudes on others’ conversations or games
How Is ADHD Diagnosed?
The process of diagnosis looks different for adults and children/adolescents.
As an adult, the first step is usually your family physician. They may refer you to a psychologist to do a formal evaluation. A thorough evaluation can include reviewing past and present symptoms, taking a medical history and exam, and using adult rating scales or checklists.
For children and adults, ADHD diagnosis is usually a collaborative process between parents, school staff, and doctors.
If you are interested in learning about specific *DSM-5 criteria for ADHD, take a look here.
*The DSM-5 (Diagnostic and Statistical Manual Of Mental Disorders 5th Edition) is the manual that professionals use to assign a formal diagnosis of several mental health issues, including ADHD.
The Connection Between ADHD And Mental Health
Having ADHD can make several areas of life significantly more challenging. This is true at all age levels.
The difficulties ADHD brings about (i.e. forgetfulness, not paying attention, interrupting others) can create difficult life experiences.
For example, children with ADHD are likely to experience academic underachievement, and have trouble making friends. They are also the targets of bullying and social exclusion. They are constantly absorbing the message that they are lazy, ineffectual, loud, disruptive, and different.
Overtime, this messaging becomes internalized. This results in children with ADHD experiencing low self-esteem.
Living With ADHD As An Adult
The low self-esteem young people experience in childhood usually does not disappear as an adult.
A person with ADHD has difficulty prioritizing tasks and paying attention. This leads to frequent mishaps such as being late, forgetting important deadlines, or not communicating effectively. It's easy for people to become frustrated or impatient with people who have ADHD, which triggers those familiar feelings of being undervalued and misunderstood.
For these reasons, adults with ADHD tend to experience issues in the workplace, and in their personal relationships.
Let's take relationships as an example. There are many symptoms of ADHD that can lead to relationship issues. For example, zoning out during a conversation, difficulty tolerating intense emotions, struggling to plan and execute daily household tasks etc.
When ADHD Interacts With Other Mental Health Concerns
ADHD does not CAUSE other mental health concerns directly. However, it can co-occur with other mental health issues.
Mood Disorders: It's not uncommon for ADHD to be accompanied by depression and other mood disorders. ADHD does not directly cause depression. However, the challenges ADHD brings about in work and relationships can make depression symptoms worse
Anxiety Disorders: Anxiety disorders can cause overwhelming feelings of worry and nervousness. Those with ADHD are more vulnerable to experiencing anxiety due to the social, academic, an organizational challenges ADHD causes
Learning Disabilities: Many people believe a learning disability and ADHD are one and the same when in fact they are two entirely different issues. However, those with ADHD tend to score lower in the academic arena due to their struggles with concentration, memory, and communication
Debunking Common Myths About ADHD
As research improves, we know a lot more about ADHD and how to manage it, both for children/adolescents, and adults. However, there are still many myths about ADHD that make it difficult for people to seek support.
Let's bust a few of these myths right here.
Myth: ADHD is not a real mental health condition
FACT: ADHD is recognized by several medical bodies (Centers for Disease Control and Prevention, American Psychiatric Association, Centre For Addiction And Mental Health) as a real mental health and medical condition.
Like many physical and mental health issues, ADHD is also heritable, meaning it tends to run in families. In fact, 1 out of 4 people who have ADHD also have a parent with ADHD.
Many people use the term ADHD colloquially, or casually, when they are feeling spacey and having bad day with focus and attention. However, anyone who has personal experience with ADHD can describe the effect it has on nearly every aspect of their lives.
Myth: People with ADHD can't focus on anything
FACT: Difficulty focusing does not mean never being able to focus.
Some people with ADHD actually experience something called hyperfocus, where they have trouble shifting they attention AWAY from something they are interested in or enjoying, like a TV show or video game.
Also, people experience ADHD differently. Some might have less difficulty focusing and struggle more with impulsivity or hyper activeness. We are all unique, making sweeping generalities an oversimplification.
Myth: You can counteract ADHD by trying harder
FACT: This one needs to be busted because it can have lasting and damaging effects on both children and adults with ADHD.
ADHD is not a disorder of motivation or laziness. On the contrary, people with ADHD in general feel motivated to overcome their symptoms because of the complications they can create in life! However, it's never useful to tell someone with ADHD to 'try harder' or 'focus more'.
It's like telling someone who has lost their sense of smell to sniff harder. Or telling someone with poor vision to see farther. It doesn't make sense!
The attention, hyperactivity, and impulsivity issues have nothing to do with attitude or motivation and everything to do with how the brain is structured.
That concludes our beginners guide to ADHD! Do you want to see a post on extended FAQs as well as debunking more common myths about ADHD? Or maybe you want to see another mental health topic explored in this manner?
Let us know in the comments below! Our Instagram DMs are also open, over at wellnesttherapy.
Until next time!