ADHD in adults

‘New hyper-fixation, Lord, I’m over-stimulated
And my mind just keeps replayin’ over and over’

(‘ADHD’ – Mae Stephens – 2024)

When school and parents feel that a child might be experiencing some form of specific learning difficulty, it is important to organise a holistic assessment: an assessment that takes information from as many sources as possible and looks at the child as a whole. It would be misguided to assume that because an individual has a diagnosis of dyspraxia, autism or dyslexia for example, they won’t also experience a degree of other Specific Learning Difficulties, such as ADHD. Individuals who have been diagnosed with a specific learning difficulty as a child, need to be aware of these issues of co-morbidity.

Key point = The presentation of ADHD in adults and children will be different. 

All individuals with ADHD will have some form of hyperactivity, but in adults this hyperactivity is likely to be internalised. Consequences of internal turmoil may include: minor car accidents, always being late or missing appointments, constantly misplacing and losing possessions, collecting parking and library fines, or feeling irritated and distressed without knowing why. 

Internal turmoil can lead to over thinking, mind wandering and excessive rumination: because of the thousand thoughts circling in the individual’s mind, they can become indecisive, procrastinate and be caught up in a circle of  low self-esteem and anxiety. ‘How does everyone else manage this without effort? Why aren’t I like that? What’s the matter with me?’

This constant stream of intrusive thoughts means that the individual will interrupt and talk over others during conversations. They will feel that if they don’t contribute as soon as a thought enters their head, they’ll forget what they were going to say. As a result they may be viewed as self-centred and rude.

Adults with entrenched ADHD are more likely to change jobs and careers;  engage enthusiastically in an interest that is dropped the following week; move house, sabotage personal relationships, and engage in risky behaviours than their neurotypical peers.

Looking back over old school reports, the individual’s ADHD symptoms may seem obvious. Teachers will have made regular comments about the need to pay attention, listen to others, concentrate in class, make more effort, improve personal organisation, and generally try harder. When the individual knows they are trying as hard as they can, but still getting it wrong, they will assume they must be stupid. When an individual receives criticism throughout their life, it is easy to see how they might over react to apparently harmless teasing or banter. Their frustration, anger, and embarrassment will lead to them being seen as overly sensitive and emotional.

Research shows 70 – 80% of people with ADHD experience anxiety or low mood during their life time. If they seek help, they may be given medication and treatment that is not designed to alleviate the cause of their difficulty. Professionals will look at the presenting symptoms: the anxiety, restlessness, depression, insomnia, binge eating, or anger management issues, and treat those issues rather than the underlying ADHD. 

If the individual is diagnosed with ADHD and given the appropriate medication and support, their problems may not be fixed immediately. They may have to overcome lingering resentment about the delay in an accurate diagnosis. They may feel angry about being criticised and made fun of when they were younger; frustrated that they were accused of not caring, when they actually did care a lot. They did keep trying to change, to concentrate more, to take care, to be thoughtful, work hard and really make an effort, but still didn’t manage it. They will have to learn new habits and attitudes for the new them, and this will take time.

A is for attention that I try to take the lead
And the D is for the deficit of functionality
Then the H is hyperactive, which is absolutely me
And (D) disorder is the wrong term, it’s just my normality’

(‘ADHD’ – Mae Stephens – 2024)