At 44, when I was diagnosed with ADHD, my neuropsychologist warned me that telling my family about it, given the personal background I provided, might not be the wisest idea.

Before I brought up ADHD to my family, they never questioned my previous medical diagnoses: migraines, a root canal, COVID-19, two bunionectomies, and two staph infections. My understanding of my health conditions was never challenged until it came to ADHD, when a single family member politely undermined my medical diagnosis, my grasp of reality, and my intelligence.

Why the ADHD denial?

To Deny ADHD Is to Uphold a Fraught Reality

Those who dismiss ADHD, I gather, often do it as an act of self-preservation. To deny ADHD is to avoid uncomfortable truths about opportunity and success.

From the moment small children can comprehend language, adult authority figures tell them that if they follow specific steps, a particular outcome is very likely or guaranteed. “Work hard, and you’ll get good grades.” “Success is no accident.”  “Practice makes perfect.” This rigid, unforgiving logic is the very foundation of the American Dream and a common justification not to help each other. Athletes, actors, musicians, authors, artists, scientists, and other recipients of professional honors, wealth, and prestige will parrot the same talking points.

[Read: Why It Hurts When Neurotypicals Claim an “ADHD Moment”]

My parents and teachers reiterated these adages too. All of my siblings ardently followed this advice, and they were richly rewarded for their legitimate hard work: private boarding schools in England, Ivy League graduate degrees, high incomes, networking with wealthy families, and professional achievements.

Not for me or the other one in 20 children in the 1980s who had ADHD, though.

The people who champion these simplistic platitudes don’t realize or account for the fact that learning isn’t that simple for those of us who are wired differently. If an undetected and untreated developmental disability stymied my academic and professional achievements – instead of my alleged lazy, unmotivated, unintelligent, and scatterbrained behaviors – then the reality for my family and all the other people who genuinely think they worked hard is shattered.

Despite steps to mitigate the effects of disability discrimination, this country still wrestles with the fact that not all opportunities for success are equal, especially in highly competitive, driven environments. Most upsetting is the fact that ADHD runs in families, meaning that “bad” genetics can threaten to upend one’s previously positive self-image and long-held beliefs about intelligence. The inability to accept reality, such as loved ones clinging to stigma over facts, takes hold in families and denies the possibility for compassion, empathy, and proper treatment.

Covert Denial and Faux Concern

I’ll give these skeptics and critics some credit: they know outright denials or rejections of an ADHD diagnosis are no longer socially acceptable. They really don’t want to appear brazenly ignorant by contradicting a widely recognized neurodevelopmental disorder.

[Read: “Is ADHD Really Real?” 6 Ranked Responses to ADD Skeptics]

What’s the “better” response? Very respectful, palatable contradictions that are cloaked in faux concern and passive-aggressive denial. “Being fidgety is normal in children, but now it’s a ‘condition!’” “The inability to focus and concentrate probably isn’t really ADHD.” “All of this ADHD nonsense is only a flashy trend.” “Is the rise in diagnoses social media’s fault?” In my case, I got the question, “Did you take this, um, ADHD test online? Because that’s not how diagnostic testing works.”

ADHD skeptics and critics don’t want to face the fact that one of the driving reasons neurotypical people flourished in life is because academic and workplace environments are mostly set up so only neurotypical people could thrive and prosper.

If there had ever been a proactive, organic nationwide movement to acknowledge and understand disabilities and work to equalize the playing field, then the Americans with Disabilities Act and the Individuals with Disabilities Education Act wouldn’t need to exist. Thankfully, legally mandated disability accommodations expand the chances of success to more people in the workplace, classroom, and other fields. However, with change comes unpredictability. Insecurity and fear drive prejudices and make ADHD accommodations difficult to obtain.

As for my family member who repeatedly attacked the credentials and professional licensure of the neuropsychologist who diagnosed me, I eventually got somewhat of an apology. “I think it’s really good you found ADHD. All of… that seems to be helping you.” I had no idea I had it so good.

ADHD Is Real: Next Steps

• Free Download: How Common Is ADHD in Adults?
• Read: The Definition of ADHD — Myths & Truths
• Read: The Controversy That Was Adult ADHD

Maria Reppas lives with her family on the East Coast. Visit her on Twitter and at mariareppas.com.

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When we fell in love with the YouTube viral video “Xmas Jammies” 10 years ago, we didn’t know that Penn Holderness had ADHD. Since then, Penn and Kim Holderness, the First Family of ADHD, have regaled us with instant classics including “10 ADHD Lifehacks from Penn,” “Me and My ADHD,” and “How to Listen (Kinda) with ADHD.”

Aside from making us LOL, these witty and endearing videos have showcased the brilliant creativity, mind-blowing energy, and totally unique perspectives that ADHD can bring. ADHD is not 100% awesome, but the Holderness Family is very good at reminding us about the aspects and elements of this condition that do not suck.

In their new book, ADHD is Awesome: A Guide To (Mostly) Thriving With ADHD, Penn and Kim encourage readers to change the narrative around ADHD with something they call Operation Mind Shift. In this webinar, they will discuss…

• How to blow up the maddening myths about ADHD that persist
• How to talk to your loved ones about ADHD in a way that educates but doesn’t blame
• How to reframe your ADHD traits in a way that doesn’t capsize your self-esteem
• How to model ADHD positivity for your children
• How to embrace routine and control your environment while remaining zany and fun
• How to win “The Amazing Race” (just kidding, but they actually did win!)
• And much more

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Living with ADHD: More Resources

• Download: How to Build a Dopamine Menu
• Get: Your Complete ADHD Guide
• Read: 9 ADHD Myths That Perpetuate Stigma
• Read: The Positives of ADHD

Obtain a Certificate of Attendance

If you attended the live webinar on May 13, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Kim and Penn have been married for 16 years. For 7 of those years, they have chronicled their marriage and their family with funny music videos, vlogs, skits, and a podcast. Their videos have resulted in over a billion views and 4.5 million followers across social media.

Penn and Kim honed their storytelling skills with 25 combined years in the TV news business. Today, they own their own company, Holderness Family Productions, where Kim is Chief Executive Officer and Penn is Chief Creative Officer.

As well as creating content for their channels, they also work alongside brands and agencies to shape product launches and marketing campaigns. Their book Everybody Fights about improving communication in marriage was released March 30, 2021. Their new book, ADHD is Awesome: A Guide To (Mostly) Thriving With ADHD was released April 30, 2024.

Webinar Sponsor

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It’s so easy to beat ourselves up for our ADHD that we often forget about all the great things about neurodivergence. At Inflow, we’re here to celebrate your victories, big or small, and remind you that your ADHD can be a strength. Developed by leading clinicians (and fellow ADHDers!), Inflow’s CBT-based program is your starting point to managing your ADHD and embracing neurodiversity. Get your ADHD score today to kick off your Inflow journey.

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

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ADHD symptoms in children are associated with unusual interactions between the frontal cortex and deep centers of the brain where information is processed, according to a recent report in the American Journal of Psychiatry.¹ These findings may help inform additional research into the ADHD brain that leads to more effective treatments and interventions.

A research team from the National Institute of Mental Health (NIMH) and National Human Genome Research found children with ADHD demonstrated heightened connectivity between brain structures involved in learning, movement, and reward, and frontal areas of the brain that regulate emotion, attention, and behavior.

“The present findings suggest that these brain alterations are specifically associated with ADHD and are not indicative of general features of childhood psychopathology or influenced by comorbid symptoms,” the study’s authors wrote.

Researchers have long suspected that ADHD symptoms result from atypical interactions between the frontal cortex and these deep information-processing brain structures. However, the study’s authors noted that prior studies testing this model returned mixed results, possibly due to the small size of the studies they suggested.

The present study examined more than 10,000 functional brain images of 1,696 youth with ADHD and 6,737 without ADHD aged 6 to 18. It was the “largest study to date on changes in subcortical-cortical connectivity in ADHD,” the study’s authors wrote.

The findings underscore the need for more research regarding the association between brain connectivity and ADHD symptoms, the genetic aspects of ADHD, and how brain connectivity patterns relate to treatment outcomes.

Source

¹Luke J. Norman, Gustavo Sudre, Jolie Price, Philip Shaw. (2024). Subcortico-Cortical Dysconnectivity in ADHD: A Voxel-Wise Mega-Analysis Across Multiple Cohorts. American Journal of Psychiatry. DOI: 10.1176/appi.ajp.20230026

The link between parental experiences and child outcomes is well established, but research has generally focused on the prenatal period (e.g., the effects of smoking, stress, or diet during pregnancy) or the postnatal period (e.g., the impact of different parenting practices). More recent is the idea that parents may influence their children’s lives and health even before conception. In animal studies, exposure to trauma, alcohol use, or poor diet before conception has been found to alter epigenetic regulation in reproductive cells (eggs, sperm), influencing the offspring’s own epigenetic makeup and future behavior.

Epigenetics refers to a set of biological mechanisms that regulate when (in time) and where (in our body) genes are activated or switched off. Environmental exposures can influence these mechanisms.

The Challenges of Studying Humans

Most of the evidence for preconception effects comes from studies using animal models, which show that certain parental exposures before conception, such as diet and stress, can lead to differences in brain development, behavior, and disease risk in their offspring. While certainly thought-provoking, these findings currently pose more questions than they answer.

One such question: Do these findings generalize to humans? Clearly, experimental studies using animal models differ from human studies, which are typically observational. Animal studies can tightly control a subject’s environment and measure the effect of a specific exposure across generations while keeping all other factors constant (e.g., genetics or environmental factors). Such control is not possible with humans. Rather, studies in humans tend to measure as many variables as possible in an individual’s environment and life without interfering with them (observing rather than experimenting), which makes it much more difficult to establish causality.

So far, a handful of human studies have provided indirect support for preconception effects (e.g., the impact on offspring of parents and grandparents affected by World War II). However, it is difficult to establish whether preconception exposure or other related factors explain these effects. For example, preconception trauma exposure may affect parental mental health and increase risky behaviors, such as substance use, which may affect a child’s environment and development.

[New Class! The Adult’s Guide to ADHD Diagnosis]

Emerging Research on Epigenetics & Preconception

Multi-generational, well-characterized studies are beginning to emerge, opening unprecedented opportunities for exploring preconception effects in humans.

Another important question: Through what mechanisms do preconception effects occur? The effects may occur through epigenetic mechanisms influenced by the environment, affecting a person’s biology and health. Research suggests the link between parental experiences and offspring health outcomes may also occur along a biological route.

To what extent do these epigenetic mechanisms contribute to preconceptional effects in humans? To date, very few studies in humans have begun to explore epigenetic differences in sperm and eggs and whether they relate to their offspring’s health.

Moving the field forward will require large investments in studies that can collect epigenetic data in both parents and children and at different life stages (e.g., preconception, pregnancy, postnatal), which is expensive and logistically challenging. However, the rise of longitudinal multi-generational studies, together with the decreasing costs of epigenetic profiling and rapid methodological advances to handle this large and complex data, will soon enable us to overcome these barriers.

[Self-Test: Do I Have ADHD? Symptoms in Adults]

In the meantime, recognizing that both biological parents contribute to the health and development of the child, perhaps even before conception, is an exciting and important scientific development. This perspective helps counteract the focus on mothers, and it can serve to mitigate self-blame when a child is diagnosed with a condition. At the same time, we caution that the biological and epigenetic work on preconception effects largely relies on animal studies. Its relevance to humans is still unclear. However, we do know these possibilities warrant further human study.

Joel T. Nigg, Ph.D., is a professor of psychiatry and behavioral neuroscience and the director of the Center for ADHD Research at the Oregon Health & Science University in Portland, Oregon.

Charlotte A.M. Cecil, Ph.D., is an associate professor in biological psychopathology at the Department of Child and Adolescent Psychiatry at the Erasmus Medical Centre, the Netherlands.

Isabelle M. Mansuy, Ph.D., is a professor in neuroepigenetics at the Faculty of Medicine of the University of Zurich, Switzerland.

Epigenetic and Preconception Experiences: Next Steps

• Read: The Future of ADHD Research Looks Like This
• Read: Is ADHD Genetic? Yes and No
• Read: What Causes ADHD? Culture Vs. Biology
• Download: Free Guide to Health & Fitness: Lifestyle Changes for Adults with ADHD

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Black children and adults with ADHD are less likely to receive an accurate diagnosis and proper treatment due to structural racism, low socioeconomic status, and stigma, all of which can worsen the symptoms of ADHD. Racial disparities in health care are critical to recognize and address because untreated symptoms of ADHD — including learning difficulties, impulsivity, inattention, and hyperactivity — can lead to harsh punishment of students in school, failure to graduate, substance use, and increased risk for incarceration.

In this webinar, you will learn:

• About risk factors for ADHD in Black individuals
• About the facets of racism and the present-day policies that impede proper diagnosis, care, and treatment of ADHD in Black communities
• About the serious consequences associated with untreated ADHD
• What adults and caregivers of children with ADHD need to know to find appropriate providers and ensure proper care and treatment
• How adults and caregivers of children with ADHD can effectively address stigma, build trusting relationships with clinicians, and overcome other barriers to treatment
• About strategies, including Parent Behavioral Training Programs, that can be effective for managing ADHD in families of color

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

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; Audacy; Spotify; Amazon Music; iHeartRADIO.

Healthy Equity in ADHD: More Resources

• Get: 2024 Scorecard of ADHD Treatments
  
• Read: The Ongoing Work of Normalizing ADHD in BIPOC Communities
• Read: Why We Must Achieve Equitable ADHD Care for African American and Latinx Children
• Download: How Common Is ADHD in Adults?

Obtain a Certificate of Attendance

If you attended the live webinar on March 7, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Napoleon Higgins, M.D., is a child, adolescent, and adult psychiatrist in Houston, Texas. He is the owner of Bay Pointe Behavioral Health Services and Kaleidoscope Clinical Research.

Dr. Higgins is the Executive Director of the Black Psychiatrists of America, CEO of Global Health Psychiatry, President of the Black Psychiatrists of Greater Houston, Psychiatry Section Chair of the National Medical Association, and Past President of the Caucus of Black Psychiatrists of the American Psychiatric Association.

Dr. Higgins is co-author of Bree’s Journey to Joy: A Story about Childhood Grief and Depression, How Amari Learned to Love School Again: A Story about ADHD, Mind Matters: A Resource Guide to Psychiatry for Black Communities and author of Transition 2 Practice: 21 Things Every Doctor Must Know In Contract Negotiations and the Job Search. (#CommissionsEarned)

Dr. Higgins has worked with and founded programs that help to direct inner-city young men and women to aspire to go to college and finish their educational goals. He has worked with countless community mentoring programs and has special interest in trauma, racism, and inner-city issues and how they affect minority and disadvantaged children and communities.

#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.

Listener Testimonials

“Fantastic webinar. The examples really brought home the points and he did a good job of showing how complicated this is to navigate.”

“Thank you for providing info about culturally competent ADHD treatment. Dr. Higgins highlighted what us Black parents have always known — that race matters when it comes to medical and educational resources. I wish this information could be proliferated in every school across the nation!”

“Great speaker, and very insightful. I enjoyed this presentation very much.”

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
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“How to ADHD” is a powerhouse. Since launching her YouTube channel in 2015, Jessica McCabe has attracted more than 1.6 million subscribers to her smart, insightful, shame-blasting videos about living with a neurodivergent brain. For many people, Jessica is the face and heart of ADHD.

Diagnosed with ADHD at age 12, Jessica lost things constantly, couldn’t finish projects, and felt like she was investing more effort than everyone around her while falling further and further behind. By her early 30s, she was broke, desperate, and determined to find answers by hyperfocusing wholeheartedly on ADHD research. An actor by trade, she began recording videos to make sense and keep track of what she was learning about her ADHD brain and, in the process, found a community that was also searching for answers and understanding.

Last month, Jessica released her first book, also called How to ADHD. In this special conversation with ADDitude editors, Jessica will discuss themes from her book, including the following:

• The key she has discovered to navigating a world not built for the neurodivergent brain
• How the ADHD acronym is misleading and unhelpful for people who have plenty of attention but an inability to focus that attention
• The economic cost of not treating ADHD, especially in women
• How she’s learned to pay attention to time in new and effective ways that improve self-time management
• How to counteract sleep comorbidities like obstructive sleep apnea, insomnia, sleepwalking, excessive daytime sleepiness, and more

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

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; Audacy; Spotify; Amazon Music; iHeartRADIO.

Living with ADHD: More Resources

• Download: The Ages & Stages of ADHD
• Sign Up: 5-Week Guide to Building Healthier Habits
• Read: ADHD Needs a Better Name. We Have One.
• Read: “Happily Neurodivergent — at Last”

Obtain a Certificate of Attendance

If you attended the live webinar on February 13, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Jessica McCabe is the creator, writer, and star of the YouTube channel How to ADHD. Since its founding in 2015, the award-winning channel—widely respected by treatment providers, ADHD researchers, and especially the ADHD community—has provided scientifically backed and experientially affirming information on how people with ADHD might work with their brains. Her work has been featured by The New York Times, The Washington Post, ADDitude magazine, Today online, Upworthy, and more.

Listener Testimonials

“So inspiring to hear how this speaker designs her life in the ways that support her well-being and strategies that enable her to accomplish the goals she has set for herself.”

“I’ve loved Jessica McCabe for a long time. As a parent who does not have ADHD, her insights into what my child might be experiencing have been invaluable. I ordered her book during the webinar and can’t wait to get started.”

“As a 53-year-old woman who was diagnosed with ADHD when I was 51, it was validating to hear Jessica talk about the challenges she experienced growing up. The last couple of years have been very hard and very enlightening. I look forward to reading Jessica’s book.”

Webinar Sponsor

The sponsor of this ADDitude webinar is….

Accentrate® is a dietary supplement formulated to address nutritional deficiencies known to be associated with ADHD. It contains omega-3 fatty acids in phospholipid form (the form already in the brain). This Brain Ready Nutrition supports attention, focus, and emotional balance. | fenixhealthscience.com

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
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The sink is overflowing with dishes. You know you need to wash them, but the thought alone is overwhelming. Another day goes by, dishes piling higher.

You remember you have a bill to pay. You try to sign in to your account, but you’ve forgotten your password. While you wait for the password reset email, you get sidetracked. Before you know it, that initial bill is forgotten.

This is ADHD – or, more accurately, executive dysfunction – in action. The brain processes humming in the background (i.e., executive functions) that are supposed to help you organize, plan, and execute simply aren’t reliable. Following through, as a result, is a core issue for you, even when you know what you’re supposed to do.

The biggest trap many of us fall into is believing we can “build” executive function or “train away” deficits. This is actually not the most effective way to help those of us with ADHD reliably and consistently do what we need to do. Here, learn why — and what to do instead.

[Take Our Executive Dysfunction Self-Test]

The Hard Truth About ADHD Executive Dysfunction

ADHD might as well be called Executive Function Deficit Disorder. It is fundamentally a disorder that impacts how we use the brain processes that help us perform day-to-day functions and work toward short- and long-term goals.

It’s not that individuals with ADHD necessarily have fewer or less effective executive functions. The problem is that executive functioning is applied inconsistently. We see this when we’re able to hyperfocus on tasks we find interesting yet find it downright painful to focus on what we find boring.

ADHD is a deficit in reliably converting intentions into actions. Your batting average on doing the right thing at the right time is a bit lower than the batting average of most people without ADHD. The question is, how can you improve your stats?

Building a library of executive function skills is not the answer. That’s because you already know how to use a planner to keep organized. You know that reminders are helpful for forgetfulness and time management. You know you should keep a to-do list. You know that you need to eliminate distractions to focus. The problem is with putting these skills to action.

[Read: The Adult ADHD Mind – Executive Function Connections]

Success comes from creating systems and backstops to support existing executive functions and take the strain off them. It’s about setting yourself up – with honesty, self-awareness, and intention – so that you can more reliably coordinate your abilities to make the better choice an easier one.

Strategies to Support Executive Functioning and Achieve Consistency

Externalize, Delegate, and Automate

Take the load off your executive functions by outsourcing the work to reliable tools.

• Externalize to-dos with intention. Whether it’s sticky notes on the bathroom mirror, planners, white boards, voice notes, texts to self, smart speakers, location-based reminders, or recurring alarms on your phone, find a way to dump it all out of your head so you don’t have to internally manage information.
• Set up automatic payments and purchases as necessary.
• Use AirTags and other trackers on your belongings. (Keep losing your keys? Consider installing a keypad or an electronic lock.)
• Use password managers to save logins for various accounts.
• Place clocks everywhere. Digital clocks are okay, but analog clocks may help you be more aware of the passage of time.

Your Environment Matters

Seek environments that allow you to perform at your best. Ask yourself: Where do I seriously do my best work? What keeps me on track?

Be as detailed and honest as possible in your answers, and don’t assume conventional approaches are best. Perhaps your productivity spikes when you work out of a bustling coffee shop. Or maybe it’s total silence you need, found at a corner of your office building or local library. Or you may be unusually productive while taking public transportation. Perhaps it’s variety you need if staying in one spot for too long becomes boring.

A note on clutter: A disorganized environment won’t do you any favors, but it may not be worth worrying about aesthetics if you’re still able to function and get things done in a full space.

Match Tasks to Brainpower

Our energy levels and ability to focus change through the day, so plan your most cognitively demanding tasks for when you have the most brain power. That may mean after a workout, in the morning before other tasks pile up, or in the evening once the day’s responsibilities are behind you. Plan to tackle demanding tasks when your ADHD medication is most effective, not when it’s wearing off.

Cut Down on “Noise” and Friction

Temptations and distractions compete for our attention 24/7. Our executive functions help keep us on track, but why make that harder than it has to be?

• Take willpower out of the equation. Why spend lots of energy resisting your phone when it would be much easier to silence notifications, install an Internet blocker, or keep the phone in another room?
• Think signal-to-noise ratio. Our attention is directed to what is big, loud, and obvious. Consider this as you boost the signal of desired tasks – where you want your attention to go – and reduce the noise of distractions.
• Would you bet $1,000 on it? Too often, we’re overly optimistic about our ability to handle distractions and muster the discipline to get things done. Cut through the false optimism by increasing what’s at stake: Would you bet money that you’ll be able to stay focused with your phone around? That you’ll be able to leave on time without setting (and honoring) reminders? What would it take for you to confidently make that bet?

Speed Up Consequences

We’re more likely to put off doing the things we need to do when the payoffs and consequences are vague, potentially avoidable, or too far off. It’s why we end up working on large and important school or work projects at the last possible minute, when consequences for failing to turn in work are front and center.

• Make potential regret come faster. Create artificial consequences that are immediate, certain, and specific enough to spur yourself into action. Take the initiative to schedule weekly check-ins with your boss to review progress on a large project. Externalize accountability by telling a friend about what you intend to do and by when.
• Create artificial circumstances. Set up a rule at home, for example, that phones can only be used after homework is completed.

Reduce Stress and Chaos

Chaos begets chaos. More things are likely to fall through the cracks with a disorganized, chaotic life. Trying to juggle it all and scrape by further burdens your executive functions. Reduce the chaos in your life by finding order wherever you can — with routines and healthy habits — to take the pressure off sensitive brain functions that are better used on cognitively demanding tasks. Intentionally build in breathing room to your daily schedule, especially during tricky transitions.

We can all agree that exercise, sleep, healthy eating, and mindfulness benefit cognitive and emotional processes, so don’t neglect these areas. Medication helps people with ADHD do what they know, so take medication as indicated.

Maintain Motivation by Enjoying the Journey

The central question that will follow you throughout your life as you manage ADHD is, “How will I do the things I know I want to do?” The answer lies in continuing to set up good processes that will help you experience more desired outcomes than negative ones. The more success and productivity you experience in managing ADHD’s impact on your life, the healthier your self-esteem will be.

• Make processes enjoyable. The benefits of making better choices — like reviewing your notes every day, dedicating time to keep your spaces organized, filing important documents, going to sleep on time, and attending to other responsibilities — often arrive far too gradually to fuel motivation. To the extent that you can, find ways to make these processes and routines fun and easy. Reward yourself along the way for putting one foot in front of the other.
• Don’t do it for anyone else. The processes you create are for your benefit only, not for anyone else’s seal of approval. The more you remember this, the easier it will be to seek changes that improve your life, without looking to the opinions of others as motivators.
• Always credit yourself for taking positive actions. Given how much criticism and correction those of us with ADHD receive, take pride whenever you make the right choices that set you up for success (or get you closer to it). Never sell yourself short, and don’t worry about achieving perfection.
• Setbacks are inevitable. Don’t beat yourself up or catastrophize when they happen. Handle them resiliently by refusing to surrender.

ADHD Executive Dysfunction: Next Steps

• Read: What Is Executive Function? 7 Deficits Tied to ADHD
• Read: Your Executive Functions Are Weak. Here’s Why.
• Read: Intention Deficit Disorder — Why ADHD Minds Struggle to Meet Goals with Action

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “Executive Function Strategies to Externalize Time, Memory, Motivation” [Video Replay & Podcast #479] with Ari Tuckman, Psy.D., MBA, which was broadcast on November 9, 2023.

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.

By Russell Barkley, Ph.D.

DSM-5 ADHD criteria are flawed for several reasons. “The DSM-5 does not capture ADHD accurately because its criteria do not conceptualize ADHD as a disorder of executive functioning and self-regulation,” says Russell Barkley, Ph.D. “This limitation greatly narrows the concept of ADHD, trivializes its nature as just an attention deficit, and discourages diagnosing clinicians from focusing on the wider range of impairments inherent in ADHD.”

Despite these flaws, Barkley explains, clinicians can ensure more accurate diagnoses by focusing more on the patient’s symptoms of disinhibition and executive dysfunction and less on the age of onset for ADHD symptoms.

Continue reading “How the DSM-5 Fails People with ADHD — and a Better Way to Diagnose”

DSM-5 ADHD Criteria Challenged: Related Resources

• Read: ADHD Is a Whole-Life Experience. The DSM Needs to Reflect That.
• Read: Why We Need U.S. Guidelines for Adults with ADHD
• Read: What do I need to understand about ADHD that is not fully represented in the DSM?
• Download: How Is ADHD Diagnosed?

2. Deciphering Irritability in Children: Causes and Links to Comorbidities

By William French, M.D., DFAACAP

“Irritability is to mental health providers what fevers are to pediatricians,” says William French, M.D., DFAACAP. “Just as a fever is a core symptom of numerous illnesses and infections, irritability is a core symptom of many mental conditions.” In this guide, French outlines possible causes of irritability and provides a detailed overview of conditions such as DMDD, ODD, ADHD, and bipolar disorder. He analyzes emerging research on treatment approaches and interventions.

Continue reading “Deciphering Irritability in Children: Causes and Links to Comorbidities”

Irritability in Children: Related Resources

• Read: The ADHD-Anger Connection
• Read: Top Emotion Regulation Difficulties for Youth with ADHD
• Self-Test: Could Your Child Have DMDD?
• Read: The Parents’ Guide to Dismantling Oppositional, Defiant Behavior

3. Treatments for Depression and ADHD: New and Forthcoming Approaches

By Nelson M. Handal, M.D., DFAPA

Rising rates of depression — a condition that often accompanies ADHD — have attracted well-deserved concern and attention. Here, Nelson M. Handal, M.D., DFAPA, reviews what we know about major depressive disorder (MDD) and ADHD, combs through the latest treatment options for depression, and touches on alternative approaches for managing depression. “The field of depression treatment is making huge advances,” Handal says, referencing psychedelics, Spravato nasal spray, Zurzuvae (zuranolone), a rapid-acting oral treatment that was approved to treat postpartum depression, and others promising treatments for MDD.

Continue reading “Treatments for Depression and ADHD: New and Forthcoming Approaches”

Treatments for Depression: Related Resources

• Read: The ADHD – Depression Link
• Read: What to Expect When You Start Depression Medication
• Download: The Facts About Major Depressive Disorder in Women
• Read: How Undiagnosed ADHD Triggers Depression and Anxiety

4. Differential Diagnosis of Bipolar and ADHD: Taking a Phenomenological Approach

By David W. Goodman, M.D., LFAPA

A thorough and accurate diagnosis is critical before treating bipolar disorder, ADHD, or the two together. However, high rates of comorbidity and a constellation of overlapping symptoms make the task of distinguishing between bipolar disorder and ADHD especially challenging. David W. Goodman, M.D., LFAPA, explains how clinicians can differentiate between the two conditions.

“To arrive at an accurate differential diagnosis, a clinician must carefully consider family psychiatric history and dial into the patient’s phenomenological experience. The latter focuses on specific symptoms and qualitative nature,” he says. “For example, there is a qualitative difference between a tension headache and a migraine headache, even though both are headaches. The same difference can be seen in sadness vs depression — a qualitative difference in the psychological experience.”

Continue reading “Differential Diagnosis of Bipolar and ADHD: Taking a Phenomenological Approach”

Bipolar Disorder and ADHD: Related Resources

• Download: Solving the Bipolar and ADHD Puzzle
• Read: How to Distinguish ADHD’s Rejection Sensitive Dysphoria (RSD) from Bipolar Disorder
• Read: The Physicians’ Guide for Distinguishing Bipolar Disorder and ADHD
• Self-Test: Bipolar Disorder in Adults

5. Prenatal and Early Life Risk Factors of ADHD: What Research Says — and What Parents Can Do

By Joel Nigg, Ph.D.

Is ADHD caused by birth trauma? Do prenatal complications like maternal obesity or hypertension increase a child’s risk for ADHD? What role do prenatal and postnatal exposures to substances, such as alcohol and smoking, play in the development of ADHD? Joel Nigg, Ph.D., explores the answers to these difficult-to-answer questions and provides an overview of the latest research and steps parents can take to protect their child’s health. “Exposure to risk factors does not guarantee ADHD, and early and effective treatment approaches can often mitigate the effects of previous complications and improve outcomes,” he says.

Continue reading “Prenatal and Early Life Risk Factors of ADHD: What Research Says — and What Parents Can Do”

What Causes ADHD? Related Resources

• Read: Epigenetics and ADHD: The Impacts of Environment, Lifestyle, and Stress
• Download: Free Guide to Hormones & ADHD in Women
• Read: Treating for Two: ADHD Meds in Pregnancy
• Watch: The Unspoken Truths of Postpartum Depression: Help for Women with and Without ADHD

6. The Future of ADHD Research Looks Like This

By Peter Jensen, M.D.

While no one can predict the scientific discoveries that lie ahead, three research areas are especially promising for improving our understanding of ADHD: neuroimaging, genetic research, and non-pharmacologic interventions, like transcranial magnetic stimulation and attention training. Here, Peter Jensen, M.D., describes these key three areas of ADHD research.

“As we discover more specific gene and brain developmental pathways, we should expect to find that different and precise interventions work for different ADHD subtypes, depending on the individual’s particular gene-environment mix and how factors unfold over time,” he says.

Continue reading “The Future of ADHD Research Looks Like This”

ADHD Research Updates: Related Resources

• Download:  Health & Fitness Lifestyle Changes for Adults with ADHD
• Read: The Evolution of ADHD: Examining the Last 25 Years — and the Future
• Watch: ADHD Then and Now: How Our Understanding Has Evolved
• Read: Beyond Genes: Leveraging Sleep, Exercise, and Nutrition to Improve ADHD

7. Sobering Advice: How to Treat ADHD Alongside SUD

By Timothy Wilens, M.D.

ADHD medications — both stimulants and non-stimulants — may be used to treat patients with comorbid substance use disorder and typically improve outcomes for patients with both conditions. “Unfortunately, many patients who have an active SUD (or even a past history of substance use issues) are either not diagnosed with ADHD or, even with a diagnosis, they are denied medication and appropriate treatment for their co-occurring ADHD due to overstated and misplaced fears, bias, and misinformation,” says Timothy Wilens, M.D. “In other words, far too many clinicians discriminate against patients with comorbid ADHD and SUDs.” Here, Wilens examines the role ADHD medications play in SUD treatment and suggests steps to curtail prescription misuse.

Continue reading “Sobering Advice: How to Treat ADHD Alongside SUD”

Substance Use Treatment with ADHD: Related Resources

• Read:  The ADHD & Addiction Link — Addictive Behaviors in Adults Explained
• Read: Does Stimulant Medication Cause Drug Dependence?
• Self-Test: Could You Have a Substance Use Disorder?
• Read: 5 Key Facts About Substance Use Disorders

8. First-Ever Adult ADHD Guidelines Forthcoming

By Carole Fleck

ADHD diagnoses among adults are growing faster than ever in the U.S. despite the absence of formal clinical guidelines for the accurate evaluation and treatment of the condition after childhood. That’s about to change. A task force commissioned by the American Professional Society of ADHD and Related Disorders (APSARD) is developing ADHD diagnosis and treatment guidelines for adults in the U.S., to be published in 2024. In an interview with ADDitude, APSARD President Ann Childress, M.D., discussed the implications of the forthcoming guidelines. “ADHD in adults is not just a minor inconvenience — it is a major public health problem,” Childress says. “Guidelines will help practitioners who previously may have felt uncomfortable evaluating and treating adults with ADHD, and these will improve access to high-quality care.”

Continue reading “First-Ever Adult ADHD Guidelines Forthcoming”

ADHD Treatment & Diagnosis Guidelines: Related Resources

• Read: Adult ADHD Is Real — and Still Heavily Stigmatized
• Read: ADHD in Older Adults: Distinct Diagnostic and Treatment Considerations
• Download: How Common Is ADHD in Adults?
• Read: ADHD in Women and Girls — Why Female Symptoms Slip Through Diagnostic Cracks

9. How Undiagnosed ADHD Triggers Depression and Anxiety

By Nelson M. Handal, M.D., DFAPA

Depression and anxiety disorders occur with ADHD at significant rates. What explains these high comorbidity rates? “Many factors may explain the overlap, and one of them I can’t stress enough: ADHD does not happen in a vacuum, and its effects are far more impairing when the condition goes undiagnosed, untreated, or improperly treated,” Nelson M. Handal, M.D., DFAPA, says. Here, Handal shares why depression appears to take a more significant toll on women with ADHD and how undiagnosed and/or untreated ADHD manifests in patients with depression.

Continue reading “How Undiagnosed ADHD Triggers Depression and Anxiety”

Untreated ADHD in Adults: Related Resources

• Download: Signs of Depression That May Surprise You
• Self-Test: Depression in Adults
• Read: The Depression Treatment Gap for Teens — And How to Close It
• Read: What’s Behind the “Depression Gap” Impacting Women?

10. “A Daily Nightmare:” One Year into the ADHD Stimulant Shortage

By ADDitude Editors

More than one year into the ADHD stimulant shortage, patients still struggle to fill their prescriptions for Adderall XR and other stimulants like Vyvanse, Concerta, and Focalin.

According to an ADDitude survey of 11,013 caregivers and adults with ADHD, roughly 38% of all patients have had trouble finding and filling their prescription medication over the last year, and 21% continue to suffer treatment disruptions today. Here, ADDitude readers share how they have been forced to forgo medications, make do with substitutes that aren’t as effective or cause bothersome side effects, and ration out a dwindling supply, often dividing it between multiple family members with ADHD.

Continue reading “‘A Daily Nightmare:’ One Year into the ADHD Stimulant Shortage”

ADHD Medication Shortage: Related Resources

• Read: How the Adderall Shortage Is Casting a Long Shadow on ADHD Treatment
• Read: The Real Reason ADHD Medication Supply Is Lagging Demand
• Read:  Generic Adderall Shortage Extends to Vyvanse, Ritalin

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

The association between Bisphenol-A (BPA) exposure and neurodevelopmental disorders is linked to a compromised metabolic process that powers plasticizer detoxification, according to a study published in PLoS ONE that expands on existing evidence linking BPA to autism spectrum disorder (ASD) and extends this finding to include attention-deficit hyperactivity disorder (ADHD).¹

Glucuronidation is a metabolic process that eliminates harmful drugs, toxins, and carcinogens from the body through urine. BPA is typically metabolized quickly; when glucuronidation is impaired, the body is exposed to the adverse effects of BPA for longer. This new research, which studied the urine samples of 149 children aged 3 to 16, found that glucuronidation efficiency for BPA was reduced by 17% for children with ADHD and by 11% for children with ASD, compared to controls.

Humans are exposed to BPA mainly through food packaging, contaminated food or water, or inhalation of plastic airborne particles. Between 2009 and 2010, the U.S. National Health and Nutrition Examination Survey (NHANES) detected BPA in 92% of urine samples in the general population, with slightly higher levels found in women and children.² A study cited by the researchers showed higher urinary concentrations of BPA in children with neurodivergent conditions.³ However, according to the FDA, the levels of BPA found in food products are not a threat to human health and safety.⁴

“How important plasticizer-originated neurodevelopmental disorder is in the overall occurrence of these disorders is not known, but it must account for a significant proportion or it would not have been so easy to detect in a metabolic study of moderate size such as this study,” the researchers wrote.

Researchers built on a previous study from 2015, which showed that the efficiency of glucuronidation of BPA metabolites was lower in children with ASD.⁵ They extended these findings to include ADHD and ruled out other plasticizer sub-pathways in the current study.

“There is nothing new about the efficiency of glucuronidation affecting metabolism and being associated with disease,” they said. “What is new is that we show this is also a plausible mechanism for ASD and ADHD.”

The use of common plasticizers and phthalates has been widespread since the 1950s to make products more flexible and durable. Exposure doesn’t always lead to harmful health effects,⁶ but recent decades have seen a decline in the use of plasticizers, particularly in products for young children. DEHP, an organic compound found in many plastic products, is prohibited in children’s toys and childcare articles, and BPA is now eliminated from baby bottles and sippy cups. At certain levels, bisphenol and phthalates can lead to reproductive harm, including infertility and early puberty.⁷

Disruptions to hormone functioning and gene mutations have also linked plasticizers to neurodevelopmental disorders, as cited by the researchers. Genetic susceptibility plays a central role. Many other factors are likely involved, says Charlotte Cecil, Ph.D. “The reality is that no single factor, either genetic or environmental, at the moment, has really emerged to be either necessary or sufficient to explain why a given individual might develop ADHD and particularly any impairment related to that,” she said in a recent webinar on epigenetic research and ADHD.

The study included 12 glucuronidation pathways, none of which showed an association with the control group. The diethylhexyl phthalate (DEHP) sub-pathway showed a similar but non-significant association with ADHD and ASD and was the only other notable sub-pathway besides BPA.

Sources

¹ Stein, T.P., Schluter, M.D., Steer, R.A., & Ming, X. (2023) Bisphenol a and phthalate metabolism in children with neurodevelopmental disorders. PLoS ONE 18(9): e0289841.https://doi.org/10.1371/journal.pone.0289841

² U.S. Environmental Protection Agency. (2013). America’s children and the environment, third edition. https://www.epa.gov/sites/default/files/2015-05/documents/biomonitoring-bpa.pdf

³ Minatoya M, Kishi R. (2021). A review of recent studies on bisphenol a and phthalate exposures and child neurodevelopment. International Journal of Environmental Research & Public Health, 18(7):30. https://doi.org/10.3390/ijerph18073585

⁴ U.S. Food and Drug Administration. (2023, April 20). Bisphenol a (BPA): use in food contact application. https://www.fda.gov/food/food-packaging-other-substances-come-contact-food-information-consumers/bisphenol-bpa-use-food-contact-application

⁵ Stein, T.P., Schluter, M.D., Steer, R.A., Guo, L., & Ming, X. (2015) Bisphenol a exposure in children with autism spectrum disorders. Autism Research, 8(3):272–83. https://onlinelibrary.wiley.com/doi/10.1002/aur.1444

⁶Centers for Disease Control and Prevention. (2021, April 5). Phthalates factsheet. https://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html

⁷Callaghan, M.A., Alatorre-Hinojosa, S., Connors, L., Singh, R.D., & Thompson, J.A. (2021). Plasticizers and cardiovascular health: role of adipose tissue dysfunction. Frontiers in Pharmacology, 11. https://www.frontiersin.org/articles/10.3389/fphar.2020.626448

Why is attention deficit still dismissed, overlooked, and misunderstood at school? It’s important to note that ADHD is not considered a learning disability in special education law.¹ Of the 13 categories listed in the Individuals with Disabilities Education Act (IDEA), ADHD is classified under “other health impairments” and not as a specific learning disability. Perhaps it’s time for a change.

Explicitly naming ADHD in the IDEA could help unlock more specific and helpful accommodations in IEP and 504 Plans. It could also facilitate the teacher training needed to guarantee an equitable education. For now, though, that training is rare and misunderstandings abound.

The Misunderstood Era of ADHD

We asked caregivers to reflect on their child’s relationship with teachers, or to look back on their own experiences in the classroom. What do educators most often misunderstand about ADHD? About learning differences?

“My 10-year-old son is answering this question, and he says, ‘They often don’t realize that we need more breaks, and think more creatively about problems and solving them, which can sometimes look different than the way the teacher would want to see the problem solved.’” — Jonathan, Texas

[eBook: The Teacher’s Guide to ADHD School Behavior]

“My 14-year-old son is a student in a public high school in New York City. I can’t believe that the school still treats his occasional unregulated behavior with both detentions and suspensions. They take any backtalk from him personally and punish him for it instead of recognizing that it is a symptom of a neurodivergent condition and treating it as such.” — Josephine, New York

“[Educators think] ADHD students are not fit for public school, and that they will not flourish in a public school setting.” — Lisa, Texas

“As a former educator, I was not adequately trained to understand or identify learning differences. I took an entire credit course on ADHD and did not know that I myself had ADHD.”

“Because of my daydreaming, I often didn’t pay attention. Then my anxiety would keep me from answering when questioned by a teacher. I feel like I was written off as ‘stupid’ in elementary school.” — Debbie, Ohio

[Read: 10 Ways We Would Fix the U.S. School System]

“Educators do a great job trying to understand ADHD. School administrators that handle behavioral issues are where we run into problems…” — An ADDitude reader

“Educators don’t seem to have an understanding of invisible disabilities and take ADHD as a personal affront to their authority.” — Denise, Alabama

“Even now, too many educators believe having ADHD is a choice. It is not! I was labeled unruly and unwilling to ‘settle down’ or take my studies seriously.” — Cee, West Virginia

“Fidgeting does not mean that I am not listening. This accusation was placed on me at a teacher training. When I stressed out, I started to crochet to calm my mind and was written up for rudeness.” — Ann, California

“I think they don’t know a lot about the differences between ADHD and LD. Even today, educators use the term ‘ADHD’ just because a child cannot focus in class. They fail to understand that even kids with LDs will not stay focused when they do not understand what is being taught.” — Boon Eu, Malaysia

“I think they understand [ADHD], but they don’t have the resources to respond appropriately. The most important thing, in my opinion, is for teachers to be kind and not label kids as naughty or deliberately disruptive.” — Jen, Australia

“Educators with enough sensitivity or compassion can work well with ADHD kids because they can intuitively make changes to help the child. Others, who just aren’t as sensitive or compassionate, can be taught about ADHD but will never be excellent teachers for ADHD kids. I left the regular school system because I got tired of teachers telling me that my kids were lazy or just weren’t trying, even after we did educational assessments to prove that they had ADHD.” — Sarah, Canada

“Many teachers do not see past disruptive behavior. My report card always said I was ‘distracted’ or ‘bored.’ As a result, they put me in advanced classes and never even talked about [my] ADHD. My kids weren’t as disruptive as I was, but I feel like most people get annoyed and ignore the behaviors rather than try to question or find the source of the it.” — Stephanie, Florida

“Educators don’t understand that you can’t just try harder like everyone else. They think you can adopt neurotypical learning styles and succeed. So, they push these tactics that work for neurotypical students rather than receive training on what else to do.” — Anne, New Zealand

“Most educators, then and now, still marginalize students with any neurodivergent condition. Some of that seems to be on the parents; not all guardians are willing to have their children tested and diagnosed. It may seem odd that adults still worry about stigma — but as a parent to an ADHD teen, an ADD sufferer myself, and a language teacher for the past 12 years in elementary schools, it has become painfully obvious that these issues still aren’t adequately addressed. I believe this is due to the challenge of educating every unique individual in what, to me, has become an outdated and ineffective educational system — one in which we still warehouse youth. Large-group learning can’t help but require conformity. And that’s obviously not a solution.” — Sandra, Pennsylvania

“Most think it is an excuse and not a real diagnosis. Also, my child is autistic with ADHD. If the teachers have ADHD experience, they don’t realize or understand that there is a difference when comorbidities are involved. Different methods are needed.” — Maureen, Texas

“They think that ADHD is something that can be changed if the person tried harder. People with ADHD can be ‘extra’ if they are not in environments that are conducive to learning. Instead of realizing that the environment is the problem and making appropriate accommodations, they view the person with ADHD as the problem. They require students to ‘suffer through it’ because they think this will somehow make the ADHD go away.” An ADDitude reader

Misunderstood ADHD in the Classroom: Next Steps

• Download: What Every Teacher Should Know About ADHD
• Read: “We Are Behind the Times:” Only 4 in 10 Educators Receive ADHD Training
• Read: How to Talk to and Uplift Students with ADHD

Sources

¹Jones, L. (n.d.) Are kids with ADHD covered under IDEA? Understood. https://www.understood.org/en/articles/are-kids-with-adhd-covered-under-idea

Far too many people of color still believe that our children are over-diagnosed and over-medicated for ADHD. They believe that giving our children ADHD medication means we are not capable of disciplining them, so we use pills to control them.

At the same time, many clinicians and education professionals still perceive ADHD as a disorder of little white boys and attribute the very same behaviors in Black children as seriously problematic, with no thought that ADHD might be the issue. This mindset continues to inflict serious consequences on Black children.

[Sign Up: The Clinicians’ Guide to Differential Diagnosis of ADHD]

Welcoming Clinicians of Color

One of the most impactful and important changes of the last 25 years is that we finally have some treating professionals who look like us and sound like us; not nearly enough, but some. This makes a tremendous difference in understanding, diagnosing, and treating ADHD in our communities. We are much more likely to trust doctors and other mental health professionals who we feel at least partially understand us and can relate to our experiences. We now have African-American and other coaches of color who were not available a generation ago. Given the importance of coaching, especially for teens and adults with ADHD, this is a huge positive change.

More adults today not only acknowledge and embrace their diagnosis, but actually celebrate it through advocacy and public-facing activities. African-American and Latinx men and women have launched Facebook pages, virtual support groups, blogs, and podcasts in which they address the challenges of, and solutions to, living with ADHD. Aside from bringing ADHD “out of the closet,” these advocates help reduce the stigma around the disorder and give hope to many with ADHD who have felt isolated and alone.

In some ways, we’ve been fighting the same battle for the 30 years of my career as an ADHD advocate. But we also have made great progress around neurodivergence in communities of color.

Let’s work together to make giant strides for the next 25 years!

Advocating for Diversity in ADHD Care: Next Steps

• Download: Step Up and Speak Out About ADHD
• Watch: Scrutinizing Barriers to Health Equity, Diagnosis, & Treatment
• Read: The History of ADHD and Its Treatments
• Read: Cultural Considerations for Clinicians

Evelyn Polk Green, M.Ed., is a past president of the Attention Deficit Disorder Association (ADDA) and Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

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.

The use of fMRI brain scans in ADHD research has helped scientists spot abnormalities in underlying neural networks and circuitries. Differences in the default mode network (overactivity) and frontostriatal circuits (underactivity) of the ADHD brain remain key findings.

“The default mode network (DMN) is one of the most fascinating and significant discoveries to come out of neuroscience in the past 20 years,” writes Edward Hallowell, M.D., in his ADDitude article, “ADHD’s Secret Demon — and How to Tame It.” “The DMN seems to be more active in those of us who have ADHD, and it may explain our tendency to make ‘careless’ mistakes. In fact, when using a functional MRI, you can predict a mistake 20 seconds before it is made by watching for activity in the DMN.”

The emergence of multiple large-scale, multi-site studies has called into question other previous conclusions from neuroscience research. In short, complex answers are replacing some of our more simple ones, and care is improving as a result.

“Large-scale, multi-site, open-science data sharing brings us closer and closer to the idea that we might discover either objective task-based markers or objective biological markers that would allow us to index risk for ADHD and make this not so much dependent on therapists’ subjectivity and the quality of a diagnostic interview,” Anderson said during his 2023 ADDitude webinar on the evolution of ADHD.

For more information about the evolution of ADHD research and diagnostic tools, watch Dr. Anderson’s free ADDitude webinar, “ADHD Then and Now: How Our Understanding Has Evolved.” Dr. Anderson is Vice President of School and Community Programs and former Senior Director of the ADHD & Behavior Disorders Center at the Child Mind Institute.

ADHD Research: Next Steps

• Download: Unraveling the Mysteries of Your ADHD Brain
• Read: 3 Areas of Research Advancing Our Understanding of ADHD
• Quiz: Check Your Knowledge — ADHD Myths vs. Reality
• Read: ADDitude’s Top 25 Reads for Professionals

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.

ADHD was not included in the DSM until 1968, when it was called Hyperkinetic Reaction of Childhood. The name was changed to attention deficit disorder in 1980. Doctors and scientists once used the terms “Clumsy Child Syndrome” and “Organic Brain Disease.”

ADDitude asked readers whether they thought ADHD was a terrible name for the condition: 52% said yes, 34% were neutral, and 14% said the name was appropriate. Here, readers offer their suggestions for an ADHD name change:

[Download: 25 Things to Love About ADHD]

• Neuro Spicy
• Capacity Management Syndrome
• Exceptional Artistic Ability of the Genius Variety
• Can’t Live Up to Your Bullsh*t Expectations Syndrome
• Variable Attention Trait Disorder (VAT)
• Executive Malfunction Disorder
• Emotional Regulation Disorder
• Zoomies
• Dysregulated Attention Disorder (DAD)
• Selective Attention Impulsive Disorder (SAID)
• Neuro-Overload Disorder (NOD)
• Chronic Overwhelm Disorder (COD)
• Racecar Brain
• Dopamine Attention Variability Executive Dysfunction (DAVE)

Other Names for ADHD: Next Steps

• Download: How Common Is ADHD in Adults?
• Read: Do You Speak ADD? Humorous ADHD Definitions
• Read: Is ADHD a Spectrum Disorder?

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.