We acknowledge that ADHD is a “context disorder.” It causes problems in certain situations.

“If a left-handed person has a job cutting origami with right-handed scissors, that doesn’t mean they have a disability; they have a context disorder,” says ADHD expert Thom Hartmann. “Short people trying to play basketball have a context disorder.”

ADHD can also be a disability in certain situations, particularly in many school and workplace settings. People with ADHD have the right to reasonable accommodations that enable them to succeed, such as extra time to complete assignments and a workspace without distractions.

There’s a time and a place for everything, but overall we believe that thinking of ADHD as a disorder or a disability is counterproductive to your personal development. People with ADHD are not broken, impaired, diseased, or pathological. We are simply wired differently.

Another key thing to remember is that there’s no way to be 100% sure that you have ADHD. In an effort to legitimize psychiatric disorders, the medical community has tended toward an “all-or-none” model in which a person either definitely does or does not have a psychiatric illness. The truth is that we can’t fully pull apart personality tendencies and brain disorders.

Are you “quite active” or “hyperactive”? Do you have an agile, creative mind or are you pathologically distractible? There’s no blood test to answer these questions. It’s all part of a complex spectrum, a continuum of traits that each individual manifests in his or her own unique way.

“There may be some real benefit from fully accepting a more dimensional view of psychiatric disorders that embraces their relations to temperament and personality,” says David Rettew, MD. “For one, such a perspective might be less stigmatizing. Rather than a person being told that he ‘has’ ADHD, it can feel much more inclusive to be told that everyone lives on this spectrum somewhere and that he is somewhere near the top but he can bring that level down with some intervention and hard work.”

We won’t go into detail here about compromised executive functioning, vulnerability to dopamine-seeking loops, and other specifics. Understanding the basic neurobiology behind ADHD is an important part of any individual’s unpacking ADHD journey, but the gist is that there is a fundamental biological basis for differing abilities in areas such as focus, organization, motivation, managing emotions, and remembering details. People living with ADHD tend to experience stimuli more intensely than the average person, and their brains are particularly challenged when it comes to handling competing stimuli.

It is true, as we discussed in Myth #1, that ADHD exists on a spectrum and that there’s no medical test to prove that you definitely do or don’t have it. Even medical professionals can only make a judgment call based on your self-reported traits.

What matters is recognizing that the way you uniquely experience the world as a result of your neurobiological wiring is real. If you have ADHD traits, whether or not you have a diagnosis, you can benefit from learning about how to live with these traits more successfully.

Without adequate treatment or support, ADHD can lead to serious problems in learning, family life, education, work life, social interactions, and driving safety. People living with ADHD are at high risk for anxiety, depression, and addiction, as well as other psychiatric and learning difficulties.

On the positive side, ADHDers often have big energy, big creativity, and other qualities that can have a big impact on the world. In fact, a lot of “big deal” people in the world have ADHD. People with ADHD traits tend to gravitate toward intense professions: artists, athletes, entrepreneurs, performers, politicians, surgeons, and business leaders.

Some of the many well-known people living with ADHD include actors Jim Carrey, Ryan Gosling, Woody Harrelson, Michelle Rodriguez, and Will Smith; musician Justin Timberlake; business magnate Sir Richard Branson; Pulitzer Prize winning journalist Katherine Ellison; celebrity chef Jamie Oliver; political consultant James Carville; Olympic gold-medalist Michael Phelps; JetBlue founder David Neeleman; Kinko’s founder Paul Orfalea; baseball star Pete Rose; and inventor Dean Kamen.

When your interest is fully engaged, you may be able to focus very well, even “hyperfocus” to the exclusion of everything else. You may notice this type of intense focus when you’re working on a passion project, solving a complicated problem, researching something that interests you, making art, playing a video game, or doing something else that’s particularly compelling to you.

But the rest of the time, your attention is probably unstable, easily draw away by competing stimuli. You may feel like you never get to the end of a thought, forget things people just told you, or start many more projects than you finish.

This difference is neurobiological.  Particularly interesting or pleasurable activities trigger the release of dopamine, which helps compensate for the dopamine deficit of ADHD and improves attention and motivation. You may also get a dopamine boost when you’re up against a deadline or believe something bad will happen quickly if you don’t accomplish a task immediately.

We’re oversimplifying here, but this is the basic reason why people living with ADHD experience selective attention. They are able to exercise their executive functions very well in certain situations which are unique to each individual, but they are challenged in most other situations. In spite of this, they can still be incredibly successful, especially when they learn to harness their strengths and create more supportive structures and environments for themselves.

If you struggle with ADHD traits, you’ve probably heard this message many times in many ways, whether from others or your own self-talk:

• You just need to develop more willpower.
• You could focus if you really wanted to.
• You’re lazy.
• You don’t care enough.
• Stop messing around and just get it done!

People with ADHD know that they can focus and perform better in some situations than others, so it’s very easy to believe these messages. You may spend a lot of time berating yourself for forgetting things, being late, overreacting emotionally, etc.

The truth is that you can’t fix ADHD with willpower. Most people find that the more they try to push past their challenges by sheer effort, the more they stress themselves out and feel like a failure. A more helpful solution is to focus on your strengths and build on the situations that do engage your attention, while taking the time to understand and accommodate all your ADHD traits.

 

“One of my special interests over the years has been adolescents and adults who are especially bright,” says Thomas Brown, PhD, author of Smart But Stuck. “They have taught me that being smart is no protection from attention impairments. Not only is it possible for people with a high IQ to suffer from ADHD, but it’s likely that they’ll suffer longer without adequate support or treatment because the people in their lives assume, quite mistakenly, that anyone who is really smart can’t suffer from ADHD.”

Brown’s book explores ADHD in the lives of people who scored within the top 9 percent of the population on IQ tests, but were still stuck. “They sought treatment because they were unable to get themselves out of chronically unproductive, self-defeating patterns of emotions, thought, and action,” he writes. “They felt trapped in their daily dealings with their education, their job, their relationships with others, or a combination of these. Their stories illustrate the persistent difficulties those with ADHD have in managing themselves and their emotions.”

The quote below, from a participant in an Unpacking ADHD group, captures the pain of undiagnosed ADHD and the hope that comes when its impact is finally recognized and addressed.

I’ve had a very successful career and somehow am able to hide my ADHD symptoms from the world. But the cost has been huge. Once I was diagnosed with ADHD, I realized how lonely I am and how little self acceptance I have. With support from others on the Unpacking ADHD journey, both my level of awareness and acceptance have drastically improved. I’m learning to be the real me in the world. ~ Patti Q.

Another important thing to know about ADHD medications is that they are complex and constantly evolving. Many physicians don’t know enough about ADHD to help you find the right balance of medications. For example, they might give you an antidepressant because they’re hesitant to prescribe a stimulant that could be more helpful.

“Translating ADHD medication theory into effective what-you-do-in-the office, step-by-step guidelines remains downright elusive,” says Dr. Charles Parker, author of New ADHD Medication Rules. “Even the most informed observer recognizes that no rule book exists that sets clear treatment options, clear objectives, and specific outcome measures.”

The personal experience of Unpacking ADHD founder Don Baker provides a bit of perspective:

My first attempt to take medication didn’t work at all. For ten years, I had to rely on strict regulation of diet, sleep, and other self-care to manage my ADHD challenges. But then when I tried medication again, it was amazingly helpful. It doesn’t cure my ADHD, but now I find myself doing stuff I hate to do!

Your experience will be different. But if you do decide to try medication, be sure to work with a clinical provider who really knows ADHD and is up-to-date on current prescriptions.

According to a 2011 CDC report, approximately 11% of children 4-17 years of age (6.4 million) have been diagnosed with ADHD, and various studies suggest that between 40 to 70% of children with ADHD continue to exhibit ADHD traits in their adult years.

Nobody knows how many children are undiagnosed, or how many adults have struggled all their lives with unrecognized ADHD.  A 2006 Harvard study funded by the National Institute of Mental Health estimated that 4.4% of American adults ages 18-44 experience ADHD symptoms. The true prevalence may be considerably higher.

Many adults learn they have ADHD after one of their children is diagnosed, or when they seek help for a related problem like anxiety or depression.

Everyone has some symptoms of ADHD, but people who are truly living with ADHD experience chronic challenges that go far beyond simple overstimulation. “People with ADHD pay a much higher price for their distracted moments and it happens much more often,” says psychologist and author Ari Tuckman, PsyD.

Real ADHD is caused by fundamentally different neurobiology. Underactive functioning in the management system of the brain causes people living with ADHD to have difficulty prioritizing and sorting through stimuli. They are both more sensitive to stimuli and less able to process that stimuli efficiently. There is much more to it, but the bottom line is that ADHD cannot be caused by environmental factors alone, though it can be helped or made worse by such factors.

The lingering stereotype that only boys have ADHD is compounded by the fact that women are more likely to have inattentive, rather than hyperactive, traits.

“The most common diagnosis of a woman before she receives her ADD diagnosis is depression,” says Kathleen Nadeau, PhD. “So many women have come in to my office and said, ‘I’ve been in therapy for years and I’ve been diagnosed with anxiety and depression, but I am still having problems.’ It’s maddening, and it’s such a treatable disorder. There’s no excuse for that.”

Women are much less likely to have their ADHD recognized during childhood, and many continue to suffer in silence as adults. “The pressure on women to be organized, self-controlled, to be the one who’s keeping everybody else organized, is a societal expectation that’s very deeply ingrained,” says Nadeau.