This month, within the space of two days, three clients asked me whether I think they have ADHD. All of these clients had some symptoms that might be indicative of attention deficit/hyperactivity disorder. All of these symptoms, on the other hand, could be signs of something else. All three were prompted to talk to me due to recent news they had read about adult ADHD.
What’s happening? Is it a fashion? Are we all becoming obsessed with ADHD? Are our devices and the internet ruining our ability to sustain concentration?
My Story
I was an okay student when I was young, but I had some issues. When I was young I was the classic fidgety kid. I lost my temper easily and flew off the handle when frustrated. I was messy, disorganised and made A LOT of careless mistakes.
At one stage, I think I was in Year 5, I got into some minor trouble for being disruptive at an interschool problem-solving group. Long story short, my parents got pulled into the school and were advised that I should get checked out for ADHD. But my parents never did, life went on, and here I am now.
Why Diagnose with ADHD?
When a child has a health problem, parents want to know what it is. They want a proper diagnosis so that proper treatment can be delivered, so the child can be well.
It’s the same with psychological or neurodevelopmental disorders. Parents want to know if their kids have ADHD because they might be able to receive treatment to make up for any deficits from the disorder.
The treatments for ADHD are medications, many of which are stimulants. Stimulants are a class of drug that work on the dopaminergic brain pathways. Drugs like cocaine, ice and coffee are stimulants. Stimulant medications improve the focus of people with ADHD.
It’s also true that stimulants improve focus for most people. Think about yourself on coffee. University students famously use ADHD medication as tool for increasing focus and ultimately for getting better grades.
But we don’t medicate every kid, just those who are really distractable and hyperactive. This, it’s hoped, helps level the playing field.
What about adults? Certainly, some adults are more easily distracted than others. Those distractable adults will likely benefit from ADHD medications.
But so will the mildly distractable adults. People whose jobs and lives have high attentional demands are already seeking out ADHD medication, with or without diagnosis. These medications are performance enhancing. They help most people achieve concentration bursts needed to complete work and study tasks to a deadline.
So, apart from improving attention, which let’s face it, we all could use a little help with, is there any other reason to get an ADHD diagnosis and start popping pills?
What about Emotions?
Adults and kids who receive an ADHD diagnosis often meet diagnostic criteria for emotional disorders. In my practice, I have worked with many clients who were diagnosed with ADHD as a child, then bipolar disorder (BD) as an adult. There is quite a high comorbidity rate (rate of two or more diagnoses) between ADHD and BD. Anxiety, Depression, addiction and traumatic disorders all have a higher than average comorbidity with ADHD.
Can medications for ADHD help with emotional difficulties?
There is some evidence they can. Certain ADHD medication may help decrease susceptibility to rejection sensitivity. On the other hand, there is some evidence that stimulant medication may worsen anxiety symptoms.
But perhaps ADHD treatment doesn’t make such an emotional difference after all. A recent study, looked at the emotional outcomes between teenagers who were ADHD-diagnosed as children, and those who had similar symptoms as children but were undiagnosed and untreated. Both groups reported similar emotional outcomes.
ADHD medication is not a silver bullet for all adult problems. For emotional problems, it is better to seek emotion-focussed treatment. Treatments for ADHD primarily should help ADHD symptoms of inattention and impulsivity. Any positive change in emotions after taking these medications should be seen as a happy bonus.
My Story
I don’t know if its correct to say that I have (or have had) ADHD. It is true that I still have issues with attention, also with impulsivity, but to a lesser extent. I’ve been able to cope without medication: how?
I semi-joke to people that the two things that have helped me in adult life are using a diary/planner and coffee. I share this now, not to give medical advice, but for reflection at a time of increasing diagnosis and medication use:
I started to drink coffee when I was about 25 years old. I had just taken a job with a lot more responsibility and I felt I couldn’t afford to fail. Coffee was unpalatable and anxiety provoking at first. Then, I realised that it significantly increased my powers of mental endurance. Despite increasing tolerance, I still feel that coffee helps with attention to this day.
Around the same time, I started using a planner/diary. Every day I’d write a priority list in my diary. Every time my attention strayed, I’d check my list. I trained myself to persist with the current item on the list and only switch to a new item when I’d finished the preceding item. I use this system (and other self-control and self-organisation techniques) to this day.
Beyond these two factors, I coped by over-compensating for attention difficulties. Becoming over-controlled and hyper-organised. Hard work, not for everyone, but worked for me.
In Conclusion
Do you have ADHD? Ask your doctor. If the medics decide you do, you’ll probably get a script, and it’ll probably help you focus. Don’t expect the diagnosis to change everything. The medication is not a cure all.