Neurodivergence, Adult ADHD and Mental Health
It is estimated that 15% of the world’s population is neurodivergent.
EY CANADA
Neurodiversity is a term that was first formed in the late 1990s by sociologist Judy Singer. Contrary to popular belief, neurodiversity is not a medical term or a diagnosis. It is a way to describe how our brains function, learn and process information. However, just as left-handed individuals navigate a world designed for the right-handed majority, neurodivergent individuals grapple with an environment not tailored to their unique ‘wiring’. As a result, neurodivergent individuals often feel like there is something ‘wrong’ with them and, traditionally the narrative around neurodiversity often focused on the perceived limitations and accommodations that individuals with neurological differences (Autism, ADHD, Dyslexia) had and needed.
However, a new perspective is emerging that recognizes that difference does not mean disability. More research and evidence suggests that individuals with neurodivergent characteristics are unfairly labelled, and their unique skill sets and perspectives are underutilized or overlooked. Awareness is the first step towards dispelling these misconceptions and understanding the value of neurodiversity.
So, let’s talk about neurodivergence, adult ADHD and mental health…
What is neurodiversity?
Neurodiversity describes the idea that people experience and interact with the world around them in many different ways. There is no one "right" way of thinking, learning, and behaving, and these differences are not viewed as deficits.
DEFINITIONS AND TERMS
NEURODIVERSITY: The natural diversity of human brains.
NEURODIVERGENT: A person whose brain functioning differs from what’s considered “normal”. There are a lot of ways to be neurodivergent including: OCD, ADHD, DYSLEXIA, AUTISM and more.
NEUROTYPICAL: A person whose brain functioning is considered “normal”.
NEURODIVERSE: A group of people with different kinds of brains.
What is ADHD?
ADHD stands for Attention-Deficit / Hyperactivity Disorder which impacts the brain’s ability to regulate executive functions which are needed to plan, focus and execute decisions.
The prevalence of ADHD is one of the highest for any condition in psychiatry, and it is estimated to affect 5% of the population.
What are typical ADHD symptoms?
ADHD presents in many ways and not all symptoms need to be present in any one individual.
ADHD is characterized by 3 main groups of behaviour traits and a range of typical behaviours within these:
INATTENTIVE (FORMERLY ADD)
COMMON BEHAVIOUR TRAITS:
Easily distracted / inability to focus
Does not seem to listen when spoken to directly
Forgetful (chores, errands, returning calls, keeping appointments)
Can seem disorganized or careless
Trouble following through with tasks
Often loses or misplacing things (wallets, keys, paperwork, etc.,)
COMMON STRENGTHS:
Creative
Excellent problem solvers
Innovative
HYPERACTIVE-IMPULSIVE
COMMON BEHAVIOUR TRAITS:
Overactive, restless
Fidgeting or tapping hands, feet
Excessive talking
Frequent interruptions
Impulsive speech and actions
Loud interactions with others
Have difficulty waiting their turn
COMMON STRENGTHS:
Energetic
Willing to try new things and take risks
Hardworking and perseverant
COMBINATION
COMMON BEHAVIOUR TRAITS:
Displays traits from INATTENTIVE and HYPERACTIVE-IMPULSIVE
COMMON STRENGTHS:
Displays strengths from INATTENTIVE and HYPERACTIVE-IMPULSIVE
What is the impact of ADHD?
GOING UNDIAGNOSED
Historically, ADHD was considered a “childhood disorder” and diagnoses were predominantly made with the view that the child would “grow out” of their symptoms as they developed into adults. However, research and evidence gathered over the past decade shows that the majority of those with ADHD continued to experience symptoms throughout their adolescent and adult life, albeit in different ways to childhood.
STRUGGLES WITH LIFE SKILLS
Many individuals with ADHD can function extremely well - with considerable effort and support - however, there are are others who struggle to cope with the important aspects of ‘adult’ life:
Problems at work, underachieving, failing at or dropping out of work (lower levels of employment with a history of frequent job changes)
Relationship problems with friends and family (twice as likely to be divorced, less satisfied with their family and social lives)
Moody
Not coping with independent living (household chores, paying bills, self-care)
Low confidence (present higher levels of low self-esteem and self-confidence)
Smoking / alcohol / drugs (significantly more likely to have been arrested)
Injury and accidents (increased serious road traffic accidents)
Struggling with parenting
Struggling with budgeting
Although ADHD is a disorder that can cause significant distress to those who suffer from it and to the family members, partners, friends and colleagues that they interact with - it is highly treatable.
MOOD INSTABILITY
Although mood instability is not an official, indicator of ADHD, it is frequently seen in ADHD behaviour. Typical ADHD symptoms of mood instability include irritability and anger, where family members, partners, friends and colleagues describe someone as ‘moody’ and that they are ‘treading on eggshells’ carefully around them. Their mood may change rapidly or dramatically, from feeling happy to sad to angry to irritated many times a day, often for no particular reason. This is often a result of frustration or over-reaction created by their attention deficit, impulsivity or hyperactivity e.g. ADHD individuals are often unduly angered because they have forgotten something or because another person is being too slow in an action. However, mood instability also seems to stem from being sensitive to rejection or perceived rejection by others, as well as their “inability to function normally.” This is not a core ADHD feature and is not present in all individuals, but many individuals struggle with anxiety and depression as a result.
SOCIETAL EXPECTATIONS AND STIGMA
Several societal expectations and misconceptions contribute to the stigma surrounding adult ADHD. These expectations often stem from a lack of understanding and awareness about the nature of ADHD and its impact on individuals' lives.
Some of the societal expectations that contribute to stigma include:
Productivity and Success: Society often values productivity, efficiency, and achievement, which can create pressure for individuals to excel in academic, professional, and personal pursuits. However, individuals with ADHD may struggle with attention, organization, and time management, leading to difficulties meeting societal expectations for productivity and success. This can contribute to feelings of inadequacy, shame, and self-doubt.
Attention and Focus: Society places a high premium on the ability to pay attention, concentrate, and stay focused, particularly in academic and workplace settings. However, individuals with ADHD may experience challenges with sustained attention, distractibility, and task persistence. Misconceptions about ADHD as simply a lack of willpower or laziness can lead to stigma and judgment from others.
Impulsivity and Self-Control: Society often expects individuals to demonstrate self-control, restraint, and impulse regulation in social interactions, decision-making, and behavior. However, individuals with ADHD may struggle with impulsivity, acting without thinking, and difficulty inhibiting inappropriate responses. This can lead to misunderstandings, conflicts, and negative judgments from others.
Organization and Responsibility: Society expects individuals to be organized, reliable, and responsible in managing their tasks, obligations, and commitments. However, individuals with ADHD may experience challenges with organization, planning, and follow-through, leading to difficulties meeting deadlines, fulfilling responsibilities, and maintaining consistency. This can contribute to perceptions of irresponsibility or unreliability.
Academic and Occupational Achievement: Society often equates academic and occupational achievement with intelligence, competence, and worth. However, individuals with ADHD may face obstacles in academic settings, such as difficulties with studying, test-taking, and completing assignments. In the workplace, they may struggle with job performance, time management, and maintaining focus. Misconceptions about ADHD as a lack of intelligence or effort can lead to stigma and discrimination.
Gender Expectations: There are gendered expectations surrounding ADHD, with stereotypes often portraying boys and men as hyperactive and disruptive, while girls and women may be overlooked or misdiagnosed due to subtler symptoms. These gendered stereotypes can contribute to stigma and disparities in diagnosis and treatment.
Medication and Treatment: Society may hold misconceptions or skepticism about the use of medication and other treatments for ADHD. Stigma surrounding psychiatric medications, such as stimulants, can lead to fears of overmedication, addiction, or dependence. This can deter individuals from seeking treatment or disclosing their ADHD diagnosis due to concerns about judgment or stigma.
Addressing stigma surrounding adult ADHD requires education, awareness, and empathy to challenge misconceptions, promote understanding, and create a more inclusive and supportive society for individuals with ADHD.
Who can be affected by ADHD?
ADHD occurs in both males and females, across all ages, and at every social status, level of intelligence and capability.
Although ADHD was traditionally thought to just affect children and teenagers, it now recognized that most people with ADHD do NOT grow out of their symptoms, which often continues into adulthood. Rather than ADHD symptoms getting better as a person reaches adulthood, they can get worse and it can be the first time that the symptoms have been noticed as a problem. Many adults who have struggled all their lives with symptoms of ADHD and were not identified as part of the disorder may not have received extra help as it may have been wrongly assumed this was just down to 'being lazy' and not trying hard enough.
It also used to be thought that ADHD was more common in boys than girls, but it was often missed in girls. Girls and women can suffer from hyperactive and impulsive symptoms as well as from symptoms of inattention, just like boys and men, so both boys and girls can suffer from ADHD.
How do I know if I have ADHD?
According to official criteria, the symptoms of ADHD should be present from age 12 for a diagnosis in adulthood to be made.
This does not mean that an official diagnosis of ADHD in childhood is needed. It requires some symptoms to have been present but these may not have been severe enough to warrant a label of ADHD.
ADHD can be more impairing and noticeable in adolescence and young adulthood than childhood. This is particularly true with the more complex demands of higher education and adult life, and with the loss of the routine and support of school and home life. This is when the first signs of ADHD can start to show. Many adults with ADHD describe struggling since teenage years and may not have received help as it was assumed that their long standing difficulties were caused by laziness, a bad attitude or a lack of motivation.
One of the primary challenges in understanding adult ADHD lies in its elusive nature. Unlike more visible mental health conditions, such as depression or anxiety, ADHD's symptoms can be subtle and easily mistaken for personality quirks or character flaws. As a result, many individuals with ADHD go undiagnosed or misdiagnosed, leading to feelings of frustration, self-doubt, and alienation.
There are many “Self Assessments” or “Self Screeners” one can use as a starting point to help you recognize the signs / symptoms of Adult ADHD. However, these assessments are not meant to replace a consultation with a trained healthcare / mental healthcare professional. An accurate diagnosis can only be made through a clinical evaluation. Regardless of the results you receive, if you have concerns about the diagnosis and treatment of Adult ADHD, it’s vital that you discuss your concerns with your physician and or a mental health care provider.
The World Health Organization
ADULT ADHD SELF-REPORT SCALE SCREENER
The Canadian ADHD Resource Alliance
ADULT ADHD SELF-REPORT SCALE (ASRS-V1.1) SYMPTOM CHECKLIST
Wisey
ADHD Clinic
How do you get diagnosed with ADHD?
Diagnosing ADHD typically involves a comprehensive evaluation conducted by a qualified healthcare professional, such as a psychologist, social worker, psychotherapist or primary care physician.
The diagnostic process typically includes the following steps:
Initial Assessment: The first step involves a thorough evaluation of your medical history, including any past or present symptoms related to attention, hyperactivity, and impulsivity. You may also be asked about your family history, as ADHD often has a genetic component.
Symptom Assessment: The healthcare provider will then assess the presence and severity of ADHD symptoms based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These criteria include symptoms which must have persisted for at least six months and have a significant impact on daily functioning.
Screening Tools: Standardized screening tools, such as behavior rating scales and checklists, may be used to assess ADHD symptoms and their impact on various aspects of your daily life.
Physical Examination: A physical examination may be conducted to rule out any underlying medical conditions or factors that could contribute to ADHD-like symptoms.
Additional Assessments: In some cases, additional assessments, such as cognitive testing or psychological evaluations, may be recommended to assess cognitive functioning and other relevant factors.
Diagnostic Criteria: The healthcare provider will compare your symptoms and functional impairments to the diagnostic criteria for ADHD outlined in the DSM-5 or other relevant diagnostic guidelines.
Differential Diagnosis: The healthcare provider will then consider other possible explanations for your symptoms, such as mood disorders, anxiety disorders, learning disabilities, or other medical conditions, to ensure an accurate diagnosis.
Feedback and Discussion: Once a diagnosis is made, the healthcare provider will discuss their findings with you providing information about ADHD, treatment options, and available resources for support.
It's important to note that diagnosing ADHD is not a one-size-fits-all process, and individual experiences may vary. A comprehensive evaluation conducted by a qualified healthcare professional is essential to ensure an accurate diagnosis and appropriate treatment recommendations tailored to your individual needs.
Is there a cure for ADHD?
There is no known cure for adult ADHD.
However, there are various treatment options available that can help manage symptoms and improve functioning. These treatment approaches typically focus on a combination of strategies, including medication, therapy, lifestyle modifications, and support.
Medication: Stimulant medications, such as methylphenidate (e.g., Ritalin) and amphetamine (e.g., Adderall), are commonly prescribed to manage ADHD symptoms in adults. These medications can help increase focus, reduce impulsivity, and improve attention span. Non-stimulant medications and certain antidepressants, may also be prescribed for some individuals.
Therapy: Behavioral therapy, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), can be beneficial for adults with ADHD. These therapies focus on teaching practical skills and strategies to manage symptoms, improve organization and time management, and address challenges related to impulsivity and emotional regulation.
Lifestyle Modifications: Making lifestyle changes, such as establishing a structured routine, setting realistic goals, prioritizing tasks, and improving sleep habits, can help manage ADHD symptoms and improve overall functioning. Regular exercise, a healthy diet, and stress-reduction techniques, such as mindfulness and relaxation exercises, may also be beneficial.
Support: Building a strong support network, including friends, family members, support groups, and mental health professionals, can provide valuable support and encouragement for adults with ADHD. Support groups and peer networks can offer opportunities for connection, validation, and shared experiences.
Education and Skill Building: Learning more about ADHD, its symptoms, and its impact can empower individuals to better understand and manage their condition. Developing coping strategies, problem-solving skills, and self-advocacy skills can help individuals navigate daily challenges more effectively.
While there is no cure for adult ADHD, with appropriate treatment and support, many individuals can learn to manage their symptoms effectively and lead fulfilling lives. It's essential for individuals with ADHD to work closely with healthcare professionals to develop a personalized treatment plan that addresses their unique needs and goals. Regular monitoring and adjustments to treatment may be necessary to ensure optimal outcomes over time.
Is ADHD hereditary?
Yes, there is evidence to suggest that ADHD has a genetic component and can run in families.
Research studies have consistently found that individuals with ADHD are more likely to have family members who also have ADHD compared to the general population. Specifically, studies examining the heritability of ADHD estimate that genetic factors contribute to around 70-80% of the risk for developing the disorder.
However, it's important to note that ADHD is a complex and multifaceted condition, and genetics is just one factor that contributes to its development. Environmental factors, such as prenatal exposure to substances like nicotine and alcohol, premature birth, low birth weight, and early childhood experiences, may also influence the risk of developing ADHD.
While having a family history of ADHD increases the likelihood of developing the disorder, it does not guarantee that an individual will have ADHD. Similarly, not all individuals with ADHD have a family history of the disorder. Other factors, such as individual differences in brain structure and function, may also contribute to the development of ADHD.
How does ADHD impact mental health if left untreated?
Untreated ADHD can have significant and long-lasting impacts on mental health, as well as overall well-being.
Here are some of the ways in which untreated ADHD can affect mental health:
Difficulty with Executive Functioning: ADHD often impairs executive functions, such as organization, planning, time management, and impulse control. Without appropriate treatment and strategies to manage these difficulties, individuals with untreated ADHD may struggle to meet deadlines, maintain relationships, and fulfill responsibilities, leading to increased stress and frustration.
Low Self-Esteem and Negative Self-Image: Chronic difficulties with attention, focus, and impulse control can take a toll on self-esteem and self-confidence. Individuals with untreated ADHD may internalize negative feedback and perceive themselves as lazy, incompetent, or flawed, contributing to feelings of shame, inadequacy, and self-doubt.
Impaired Academic and Occupational Functioning: Untreated ADHD can significantly impact academic and occupational performance. Difficulties with attention, organization, and follow-through may result in poor performance, job instability, and underachievement. Over time, these challenges can erode self-confidence and limit opportunities for success.
Relationship Problems: ADHD can strain relationships with family members, friends, and colleagues. Impulsivity, forgetfulness, and difficulty listening can lead to misunderstandings, conflicts, and social isolation. Without intervention, untreated ADHD may contribute to marital discord, friendship problems, and difficulties in the workplace.
Increased Risk of Co-occurring Mental Health Conditions: Untreated ADHD is associated with an increased risk of co-occurring mental health conditions, such as depression, anxiety disorders, substance abuse, and conduct problems. This can exacerbate ADHD symptoms and complicate treatment, further impacting mental health and functioning.
Substance Abuse and Risky Behavior: Individuals with untreated ADHD may be more prone to engaging in risky behaviors, such as substance abuse, reckless driving, and impulsivity-driven decision-making. Without effective coping strategies and support, these behaviors can have serious consequences for mental health, physical health, and overall well-being.
Chronic Stress and Burnout: Managing untreated ADHD symptoms can be exhausting and overwhelming, leading to chronic stress, burnout, and physical health problems. Persistent feelings of frustration, anxiety, and overwhelm can take a toll on mental health, contributing to a cycle of negative emotions and impaired functioning.
Overall, untreated ADHD can have far-reaching effects on mental health, relationships, occupational functioning, and overall quality of life. Seeking timely diagnosis and appropriate treatment can help mitigate these impacts and improve outcomes for individuals with ADHD.
How can a therapist or social worker help an adult with ADHD?
Therapists and social workers can play a crucial role in helping individuals with adult ADHD navigate the challenges associated with their condition and improve their overall well-being.
Here are several ways in which therapists and social workers can provide support:
Psychoeducation: Therapists and social workers can educate individuals about ADHD, helping them understand the nature of the condition, its symptoms, and its impact on various aspects of life. Education can empower individuals to recognize their strengths and challenges, normalize their experiences, and develop strategies for managing ADHD-related difficulties.
Skill Building: Therapists and social workers can teach practical skills and coping strategies to help individuals manage ADHD symptoms more effectively. This may include techniques for improving organization, time management, task prioritization, and impulse control. Cognitive-behavioral therapy (CBT) techniques, such as cognitive restructuring and problem-solving skills training, can also be helpful.
Emotional Regulation: Many individuals with ADHD struggle with emotional regulation, experiencing intense emotions and difficulty managing stress. Therapists and social workers can provide support in developing skills for emotion regulation, stress management, and mindfulness. By learning to recognize and cope with their emotions more effectively, individuals can improve their overall well-being and reduce the impact of ADHD-related stressors.
Relationship Counseling: ADHD can impact relationships with family members, partners, friends, and colleagues. Therapists and social workers can provide couples counselling, family therapy, or interpersonal skills training to help individuals improve communication, resolve conflicts, and strengthen their relationships. Building healthy relationships and support networks can be particularly beneficial for individuals with ADHD.
Executive Function Coaching: Executive function coaching focuses on developing strategies to improve executive functioning skills, such as organization, planning, and goal setting. Therapists and social workers with expertise in ADHD coaching can work with individuals to identify specific areas of difficulty and implement tailored strategies to address them. Executive function coaching can be particularly helpful for adults with ADHD who struggle with academic or occupational tasks.
Medication Management Support: While therapists and social workers cannot prescribe medication, they can collaborate with primary care physicians to support individuals in managing their medication regimen. This may include monitoring medication effectiveness, addressing side effects, promoting medication adherence, and providing education about the role of medication in treating ADHD.
Advocacy and Support: Therapists and social workers can advocate for individuals with ADHD and help them navigate systems of care, including accessing accommodations in academic or workplace settings, seeking support services, and connecting with community resources. Additionally, therapists and social workers can provide emotional support, validation, and encouragement as individuals navigate the challenges of living with ADHD.
Overall, therapists and social workers can play a vital role in supporting individuals with adult ADHD by providing education, skill building, emotional support, and advocacy. By working collaboratively with clients, therapists and social workers can help empower individuals to manage their symptoms, improve their functioning, and enhance their overall quality of life.
What do family members need to know about caring for a loved one with ADHD?
Caring for a loved one with ADHD can present unique challenges, but with understanding, patience, and support, family members can play a crucial role in helping their loved one manage their symptoms and thrive.
Here are some important things for family members to know about caring for a loved one with ADHD:
Educate Yourself: Learn as much as you can about ADHD, including its symptoms, challenges, and treatment options. Understanding the nature of ADHD can help you better support your loved one and respond to their needs with empathy and compassion.
Be Patient and Understanding: Individuals with ADHD may struggle with attention, organization, impulsivity, and emotional regulation. Be patient and understanding when your loved one experiences difficulties or makes mistakes. Avoid criticism or blame, and instead focus on offering encouragement, support, and reassurance.
Establish Structure and Routine: Creating a structured environment can help individuals with ADHD manage their symptoms more effectively. Establish routines for daily activities, such as meals, bedtime, household chores or work tasks. Use visual schedules, checklists, and reminders to help your loved one stay organized and on track.
Encourage Healthy Habits: Encourage your loved one to prioritize healthy habits, such as regular exercise, a balanced diet, adequate sleep, and stress-reduction techniques. Physical activity can help reduce hyperactivity and impulsivity, while proper nutrition and sleep can support overall well-being and cognitive functioning.
Provide Clear Communication: Individuals with ADHD may have difficulty with communication, listening, and following directions. Use clear, concise language when communicating with your loved one, and provide specific instructions or expectations. Break tasks into manageable steps, and offer praise and positive reinforcement for their efforts.
Offer Support with Organization and Time Management: Help your loved one develop strategies for managing their time and staying organized. This may include using calendars, planners, and digital tools to track appointments, deadlines, and tasks. Offer guidance and assistance as needed, but also encourage independence and self-reliance.
Promote Self-Advocacy: Encourage your loved one to advocate for their needs and communicate their challenges to others, such as teachers, employers, or healthcare providers. Help them identify accommodations or support services that may be helpful, such as extended time on tests or workplace accommodations.
Celebrate Strengths and Successes: Individuals with ADHD often possess unique strengths, such as creativity, enthusiasm, and resilience. Recognize and celebrate your loved one's accomplishments, talents, and positive qualities. Offer praise and encouragement to boost their self-esteem and confidence.
Seek Professional Support: Encourage your loved one to seek professional support from therapists, counsellors, or healthcare providers who specialize in ADHD. Therapy can provide valuable strategies for managing symptoms, improving coping skills, and addressing any co-occurring mental health concerns.
Take Care of Yourself: Caring for a loved one with ADHD can be challenging and emotionally demanding. Make sure to prioritize your own self-care and well-being. Seek support from friends, family members, support groups, or mental health professionals as needed.
By providing understanding, support, and encouragement, family members can play a vital role in helping their loved one with ADHD thrive and succeed. Building a supportive and nurturing environment can empower individuals with ADHD to reach their full potential and lead fulfilling lives.
In a world that often demands conformity, embracing neurodiversity celebrates the beautiful spectrum of human brains, recognizing that differences in neurological functioning are not deficits to be fixed, but variations to be valued.
Among these variations, adult ADHD stands as a testament to the unique ways our brains perceive and interact with the world. Adult ADHD, often misunderstood and stigmatized, is not merely a disorder but a distinctive cognitive style. Those with ADHD frequently exhibit traits such as hyperactivity, impulsivity, and inattention. However, these characteristics also come with incredible strengths: creativity, hyperfocus, and a knack for thinking outside the box. Understanding ADHD through the lens of neurodiversity allows individuals to reframe their challenges as opportunities for growth and innovation.
Despite the prevailing misconception that ADHD is solely a childhood condition, many adults grapple with its effects daily. From difficulties in time management to struggles with organization, navigating the demands of adulthood can feel like an uphill battle. Yet, seeking support and therapy can transform these obstacles into stepping stones toward personal and professional success.
Therapy provides a safe space for individuals with ADHD to explore their unique strengths and challenges, fostering self-awareness and acceptance. Through techniques such as cognitive-behavioral therapy (CBT) and mindfulness practices, individuals can develop strategies to manage symptoms and harness their innate abilities. Additionally, connecting with peers and joining support groups can offer validation, camaraderie, and invaluable insights into navigating life with ADHD.
Ultimately, embracing neurodiversity and reframing ADHD as a journey of self-discovery and empowerment, recognizes the inherent value in our differences. To anyone wrestling with the complexities of adult ADHD, know that you are not alone, and your neurodiversity is not a limitation but a gift waiting to be unwrapped. With therapy, support, and a dash of self-love, you have the power to rewrite your narrative and soar beyond expectations.
If you have been struggling and think you might have ADHD, a formal diagnosis can help lead to the treatment you need to reach your full potential. Don’t hesitate to get the answers you need.
Whatever it is, we’re here for you.
Life is uncertain. Jobs are stressful. Parenting is hard. Relationships take work. Families can be dysfunctional. And sometimes, love hurts. When you’re confronted by feelings, events, or issues that are making your life challenging, it’s okay to ask for some help.
