ADHD affects millions around the world but is still surrounded by misconceptions. Photo / 123rf
ADHD affects millions around the world but is still surrounded by misconceptions. This collection of stories offers information, solidarity, help and support.
This story was first published in August and has been updated with additional content.
ADHD is one of the most common psychiatric disorders in adults. Yet many healthcare providers have uneven training on how to evaluate it, and there are no United States clinical practice guidelines for diagnosing and treating patients beyond childhood.
Without clear rules, some providers, while well-intentioned, are just “making it up as they go along”, said Dr David W. Goodman, an assistant professor of psychiatry and behavioural sciences at the Johns Hopkins University School of Medicine.
This lack of clarity leaves providers and adult patients in a bind.
Having ADHD has meant a lifetime of challenges for Sonia Gray and her daughter Inez. Now, she tells Joanna Wane, they’re celebrating the wins
Sonia Gray, who has had her own battles with anxiety and depression, was diagnosed with ADHD after a psychologist working with Inez suggested she and her husband, Simon, get tested. Her mother told her it explained Gray’s entire childhood.
“My big thing was that I couldn’t trust my brain, so I had to be hypervigilant and would get into absolute panics if things weren’t exactly right,” says Gray, who knew from an early age that there was something different about her.
Medication has helped calm the chaos in her mind – “not completely, but just enough so it’s not 15 voices all speaking at the time and at the same volume”.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition. It affects the way the brain functions. Symptoms exist on a spectrum of severity ranging from mild to severe and affect millions of adults and children around the world.
Dr Max Davie is the co-founder of ADHD UK, and a consultant paediatrician who specialises in ADHD. He also has the condition.
“People who have it talk a lot about restlessness; about being easily bored and finding boredom physically unpleasant, and sometimes unbearable. They talk about being under-stimulated and about their emotions feeling out of control.”
The condition is often misunderstood.
Finding out I had the neurological condition helped to explain so much of my behaviour and enabled me to live happily, writes The Telegraph’s Annabel Fenwick Elliott
It was a crisp winter day in Zurich six years ago and I was in rehab, following a bender in Budapest. No less than 10 minutes into my first session with the eminent psychiatrist Dr Thilo Beck, he asked me a fleeting question that was about to change my life. “You do know,” he said, head cocked to one side, “that it is highly likely you have ADHD?”.
My formal diagnosis back in the UK shortly thereafter confirmed it - I scored a near-perfect score on the test – “9/9 for attention-deficit and 8/9 for hyperactivity,” Dr Frances Klemperer wrote in my report to the GP, “reflecting a life-long pattern of symptoms and impairment in multiple domains of functioning”. It explained everything from my dismal school reports and dropping out of two university courses to my self-loathing and heavy drinking.
The growing number of high-profile women who have gone public about their ADHD – the former Spice Girl Mel B, TV presenter Sue Perkins and the actress Sheridan Smith to name a few – coupled with a plethora of ADHD content across social media platforms, especially TikTok, have all prompted more women and girls to see it in themselves and seek help.
Women are now being diagnosed at unprecedented rates. So what does ADHD look like in women – and why are we only recognising it now?
D’Arcy Waldegrave shares his experiences of living with ADHD.
I was first diagnosed five years ago. I had sailed downhill mentally again with alarming pace and, at the insistence of a good friend, I booked an appointment to address it. I was diagnosed but resisted medication until late last year after another intense depressive episode. I went back, got assessed again and acquiesced to the wants of the professionals.
The shrinks couldn’t believe that I didn’t know, I’m a cookie cutter case apparently. Go figure. I’m very impatient. I build multiple outcomes in my head for even the simplest issue. I start many projects, get bored quickly, then walk away. I’ve made choices without knowing or caring about what they may result in. Reckless. I have excessive energy and enthusiasm. I’m quite exhausting to be around!
The inability to focus fully on a task required a lot of mental horsepower to overcome. The impatience meant I lost my cool too often and too quickly.
Cognitive overload can cause overwhelm in those with ADHD. Here’s how to recognise the symptoms of ADHD paralysis and ways to manage it
What is ADHD paralysis? While it’s not a medical diagnosis, nor the physical paralysis we associate with the term, people with ADHD increasingly use paralysis to describe the very real experience of cognitive overload.
It’s the brain freeze that happens when they become completely stuck, unable to make a choice, complete a task, or do anything at all.
It comes from being overwhelmed, whether that’s by a to-do list, a complicated project, mood disorders or exhaustion, and the resulting ‘paralysis’ can make their symptoms even worse.
Depression, heavy drinking, binge eating, insomnia, compulsive shopping — by her thirties, Kat Brown had accumulated a list of mental health problems. It was only when she began treatment for ADHD that life began to make sense.
Shortly before I turned 30, and while in a period of depression I seemed to cycle through every few years, I started seeing a new therapist who appeared only to wear cargo shorts. After one session, I wrote in my Notes app on my phone, “Today I suspect we got to the crux of the matter with Doctor Steve: “It sounds as though you think you are defective”. It was a testament to this man’s gentle competence that I minded neither the shorts nor his conclusions. I had spent my life trying to control how people perceived me and it was a relief to drop the act. But as much as I had started opening up about my constant sense of dread, and generally feeling more like an avatar in a meat suit than a person, I didn’t know how much time was still to go before I would get the answer to why I felt defective.
Many people with ADHD have ‘delayed sleep phase disorder’, meaning falling – and staying – asleep can be difficult. Here’s how to treat it.
With minds that whir away at night as soon as their heads hit the pillow, people with ADHD often struggle to get to sleep, and when they do their sleep is restless and disturbed.
Clinicians estimate that between 50-75 per cent of people with ADHD will suffer from debilitating sleep disorders.
“Sufferers often call it “perverse sleep” — when they want to be asleep, they are awake; when they want to be awake, they are asleep,” says Dr William Dodson, a US-based psychiatrist and leading specialist in ADHD in adults.
New research suggests symptoms of the disorder may be less severe in those with a demanding schedule.
Research has shown that ADHD symptoms can change over time, improving and then worsening again or vice versa.
And according to a recently published study, having additional responsibilities and obligations is associated with periods of milder ADHD. This might mean that staying busy had been beneficial, researchers said. It could also just mean that people with milder symptoms had been able to handle more demands, they added.
Often, people with ADHD “seem to do best when there’s an urgent deadline or when the stakes are high”, said Margaret Sibley, who is a professor of psychiatry and behavioural sciences at the University of Washington School of Medicine in Seattle and who led the study.
The study, published online in October in the Journal of Clinical Psychiatry, tracked 483 patients in the United States and Canada who each had a combination of inattentive and hyperactive-impulsive ADHD symptoms.
Researchers followed the participants for 16 years, starting at an average age of 8. They found that about three-quarters of the patients experienced fluctuations in their symptoms, generally beginning around age 12, which included either a full or partial remission of symptoms.
Experts are learning that ADHD and autism – known as AuDHD – often go hand-in-hand, leading to a brain in a constant tug-of-war.
Leanne Maskell is the founder and director of ADHD coaching company ADHD Works, and the author of ADHD Works at Work and ADHD an A-Z
OPINION
Imagine having a brain that is at constant war with itself. Desperate to fit in, yet determined to escape social situations. Obsessively creating complex structures for stability, but just as predictably smashing them all up. Chronically overwhelmed, yet unable to say no.
That’s the reality of living with both ADHD and autism. The two conditions might seem at odds with each other but can, as experts are increasingly realising, coexist and lead to non-stop internal conflict.
While ADHD brings hyperactivity, impulsivity and inattention, autism is associated with social challenges, sensory sensitivity and repetitive behaviours.
Until 2013, autism and ADHD couldn’t be diagnosed in the same person. Today, researchers have found that there is a 50% to 70% crossover between these neurodevelopmental conditions, which is increasingly being referred to as AuDHD.
I was diagnosed with ADHD at the age of 25 after spending a year ruminating daily over the best way to end my life, moving to a different country every month and quitting any job that I started. The diagnosis helped me make sense of my life, but it didn’t seem to fully fit with my experience.
Now, six years later, I finally have the missing piece of the puzzle: an autism diagnosis.
It might sound like a diagnosis too far for most people, but I was relieved. It explained an awful lot about my life to date and why I’ve always struggled with social situations.
Annabel Fenwick Elliott is a UK-based freelance journalist who was diagnosed with ADHD in 2018.
This neurological condition can be both a handicap and a blessing, but many corporate environments stifle the benefits
My relationship with “the office” has always been a troubled one. “You were brilliant and a shambles; it was never clear which version would show up on any given day,” one of my first bosses in advertising told me, years before I was diagnosed with ADHD. Regardless, no matter how much I often loathed the office, I also owe my career to it. Were it not for the structure, discipline and fiery overlords involved in a typical corporate environment I would never have made it in journalism. In all honesty, I might have ended up on a park bench.
Such is the paradox with having ADHD (attention deficit hyperactivity disorder; itself, both a handicap and a superpower) and working shoulder-to-shoulder, in a highly distracting goldfish bowl, with “normal” humans all day every day for most of your adult life. “People with ADHD may have problems with organisation and time management, following instructions and focusing on tasks,” says the UK’s NHS (National Health Service) website, as well as being “restless, impatient, impulsive and risk-taking”. All qualities I possess and that would look very bad on a CV, I think we can agree.
To understand why it can be so hard at the office with a brain like mine (I tested very high in all facets on the ADHD diagnostic scale), you first need a glimpse into how my mind operates before I even step inside those four walls. Imagine being in a room. The TV is on and it’s something flashy but inane, like Strictly Come Dancing. So is the radio, broadcasting the news, which is important. They’re both set to the same volume, though, so it’s hard to separate them. There’s also a DJ, playing the same song over and over again. And two monkeys squabbling in the corner. You’re trying to do a crossword. And there’s someone in the doorway asking you for directions; rolling their eyes, because “why can’t you just focus?”.
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