Giving Voice to Adult ADHD

Is it difficult to figure whether adult ADHD is a negative or a positive? Do others' doubts about ADHD affect you? Read what other adults with ADHD have to say about it.

Source: motional studio/Pexels

Apart from having something touch one’s life or the life of a loved one, enlightenment and changing human minds and beliefs often happens through hearing and empathizing with the accounts and stories of people facing those difficulties¹—in this case, adult ADHD.

Several qualitative studies using interviews and accounts of the lived experience of adults with ADHD have been published in recent years, including a psychiatrist-in-training’s personal and professional experiences with his own ADHD.^2-5 A single post will not do justice to the nuances of these accounts, but here are some takeaway themes that resonated with me.

Issues with recognizing ADHD and help-seeking

Adults with ADHD often struggle for a long time before seeking help, often due to social stigma about ADHD. The process of getting a specialized evaluation for adult ADHD itself is often difficult and laborious, which is another impediment.

The fact that attention problems are highly context-specific—such as adults with ADHD being able to focus well on interesting topics—creates doubts in their minds and in the minds of others about the relevance of ADHD despite undeniable problems in their lives, not to mention that ADHD involves much more than attention problems.

Impulsivity problems are frequently cited in accounts of adults with ADHD and hyperactivity is often minimized because it is experienced as an internal sense of restlessness. Such examples of not fitting the stereotype of what ADHD looks like and stigma further delay recognition (especially for women with ADHD).

Many adults with ADHD eventually seek help at the encouragement of others in their lives.

The experience of “chaos,” difficulties structuring one’s time, and the corresponding emotional effects (anxiety, agitation, and mood lability) are commonly cited problems. Emotional dysregulation may lead adults with ADHD to first seek help for mood and anxiety issues based on the assumption (now understood to be mistaken) that emotions are not associated with ADHD.

There are common reports of ambivalence about an ADHD diagnosis. For some adults, the reaction is positive, including relief and clarity. For others, there are negative and sometimes resistant reactions to a diagnosis, such as regret for lost opportunities. Most late-identified adults with ADHD go through a re-examination process of their sense of self-identity. Ultimately, though, the eventual ADHD diagnosis is generally not regretted and, in fact, is seen as validation of their circumstances.

The psychiatrist-in-training expressed the realization that “high functioning does not exclude dysfunction.”

Coping experiences

A consensus was that ADHD makes “everything a little harder.”

Everyone in these qualitative studies cited the use of some form of time management and organizational strategies to manage adult ADHD.

Another common theme was setting up ADHD-friendly environments and systems to support coping and well-being.

Increased self-awareness and accurate understanding of ADHD helped reduce self-blame as well as to identify personal strengths and aptitudes. For some, this included a sense of courage and resilience that grew from navigating difficulties, setbacks, and even failures.⁶

On the other hand, many adults found their difficulties with adjusting to new situations and roles to be stressful—such as a new job, moving, or parenthood.

Treatments and support

Medications, psychosocial treatment, various accommodations, and support groups adapted to adult ADHD were reported as helpful options with positive effects on functioning.

The psychiatrist-in-training with ADHD avoided ADHD medications for a while due to their negative reputation in his field, though he later found them to be very helpful. He still noted that despite their obvious benefits for his ability to focus, he had side effects in which he felt they inhibited his “real me” personality, at times.

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Psychological effects of adult ADHD

Many individuals reported a sense of low self-esteem or a “less than” self-view, at some point.

Individuals had diverse ways to view and describe their ADHD:

• ADHD as a difference or trait versus disorder.
• ADHD as a limiting label versus self-identifying with ADHD.
• ADHD as an interface of both negative and positive aspects.

Ultimately, most individuals in the qualitative studies reported learning to approach various tasks and roles differently to account for the effects of ADHD and with a greater sense of optimism.

The effects of others’ opinions

There were accounts of citing ADHD symptoms and related difficulties to others (including helping professionals) and having them be trivialized, dismissed (“You’re in college. You can’t have ADHD"), or attributed to negative characteristics, such as “laziness.”

Such negative messaging was described as contributing to masking problems, avoidance of help-seeking, being overly apologetic to avoid criticism, and a sense in at least one case of viewing others as “putting up with me.”

The psychiatrist-in-training noted that, once diagnosed and treated, he could be more empathic with patients and their experiences of medication side effects, not just patients with ADHD. He also cited the stigma about ADHD in behavioral healthcare, including individuals (including other doctors) who choose to pay out of pocket for behavioral health services covered by their insurance to avoid their psychiatric diagnosis coming to light in some manner.

Summary

The number of individuals providing accounts in these published studies is not large. However, they are enough to start giving voice to adult ADHD. Their voices will hopefully echo through classic data-driven studies to help others hear and see adults with ADHD and help them obtain effective help and support.