One of the most treatable âpsychiatricâ disorders (although itâs more accurately a neurodevelopmental disorder), with approximately 90% of patients able to find a treatment regimen that works well for them, given appropriate medical support. ADHD stimulant medications in particular (Ritalin and Adderall and their variations) are some of the most effective psychiatric medications in existence.Â
Contrary to popular opinion, extremely under diagnosed overall, particularly in populations that are not young white boys (women, adults, people of color, etc.)
So there are a LOT of people out there who could be helped by getting a diagnosis and treatment but are not, in part because of the negative stereotypes around ADHD and ADHD medication that are prevalent in pop culture.
Able to coexist with a number of other conditions or traits that may change its presentation and/or impact, including mental illnesses such as anxiety or depression and various learning disabilities but also giftedness/high intelligence.
In fact, in adults diagnosed for the first time, it is extremely common to have comorbidities, in large part because ADHD can be so hard to cope with.
Sleep disorders are also frequently comorbid with ADHD. Additionally, being poorly-rested makes ADHD symptoms worse, which makes you more likely to sleep badly. Itâs a hellish merry-go-round.
In some cases, âtwice exceptionalâ people (gifted + ADHD) have extra trouble getting appropriate support, because some ADHD symptoms can be masked by intelligence (for instance, if a child is bright enough to do their homework in the ten minutes between classes and master the test material by cramming the night before, they may never see the poor academic performance that might lead to testing), and because the symptoms of ADHD may also mask their giftedness - so they end up stuck in classes that are too easy for them, and therefore boring, which makes the ADHD symptoms worse. Also, people who know they are intelligent but have untreated ADHD can be really prone to some of the other psychological comorbidities, especially as they become adults, because they know what to do and how to do it and that they SHOULD do it, and they WANT to do it, but they still canât make themselves actually do it, so they start to beat themselves up, thinking âIâm too smart to constantly be this stupid, I must just be really lazy, maybe I really DONâT care, maybe Iâm just a terrible person.â Ask me how I know.
Can also have less-common symptoms associated with it. I actually had my hearing tested before my diagnosis because I had so much trouble following conversations if there was background noise. My hearing is fine: my issue is auditory processing. My brain just canât focus on conversations if too much else is going on. (This also applies to following dialogue on television if there is a lot of background noise/music. I use the captions a lot.
In some cases, extremely disabling. Under the Americans With Disabilities Act, a disability is âa physical or mental impairment that substantially limits one or more major life activity.â A sampling of major life activities that might be substantially limited by untreated ADHD includes:
Managing finances (largely through impulsive spending, frequent lost items that need replacing, forgetting to pay bills, forgetting to do routine maintenance and having issues like larger repairs needed)
Basic self-care (remembering to take meds, go to doctor appointments, eat and drink at appropriate times, go to bed at appropriate times)
Employment (difficulty being on time for work or work activities, difficulty meeting deadlines, propensity to make âcareless errorsâ, difficulty with emotional regulation)
Interpersonal relationships (memory problems so you never remember important dates, time issues meaning youâre late meeting them, forgetting commitments, easily distracted during conversations, impulsivity leading to interruptions/saying or doing stuff you didnât think through, difficulty responding appropriately to social cues (through distraction/impulsivity), difficulty with emotional regulation)
Maintaining a clean and sanitary home (forgets steps in household chores, distracted away from finishing them, loses key equipment, impulsive purchases clutter up the home, loses interest in projects and leaves them out half-done)
If untreated, linked to higher rates of all manner of negative outcomes when compared to similar neurotypical populations, including:Â
injury or death in accidents, especially car accidentsÂ
None of this is because people with ADHD as a group are, like, bad or lazy or evil or irresponsible or donât care. People with ADHD are just people, and exist on the same range of good, bad, and in-between that all people do. However, the parts of our brains that are meant to help us regulate our emotions, plan for the future, remember to do important things, and not act on every impulse that crosses our minds just donât work properly. A lot of us might lean in to an airhead, spacy artistic type, class clown, or similar persona to mask our deep shame over not being able to âjustâ do all these basic things that other people seem to do with no trouble at all.Â
Additionally, even accessing ADHD treatment can be extremely challenging, because stimulant medications are controlled substances and there are so many false and damaging perceptions about the condition and medications out there. And even when you have a well-established diagnosis and are well controlled on a medication youâve taken for years, you are never far away from potential disruptions to your treatment. I personally am a white professional with good health insurance and was able to get diagnosed and medication prescribed - which in itself is often really difficult - but even from that position of privilege I have experienced multiple gaps in my treatment for reasons like:
My pharmacy lost a prescription and had to get a new one. (My medication cannot be refilled; each month has to be a brand new prescription.)
My pharmacy was out of stock of my medication (I canât transfer that prescription to a different pharmacy, and even if I had a paper prescription, you canât call a pharmacy and be told the medication is in stock, you have to physically go there and ask.)
I forgot to make a doctor appointment in time (I have to have a doctor visit every three months to continue to get the prescription.)
I forgot to fill the prescription (since I, you know, HAVE ADHD, and you canât set them up to auto-renew like you can other meds.)
My prescription is really expensive and there arenât many savings options because itâs a controlled medication. (Even with savings I pay over $100 out of pocket for my ADHD meds every month. If the manufacturer isnât offering a coupon that month itâs close to $300.)
Again, this is a LEGAL medication that I am LEGALLY prescribed by my supportive doctor with consultation from my supportive psychologist, for my actual disabling medical condition, and which all parties involved agree is extremely effective in helping me manage said condition. Iâm in about the best situation you can be in short of being a millionaire who doesnât have to worry about things like preapprovals or copays or taking sick time from work.Â
Iâve also heard from others who have had to change doctors due to moving, job or insurance changes, etc., only to get issues like:
medical practices that flatly refuse to prescribe any controlled medications at all.
medical practices that donât deal with ADHD specifically at all.
doctors that âdonât believe inâ medicating adults/women/people with good jobs/people with good grades/anyone for ADHD.
doctors that wonât accept existing diagnoses or treatment plans.
ADHD is a treatable and manageable condition, but it isnât a joke, it isnât âmade up,â we arenât âall a little ADHD these days anywayâ. Itâs a complex and wide-ranging condition that can impact nearly every part of your life in serious and possibly very damaging ways.
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