By Jeni Robinson, MD
She wonders if she’s just being scatterbrained, and is frustrated that she double-booked herself again.
He’s been fighting with his partner more frequently, because his lack of attention has started to feel personal.
She’s 9 years old, and can’t express the shame she feels when everyone else finishes class assignments so much faster.
He’s brilliant, but his extreme procrastination on his thesis threatens his ability to graduate.
Feel familiar? It can feel isolating – even hopeless – to struggle with everyday activities that others handle with ease.
It could be ADHD – attention deficit hyperactive disorder. ADHD is often marked by a pattern of inattention and/or impulsive behavior that makes it hard to function. Diagnoses of ADHD have more than tripled since 2010, due in part to increased testing – and better understanding that women are more likely to fly under the radar because they’re less likely to have the hyperactive component. (Tests are evolving to better measure the mix of symptoms, and to address ADHD on a spectrum, not as a yes-no diagnosis.)
Concern about ADHD symptoms has skyrocketed across the U.S. and here at home. That’s actually a good thing. There’s more awareness of neuro diversity – the many different ways human brains work. Credit social media, films and TV, and advocacy by and for people with ADHD, autism and other neurodivergent conditions. At the same time, a decrease in stigma about mental health concerns has encouraged people to seek diagnosis and treatment.
Those with ADHD are often quick on their feet, adaptable, good in a crisis and think creatively about problems. But there are challenges with ADHD, too.
ADHD symptoms include:
- Inattention
- Hyperactivity
- Trouble focusing on a task, conversation, or thought
- Challenges in relationships
A formal diagnosis can help differentiate between ADHD and other conditions like anxiety, to treat it appropriately. ADHD treatment might include medication; developing coping strategies; adjusting expectations; and – for students – accommodations to better succeed in learning.
The best option is formal testing by a psychologist or psychiatrist, though testing can be done via a questionnaire for adults, and multiple questionnaires for kids from family and school. It’s best for kids to be tested in-person.
But there are barriers to testing: Demand has outpaced capacity, locally and across the U.S.
Some facilities have a 2-year waiting list. To fill the void, online diagnosis mills have popped up, providing questionable and sometimes harmful testing.
It’s important to schedule an ADHD diagnostic test with a qualified mental health provider. Even if the wait is long, it’s best to schedule a formal evaluation.
In the meantime, these resources can help you cope with challenges of suspected ADHD:
Your peers. There are others in your community struggling with similar concerns. You are not alone.
Time management tools. Think back to a time you stayed on-task. What worked? Some people with ADHD set up a multi-pronged system with built-in reminders and calendars with list functions. Others find that overwhelming. Try to be curious about how you function, to find the best system for you.
A body double. Enlist a friend to do tasks at the same time as you – even something as simple as cleaning your room or brushing your teeth. Doing it in tandem can help you prioritize and stick with the task.
A place for everything (and everything in its place). Set a permanent location for whatever it is you keep losing – keys, phone, wallet. It’s like cubbies for schoolkids, or key racks for patients with dementia. You can outsmart that ADHD impulse to set it and forget it.
Time blocks. To visualize your day better, set a block of time for a task – opening the mail, sorting paperwork. Break tasks into chunks you can manage and measure. Is 30 minutes your maximum for concentration? Set aside that half hour and tackle only what you can achieve in that time.
Check ins. Intentionally connect with your partner and family members to give them your attention, and decrease possible resentments.
This book: Gabor Maté is a psychiatrist who has ADHD. His book Scattered Minds covers the inner workings of ADHD, from inattention (and the shame that comes with it) and relationship challenges to explaining how stimulant medication can help. Maté offers this great analogy: He compares the brain’s inability (in the prefrontal cortex) to manage incoming data to a busy intersection with a police officer asleep on the job . . . crowded, chaotic, disorganized. Stimulants help “wake up” the officer in the prefrontal cortex, which helps regulate information overload.
Be curious, not critical. Observing what makes you different is healthier than criticizing yourself for “making mistakes.” Get to know yourself; then it’s easier to figure out what works for you as you make your way in the world.
Dr. Jeni Robinson is a Family Medicine physician, caring for patients of all ages in NH+C’s Farmington Clinic. Special interests include female health and mood concerns. Her philosophy of care: “I want to listen, especially if you’ve felt unheard, and I want to organize if the complexity feels overwhelming. I want to get to know your whole family, help dispel worries, and have the honor of walking beside you if your health becomes a journey you never really wanted to take.”