According To Doctors
A stereotypical description of someone with ADHD might paint them as fidgety, flighty, or easily distracted. But the signs of high-functioning ADHD, particularly in adults, don’t always present so straightforwardly. The disorder can involve more than an inability to focus; often, people who are diagnosed later in life aren’t clued into the possibility that they have it, since symptoms can be unrelated to focus or attention altogether.
“In general, when someone has a diagnosis of ADHD, it usually describes a collection of symptoms and life impairments,†psychologist Dr. Laura L. Walsh, Psy.D., tells Bustle. “It’s slightly different for everyone and changes as a person grows from being a child, with relatively few coping skills, to adulthood,†she says. Many people manage without therapy, medication, or targeted resources, but getting diagnosed can help to establish a better understanding of the particular way the ADHD brain works. That said, getting diagnosed can be difficult if you don’t know what to look for.
Dani Donovan is a mental health influencer who makes TikToks about ADHD awareness with millions of views. Though Donovan was diagnosed and treated for ADHD as a college freshman, she never felt compelled to learn more about it. “No one who has ADHD was sharing what their experience was like in an educational way,†she says. This inspired her to create her own content, which started with an ADHD comic strip that went viral. TikTok, she says, is a perfect place “for people with short attention spans to get concise information.â€
Now, her inbox is filled with people telling her that her content inspired them to see a doctor, and that they now have a diagnosis and treatment plan. “They tell me that they didn’t know to look up ADHD. They couldn’t before put together that the things they were struggling with were related to ADHD.â€
According to Donovan, ADHD is finally being normalized thanks to platforms like TikTok or Twitter. “People with ADHD are sharing honest things, like how it can be hard to remember to brush your teeth, or how laundry is nearly impossible to complete with all of the starting and stopping,†she says.
“At first, when adults are diagnosed with ADHD, they are shocked, and then everything comes together for them,†Harold Meyer, founder of the ADD Resource Center, tells Bustle. The symptoms that diagnosed adults experience, Meyer says, can seem unrelated to each other, but they do make sense at a distance. “People with ADHD might have low self-esteem and think everything is their fault. They feel like they are an imposter. They might have extreme highs and lows,†Meyer says. Because most of the research on the disorder is on kids, it’s not always easy for adults to get diagnosed, and according to Meyer, that can lead to anger. Many patients grew up without knowing why it was harder for them to function than their peers, which can make it both frustrating and enlightening to finally understand why.
Meyer says it’s important to note that not everyone who has focus issues has ADHD, and only a doctor can give a diagnosis and apply appropriate treatment. The only ADHD criteria that doctors acknowledge in adults over the age of 17 is multiple, long-lasting symptoms of inattention — like an inability to follow instructions — and of hyperactivity and impulsivity — like an inability to wait one’s turn to speak. These symptoms must also be deemed disruptive and interfere with quality of life.
On top of diagnostic criteria, there are certain life experiences or habits that might be more common in adults with ADHD, as manifestations of other symptoms. Here are some of the common behaviors adults who have ADHD experience.
People with ADHD may have difficulty keeping up in an argument, or getting their point across in the way they intend to. “Sometimes the ADHD brain moves faster than you can speak, so words may be tripped over,†clinical psychotherapist and ADHD expert Stephanie Sarkis, Ph.D, tells Bustle. “Also, quite a few people with ADHD also have social anxiety, which can worsen this,†she says. According to Meyer, the communication between the internal mind and the external mind can be fraught. People with ADHD might be in one place in their head, and another with their words. Often, it’s after the initial conversation that the internal and external minds sync up, which can be a disadvantage to someone in a heated debate — verbal clarity comes after the conversation is over, even though the thoughts were already there.
Exhaustion during the workday can be a result of ADHD. “If you have untreated ADHD, you have to really work at making yourself focus,†says Sarkis. “This can lead to you being exhausted at the end of the day.†Meyer adds that fatigue is also often a result of sleep issues, which people with ADHD might also go through.
“It is commonly thought that if you have laser-sharp focus that you don’t have ADHD,†says Sarkis. “However, ADHD is actually a problem with motivation, not attention. Your brain can’t get motivated enough to focus on things that aren’t interesting, and it has difficulty tearing itself away from things that it really likes. Hyperfocus is just as much a symptom of ADHD as lack of focus,†she says.
Many people with high-functioning ADHD find that they struggle with directions. “I refer to it as ‘left and right dyslexia,’†says Sarkis. “This is possibly tied to the fact that 50% of people with ADHD have learning disabilities.†According to Children and Adults with Attention-Deficit/Hyperactivity Disorder, ADHD and learning disabilities are both rooted in neurodevelopment, and their effects stem from a similar location of the brain. This often means that people who have ADHD also concurrently have a learning disabilities, like dyslexia, which can make it doubly hard to assess directions.
People with ADHD are at risk of partaking in dangerous habits, like gambling or drug use, than the general population. Sarkis says these kinds of behaviors help “raise the low levels of dopamine, serotonin, norepinephrine, and GABA in the ADHD brain. However, the drawbacks are immense and damaging.†Meyer stresses, though, that risky behavior alone does not point to ADHD.
People with ADHD are more likely to be have a hard time staying committed in relationships than the general population. Part of it is the thrill-seeking and novelty-seeking aspect, as risky behavior boosts dopamine. “There are also some gene mutations that make some people with ADHD more prone to risky sexual behavior than others,†says Sarkis.
But Meyer adds that going through with an affair isn’t always the goal of someone with ADHD. Instead, they might be more likely to flirt due to low self-esteem, which can be a result of feeling insecure as a partner. For example, Meyer says, someone with ADHD might forget to get their partner an anniversary present, but that it wouldn’t be a reflection of how much they love their partner, rather, a result of an overtaxed mind that forgot, or was simply focused on something else. “They might see this as a moral failure,†Meyer say. A build-up of these scenarios might make it hard for someone with ADHD to feel like they are capable of being the kind of partner they might want to be.
“People with ADHD have an ‘interest-based’ nervous system and respond strongly to novel experiences,†says Dr. Walsh. “Over time, sex, especially with a regular partner, may not be as much of a mental puzzle. This doesn’t necessarily indicate a lack of interest in the partner — just a need to vary it up a little.†Meyer explains that people with ADHD often cannot slow down their minds enough to enjoy sex, or even focus on it, as they are thinking of other things and not in the moment.
While some people with ADHD may experience these signs, others might not, and none of these symptoms definitively point to having ADHD. Only a doctor can provide a diagnosis after a proper evaluation.
Dr. Laura L. Walsh, Psy.D, psychologist
Stephanie Sarkis, Ph.D, clinical psychotherapist and ADHD expert
Harold Meyer, founder of The ADD Resource Center
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