Sometimes, conversations around mental health and neurotype are divided into a false dichotomy of consumers/clients and providers/professionals. Many assume that providers cannot have their own lived experience with a diagnosis they also treat, which is simply not the case.
I am a psychologist with attention-deficit/hyperactivity disorder (ADHD). I got my diagnosis in 2020 after spending years diagnosing ADHD in my clients and not realizing that their “relatable” traits were actually a sign that we had more in common than I thought.
ADHD is a part of my daily life, both in my career and in my own brain. As someone who has both clinical expertise and life experience as a person with ADHD, here are seven things I wish everyone knew about the diagnosis.
If You’ve Met One Person with ADHD, You’ve Met One Person with ADHD
When I share my ADHD diagnosis, I am sometimes met with disbelief. Some will point out that I do not behave like a child they know who has ADHD. Part of the reason for that is, of course, that I am in my 30s. Even in childhood, though, I did not look like some of my peers with ADHD, which is probably why I was not diagnosed until I was an adult. I was never disruptive in the classroom and appeared to pay close attention to my teachers. Since I could keep my grades up, no one realized how much of the day I spent zoned out or daydreaming (it was a lot).
Each person is unique, including people with the same diagnosis. People with ADHD can have predominantly inattentive symptoms, predominantly hyperactive-impulsive symptoms, combined symptoms, “other” presentation, and “unspecified” symptoms.
Even within these subtypes, no two people with ADHD will be exactly the same. For example, there are nine inattentive symptoms, and an adult only needs to meet five of these criteria for a diagnosis. Two people with the same ADHD subtype may only experience one symptom in common, and both still have ADHD.
No, Everyone Is Not “A Little ADHD”
Another response I get when I share my diagnosis is, “Isn’t everyone a little bit ADHD?” If I disclose, for example, that I struggle to stay organized and often misplace things as a result, I might hear, “Oh, everyone loses things sometimes!” I understand that, and I am saying that my disorganization goes beyond what is typical or part of life.
The Center for Disease Control estimates that 6 to 16% of children meet the criteria for a diagnosis of ADHD.1 It is estimated that fewer adults meet the criteria, although this could be because adults have had time to develop coping skills and compensation for their symptoms. Adults also have more control over their environment than children, so symptoms may not be as prevalent.
ADHD is not the same thing as typical challenges that come with being a person. That’s why the Diagnostic and Statistical Manual of Mental Disorders lists it as a diagnosis. To meet the criteria, an individual’s symptoms must cause “clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.”2 In other words, no, everyone is not “a little ADHD.”
If you find yourself relating to people’s experiences with ADHD, consider looking into an evaluation. It is possible that there is a reason you relate to those symptoms and difficulties.
We’re Not Trying To Be Difficult
Many people with ADHD share experiences of being called “lazy” or accused of “not trying hard enough.” As children, we internalize this message and believe that the things we struggle with result from our laziness. The belief that we are not working hard enough, not living up to our “potential,” or are otherwise not good enough may contribute to higher rates of depression in those with ADHD versus those without ADHD.3
As I noted in a previous section, ADHD symptoms create challenges. By definition, they interfere with our ability to function and do things that come automatically to others. An ADHD brain is different from a non-ADHD brain, which means that it impacts how the individual behaves and perceives the world.
Behaviors related to this brain difference are not the result of laziness, disrespect, or lack of effort. Insisting otherwise does not alleviate our symptoms, but it can hurt our self-esteem.
Executive Dysfunction Is Awful
“Executive functioning” refers to a set of tasks and skills our brain can carry out, including regulating emotions, holding information in our working memory, monitoring what we are doing and how long it is taking, planning, breaking tasks down into manageable portions, and staying organized. While everyone struggles with executive dysfunction from time to time, people with ADHD often experience severe executive dysfunction that interferes with their ability to function.
For example, research has shown that people with ADHD do not form automatic habits in the same way as those without ADHD.4 We do not automatically do things we have repeatedly done in the past if those things do not play into our brain’s reward system. (By the way, if you struggle with this, habit stacking might help!)
Hyperfocus Is Real
The term “attention deficit” is a bit misleading, as many people with ADHD also experience hyperfocus. Hyperfocus occurs when someone is intensely engaged in and focused on an activity for an extended time, often to the point that they forget to take breaks to eat, sleep, or use the bathroom. When someone is hyperfocused, they might not respond at all to an interruption or might become frustrated by the disruption.
While it is true that people with ADHD may struggle with sustaining attention to tasks, when hyperfocus comes online, it is like taking a Bugatti out of park and hitting the accelerator. Of course, hyperfocus can be productive—how do you think I wrote an entire dissertation?
While it is true that people with ADHD may struggle with sustaining attention to tasks, when hyperfocus comes online, it is like taking a Bugatti out of park and hitting the accelerator.
So Is Rejection Sensitive Dysphoria
Rejection-sensitive dysphoria (RSD) is not an official diagnosis in the DSM, but it is a documented phenomenon that some people with ADHD experience. RSD occurs when an individual experiences perceived rejection or criticism with extreme intensity. Combined with difficulty regulating emotions, RSD can make it difficult for someone with ADHD to cope with rejection.
While no diagnosis excuses harmful or abusive behavior, people with RSD might be told that they are “dramatic” and “causing a scene” when they are simply feeling something more intensely than the people around them. Be patient, be kind, and give space to process our emotions.
Our Treatment Is Between Us and Our Treatment Team
I am fortunate that I can safely be open about my ADHD diagnosis. As a private practice psychologist, I am my own boss, so I don’t have to worry about workplace discrimination. In my personal life, I have an excellent support system of people who get me.
At the same time, I face stigma as a result of being open about my diagnosis. Recently, a complete stranger called me “drug-seeking” because I mentioned having ADHD, and I wasn’t even talking about medication! (It should go without saying, but calling someone “drug-seeking” is all kinds of problematic regardless of the context.)
There is no one-size-fits-all approach to managing ADHD symptoms. Some people thrive with support and do not take medication; others describe their medication as life-changing. An individual’s treatment plan is none of your business, and unless you are on their treatment team, you cannot presume that you know what they need better than they, or the professionals they work with, do.
If someone asks for feedback or ideas, it is absolutely okay to make suggestions. However, it is not your place to criticize the choices they make about their treatment. Be kind, be patient, and realize that you will never know another person’s brain better than they do.