“My autism is extremely invisible,” Lehmann says. “Society has more tolerance for a child having a meltdown but when an adult male who doesn’t look disabled does it, it comes across as very threatening.”

Recently on a work trip, Lehmann’s flight was delayed, causing his “Jenga tower of functioning” to come tumbling down. He kicked a trash can in frustration, attracting the attention of a heavily-armed police officer. Lehmann’s mother stepped in, explaining, “My son has autism. I’ve got this.” The officer took a step back, ready but waiting, as Lehmann calmed down.

Lehmann has had enough negative encounters with law enforcement — cornering him, cursing at him, shaming him — to know this was a best-case scenario. He’s terrified about what could have happened if he hadn’t had a traveling companion, or if the officer was more forceful. He wonders what the outcome might have been if he’d been Black.

The duty of law enforcement is to protect and serve, but when they encounter people with disabilities, too often the result is harm instead of help. Adults and teens with autism, ADHD, and other neurodevelopmental disorders appear to be at a heightened risk for negative outcomes every step of the way in the criminal justice system, from first police contact to questioning and detainment, to jail, trial, and beyond. Mishandled interactions can result in everything from distress and humiliation to jail time, or even death.

[Read: What the Americans with Disabilities Act Means For You]

While no comprehensive data exists on the collective outcomes when people with disabilities encounter police, we do know that neurodivergent individuals are over-represented in the carceral system. Rates of ADHD are six times higher among inmates than in the general public,¹  and rates of intellectual and developmental disabilities (including autism) are four times higher.²

Law Enforcement and the Neurodivergent: Unique Risks

Neurodivergent people face challenges with law enforcement as victims, witnesses, and especially as suspects. For individuals with autism, common behaviors like stimming, avoiding contact, or meltdowns arouse suspicion, which can lead officers to shout commands or make physical contact. This, in turn, intensifies sensory overwhelm and anxiety, making compliance less likely, not more.

Similarly, people with ADHD may have trouble following commands, because of impulsivity or distractibility, and this behavior can be viewed by police as uncooperative or disrespectful. An individual’s hyperactivity and restlessness, exacerbated by confinement to a chair in a small room, might be perceived as a sign of guilt. Working memory problems, time blindness, and memory distrust syndrome may cause a person with ADHD to have difficulty accurately answering questions or to reply, “I don’t know” to even simple questions such as: “Is this the road you live on?” Police may misinterpret this as evasiveness, another possible sign of guilt.

[Read About the Mom Spearheading Police Training on Autism]

In all these cases, what might have begun as a harmless situation can escalate quickly. “Officers that can’t identify the signs of disability may over-utilize force, may make an arrest for a situation that doesn’t call for one,” explains Texas Police Sergeant James Turner, who spent nearly a decade heading the Crisis Intervention Team (CIT) training in Austin, Texas.

Heightened Threats for People of Color

For neurodivergent people of color, the perils of an interaction with police are even greater. Black Americans are killed by police at twice the rate of White Americans, according to the Fatal Force Database, which has been tracking deadly police shootings since 2015.

Stephon Watts, a Black 15-year-old with autism in Illinois, was one of these victims. Watts’ parents called 911 to help respond to their son’s meltdown, but the arrival of the police only escalated Watts’ distress. Police fired two shots, killing Watts in his own home. In 2021, Illinois passed the Stephon Watts Act, also called the Community Emergency Services and Support Act (CESSA), which requires emergency responders to send mental health professionals to respond to mental or behavioral health calls.

Devastating stories like these keep Evelyn Polk Green, M.S., Ed., up at night. Past president of ADDA (Attention Deficit Disorder Association) and CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), Green says that as a mother to Black sons with ADHD, she worries about all the things that any mother of a person with ADHD worries about in a police encounter. “It’s just multiplied exponentially by all the other things that we already have to worry about on top of it,” she explains. “Unfortunately, so often law enforcement is ready to jump to the absolute worst conclusion and with Black and brown kids, it’s even worse, because they often automatically assume they’re up to something.”

Disability Awareness Training on De-escalation Techniques

Experts agree: training is the essential first step in ensuring better outcomes. “Most people call 911 when they don’t know what to do. We have to be properly equipped in that moment to handle that crisis,” says Sergeant Turner. “We are problem solvers but we have to have the tools.”

Those tools are exactly what David Whalen, project director for Niagara University First Responder Disability Awareness Training (DAT), aims to provide. The DAT is an eight-hour comprehensive training that covers victimization, Americans with Disabilities Act (ADA) compliance, interface with CIT, interaction skills, proper language and specific information on identifying and understanding a dozen disabilities including ADHD, autism, Tourette’s syndrome, dementia, and epilepsy.

Sergeant Turner’s disability awareness training was received during a 40-hour CIT training, required for all cadets in Texas. CIT training addresses how to support people experiencing a mental health crisis, and Turner hastens to clarify: “People with disabilities are not mentally ill, though they can have that issue as well.” Because some of the techniques (including de-escalation) overlap, disability awareness is often folded into CIT training.

Key topics include:

• Recognition of Disability: Officers learn common signs and symptoms of disabilities. Not all individuals can self-identify, and some choose not to. Proper identification of disability prevents officers from jumping to erroneous conclusions, including that the person is intoxicated, and allows for ADA accommodations.
• De-escalation Techniques, including:
  • Giving the individual space and time to respond. Many encounters with disabled individuals take a tragic turn simply because of the speed at which they unfold, creating unmanageable (and often unnecessary) distress. “You don’t always need to rush up on them,” says Turner. “You need to ask yourself, what are the risks vs. benefits of delaying action?”
  • Appropriate communication is essential. If someone with autism is distressed or experiencing sensory overwhelm, for example, a loud, commanding voice may cause further overwhelm. Adjusting tone and pace of speech, or using a pad and pen or hand signals, might be appropriate. Sometimes, Turner says, the key might be to call a family member to ask for specific guidance about support.
  • When force is unavoidable, using less lethal tools like tasers and pepper spray can save lives.
• Connect with Community Resources: Often, Whalen says, it is invaluable for officers to help individuals pursue longer-term support. Turner agrees: “We are not the experts. We just need to know who the experts are.”

“Fighting for Crumbs of Funding”

It’s clear that training works to improve outcomes. Yet there’s enormous variability in how much, if any, disability awareness training police officers receive, since it’s largely determined on a local level.  Too often, Whalen says, training only happens as a term of a settlement after a person with disability, or their family, sues the police for wrongdoing.

This was the case in Maryland; the bill that now requires disability awareness training for all police officers — through the Ethan Saylor Alliance — was created only after a 26-year-old man with Down Syndrome was killed when sheriff deputies tried to forcibly eject him from a movie theater where he neglected to buy a ticket.

“It would be beneficial to have something mandated at the national level but you have got to have the funding to support implementation,” says Leigh Anne McKingsley, senior director of Criminal Justice Initiatives at The Arc. “This issue of disability justice has been bumped down the priority list, and we’re fighting for crumbs of funding to bring about the exposure and education we need.”

Beyond Training: Community Resources

Training is crucial, but McKingsley says: “You can’t just expect training to take care of everything,” This is why, as part of its training, The Arc’s Pathway to Justice program assembles Disability Response Teams (DRT). These are multidisciplinary planning teams that bring together law enforcement, people with disabilities, attorneys, victim advocates, and disability advocates to collaborate in an open dialogue.

“The mandate is, on the day of training, the DRT starts making a plan of action moving forward,” McKingsley says. That includes brainstorming how to address the most glaring gaps in support and services both short and long term, and figuring out how to expand disability training in the community.

Sergeant Turner, who served on a DRT in 2019, agrees that bringing together police officers and people with disabilities leads to better policing. “Anytime someone calls 911, well, it’s probably not the best day of that person’s life,” Turner says. “Showing what a person with a disability looks like when they’re not in crisis is important.” Lehmann agrees: “Get-togethers with fun activities allow police officers to see the human side of disability, and they give that context.”

On the flip side, Lehmann points out, these community events help people with disabilities familiarize themselves with police officers in a calm environment, alleviating anxiety and setting the stage for better outcomes.

To truly tackle the problem though, McKingsley says, we have to understand its contours more fully, and this requires research, which is currently scarce. “Data would help us better evaluate the training, to know what strategies work and why,” he says. “The more we can show how often these encounters are happening, the more we can bolster our ability to go to local and state entities for action.”

Detained by Police? Keep This in Mind

If law enforcement stops you with questions, remember these three key pieces of advice from Rosemary Hollinger, J.D., founder of Partner Up, LLC:

1. First, pause. It’s important to not say the first thought that goes through your mind.
2. Tell the officer you have ADHD. Under the ADA, you’re entitled to reasonable accommodations, including modified questioning, fidgets, frequent breaks, and access to your medication.
3. Before you answer questions, make sure to have someone you trust, such as a lawyer or family member, with you to figure out exactly what happened. You must be truthful and accurate with police, so if you are forgetful and have time blindness, it’s essential to have a lawyer or trusted person with you to support you.

ADHD and the Risk of False Confession

Susan Young, Ph.D., a clinical psychologist in London, has conducted extensive research about people with ADHD in the criminal justice system. One study in which she was involved found that people with ADHD were at an increased risk of making a false confession, and the more severe the person’s ADHD, the greater the risk.³

If police don’t recognize that an individual’s difficulty following commands, sitting still, and answering questions is a result of ADHD, they may misinterpret these behaviors as evasive and guilty, explains Young. This may cause police to detain the person for even longer, which in turn exacerbates symptoms — particularly if the person’s ADHD medication has worn off. It’s a vicious, dangerous cycle which creates desperation.

“There’s all this anxiety; they want to get out,” says Young, who adds that sometimes, people with ADHD will choose to proceed without an attorney present, because they can’t bear to extend the process at all.

“They just want to leave,” Young concludes. “And they’ll say anything.”

The study concluded that safeguards for people with ADHD must be “put in place to prevent miscarriages of justice.”

Law Enforcement and Neurodivergent Justice: Next Steps

• Read: Crime, Punishment, and Redemption for My Son with ADHD
• Q&A: Recently Diagnosed, ADA Information
• Read: ADHD Clinicians Must Consider Racial Bias in Evaluation and Treatment of Black Children
• Upcoming Webinar: AuDHD Guidance – Why Autism Is So Difficult to Diagnose in Women and Girls with ADHD

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹ Young S, Moss D, Sedgwick O, Fridman M, Hodgkins P. A meta-analysis of the prevalence of attention deficit hyperactivity disorder in incarcerated populations. Psychol Med. 2015 Jan;45(2):247–58. https://doi.org/10.1017/S0033291714000762

²   Bureau of Justice Statistics, Disabilities Among Prison and Jail Inmates, 2011-2012 (U.S. Department of Justice, 2015), tables 4 and 5, http://www.bjs.gov/content/pub/pdf/dpji1112.pdf.

³ Gudjonsson, G. H., Gonzalez, R. A., & Young, S. (2021). The Risk of Making False Confessions: The Role of Developmental Disorders, Conduct Disorder, Psychiatric Symptoms, and Compliance. Journal of Attention Disorders, 25(5), 715-723. https://doi.org/10.1177/1087054719833169

ADHD traits such as distractibility and impulsivity may have benefited our ancestors as they foraged for food, and they continue to play a crucial role in how people with ADHD adapt and survive, suggests new research published in the journal Proceedings of the Royal Society B Biological Sciences.¹

University of Pennsylvania researchers recruited 457 study participants to play an online virtual berry-picking game. The goal was to collect as many berries as possible within eight minutes by hovering their cursor over bushes. The players could stay at a bush or move to another, which would incur a brief timeout.

Slightly less than half (45%) of the participants screened positive for symptoms consistent with an ADHD diagnosis, though this did not constitute a diagnosis because it was a self-reported assessment. Those participants spent shorter periods in each patch and achieved higher reward rates than did participants who did not exhibit ADHD traits.

The results indicated that populations with nomadic lifestyles that benefited from exploring tended to have genes associated with ADHD. Those ADHD traits continue to serve a function today.

“We speculate that ADHD serves as an adaptive specialization for foraging, thus explaining its widespread prevalence and continued persistence in the human population,” the researchers said. “This tendency to explore while foraging might extend to other behaviors such as cycling more frequently between information sources in the classroom or sources of stimulation in the home environment.”

While the study had limitations, the theory as to why ADHD exists — and prevails — may be validating for people with ADHD. Could ADHD traits needed for exploration, such as distractibility, impulsivity, or restlessness, help adults or children with ADHD adapt and thrive? Might this research help educate others about the condition? We asked ADDitude readers for their viewpoints.

“There Is Power in Understanding”

“Yes! I love this theory. I can see how flitting from berry bush to berry bush with my ‘Oooh, look over there!’ brain could have helped my clan thrive.”

“I find it very validating that we are ‘wired for survival.’”

“I absolutely think this theory can help educate others about the condition. However, it’s important not to minimize the struggles that come with ADHD because our modern world is geared toward neurotypical individuals. Put the ADHD mind in an environment it was made for (i.e., foraging), and it will thrive! We need to have a more inclusive view of ADHD and acknowledge both the struggles and the strengths.”

“I find this so validating! Our society and culture make me feel like I’m never good enough. I wish it were the norm to celebrate our unique strengths. We still have a long way to go, but I feel there’s a shift in that direction.”

“As an end-of-career psychotherapist, I got so excited when I read this research. There is power in understanding that we did (and do) indeed belong in the human circle.”

“I loved learning about this theory and that we would have been the ones to think outside the box and find solutions.”

“ADHD Traits Help Me Adapt and Thrive”

“I do feel like my ADHD traits have helped me adapt and thrive. Because of my restlessness and distractibility, I keep up with the latest information in my career. My impulsiveness has allowed me to take risks in my job and other areas of my life, which have turned out incredible (e.g., finding the love of my life, ending up in a career I never imagined that I love, etc.).”

“I travel and have moved a lot for work. If it weren’t for my ADHD, I wouldn’t be as successful as I am today and okay with constantly moving and changing my environment and structure.”

“Because of my ADHD, I have a much wider knowledge base on a self-reported assessment, which is useful when searching for an innovative solution to a problem. The downside is that my ADHD traits have hindered me from becoming an expert in a single subject.”

“Theories Are Great, But Attitudes Need to Change”

“I found the theory interesting and a little validating. I’d really like to see research on the potential evolutionary advantages of two other ADHD traits: hyperfocus and time-blindness.”

“I find it somewhat validating, but more often, I wish my brain would ‘get with the times.’”

“We live in a linear world. I’ve lost out on more jobs because I couldn’t give a linear answer in a job interview and seemed scattered and disorganized. Theories are great, but it’s the attitudes out there and stereotypes that need to change.”

“We Shouldn’t Have to Justify ADHD”

“Frankly, we shouldn’t have to justify ADHD based on a theoretical evolutionary advantage. I’m sick to death of having to sell the validity of disabled people as human beings to an uncaring mainstream. To be considered ‘fully human,’ the average neurotypical person does not have to demonstrate their utility (or the utility of people who shared their traits in the ancestral environment). I don’t think it’s great advocacy to lean on this stuff heavily today.”

“The theory sounds preposterous to me. Distraction, impulsiveness, and depression ruined what might have been a productive life worth living.”

“I don’t buy into the theory at all! Being distracted or impulsive while foraging for food means I’d get eaten first by the lion while those without ADHD would have run to safety.”

“This isn’t helpful. No matter what we tell ourselves to make us feel better, ADHD is not a positive trait. The people with ADHD that we see thriving in the media are the unicorns, not the norm. It won’t help educate others, but it will be a fun fact to tell my son, who has ADHD.”

“I don’t appreciate people saying that the things I struggle with daily are an evolutionary trait or ‘superpower.’ Living in the world with ADHD is hard, and it makes my life more difficult. I wish I didn’t have ADHD.”

“This theory is only validating if it leads to improvements or advances in treatment or ways to handle ADHD symptoms. Is it going to help me get stuff done? Will it help my child succeed in school, be a competent and caring adult, and have meaningful friendships? If not, it might be interesting to think about, but otherwise, it doesn’t matter much to me.”

Sources

¹Barack, D.L., Ludwig, V.U., Parodi, F., Ahmed, N., Brannon, E.M., Ramakrishnan, A.M., and Platt, M.L. (2024). Attention Deficits Linked with Proclivity to Explore While Foraging. Proceedings of the Royal Society B Biological Sciences.doi.org/10.1098/rspb.2022.2584.

Still, I ride a motorbike every day, knowing that the only laws that I cannot defy are physics and fate. One mistake and I’m injured — or worse. It may be a dark and uneasy truth, but it’s also quite liberating.

So why is a machine that I know may maim or kill me one day such a vital part of my life?

I think it has something to do with my ADHD. Riding gives me pure peace of mind, total focus, and a rush of adrenaline. There’s a single task and purpose: To get from Point A to Point B alive. It’s urgent for the sake of everything and nothing, making every journey and movement matter with an energy that defies fatigue. There simply is no room for error and no safety net beyond my reactions and skills as a rider.

I can feel the danger in the air pushing back on me as I choose to accelerate, a quiet demonstration of the immense power beyond my daring. Nothing else matters. No distractions, just me, a little music in my ears, and the ribbon of asphalt and the obstacles on it before me as I grip an explosive rocket nestled snugly against me. It puts me right there, right on the edge of oblivion. Every. Single. Time. (It makes grocery shopping rather dramatic, too.)

[Get This Free Resource: Secrets of Your ADHD Brain]

Love at First Bike

Something about me changed after I got on my first bike at age 14. I truly loved that feeling, the rollercoaster with no end. I needed it. I obsessed about bikes for seven years until I finally persuaded my parents to let me get one. They were beautiful and dangerous, like diving eagles. I’ve since ridden bikes through tropical storms and down hellish, tattered roads — never once wishing I’d bought a car.

When my last bike was stolen and destroyed, my heart shattered. I mourned her like a lost love. I felt naked somehow like the thieves had taken more than just a vehicle, but a part of me — a part that gives me license to feel really and truly free.

Risky Behaviors Help ADHD Brains Thrive

We live in a sensible society that can feel very restrictive for people with ADHD. Our society relies on rules and a degree of moderation to function. Everything is controlled, predictable, economically prosperous, safe, and in good order. I don’t have a big problem with rules; most make a lot of sense. However, this isn’t how our ADHD brains thrive. Rules discourage the risky behaviors that are like catnip for our dopamine-starved brains.

Every Sunday, I teach one-on-one swim lessons for children with autism and ADHD. In the two years I’ve been doing it, I’ve noticed that most of my neurodivergent students quickly outstrip their neurotypical peers once they’re allowed to skip ahead and face deep water directly. I’ve been tutoring a five-year-old girl with autism who now swims 25-meter lengths. She thrives because nothing I was trained to do in standard lessons worked, so I jumped in the water with her to keep her safe. With her mother’s consent, we bypassed the centre’s depth limit (The pool manager names his headaches after me!), and I gave her tasks to do while I followed her around the deep end. She instinctively adapts to mitigate the danger. She’s perfectly capable and happy, but if I teach her at the shallow end, it’s a completely different experience, and she won’t engage.

[Get This eBook: Emotions of ADHD]

Another time, I needed to teach a student with ADHD how to tread water to ensure he could survive out of his depth. After a few lessons together, I jumped into the deep end of the pool with a float and told him to fetch the rubber duck beside me. At first, he was a bit freaked out over the depth. Then he looked into the deep and said, “Give me a minute. I’ve not got Lord Duckington yet!” He got the duck, and he trod water for a full minute. Challenging him like that forced him to innovate, which he did successfully. He’s only eight years old, but what a man.

When the only real restrictions are the irrefutable, unforgiving, and yet totally fair and logical laws of nature, it puts everything else into perspective. The laws of nature are a beautiful thing for neurotypical minds. It’s literally sink or swim. Death, or the threat thereof, provides the ultimate boundary. In doing so, it simplifies things, making the often confusing (and sometimes trivial) reality of our broad social and economic structures so much easier to rationalize and understand.

Learn to ride a motorbike or swim (safely, with witnesses, please!) a little out of your depth (safely, or at least with witnesses, please!), and you’ll see what I mean.

Risky Behaviors and ADHD: Next Steps

• Free Download: Is It Adult ADHD?
• Read: Never Enough? Why ADHD Brains Crave Stimulation
• Read: ADHD Impulsivity in Real Life

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Emotion dysregulation, which research has shown to be a fundamental component of ADHD,^{2, 3} is one such symptom. Another is gender differences, particularly in females who tend to mask or internalize their symptoms.⁴ “There’s some research on whether there might be a completely different presentation [of ADHD], at least in females, with a different time of onset and a different level of severity,” said Dave Anderson, Ph.D., in a recent ADDitude webinar on understanding the evolution of ADHD.

If you could add any symptom to the DSM diagnostic criteria for ADHD, what would it be? The answers we received from ADDitude readers included many familiar ADHD behaviors like rumination, daydreaming, time blindness, insomnia, sensory sensitivity, anger, and anxiety. Some readers even suggested changing the name entirely.

“‘Attention deficit’ seems to be the exact opposite of my experience,” said Amanda, an ADDitude reader in Utah. “I cannot pull myself away from the things I am interested in! And hyperactivity represents such a small portion of diagnosed individuals (primarily boys younger than 12). It is only one of dozens of significant symptoms that affect the greater population.”

Below, ADDitude readers share the symptoms that they feel are central dimensions of ADHD. What would you choose to add? Tell us in the Comments section, above.

[Download: 3 Defining Features of ADHD That Everyone Overlooks]

ADHD Symptoms Not in the DSM

“I would love to see separate sets of diagnostic criteria for boys, girls, adult men, and adult women, because (generally speaking) ADHD can look quite different in each of those four groups. Yes, there is some overlap, but I don’t think it serves girls or adult men and women to compare them to a single ADHD picture, that of the stereotypical hyperactive young boy. The rest of us know that isn’t the only face of ADHD.” — Jen, Missouri

“I think the biggest thing I would like to see is more of a focus on emotional dysregulation and the intense emotions that you can feel as a symptom of ADHD. This is one of the main ADHD symptoms that I personally struggle with, and it was never recognized. I was misdiagnosed with bipolar as a teenager because my intense emotions were more associated with BD than with ADHD.” — Kate, Florida

“I’d make sure that comorbidities are noted more directly with the DSM diagnosis of ADHD.” — An ADDitude reader

“I believe today’s criteria don’t adequately address adult patients. The word ‘adult’ obliquely refers to patients age 17 and older, but ADHD may manifest differently in older adults. Our prefrontal cortex continues to develop into our mid-20s, does it not? Typically, career advances are met with increased responsibility and visibility, and ADHD traits can become more of an encumbrance further up the corporate ladder (as I learned in my 40s and 50s). Clinicians would likely benefit from a subset of criteria for adults 25 and older.” — Greg, Ohio

[Read: A Critical Need Ignored: Inadequate Diagnosis and Treatment of ADHD After Age 60]

“Feeling like you have multiple thoughts at once; thinking spherically as opposed to linearly.” — Sunshine, Colorado

“Apparently, sleep issues are a telltale sign [of ADHD] for young children, yet I read every sleep training book I could get my hands on when [my daughter] was a baby, and not one of them mentioned [ADHD]. I didn’t learn this until she was in high school, which I feel is not just criminal negligence by so-called sleep experts but a huge disservice to parents and to kids with ADHD who could be assessed earlier.” — Kelly, California

“The emotional regulation symptoms of ADHD are sorely lacking.” — An ADDitude reader

“The social impacts of ADHD and how it impacts the ability to maintain friendships is a big hallmark for me. In general, I wish the DSM had a great deal more nuance, especially when it comes to identifying ADHD in girls and adults.” — LeAnn, Wisconsin

“I would differentiate between symptoms that boys have versus symptoms that girls have.” — Tracy, New York

“Anything about sensory challenges. To me, this is actually what ADHD is all about: difficulty blocking out sensory input. ADHD encompasses the challenges and ways people deal with sensory overwhelm. The fact that the DSM — and as a result, many practitioners — don’t understand this is so frustrating. Without this understanding, they are missing so many people who are probably unable to get support.” — Katie, Maryland

“Communication lapses: The tendency [for my son] to think that he communicated something verbally because he already thought it in his mind. We’ve had many incidents where family dynamics were impacted by communication lapses. From his point of view, the communication happened even though nothing verbal was spoken, so the other person wasn’t in the know. This also happens with my spouse (who was diagnosed at 52 after our son).” — Julieann, Ohio

“Clumsiness — anecdotally, this is very common among ADHDers, even being accident-prone. I see this a lot in the chat rooms I frequent for ADHDers.” — Diane, New Hampshire

“If it is not already in there, I believe the aspect of emotional dysregulation and/or rejection sensitivity dysphoria is such a huge component of ADHD that gets so very little attention – especially when it comes to treatment for younger children. But even for me as an adult, when I learned about the term RSD and what it meant, it stopped me in my tracks and totally changed the way I looked at my ADHD.” — Geoff, Rhode Island

“I would add criteria under affective disorders relating to anxiety and personality disorders like BPD/OCD to ensure it isn’t ADHD before making one of those other diagnoses.” — Greg, Canada

“Include not recalling content in a conversation literally right after or immediately after the information is shared. I think my kids are ready to kill me; they have told me that they purposefully don’t talk with me that much because I never remember. It’s awful.” — Shannon, Ohio

“I would make sure that something like survivalist, problem-solver, or despiser of mundane tasks were all in there!” — Blythe, Oklahoma

“A ‘constant state of overwhelm’ would be one. Or ‘takes tons of effort just to exist.’” — Natalie, Pennsylvania

ADHD Symptoms Not in the DSM: Next Steps

• Download: Common ADHD Diagnosis Mistakes
• Read: ADHD in Adults Looks Different. Most Diagnostic Criteria Ignores This Fact.
• Watch: The Grave Consequences of Persistent Gender Role Expectations in ADHD
• Read: ADHD Needs a Better Name. We Have One.

Sources

¹ PsychDB. (n.d.) History of the DSM. https://www.psychdb.com/teaching/1-history-of-dsm

² Hirsch, O., Chavanon, M., Riechmann, E., & Christiansen, H.. (2018). Emotional dysregulation is a primary symptom in adult attention-deficit/hyperactivity disorder (ADHD). Journal of Affective Disorders, 232, 41-47. https://doi.org/10.1016/j.jad.2018.02.007

³ Soler-Gutiérrez, A.M., Pérez-González, J.C., & Mayas, J. (2023). Evidence of emotion dysregulation as a core symptom of adult ADHD: a systematic review. PLoS One, 18(1), e0280131. https://doi.org/10.1371/journal.pone.0280131.

⁴ Young, S., Adamo, N., Ásgeirsdóttir, B.B., et al. (2020). Females with ADHD: an expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry, 20, 404. https://doi.org/10.1186/s12888-020-02707-9

Intrusive thoughts, especially when they’re frequent and cause much distress, are linked to conditions like obsessive compulsive disorder (OCD), anxiety, and post-traumatic stress disorder (PTSD).³ Stress can also trigger intrusive thoughts.⁴

But what about intrusive thoughts in attention deficit hyperactivity disorder (ADHD)? There isn’t much research on the relationship, though one small exploratory study found that participants with ADHD reported experiencing more intrusive and worrisome thoughts than did the participants without ADHD.⁵ The conditions tied to intrusive thoughts, furthermore, also tend to co-occur with ADHD. Interestingly, the distinction between intrusive and impulsive thoughts is sometimes unclear — and a topic of great recent attention.

Anecdotally, many ADDitude readers (with ADHD and with complex ADHD) say intrusive thoughts have always been with them — and they are surprised to know that they’re not alone in this regard. “Knowing that other people have them has made me feel so much better about myself,” said one reader.

Below, read more* from ADDitude readers on their experiences with unwanted thoughts. Then, tell us in the comments section about your own experiences with intrusive or impulsive thoughts and the role you think ADHD plays, if at all, in their appearance, intensity, and/or frequency.

[Read: ADHD and Obsessive Thoughts — How to Stop the Endless Analysis]

“I get lots of intrusive thoughts and they make me feel like a massive weirdo.” — Jenny

“I always think about veering into someone or into a fence. I am not suicidal. I have no death wish. These thoughts in no way make me want to crash my car. But these thoughts happen a lot when driving and then spiral into whether it would hurt, how long it would take the ambulance to come, what state would I be in, etc. I feel like I am manifesting my future death! I wish I could stop it.” — Abbi

“It’s very disconcerting. The worst are the vile curse words that I do not ever say. I have to tell myself, ‘No, we don’t say those words.’ The harder I try to make it stop, the worse it gets. I truly thought I was the only one who did this.” — Lorie

“My intrusive thoughts are dark, and I become so angry with myself. There are absolutely no triggers for these thoughts that I’m aware of, and they usually center around violence.” — Nick

[Read: 9 Calming Strategies for a Racing, Restless Mind]

“[Intrusive thoughts] are hands down the worst part of my brain function. I love my vivid imagination and how detailed and rich it is, but when these intrusive thoughts come it’s like watching real life — and it’s so disturbing. All the feelings they incite are real — like waking nightmares.” — Dani

“I have always had a couple of very weird and strong ones. One thought is of driving off a cliff when I’m on a very high mountain road. Another is a quick thought of cutting my finger every time I pull a knife out of the holder. It’s a flash thought, but it makes me cringe every time. So weird.” — Janice

“I was playing with my friend’s pet rat and had a sudden impulsive thought to smash it on the concrete. I would never do it, of course. Never. But I made the error of blurting it out loud. My friend has never spoken to me since.” — Seren

“I’ve had big out-of-the-box thoughts of leaving my partner, even though I’ve been happily married for 27 years and have never wanted to leave. It’s just cycles of intrusive thinking; it is exhausting.” — An ADDitude reader

“When [intrusive thoughts] are comorbid with depression and anxiety, you’ve got a never-ending cycle of negative, self-critical, shaming, upsetting thoughts — including in your sleep and when you wake up. It’s absolute torture, like being pursued by harpies all day long.” — Caoimhe

“Mine were awful. I can’t mention how bad. I thought I was slowly cracking up. I thought I was going to agree with the thoughts. Then I got help. I realized these thoughts are not symptoms of going crazy. They are not my desires. It’s ADHD.” — An ADDitude reader

“I never understood the term ‘intrusive thoughts’ (which can be an issue when searching for answers). In childhood, I had thoughts like seeing myself falling headfirst down the stairs and breaking my teeth and of ricocheting from my bike while turning a corner fast. In young adulthood, I avoided roller coasters due to a fear of standing up to jump to my escape. I always ascribed this to an active imagination, but the issue is that the associated anxiety/feelings of danger can persist and affect mood and presence in the moment. Early on l started calming myself by thinking that the likelihood of such things happening after imagining them was small, so the opposite could be termed ‘dreadful thinking.’” — An ADDitude reader

“All people have intrusive thoughts at some point since our brains are storytellers. Notice, name them, and recognize that they are just thoughts. Letting them come without shaming myself and knowing that they will pass and don’t have to affect my behavior helps.” — Nicole

*reader responses edited for clarity and brevity

ADHD Intrusive Thoughts: Next Steps

• Read: How to Stop Overthinking Things — a User’s Manual for Your ADHD Brain
• Read: “ADHD Impulsivity Has Been a Deciding Factor in My Life… Seldom for the Best.”
• Read: When OCD and ADHD Coexist

CELEBRATING 25 YEARS OF ADDITUDE
Since 1998, ADDitude has worked to provide ADHD education and guidance through webinars, newsletters, community engagement, and its groundbreaking magazine. To support ADDitude’s mission, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹Radomsky, A. S., Alcolado, G. M., Abramowitz, J. S., Alonso, P., Belloch, A., Bouvard, M., Clark, D. A., Coles, M. E., Doron, G., Fernández-Álvarez, H., Garcia-Soriano, G., Ghisi, M., Gomez, B., Inozu, M., Moulding, R., Shams, G., Sica, C., Simos, G., & Wong, W. (2014). Part 1—You can run but you can’t hide: Intrusive thoughts on six continents. Journal of Obsessive-Compulsive and Related Disorders, 3(3), 269–279. https://doi.org/10.1016/j.jocrd.2013.09.002

²Teismann, T., Brailovskaia, J., Schaumburg, S., & Wannemüller, A. (2020). High place phenomenon: prevalence and clinical correlates in two German samples. BMC psychiatry, 20(1), 478. https://doi.org/10.1186/s12888-020-02875-8

³Brewin, C. R., Gregory, J. D., Lipton, M., & Burgess, N. (2010). Intrusive images in psychological disorders: characteristics, neural mechanisms, and treatment implications. Psychological review, 117(1), 210–232. https://doi.org/10.1037/a0018113

⁴Bolodeau, K. (2021). Managing intrusive thoughts. Harvard Health Publishing. https://www.health.harvard.edu/mind-and-mood/managing-intrusive-thoughts

⁵Abramovitch, A., & Schweiger, A. (2009). Unwanted intrusive and worrisome thoughts in adults with Attention Deficit\Hyperactivity Disorder. Psychiatry research, 168(3), 230–233. https://doi.org/10.1016/j.psychres.2008.06.004

My goal as an ADHD coach is to help people with attention deficit hyperactivity disorder (ADHD) view their condition differently. When they finally get to me, I know they’ve not yet experienced this “aha” moment because their stories are almost all the same: They’ve tried it all — to no avail — and they’re drowning in strategies for managing their life with ADHD.

This is when I can step in to help them reach a crucial epiphany: They’ve been looking at the roots of their ADHD challenges — from procrastination and motivation to prioritization and productivity — all wrong.

Here are the most important ADHD insights I’ve collected and shared with my clients over the years to help them separate their symptoms from themselves and reach their goals.

1. The ADHD brain likes to seek escape.

Every time we think, we engage our executive functions — a set of cognitive processes that allow us to plan, organize, remember information, and initiate action on a goal. For people with ADHD, thinking is effortful and difficult because these underlying executive functions are impaired. That’s why the ADHD brain’s reaction is to seek escape when thinking is too taxing, even if it’s directed toward a desired goal.

[Get This Free Download: Secrets of the ADHD Brain]

I spend a lot of time helping my clients acknowledge that this tendency is at the root of most ADHD-related challenges. Managing ADHD is more about making thinking easier, which reduces escapism and facilitates goal-directed behavior.

2. The ADHD brain is emotional and reflexive.

Just as thinking is effortful and difficult due to executive dysfunction, so too is self-regulation. Poor self-regulation makes it challenging to control emotions and inhibit impulses, especially when based on feelings. Emotional dysregulation also makes it difficult to endure temporary discomfort for a desired goal. The ADHD brain wants to feel good now, not later.

3. Ambiguity fuels procrastination.

The ADHD brain wants to procrastinate when there’s something unpleasant about the task at hand. That unpleasantness, I’ve found, is often rooted in ambiguity.

You might be totally unclear about the task in front of you. Or you might understand the end goal but have trouble wrapping your head around the steps needed to reach it. Either way, avoidance makes all the sense in the world when the unpleasantness of uncertainty is present.

[Take This Quiz: How Seriously Do You Procrastinate?]

No matter where your procrastination blooms, it helps to admit that you find the task hard, even if that task is simple by other people’s standards. To the ADHD brain, which struggles with effortful thinking and goal-directed behavior, it’s not so simple at all. Admitting that a task is difficult increases self-awareness and allows you to think of solutions. Is the task difficult because it is unclear? Do you lack skills or tools to carry it out?

4. There is no such thing as a lack of motivation.

Like countless others with ADHD, you might be quick to say that you’re lazy or unmotivated if you don’t follow through on a task. That couldn’t be farther from the truth. I’ll never forget a conversation I had long ago with Roberto Olivardia, Ph.D., who said that everything we’ll ever do in life, even if we engage in avoidance, is rooted in motivation.

Some clients, filled with shame, will say things to me like, “I’m unmotivated. I just sit on the couch all day and watch Netflix.” I reframe it for them. I say, “You are motivated — to watch Netflix.” I also tell them about the link between clarity and motivation. When we lack clarity on what to do, motivation to engage in that task diminishes.

Here’s yet another way to think about it: Your dopamine-starved brain, unable to find pleasure in an unpleasant task (even boredom is physically uncomfortable), is greatly motivated to avoid pain and seek pleasure elsewhere.

Acknowledge that there’s really no such thing as being unmotivated. It will help you avoid shaming yourself. As Laura MacNiven, a fellow ADHD coach, said, “You can’t treat ADHD from a lens of shame or blame.”

5. Popular productivity tools may stifle the ADHD brain.

The tools and systems that work conveniently and consistently for others may be totally unhelpful for your ADHD brain. What’s worse, you might not even realize that you’ve fallen victim to illusions of convenience.

I recently worked with a client whose productivity issues at work, unbeknownst to him, were in large part due to the company’s practice of communicating complex information and reports via email. Each time he received an email, he’d have to re-engage his mind on the topic, consider the new information he received, and develop a response — an effortful process that taxed his working memory. Email is convenient for others so he never questioned whether the tool worked for him. Once he did question it, he realized that he was better off talking — not emailing — with colleagues about dense, complex projects.

Think carefully about the systems and procedures you use in your day-to-day life. Are you sticking to unproductive methods because they seems to work for everyone else? Let go of what isn’t serving you. Consider the systems and tools to which you gravitate.

6. ‘Task Darwinism’ is why prioritization plans fall through.

How many times have you organized items on your to-do list by order of importance, only to focus on low-priority items first over more urgent ones (and beat yourself up for it)? I call this “task Darwinism” — the natural selection process that tasks undergo and a common ADHD phenomenon.

You choose to do the less important task first not because you’re lazy, but because conditions and elements allow for it. You have clarity, time, and a conducive location, all of which facilitate performance. You avoid or skip over a task, even one you deem important, because it’s missing these elements.

Say you have an important presentation to prepare. Though you’re in a conducive location and have time and tools, you lack clarity on how and where to start. So, rather than focus on the presentation, you find yourself answering emails — a low-priority item on your list. You’re drawn to that item because you have all the right elements in place to facilitate action. Still, your inner voice reminds you that you should be preparing the presentation.

Remember the task Darwinism principle the next time you prioritize. It will save you from self-torment and allow you to think about the elements you need to take action on important items.

7. The right kind of stimulation induces sleep.

It takes most people about 15 minutes to fall asleep. It often takes much longer than that for people with ADHD. Why? Because waiting to drift into unconsciousness is boring, even uncomfortable. Many of my clients admit that they’ll do anything not to get into bed. If they are in bed, they’ll seek to stimulate their mind and further delay sleep. They do this even as they know that they’ll wake up exhausted the next day.

The trick to falling asleep is to find an activity that stimulates your reward-seeking brain, but not to the point where your mind won’t surrender to sleep. It will take a bit of self-observation along with trial and error to find the right balance of stimulation and mindlessness. If you need inspiration, consider the following strategies that have worked for some of my clients:

• Invest in a coloring book — a creative, soothing, relaxing activity.
• Dim the lights and do some light cleaning and organizing.
• Listen to a podcast episode and lower the volume so your mind must strain a bit to hear it.

8. Rehearsing the past won’t change the future.

Constant feelings of guilt and shame are an unfortunate part of the ADHD experience for many people, especially those who did not have an explanation for their challenges until later in life. Ultimately, while there is useful information in these experiences, fixating too much on past mistakes and painful memories prevents progress.

Some people with ADHD may benefit from psychotherapy to learn how to cope with intense feelings. But mindfulness, meditation, and self-compassion are excellent tools to help regulate feelings, even with an emotional brain. Mindfulness decreases emotional reactivity, while self-compassion allows for self-forgiveness.

Understanding ADHD: Next Steps

• Free Download: The ADHD Healthy Habits Handbook
• Read: Uncomfortable Truths About the ADHD Nervous System
• Read: 3 Defining Features of ADHD That Everyone Overlooks
  

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “7 Insights Into the ADHD Brain That Transform Lives” [Video Replay & Podcast #389],” with Jeff Copper, PCAC, PCC, MBA which was broadcast on February 22, 2022.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

His psychology professor once told him, “You’re not on the [autism] spectrum. But you’re not not on the spectrum.” In other words, my husband has ADHD, which was diagnosed late in life; he certainly does not have autism. However, his ADHD manifests many traits that some consider autistic.

Pause.

Obviously, not every person with ADHD will exhibit traits associated with autism — and while “up to a quarter of children with ADHD have low-level signs of ASD, which might include having difficulty with social skills or being very sensitive to clothing textures, for example,” sharing some traits with autism is not the same as having autism. I’ll repeat it for the people in the back: my husband does not have autism. Claiming a neurodiversity you don’t have is gross.

We can keep going now.

How Our ADHD Sometimes Looks Like Autism

Like 10 to 20 percent of people with ADHD, my husband has been diagnosed with dyscalculia, a learning difference related to math. By his own admission, he masks, or imitates other people’s social cues, facial expressions, and gestures, all the way down to handshakes. He “fixates on specific interests” (obviously, Tolkien) and, despite his ADHD, he tends toward a rigid schedule in which he vastly prefers that the same things happen at the same time every day.

[Self Test: Autism Test for Adults]

I’ve also been diagnosed with ADHD, and like my husband, I exhibit many traits associated with autism (no, I do not have autism. I would never claim to have autism. That would be gross and deeply offensive to my friends with autism or who self-identify as autistic). Like my husband, I mask. I tend toward fixations: The Magicians, which I used to live-tweet. Once, my husband made vanilla coffee in the morning. I glared over my mug and told him, “You’re going to become a podcast if you do this again.”

I also have trouble with “social emotional reciprocity,” which is a really fancy way of saying that I interrupt people a lot; I monologue; and I have trouble with peopling in general. I stim: did you know that obsessive cuticle-picking counts? I didn’t. I also have trouble with sensory overload and would happily eat my husband’s vegetarian chili every single night for the rest of my life.

The ADHD-Autism Connection

It shouldn’t come as a shock that two people with ADHD show traits associated with autism. A recent study of children with ADHD and children with autism found that “children with abnormal white matter nerve bundles are more likely to demonstrate more severe symptoms of either ADHD or ASD.” Brain scans showed that “structural abnormalities in the brains’ white matter nerve bundles were associated with more severe symptoms of both ADHD and ASD,” and these structures were related to the part of the brain related to communication.

Knowing these commonalities are normal offshoots of ADHD has helped us both tremendously. It’s that same lightbulb: “Oh, I’m not [insert negative self-talk that’s been drummed into me by years of people judging my behavior]!” Both my husband and I were diagnosed as adults, and it’s deeply reassuring, for me at least, to know that my tendency toward strange fixations is 100% normal for my neurodivergent brain.

[Read: The ADHD Brain – Neuroscience Behind Attention Deficit Disorder]

“Oh my gosh, how do you wake up every single day at 5 am and write?” people always ask me. Then their faces drop into confusion. “Wait,” they’ll say. “You mean you do it on weekends, too?” I never knew what to say, because I simply do it; I’ve done it for a decade now. If I don’t wake up and write at 5, the day feels strange and wrong. I finally understand why. My ADHD brain insists on that daily sameness—a sameness often needed, to a greater degree, by people with autism.

This knowledge has also helped me understand that my occasional meltdowns are sensory overload. There’s a solid neurological reason why my son’s incessant clicking noise might drive me over the edge, and why a brotherly shove or shout might send me fleeing. I hate loud movies; my husband thinks that films should shake the foundations. I’ve often stopped on our stairs, looked at the TV screen, and turned right around again.

Now he understands why that happens and why, when I appear, he has to turn it down.

Sometimes, it seems like childhood was one long stretch of the world shouting that I was weird, and adulthood has been a long road of realizations that wait, no, I’m not weird—and neither am I [insert negative self-talk about laziness, spaciness, time-management, messiness, a need for sameness, etc.]. Unwinding those ugly beliefs has taken a lot of time and therapy. Knowing that my ADHD can manifest traits associated with autism has handed me another piece in that puzzle.

Life makes so much more sense. I’m not the weird kid anymore. I’m a person whose ADHD shares some traits with autism. Maybe it seems small. But it points me in an important direction; it helps me to understand why I do what I do, and as a neurodivergent person, better ways to cope with a world designed for neurotypical people.

Score one for the former weird kid.

Autism Traits in Adults with ADHD: Next Steps

• Read: ADHD and Autism – Differing Symptoms of ADD and ASD
• Free Download: ADHD Brain Differences: ADD Symptoms vs. Neurotypical
• Read: Sensory Processing Disorder in Adults: SPD Symptoms & Causes

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

If you answered yes to these questions, you may have the largely overlooked but hugely impactful ADHD trait called justice sensitivity. Whether it’s triggered by societal injustice or small inequities, justice sensitivity causes you to perceive unfairness and wrongdoing in the world more frequently — and to feel it more acutely — than do neurotypical peers.

Several studies have found that ADHD brains (particularly inattentive type) are significantly more justice-sensitive than are neurotypical brains. Possible reasons for this include emotional lability, intensity, and dysregulation, which are common symptoms of ADHD. But researchers also theorize that ADHD brains tend to perceive information with a less positive view; this, along with cognitive rigidity and ADHD-impacted brain networks, can lead to intense rumination. And it doesn’t stop there. Researchers found that people who have ADHD feel such a strong need to restore justice that they will take action to do so even if they hurt themselves in the long run.

Fixated on Unfairness: Symptoms of Justice Sensitivity

How do you know if you might be prone to justice sensitivity? If you identify with the following emotions, you may have this trait:

• Frequent anger and resentment about victimization
• Fear of future victimization
• Indignation about injustice done to others
• Strong drive to restore justice
• Perceiving injustice where others do not
• Hopelessness about large-scale issues facing the world
• Feelings of worthlessness when unfairly treated
• Rumination about inequity and injustice
• Intense guilt or shame about causing injustice

[Self Test: Could You Have Emotional Hyperarousal?]

When Social Injustice Becomes All-Consuming

As anyone who’s ever stumbled down the doomscrolling rabbit hole can tell you, justice sensitivity can wreak havoc on mood, productivity, and energy levels. This is because people with ADHD are more likely to ruminate, and to feel the anger, helplessness, and despair that injustice can trigger, preventing them from moving on to other tasks and potentially affecting their mental health. In fact, research has shown that justice sensitivity, along with rejection sensitivity, largely accounts for the association between ADHD, depression, and anxiety.

But justice sensitivity doesn’t have to overwhelm you, and there’s plenty you can to do to prevent feelings of helplessness and despair. To begin, avoid being bombarded with news reports that heighten emotions by filtering your newsfeeds or turning off notifications.

Try integrating a mindfulness practice or relaxation strategies into your day by doing breathing exercises, walking in nature, or using other calming strategies that center and ground you when the world feels unbearably unjust.

Harnessing your Power: Taking Action on Social Justice Issues

If managed correctly, a healthy dose of frustration and sadness regarding inequities can be useful. After all, the world needs individuals who are committed to making a positive difference in the lives of others—so long as it doesn’t come at too great a personal cost.

[Read: Being Sensitive is One of the Gifts of ADHD]

Instead of succumbing to fury and despair, mobilize yourself to do something positive. Taking even small actions can help people feel more empowered and less despondent. Here are some suggestions:

• Feeling desperate about climate change? Take actions to reduce your daily carbon footprint.
• Heartbroken about homelessness in your city? Offer to volunteer at a local shelter.
• Eager to strengthen local crime prevention? Contact your local law enforcement authorities and ask how you can help.

Marcy Caldwell, Psy.D., is a clinical psychologist and founder of Rittenhouse Psychological Services, which specializes in adult ADHD, in Philadelphia, Pennsylvania. She also created ADDept.org.

Why Am I So Sensitive?: Next Steps

• Watch: Emotional Dysregulation with ADHD – DESR Signs, Treatments
• Self Test: Depression in Adults
• Read: What Is Rejection Sensitive Dysphoria? ADHD and Emotional Dysregulation

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Emotional dysregulation is a core facet of ADHD. Though it’s not included in the DSM diagnostic criteria for ADHD, deficient emotional self-regulation is an almost-universal problem that looks like this:

• Inappropriate or exaggerated responses triggered by strong emotions
• An inability to self-soothe or reduce the severity of a strong emotion
• An inability to refocus attention away from emotionally provocative events or people
• A struggle to adopt healthier responses to stressful situations

In males, emotional dysregulation is more likely to manifest as aggression or hostility. In females, it may look like anxiety or a mood disorder. In both genders, it is exacerbated by elevated stress and by trauma — both of which our children and teens have experienced in spades during the pandemic and amid news of recent school shootings.

When emotional dysregulation spirals out of control, caregivers and educators often feel helpless and trapped. Here, learn how to de-escalate an explosive situation with a dysregulated child or student while protecting everyone’s safety.

In this conversation with ADHD expert William Dodson, M.D., you will learn the following:

• How to recognize the emotional, behavioral, and cognitive signs of agitation
• How to safely approach and respond to a person’s anger, aggression, and/or agitation
• Age-appropriate de-escalation techniques including active listening, reflections, and emotion-less responses
• Self-calming strategies to teach children and teens
• Suggested language to use when flooded with emotion during an outburst

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay” to watch the Q&A recording and access related resources.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Google Podcasts; Stitcher; Spotify; Amazon Music; iHeartRADIO.

More on Emotional Dysregulation and ADHD

• Download: Rein In Intense ADHD Emotions
• Read: Why Your Child’s ADHD Outbursts Are So Explosive — and Isolating
• Read: How ADHD Ignites Rejection Sensitive Dysphoria

Meet the Expert Speaker:

Dr. Dodson is a board-certified adult psychiatrist who has specialized in adults with ADHD for the last 26 years. He has written on how the basic research on ADHD can be applied to everyday clinical practice.

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
Apple Podcasts | Google Podcasts | Spotify | Google Play | Amazon Music | RadioPublic | Pocket Casts | iHeartRADIO | Stitcher

Higher levels of ADHD symptoms predict lower-than-average economic outcomes, mental health indices, and adherence to preventive measures in response to challenges created by the pandemic, according to a new study out of Israel. Additionally, ADHD symptoms were linked to higher perceived risk of contracting COVID-19 but also to perceptions that encourage non-adherence to preventive measures, according to a Journal of Attention Disorders¹ study.

Data was drawn from 2,055 Israeli adults who completed an online survey after the first quarantine. Participants provided information about financial status, adherence to preventive measures, mental health, and COVID-19 related perceptions.

High symptoms of ADHD were associated with poor adaptation to pandemic challenges — namely, less optimal behavioral, emotional, and perceptual responses — as reflected in the findings outlined below.

Financial decline: Higher level of ADHD symptoms correlated to lower position and income, particularly during the pandemic. Inattention, rather than hyperactivity/impulsivity, predicted this inverse relationship.

Lower Adherence to Preventive Measures: Severe ADHD was correlated with non-adherence to preventive COVID measures, which reflected greater risk-taking behavior, lower perceived severity of the illness, and greater distrust regarding the efficacy of adhering to preventive measures.

Higher Psychological Distress: The direct correlation between level of ADHD symptoms and psychological distress was not unique to the pandemic and appeared linked to financial decline.

Researchers concluded that people with elevated ADHD symptoms are more vulnerable to challenges created by the pandemic and therefore deserve special attention and care. Vocational and mental counseling can help, as well as a healthy lifestyle that includes optimal adherence to preventive measures.

Sources

¹ Pollak Y, Shoham R, Dayan H, Gabrieli-Seri O, Berger I. Symptoms of ADHD Predict Lower Adaptation to the COVID-19 Outbreak: Financial Decline, Low Adherence to Preventive Measures, Psychological Distress, and Illness-Related Negative Perceptions. Journal of Attention Disorders. June 2021. doi:10.1177/10870547211027934

When did you discover the power of hyperfocus? What were you doing? How much time flew by? What did it feel like when your brain was jolted back to reality? ADDitude readers responded to these questions in a recent survey, and here are some of answers that struck a strong chord.  Please add your hyperfocus stories in the Comments section below.

“I remember counting changes in patterns of light in my room, or on my mom’s checked apron. I found the activity very soothing and never wanted it to end. It always felt jarring to go back to reality with the noises of regular life. A few years later, this hyperfocus on patterns translated to puzzles. I would do every single puzzle in our cupboard and come up for air to see an entire day had flown by. This was a common Saturday occurrence for me when I was 5 years old. There are photos of me in the hallway with puzzles covering the floor, and a stack of puzzle boxes taller than me nearby.”
— Esther, Canada

“When I was in secondary training in the Army, I volunteered to strip the floor in the barracks and put down new layers of wax. Three hours into it, I ‘woke up’ as the drill sergeant came to check in. He was surprised to find the entire squad standing back in silence watching me as I made the wax finish look like half-inch-thick glass with a third coat. Apparently I began to hum and move rhythmically like a machine as I took over the entire project myself, and they all fell back in silence to watch me work. Several of them said they had never seen someone so ‘in the zone‘ before. The drill sergeant told me later that he had never seen a barracks floor look as nice as mine did.”
— ADDitude reader

“I was about 10 years old and reading books my mum got me from the library. I finished one book and looked up to see that 5 hours had passed and it was dark. I felt like I was coming out of a trance, like the real world had stopped existing and I’d forgotten about anything that wasn’t the story in the book. I was fully absorbed in the world I was reading about.”
— Charlotte, England

[Read This Next: “I’m Hyper Because I Hyperfocus On The Wrong Things”]

“I am an artist. I work in several mediums, but currently I take pottery classes. I will be working on a piece perfecting every last detail — intricate carving, trimming a fraction of a mm off a surface to make it perfect. The NEED to make it perfect is so strong I can’t stop it. My classmates will crank out several pieces in a day and I will work on one for weeks.”
— Linnea, US

“I am a hairstylist and when I learned about hyperfocus I realized I do it every day at work. When I do hair, I get into my own zone and almost everything around me fades away; it’s just my client and me. Once I am finished with my client, two or three hours later, it maybe feels like one hour to me. Once they leave, I have a sense of accomplishment and I feel lighter, as if a huge burden was lifted and I can carry on to the next task. It’s almost like therapy.”
— Kristen, Florida

“When I was around 6 years old, I was intent on building a snowman. I usually only played in the snow with my siblings, but this day I had an irresistible urge to build a snowman, so I went outside by myself. I don’t think I intended to do anything but build one snowman, but I got distracted and kept playing in the snow. I probably spent three hours outside. My mom called me for dinner and I remember being surprised that it was getting dark.”
— ADDitude reader

“I was about 12. It was a Saturday and I had a new novel that I started reading stretched out on my bed just after breakfast. The next thing I know (10 hours later as it turned out) my mom is at my door asking if I’m really going to skip dinner. To this day I can’t start a new book on a weeknight because it might be my morning alarm going off the next time I realize the world exists.”
— Cynthia, California

[Could You Have Hyperactive ADHD? Take This Test To Find Out]

“I was in my late teens, totally captivated by the sight of dew drops on a spider web, backlit by the early morning sun. Gradually I slipped into a reverie and lost all awareness of my body and the world around me; I was aware of nothing but the light. After a while, I returned fairly abruptly to normal awareness but it wasn’t a shock. On the contrary I was filled with peace, calm, and what I can only describe as love for all of existence. It was a transcendent experience.”

-Kara, Australia

“Painting was an early source of hyperfocus for me. My eyes would be blurry, the walls would be splattered with paint and my hands wouldn’t have any skin showing, but I would still be painting 12 hours in. Sleep didn’t matter.”
— Grace, Australia

“I wasn’t diagnosed until the age of 53. There have always been activities I felt pulled into and passionate about, and the silence during those activities was golden to me. I’d lose 3 hours and wonder where in the world time had flown to. Often the jolt back to reality is/was rather depressing because, during these activities, my Inner Critic is silenced, and my anxiety dissolves. Briefly, during hyperfocus, I am at one with a world that otherwise seems to be making incessant demands of me through a barrage of noise.”
— Chris, Canada

“I recently stayed up all night to complete both my corporate and personal tax returns because I waited until the last minute (I know, shocker.) I was at my desk when my family went to bed and I had Netflix on in the background to keep me company. Eight hours flew by so quickly I couldn’t believe it when my son woke up and came downstairs!”
— Kyley, California

“I was probably 10 or 11, reading a long book in the summer, when I first experienced memorable hyperfocus. We lived on a farm, so I was out in our woods, on a blanket, sun shining with a nice breeze. I lost 10 hours before my mom sent my brother looking for me. It took at least an hour before I felt like I could interact properly with my family again.”
— Christina, Arizona

“I could hyperfocus on a 1,000-piece puzzle for hours. When in this state, I can see minute changes in the colors that allow me to work through a puzzle very quickly. If I am jolted back to life, it is actually painful in my head; I’m usually a little lost as to what time it is and what is going on.”
— Jennifer, Louisiana

Hyperfixation and ADHD: Next Steps

• Read: Hyperfocus: The ADHD Phenomenon of Intense Fixation
• Learn: The Good, The Bad, and The Ugly of Hyperfocus
• Understand: Hyperfocus — at Your Service
• Find: ADHD Specialists or Clinics Near You

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Managing ADHD well is a challenging process. It becomes more difficult when a co-existing chemical or behavioral addiction is part of the picture. Many adults with ADHD struggle with addictive behaviors, which are often unrecognized and untreated.

There is no direct genetic link between addictive behaviors and ADHD. Addictive disorders are complex and often caused by behavioral, emotional, and life factors. Thrill-seeking behavior, the need for immediate gratification, and a search for novel pleasure-seeking experiences are more common for many people with ADHD. Life stressors, such as job loss and financial difficulties, are more frequent with ADHD, and are also risk factors for substance use and other addictive behaviors.

Initially, addictive behaviors provide a jolt of dopamine that is very satisfying for the brain’s reward circuitry. Over time, the “thrill” wears off, but the addictive behavior continues due to physical or emotional cravings. Some indicators of addiction are:

• Strong and urgent cravings for the substance or behavior. These might include physical cravings (alcohol, cocaine) or emotional cravings (gambling), or both.
• No control over consumption. This is why one drink leads to seven, and 30 minutes of video games turns into five hours (or an entire night).
• Continued use despite negative consequences. Sometimes this involves denial (“I don’t have a drinking problem”), but many individuals are aware of the problems caused by their addictive behaviors and continue them anyway.
• Inability to stop the behaviors despite the desire to do so. When this is the case, it is time to see a counselor who specializes in working with people with addictions.

[“The Story of My Son’s Video-Game Addiction”]

Below are some common chemical, behavioral, and food addictions. These are potential problems for everyone, but their risks are heightened for adults with ADHD.

Addictive Behaviors with Chemicals

The lifetime occurrence of substance use problems among adults in the general population is approximately 25 percent. They may be addicted to alcohol, recreational drugs, or prescription medications. In comparison, 50 percent of adults with ADHD have a history of dealing with substance use at some point in their lives.

Many reasons account for addictions among adults with ADHD, however two general causes come up again and again. First, adults with ADHD are more likely to self-medicate, particularly so when they lack awareness or understanding of their ADHD biology and have not yet learned how to manage it well. Second, many adults with ADHD are drawn to thrill-seeking and novel experiences. One individual said he liked to “play with” his brain.

Stimulants and the ADHD Brain

Many adults with ADHD self-medicate with large amounts of caffeine on a daily basis. Some self-medicate with nicotine via cigarette smoking or vaping. Other stimulants that are abused include cocaine, crystal meth, MDMA (ecstasy), and ephedrine. All of these pose serious health risks (including caffeine in large amounts), and some lead to fatal consequences. The temporary “benefits” of these drugs are limited, and are far outweighed by their serious risks to health and life.

[Download This Comprehensive Chart Comparing Stimulant Medications for ADHD]

Prescribed stimulant medications, when used properly and taken as prescribed, are more effective and safer than the drugs discussed above. If you’re going to medicate yourself, do it right and do it safely. To be used safely, the medications must only be taken orally and in prescribed doses.

Alcohol and the ADHD Brain

When used in moderation, alcohol can enhance life experiences, such as dining and social interactions. When used in excess, it becomes highly addictive. Alcohol addiction is considered to be as severe as heroin addiction. Alcohol is often the self-medicating drug of choice for individuals experiencing symptoms of depression or anxiety.

Marijuana and the ADHD Brain

Marijuana is approaching a level of social acceptance to rival that of alcohol. It is used by many people to promote a sense of calmness and relaxation. There are many different strains of marijuana that produce different effects for different people. Some adults with ADHD who are hyperactive believe that it helps tone down their hyperactivity. Some just enjoy the pleasant “high” that they get from the drug. Marijuana, for many people, falls into the “play with my brain” category.

Adults with ADHD who consider using marijuana should be aware that regular use can have a negative impact on attention, memory functioning, and activation difficulty. In other words, regular marijuana use could potentially exacerbate problems associated with distractibility, forgetfulness, as well as procrastination.

Opiates and the ADHD Brain

Opiate drugs include heroin, morphine, and codeine. In the past several years, the abuse of opioid prescription medications (e.g., Vicodin, OxyContin, Percocet), commonly prescribed as pain relievers, has become a national epidemic, resulting in thousands of deaths. These are highly addictive drugs and deadly when abused. They cause more than twice the number of deaths by overdosing than does heroin.

Sedatives and Tranquilizers

Prescription sedatives and tranquilizers act as central nervous system depressants. Their effect on the brain is basically the opposite of that caused by stimulant medications. They are commonly prescribed for anxiety, tension, and sleep disorders. Some people with ADHD take them to help their problems with falling asleep and staying asleep. When the medications are prescribed as sleep aids, continued long-term use can lead to addiction.

Hallucinogens

The hallucinogens include LSD, mescaline, psilocybin (“magic mushrooms”), PCP, and DMT. These are powerful, mind-altering drugs that can produce hallucinations, severe mood alterations, and changes in reality perception.

[“Opening Up About ADHD and Alcoholism”]

Behavioral Addictions and ADHD

Behavioral addictions get less attention than chemical addictions. However, like all addictions, they can cause severe problems in people’s lives. They should be taken seriously, and, when necessary, treated professionally.

Internet Addictions

The Internet is designed to be distracting and addictive. It gives immediate gratification. There is an endless variety of entertainment, information, and social connections. “Hello, there,” says the ADHD brain, “where have you been all my life?”

Internet addictions include excessive use of online media, including social media, message boards, and innumerable websites. But most people will say, you just described modern life! Actually, no. What makes an addiction is excessive use. If time spent on the Internet makes you fail to get work done, or ignore or hurt the people you love, then it must be acknowledged that you have a problem with the Internet.

Gambling Addictions

Gambling addictions are among the most powerful and destructive behaviors. Whether this involves sports gambling, casino gambling, or other forms of gambling, they cause disruptions in people’s lives. Financial and relationship problems follow in their wake.

Shopping Addictions

For many people, with or without ADHD, shopping provides instant gratification and a temporary mood boost. People with ADHD are at high risk for overspending and for shopping addictions for two major reasons: People who are naturally impulsive are impulsive shoppers. And not keeping track of finances makes it easy to lose track of how much money a person is spending.

Sexual Addictions

By definition, a sexual addiction involves a loss of control over one’s sexual behavior. For some people this involves having “serial affairs,” whether or not the person is engaged in a committed relationship. For some it involves soliciting sexual partners online, or making use of prostitutes. The most common form of sexual addiction is porn addiction.

Addictive Behaviors with Food

Food addictions are considered to be both physical and behavioral addictions. They are so common that many people regard them as regular eating habits. Unfortunately, the foods that are most addictive are the foods that are the most unhealthy. A steady diet of them not only increases risk for obesity and physical illnesses, such as diabetes, but also wreaks havoc with mood regulation and cognitive functioning as blood sugar levels take a roller-coaster ride.

Highly processed foods, such as cookies and cakes, are addictive for the same reason that addictive drugs are addictive: They deliver a high dose (in this case, of sugar) and have a rapid rate of absorption. That “sugar high” you feel after a bowl of ice cream is an actual high. That “carbohydrate craving” you feel for a bag of chips is a real craving for carbs. Strong cravings are a symptom of addiction.

When does eating become a food addiction? Important factors to consider are:

• When having a cup of ice cream leads to eating the whole pint, there may be a problem. As there might be with eating half of a large pizza, the entire bag of chips, and so on.
• When a person is significantly overweight (a BMI over 30 is considered obese), or having health problems, such as hypertension or diabetes, but cannot stop eating, there is a problem.
• Making an effort to change unhealthy behavior, and being unable to do it by yourself, is a primary defining characteristic of addictive behavior.

Addictive Behaviors and ADHD: Next Steps

• Learn: The Truth About ADHD and Addiction
• Understand: Is ADHD Medication Safe If You Have a History of Substance Abuse?
• Read: Book Review: When Too Much Isn’t Enough

From the book, Life with ADHD (#CommissionsEarned), by Peter Jaksa, Ph.D. A clinical psychologist in Chicago, Illinois, Peter has worked extensively with adults and children diagnosed with ADHD for the past 35 years. He serves on ADDitude’s Scientific Advisory Board.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

#CommissionsEarned
As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

We feel we should be able to conquer all of those lingering projects cluttering our homes and our minds. But by the end of the day, we’re overwhelmed with fatigue and feelings of listlessness. Aggravating it all is out-of-control productivity shaming — something that individuals with ADHD, and especially women, know all too well. Our to-do lists actually seem to be growing, and we’re left beating ourselves up, asking, “What’s really going on with me?”

The weariness you’re feeling right now is real. It stems from stress, which affects the alertness and arousal pathways of the mind; unique aspects of the ADHD brain further impair our ability to regulate those channels. Basic but effective coping mechanisms, however, can help us regain some footing during this time.

Why You Can’t Get Anything Done Now: ADHD Brain Primers

Everyone experiences ADHD and stress uniquely. The chaos and intensity of this global pandemic are stimulating for some. Others feel they are just barely treading water — working hard just to stay afloat. Women with ADHD and other marginalized groups, accustomed to facing societal pressures and demands well before this pandemic, are largely in the latter group.

These are just some features of the ADHD brain that help set the scene for our responses to this pandemic:

[Click to Read: Anxiety Is Our New Normal. Surrendering to It Is Not.]

1. The ADHD brain struggles with emotional regulation. People with ADHD are easily flooded, tend to be highly emotional, and have a low frustration tolerance. In this period of heightened emotions, it’s no wonder that the emotional facet of our brains makes coping feel uncomfortable and overwhelming.

2. ADHD brains struggle to regulate arousal states. Brain scans show that ADHD minds can sometimes be “hyper-aroused” or “hypo-aroused.” It explains why people with ADHD fall asleep when they’re under-stimulated — it’s not about fatigue at all — or freeze up when over-stimulated. Our arousal states are also drastically impacted by stress.

3. ADHD minds have a tendency to wander. In neurotypical brains, the default mode network — the background, stream-of-consciousness chatter — shuts off when engaging in a task. For ADHD brains, that switch doesn’t happen so smoothly, so our minds can get stuck wandering. When we’re in a space of anxiety, we can get ruminative, especially about something that’s causing us stress.

To better understand why recent stressors are particularly paralyzing to ADHD minds in quarantine, we can turn to relatively new concepts in the fields of behavioral neuroscience and psychology.

[Essential Reading: ADHD Catastrophizing in Times of Crisis — What To Do When Fear Spirals]

An Integrated Model: The Polyvagal and Window of Tolerance Theories

The “Window of Tolerance” and polyvagal theories posit, in part, that we all inhabit neutral-like spaces in which we feel like we’re present, content, able to engage, and be our best selves. In so many terms, we are “on” in this optimal state, which also requires us to feel some level of safety and comfort. In the language of the polyvagal theory, this window is called the “ventral vagal state.” The vagal refers to the vagus nerve, which runs from the brainstem to the gut.

At each end of this window of tolerance are the zones of hyperarousal and hypoarousal. When we experience stress, as we are now in response to this pandemic, we go into the hyperarousal zone. This is where our sympathetic nervous system is activated, and our fight or flight responses are triggered. In this zone, we feel anxious, reactive, irritable, and, above all, threatened.

When we spend more time in this heightened state and can’t seem to escape our stressors, as is happening now, we go into overwhelm — this is when we enter the zone of hypoarousal, or the “dorsal vagal freeze state.” We can look at this zone as a protective path of last resort. We become numb, we feel disassociated, and are unable to act. We effectively shut down.

The ADHD brain, even without a global pandemic, sure seems to bounce frequently between the two zones. We tend to gravitate to the hyperarousal space because it satisfies cravings for stimulation and because of our struggles with emotional regulation. We are often able to return to the neutral window, and we do our best to avoid the zone of hypoarousal.

But faced with this collective, continuing trauma — the pandemic news cycle, lost jobs, sick loved ones, mourning the ones we’ve lost, remote schooling, work, and more — we’ve lived in a hyperarousal state for so long that we’ve passed it and merged almost semi-permanently into the hypoarousal. All we can do in this state is sit down on the couch, stare into space, and think, “I can’t.”

Finding the Way Back to Your Window of Tolerance

We can shift our stress responses back into our window of tolerance by developing a meaningful set of coping skills. The following mechanisms, while simple and potent, are merely suggestions — they appear in no particular order, look different in practice from individual to individual, and do not represent all the tools that can help.

In this unprecedented pause, we don’t want healing to become another rat race toward greater productivity. Hold yourself with compassion and validation in the process of healing, and understand that there is no perfect way to cope — to our benefit. When we let hardships impact us, that’s when we can become stronger and learn to trust ourselves.

Pause and Notice

Another name for pausing and noticing is mindfulness, which doesn’t necessarily mean meditation. As the saying goes, it’s “the space between stimulus and response” where choice lies.

The ADHD brain, as we know, does not automatically do well at putting on the brakes. But when we practice pausing, we are able to create the space to regulate and reason against stressors.

Create Safety

We feel safest in our windows of tolerance, so creating a sense of safety even when weathering the storm can help our minds regain some sense of control. There are three areas to focus on when thinking of safety:

Emotional and mental safety: As with pausing, creating emotional and mental safety means literally taking time and space to regulate. For example, it takes about half an hour on average for our nervous system to come down and “drain the flood,” so it’s crucial to work into our days fragments of time for ourselves — more so when uncertainty and unpredictability are at play.

Environmental safety: This means physically changing your space. That could be making a “timeout” for yourself at home, or setting boundaries around social media and news. It could be getting away from the stress at home, under the guise of running an errand, and sitting at a park bench or a parking lot.

Relational safety: We need to create time and space for ourselves without being tied to our children, roommates, spouses, or others. Doing so is hard, especially for women, as we’re socialized into being people-pleasers and keeping the peace when things get tough. But it must be done. Tell your kids, partner, and others that when you’re creating space for yourself, you’re not walking away from them, but helping yourself and your relationship with them.

Regulate Your Mind and Body

The following mind-body activities are based in somatic experiencing, or body sensations, that are proven to snap the stress response back.

• Take a cold shower
• Do a body scan — paying attention to how your body feels by moving in sections from the feet to the head
• Deep breathing — we want to stimulate the vagus nerve, so focus on strong exhales. Hold them for as long as possible; 7 to 10 counts if possible
• Ground yourself by doing sensory-stimulating activities like wrapping yourself in a weighted blanket or walking barefoot on the grass
• Practice gentle movement like dancing, stretching, walking
• Seek positive stimulation through cooking, gardening, painting, and the like. For ADHD in particular, it’s essential to keep the dopamine flowing

[Read This Next: How to Re-Build a Life — 7 Framing Tools for ADHD Minds Emerging from Quarantine]

This article is based on Michelle Frank’s ADDitude webinar, “‘I Thought I’d Be More Productive!’ Why Women with ADHD Are Struggling While Staying at Home,” which was broadcast live on May 13, 2020.

THIS ARTICLE IS PART OF ADDITUDE’S FREE PANDEMIC COVERAGE
To support our team as it pursues helpful and timely content throughout this pandemic, please join us as a subscriber. Your readership and support help make this possible. Thank you.

High-IQ people with attention deficit often excel at tasks requiring divergent thinking, which is spontaneous and non-linear — “out of the box” thinking. They are usually less successful at tasks requiring convergent thinking, which requires accuracy, logic, and speed — the math-SAT thinking.

Many high-IQ adults who struggle with ADHD symptoms wonder why their condition is considered to be less than credible. Lori, 43, a TV producer, said, “I just saw the second doctor who told me I couldn’t have ADHD — I’m too smart, I did well in school, I don’t have behavioral problems, I’m a high-functioning professional. Looks are deceiving; it’s a hot mess inside my head.”

Intelligence and IQ Do Not Counteract ADHD

Many assume that a high IQ makes everything in life easier, including the management of ADHD. However, research tells us that a high IQ does not protect anyone from the executive dysfunction or emotional dysregulation typical of ADHD.

Despite their strengths and talents, high-IQ adults with ADHD demonstrate more cognitive difficulties, functional impairments, and comorbidities than do high-IQ adults without ADHD.

In fact, the severity of their executive function impairments, especially in working memory and processing speed, does not differ from that in average-IQ adults with ADHD. What these intriguing individuals do have is a unique set of challenges.

Unique Challenges That Accompany High Functioning ADHD

Those who grow up celebrated as “smart” internalize their intellect as a foundation of their identities and a source of self-esteem. They know that they carry the expectation of success. Thriving in school with little effort, they have been told that success will be theirs.

[Get this Free Resource: Yes! There Are People Like You]

But here’s where the path begins to diverge for those with ADHD: Due to the developmental delays that characterize ADHD, children with the condition tend to lag three to five years behind their chronological peers in social/emotional functioning. At the same time, very bright children with the condition often function three to five years beyond their peers intellectually.

Such extreme discrepancies in functioning are baffling to those living with them, as well as to those observing them. Rob, 31, a cyber-security technician, recalls the awkwardness he felt in middle school: “I got 100 on everything, but was seriously geeky and never had friends in my grade. I was more comfortable with younger kids or adults. Being smart with ADHD is a mixed bag.”

“Potential” Becomes a Four-Letter Word

Intellectual prowess falters in those with ADHD as academic demands grow in speed and complexity. Confused by their inconsistent achievement, they find themselves unable to realize their potential. Parents and teachers usually attribute their underachievement to boredom, carelessness, laziness, or lack of caring, and these bright, demoralized teens have no better explanations.

A consistent refrain I hear is, “How could I have been so stupid?” Even after diagnosis, they deny the impact that ADHD has on their performance. Rather than acknowledge the complexity that ADHD adds to any task, they attribute their struggles to their flaws.

[Written for You: An Open Letter from a Smart Kid With ADHD]

The High Functioning ADHD Identity Crisis

Academic achievement is highly susceptible to impairment by ADHD. Studies show that 42 percent of high-IQ ADHD adults have dropped out of college at least once. Nonetheless, they still believe that their intellect should enable them to triumph over their impairments.

Mark’s story is typical: A stellar student back in the day — debate team captain, accepted at two Ivy League schools — he can’t relate to that earlier self. Now a 38-year-old advertising executive, he zoned out in his last business meeting, and worried that he missed something relevant. After finishing his PowerPoint at 2:30 a.m., he overslept the next day and left home without coffee. He says, “Whoever I was, I’m not that guy anymore. Doesn’t seem to matter how much I know. When I have to perform, I freeze up and feel incompetent.”

A high IQ can make it easier to compensate for ADHD symptoms. High-IQ adults with ADHD appear to function well, but this comes at a high emotional cost. Investing much time and energy to present a flawless public persona, they rely on obsessive behaviors to guarantee organization and structure. However successfully they manage their cycles of procrastination and hyperfocus, they inevitably feel burdened and exhausted. Determined to keep anxiety, frustration, shame, and disappointment internalized, they relentlessly self-monitor. They are hypervigilant about hiding anything that might expose their internal chaos.

Susan, 51, a magazine editor, explains how perfectionism works for her: “It doesn’t matter what I have to do, as long as I come across as smart and in control. I know I can get a little rigid, but, if the managing editors are impressed, it’s all good. It’s just that I’m always so anxious, dreading the day they find out I’m a fraud.”

The Secret Struggle of High IQ Adults with ADHD

High-IQ adults with ADHD feel most successful when their performance doesn’t reflect the challenges over which they triumph each day. If they are not overtly suffering, nor appear to be in need, it is unlikely that they will get the support they need. The combination of pride and shame deters them from revealing their inner experience, and, as a result, they are isolated with their burdens.

Without the history of difficulties required for diagnosis, and given their high functioning, they present with a form of ADHD unfamiliar to most clinicians. If they are ever diagnosed, their diagnoses will likely be delayed until comorbid issues complicate their difficulties. The result of coping well is that the struggle remains secret, but no less damaging.

Having High IQ Doesn’t Mean You Feel Smart

The fall from grace, when it comes, often involves revisiting the glowing recognition earned in the past. They judge themselves harshly — ashamed that they can’t process faster, remember more, follow through better, be less emotionally reactive. It is painful to accept that they’re working twice as hard, for twice as long, to achieve half as much.

What makes this more demoralizing is that, like Mark, they feel compelled to redefine their identities. Isolated by her secret life, Lori grieves for her lost confidence: “Who am I kidding? If I were really smart, I could crush this.” These despairing individuals face a shame-based identity crisis, in addition to the impact of a neurobiological disorder.

What’s Ahead After Getting Help with High Achieving ADHD

Lori was finally diagnosed after finding the right clinician, and began to recognize how her job as a producer was a good fit for her because she works in a highly stimulating, fast-moving, ADHD-friendly environment. Rather than trying to stifle her constant stream of ideas, she took the risk and found that they were well-received, even if she occasionally interrupted.

Rob began to accept that the way his brain worked was an advantage in his job, and that the other techs were similarly wired. No longer viewing himself as a social pariah, he went out to lunch with a colleague for the first time. Mark began to use his artistic creativity to make his ad campaigns funnier, edgier, and more colorful; he felt proud when his colleagues said that he was walking around smiling too much.

Susan began to relax her perfectionist instincts and see that the details she obsessed about were apparently not as critical as she thought. She loved feeling less vigilant and anxious.

Those who dwell at that random intersection of the genes for high IQ and ADHD have abilities that, properly channeled, define our entrepreneurs and our leaders. There is no shortage of successful people with ADHD! What makes the difference is the lens through which you view yourself relative to the rest of your world. The good news is that you can reframe the ways in which you label yourself, once you recognize that you applied those labels in the first place—and only you can peel them off.

Six Steps to Accepting Yourself: ADHD, IQ, and All

Having someone bear witness to your experience is the first step toward self-acceptance. You can’t change your brain wiring, but there are many ways to feel worthier in your own skin.

1. Learn everything you can about your ADHD brain. Read, watch webinars, join online groups, so you can understand why you can’t always control your responses, regardless of how smart you are. There is relief in discovering that many share the journey that feels like yours alone.
2. Strip away labels. You are not your symptoms nor your diagnosis nor your IQ. Separate the essence of who you are from the labels that might limit you. As you rid yourself of those labels, you can begin to redefine your identity with more realistic aspects of who you are, not who you “should” be.
3. Break out of the prison of isolation. Take the risk—with a therapist, a best friend, a partner, or a support group. Imagine feeling safe enough to take off your mask without fear of rejection.
4. Remind yourself that most people juggle issues that make the world less predictable. None of us has that coveted sense of control all the time.
5. Optimize your functioning through better self-care: diet, sleep, exercise, stress management, hobbies, and relaxation. Investing in yourself sends the message that you are worth it.
6. Celebrate your gifts. You may feel that your capabilities don’t exist because you can’t reliably access them. We don’t expect artists to create masterpieces every day; show the same compassion for yourself and don’t hold yourself to unrealistically high standards. Nothing can steal your brilliant solutions from you; rather than lament that they don’t occur often enough, celebrate them when they do.

[Read This Next: “What If My Intense Drive Is Because of — Not in Spite of — My ADHD?”]

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While my children and I laughed over the truth serum scenes and the calming glitter kitties, I found myself most attracted to the “inflatable hug,” which is an endearing device easily activated to surround and protect an individual from an explosion or detonation.

An inflatable hug sounds like just the right solution these days for children and families with attention deficit hyperactivity disorder (ADHD) who could use some protection from the emotional explosions taking place in their homes. As a clinical psychologist, I frequently work with children diagnosed with ADHD — and their parents, siblings, and other family members as well. Despite the number of executive functioning deficits inherent in ADHD, most parents find themselves in my office due to one specific challenge: emotional control.

Children with ADHD can often become flooded with emotions; they struggle to regulate those feelings in order to control their words and actions. In addition, children with ADHD may be hypersensitive to perceived disapproval, slights, and social embarrassments. Pair that with a brain that struggles to differentiate between small and large problems, and you can have yourself an explosive situation quite frequently in the home. Hence, the need for an inflatable hug.

Tips to Help You and Your Child Recover from ADHD Anger

I use a number of strategies to help children develop an increased understanding of their ADHD brains and emotions and to find strategies that help them express themselves more effectively. At the same time, I also try to educate parents (and provide reassurance) that, while there are no quick fixes, things will improve with time and development. It is critical to remember that children with ADHD have a 30 to 40% delay in their executive functioning development, which may mean they seem 3 to 4 years younger than same-aged peers in terms of emotional control.

[Read This Next: Never Punish a Child for Behavior Outside Their Control]

I often tell parents that, while we are waiting and supporting their child’s brain development, we are just trying to keep the house from burning down — quite literally these days! Below are a few tips for managing emotional explosions with an inflatable hug — and without burning down your home:

1. Watch the clock: Moments of intense anger or emotional dysregulation can feel so overpowering that they “contaminate” the entire day. While it’s true these episodes often last longer than we would like, it can help to physically watch the clock for a number of reasons. One, it can help you gauge your own emotional reactions and the amount of time you will have to wait this out. If your child normally flies into a rage that lasts 30 minutes, you can coach yourself to push pause until it de-escalates in a half hour. This can help you manage your own internal thoughts such as “I can’t stand this” or “This will never end.”

Watching the clock can also help you to create more realistic thoughts about your child’s behavior. While a very difficult emotional outburst is not easy to manage, it may be helpful to put this amount of time in the context of the entire day.

2. Conjure and cue your best self. Think about a time when you handled a situation with your child well. Write out the details and describe how you behaved, what you were thinking, and how you felt during and after. Find a way to remind yourself of this moment and your “best parent self.” Tape up this writing on the fridge or put a picture on your bathroom mirror that reminds you of this “best self.”

If you cannot recall a time when you handled a situation with your child well, then imagine what a successful interaction would look like. Be specific in writing out how you would behave, what your face would look like, and what you would say. If you need help with this, consult a trusted resource such as an admired friend, a family member, or a professional.

[Download This Free Resource: Common Executive Function Challenges and Solutions]

3. Say as little as possible in the heat of the moment. Your child will remember your words, especially when you would rather they wouldn’t. What’s more, siblings will remember what you said and repeat it later. You cannot control what your child says in the moment, but you can control the message that you communicate in those tough moments. It may be easier to repeat one or two standard phrases of support, validation, and personal limits. Going “off script” in these heated moments can be less than ideal.

4. Identify the emotion(s) underneath the anger or rage. When your dysregulated child is angry, they may say things that are both distressing and distracting. Don’t allow yourself to be distracted by the outward anger, which is very often the “secondary” emotion — the manifestation of an even stronger driving emotion under the surface.

Could your child be upset because of an unexpected change in plans? Are they feeling embarrassed or like they seem babyish or uncool? Do they feel as if others are not listening or “ganging up” on them? Trying to understand the root cause of this emotion can help create some understanding, and help to keep you calm even when your child is hurling harsh words, threats, or accusations at you.

5. Wait for everyone to calm down before you have a conversation. There is no exact moment of “calm enough” — you will need to gauge your own level of arousal, the intensity of your child’s cry or tone of voice, their body language, etc. Try your best, and if you realize that one or both of you are still too upset, ask for a little more time. But make sure to come back to the conversation together to help create understanding, repair any damage in the relationship, and make a plan for the next time this emotion or situation presents itself.

6. Be kind — not only to your child, but to yourself. You have an amygdala, too! Kids can say scary, unsettling, mean, and challenging things sometimes. It is natural to feel hurt, scared, or incredibly angry. Forgiveness is a powerful tool — for both you and your child.

And if all else fails, can we get our hands on some inflatable hugs?!

[Read This Next: How ADHD Ignites Rejection Sensitive Dysphoria]

THIS ARTICLE IS PART OF ADDITUDE’S FREE PANDEMIC COVERAGE
To support our team as it pursues helpful and timely content throughout this pandemic, please join us as a subscriber. Your readership and support help make this possible. Thank you.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication