Forget the myths: What ADHD is actually like
This started life as a more accessible version of my ADHD list for writers, and turned into a two-part series. That’s how ADHD works sometimes.
EDIT 1/1/17: New images added to point #7 and header formatting fixed. Please share this version instead!
1. We’re not all hyperactive, extraverted little boys.
Not hyperactive (this is called Inattentive type).
Another myth is that men have hyperactive or combined ADHD and women have inattentive ADHD. But there are men with inattentive ADHD and women with hyperactive or combined ADHD. They’re just less common.
Yet another myth is that people with ADHD lose their hyperactive symptoms by the time they grow up. Many do, but there are still adults with combined type around.
2. Some of us get good grades and behave well in school.
A common myth about ADHD is that we’re just misbehaving kids who need to be spanked more. Nonsense like this:
But actually, many of us looked more like this in school, especially if we had Inattentive type ADHD.
When bored, we can daydream, look out the window, or doodle. Teachers might not notice us, or might even enjoy teaching us.
Furthermore, some people with ADHD are smart, learn easily, and are interested in school. This lets them get good grades…until the demands to turn organized work in on time become too overwhelming.
3. We can pay attention. We just can’t regulate our attention.
Some parents and doctors claim a child can’t have ADHD if they can focus on video games for hours. Nothing can be further from the truth. If anything, we have trouble stopping!
We can focus for hours on something that interests us. Or on procrastinating.
But we’re worse than most people at focusing on things that are boring or unimportant to us.
We also have difficulty controlling the amount of attention we pay. Our attention works like this:
When we pay full-on attention, it’s called “hyperfocus.”
Hyperfocus is great when you’re writing a paper, but exhausting when you’re doing mindless tasks like washing dishes or checking e-mail.
4. We don’t always think fast, talk fast, or have lots of energy.
Some of us struggle with fatigue and slow processing speed. In fact, a new subtype of ADHD, Sluggish Cognitive Tempo, was proposed to describe this problem.
The stereotype about ADHD is that we can’t focus because there are too many thoughts and sensations in our heads, and we keep jumping from one to another.
But those of us who fit the Sluggish Cognitive Tempo description can be distracted for very different reasons.
Imagine how you feel after getting only three hours of sleep several nights in a row. You probably feel groggy, have very few thoughts moving through your head, and respond slowly when people talk to you. You probably have trouble concentrating, multitasking, remembering to do things, and making decisions. Instead of having too many thoughts, and noticing too many things, you have too few. You just feel like you don’t have the energy to pay attention to anything. That’s what it’s like.
This experience is sometimes called “brain fog.”
We can also have inconsistent processing speed.
Sometimes, I think and talk so fast it irritates other people. Everything feels like it’s happening in slow motion and I get bored. I interrupt other people because I’ve already processed what they’re saying before they finish, and I don’t realize it’s my listening that’s finished, not their talking.
Other times, I am just about to answer someone’s question when they irritably repeat themselves, or ask why I’m taking so long to answer. It feels like I’m thinking at normal speed, but other people’s reactions make clear that I’m going too slow.
5. We’re not all athletic adrenaline junkies.
There’s a stereotype that we’re adrenaline junkies who perform surgeries, jump out of planes, or travel round the world starting new businesses.
First of all, many of us have delays or disabilities with motor coordination. As children, people with ADHD can have difficulty with:
Throwing or catching a ball
Second, when you look at the people with ADHD who fit this stereotype, what do they have in common? Most are men, with high energy and either hyperactive/impulsive or combined type ADHD.
Even in mice, male and female brains react to stress differently. It’s possible that men, who tend to externalize, are more likely to thrive on stress. By contrast, women tend to internalize, and might get overwhelmed instead.
Up to a certain point, increasing stress helps you focus. That’s why some people wait until the last minute to study for exams.
But past a certain amount, becoming more stressed starts to hurt you.
And long term, living under high stress hurts both your physical and mental health.
Some people with ADHD rely on increasing their stress levels to get stuff done. A disability services counselor I met in graduate school actually recommended this strategy to me.
She should have known better. Even if you benefit from putting yourself under stress, you will pay steep long-term costs. Having seen family and friends pay them, I don’t think the costs are worth it.
TL;DR, Not all of us benefit from stress, so we don’t all seek it out.
6. Some of us are socially awkward penguins, not social butterflies.
Another stereotype describes us as social butterflies who hide our school difficulties by playing class clown or making friends with everyone. But some of us are socially awkward.
We can come off as awkward or rude because we’re not paying attention and miss cues.
We can have poor sense of timing and inconsistent processing speed. These can make us interrupt other people, or just seem weird.
We can be annoying. We interrupt other people, talk too much, change subjects often, or zone out in the middle of a conversation.
Like elderly people, we can tell you the same thing many times because we forgot we told you.
We also often forget what you tell us. It takes heroic effort to remember, say, friends’ birthdays.
As a result, many of us have mild social difficulties that don’t meet criteria for Autism Spectrum Disorder.
People with ADHD are also more likely to be on the autism spectrum.
7. Being diagnosed and labeled can improve our lives.
People worry about letting their child be diagnosed or labeled, because they think it will make people treat their child worse.
But when you actually talk to people with ADHD, many of them had a very different experience.
Having the label is a relief.
It gives you understanding. It gives you words to describe your experiences for the first time. It means you’re not broken. It means there are other people like you.
The title of a popular ADHD book, “You mean I’m not lazy, stupid, or crazy?” describes the feeling well.
I’ve written about how bad it is to grow up without a diagnosis, and how good it feels to get one, here, here, and here.
What it feels like before diagnosis:
What it feels like after diagnosis:
8. Stimulants don’t turn you into a zombie, but they’re not a cure, either.
If a person with ADHD gets the right medication at the right dose, they don’t turn into zombies. They just become a better-functioning version of themselves.
But stimulants don’t cure ADHD. Yes, if taken for a long time, they do create changes in the brain. But the person still has the same underlying characteristics. If they stop taking stimulants, their ADHD symptoms will become visible again.
Stimulants, like antidepressants, should be thought of like insulin for diabetics. They’re not a cure, and they need to be taken long-term. But they help you manage your symptoms and live a full life.
9. Stimulants aren’t the only way to manage ADHD, and some of us choose not to take them.
Some people with ADHD choose not to take stimulants. And it’s not just because they hate drug companies or fear that the drugs will turn them into a different person.
First of all, only 80% of people with ADHD respond to stimulants. The other fifth can try other kinds of medications. These include:
wakefulness medications (like Provigil),
medications that treat mood disorders (like Welbutrin),
Non-stimulants designed to treat ADHD (Strattera, Edit: NOT Concerta)
Non-stimulants are less powerful than stimulants, so they reduce ADHD symptoms less, but they also have fewer side effects.
Which brings me to the main reason people with ADHD avoid stimulants: side effects.
Stimulants activate the sympathetic nervous system—the one involved in the fight or flight response. As a result, you can get the following side effects:
Increased rate of headaches and migraines
Note: These symptoms are probably the reason for the claim that stimulants stunt children’s growth.
If we’re not taking stimulants, you might see us consuming huge quantities of more socially acceptable drugs: caffeine and nicotine.
That person who goes through a pot of coffee a day, always has a Pepsi in hand, or can’t quit smoking?
They might be self-medicating their ADHD.
Please share this information and help combat myths about ADHD.
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