The disorder can go undiagnosed in childhood—and show up in subtle ways as you get older.
Like a lot of people who use TikTok, Olivia Howell has noticed that her feed often offers up posts about attention deficit hyperactivity disorder (ADHD). Still, she never paid that much attention to them, until her sister DM’d her a video—which featured a woman’s chaotic inner monologue as she walked through her house—that struck a nerve. “I didn’t know other people lived like that in their head,” Howell tells SELF. After that, more ADHD-related videos that felt a little too familiar popped up on her feed (isn’t TikTok’s personalized algorithm scary-fun like that?), which prompted her to mention it to the psychiatrist treating her for anxiety. Unbeknownst to Howell, the two issues often occur together. She was diagnosed with ADHD shortly after.
Though Howell’s For You page helped clue her in to the potential signs of ADHD in adults, it’s something she (and most others diagnosed with the disorder later in life) have probably had since childhood, Lawrence A. Vitulano, PhD, ABPP, a clinical psychologist and professor of psychology at Yale University, tells SELF. How does that happen? The symptoms may not have been obvious to those around you—say, you got decent grades in school and were more likely to stare out the window than jump around a classroom—or it wasn’t until you had to plan your own schedule as an adult that it was clear how tough it is for you to stay on track.
If you do receive a diagnosis, it’s crucial to remember that ADHD is super treatable, Dr. Vitulano points out, which makes catching its symptoms, even in adulthood, sometimes life-changing. “This disorder, when it’s not managed, can be debilitating,” he says. “If you have diabetes, we treat it. If you have an infection, we treat it—and we want people to feel that way about ADHD.” Here are five (sometimes subtle) signs to be aware of.
1. You find yourself getting distracted by every. little thing
Although scientists aren’t entirely sure what causes ADHD, research suggests genetics plays a pretty big role. “It’s highly inheritable,” Dr. Vitulano explains. The disorder can show up in three major ways, according to the National Institutes of Health (NIH):
Inattention (difficulty staying focused)
Hyperactivity (feeling restless or overly energetic)
Impulsivity (acting without thinking much first)
To be diagnosed with ADHD as an adult, you need to have at least five symptoms that could fit into one or more of these categories (more deets on those in a bit). If you’ve had certain symptoms for at least six months (and some that started before age 12, even if you were never diagnosed) and you find that they interfere with your life, ADHD might be a potential cause to explore. The signs tend to show a little differently in adults, however, which makes detection later in life a little challenging. “I like to think of ADHD as a disorder of motivation,” Dr. Vitulano explains. “It’s really hard to be focused on what you want to get done.” This might look like swiveling your head each time the door opens at a coffee shop, but Dr. Vitulano says that diversion can be subtle. In adults, hyperactivity can also look like extreme restlessness, or you might wear other people out with a go-go-go mentality.
You could also feel scattered or forgetful. “Someone might send their significant other [with ADHD] to the grocery store and ask them to get five things, and they either come home with completely different things than what was asked for or just two of them,” Sid Khurana, MD, a psychiatrist with Nevada Mental Health, tells SELF.
2. Or you can’t seem to control where you steer your attention.
While people tend to think that ADHD is largely about lack of focus, sometimes your tendency to laser on to something can also be too intense, so much so that you can’t seem to control or direct it to other areas of your life. “Maybe you find yourself searching the internet for something for long periods and can’t get off or perhaps you play video games until the wee hours of the morning,” Dr. Khurana notes. Alternatively, you might put off large, long-term goals (say, scheduling health appointments or applying for jobs) in favor of smaller, less critical ones (reorganizing your desk or continuously refreshing your inbox). Basically, per Dr. Vitulano, you might have a hard time making and adhering to a schedule.
Most people can do a task for an allotted period and then move to another one (though, he acknowledges that modern life—with demanding work schedules and constant access to distracting smartphones—can make this difficult for everyone at times). But when you have ADHD, “it would be hard for you to keep a schedule and stay organized—you might get lost in what you’re doing and nothing else matters.”
3. You can’t stay on top of work deadlines—or a recent promotion has left you spiraling.
When Dr. Khurana diagnoses kids with ADHD, behavior in the classroom—where you have to stick to a schedule, follow rules, and navigate social norms—tends to really spotlight symptoms. When he diagnoses adults, the grown-up equivalent—work—tends to be where problems surface: In fact, people with ADHD are 60% more likely to be fired from a job and 30% more likely to have chronic employment problems than their peers without it, some research suggests.
“You’ll see a lot of people who do not finish projects on time or run late for meetings,” Dr. Khurana explains. “In meetings, they might seem very scattered, or they’re shuffling through papers, not organized, or missing deadlines.”
Still, Dr. Khurana says, you might be bright and high-achieving—he has ADHD patients who are physicians and engineers. But when your role changes or requires you to wear a lot of hats (say, you just got a promotion and now manage a big team with a lot of extra tasks beyond your day-to-day work, whether you run things in an office or a restaurant), that’s when the cracks might start to show, Dr. Vitulano notes: “When you’re faced with managing all these executive functions, that’s when ADHD really attacks.”
He says that this is also a big reason why some people go undiagnosed until adulthood. “They may have managed it pretty well because they had a good school system; a really strong, supportive family; and good friends—the symptoms kind of get covered up,” he explains.
It’s also important to note that, there’s a major gender discrepancy in ADHD diagnoses: Girls with the disorder, on average, tend to be more forgetful and disorganized, as opposed to hyperactive and impulsive, so when observing children, doctors don’t always detect it right away and are less likely to diagnose them. “The people around them will say ‘Yeah, she’s a B and C kid, that’s fine,’” Dr. Khurana says. “Those kids aren’t creating a ruckus in the class. The inattentive piece often goes more underdiagnosed, and the hyperactive and the impulsive [pieces] get more attention.”
4. You’re generally having a frustrating time in life (and you don’t know why).
According to Dr. Vitulano, when a person with undiagnosed, untreated ADHD needs help, they don’t usually list off classic symptoms (a.k.a. inattentiveness or hyperactivity). They might just feel like they’re not doing super well in life, or they’re easily discouraged during their day-to-day. “[Patients] will tell me, ‘I’ve worked so hard on this and I’ve got nothing done, why is this happening?” he says. “Or they might struggle with relationships and dating. It’s sometimes a response to disorganization and impulsivity.”
For example, though Howell has always had career and academic success, “everyday tasks,” like paying bills, putting away clothes, or assembling things, used to bring her a lot of grief—and she had no idea why. “When everyone my age was learning to drive, I struggled with processing directions on a map, and it was frustrating,” she says.
Dr. Khurana adds that people with the condition might also seem “hotheaded” or have a “short fuse.” As you might imagine, living with an undiagnosed neurodevelopmental issue long after childhood can be really challenging and have a major impact on someone’s relationships and overall self-esteem, research shows.
Dr. Vitulano says it’s dangerous if you assume these setbacks are simply due to your own inadequacies, or if they make you overly self-critical or make you doubt your strengths and capabilities. “This can increase the risk of [misusing substances] and employment problems,” he says. “It can really lead to a more difficult life.”
5. You have another mental health condition.
Although lots of social media posts suggest that ADHD is easy to identify, the opposite is actually true. “Just by looking at someone, it’s very hard,” Dr. Vitulano notes. There’s also no single test that a doctor can use to make the call. One thing to consider, however, is whether you’re already dealing with another mental health condition in addition to some of the symptoms above. “About half of people with ADHD have another diagnosis,” Dr. Vitulano explains. This can include anxiety (as Howell has), but the disorder is closely linked to depression and bipolar disorder too.
Regardless, if you’re feeling off, it’s important to speak up, per Dr. Vitulano: “If [the treatments] you’ve tried haven’t worked, then it’s time to consult someone. There’s absolutely no shame in it.”
Since being treated for her ADHD—a mixture of therapy and medication, which is common for people with the condition—Howell has seen major improvements in her day-to-day. “It’s been incredibly validating knowing that not only is there nothing wrong with me, that there are other people like me in this world,” she says. “Going on medication has helped the anxious chatter in my brain a lot, which has allowed me to slow down and pursue hobbies, create art, and be a better friend and listener.”
Original article can be found on SELF
