ADHD @ Work

“I feel like I should talk to my boss about my ADHD. Is this a bad idea?” 

This is a tricky situation to navigate and requires a lot of careful thought of both the law and your situation at work.

Let’s start with the facts. In Canada, ADHD is considered a disability and an employer cannot legally discriminate against an employee with a disability. 

Furthermore, an employer in Canada has a Duty to Accommodate an employee with a disability to reduce barriers and mitigate undue hardship, according to the Canadian Human Rights Commission. 

In practice, the decision to disclose your ADHD status at work is often more nuanced.

Benefits of Disclosing ADHD @ Work

• An employer would need to know an employee has a disability (and may request formal documentation) to put formal accommodations in place

• If issues have been identified, disclosing your status at work could help reframe your performance from an unmotivated / underperforming employee to someone struggling with ADHD at work

• Some workplaces have Working Groups for Neurodivergent Staff to increase support, visibility and understanding within the organization

Risks of Disclosing ADHD @ Work

• A lack of understanding of ADHD or even stigma toward those with ADHD from both management and colleagues can have a negative impact on employee experience

• Disclosure of ADHD status could make some individuals in these settings feel more like a target for discrimination, even if it isn’t legally allowed

• Some employees with ADHD may feel that disclosing means they are making excuses or asking for preferential treatment at work rather than advocating for themselves 

Alternatives to Disclosing ADHD @ Work

• If you are concerned that full disclosure of your ADHD status could lead to negative impacts, consider asking for specific support to help you work more efficiently

• For example, If you struggle to focus in an open-office environment perhaps you can request to work from a quieter space such as your home or a breakout room. If this isn’t possible, try using headphones to reduce ambient noise

Please note this information is shared for education purposes but is not intended as a substitute for legal advice.

If you are experiencing discrimination at the workplace due to your ADHD status, please contact a lawyer who specializes in this area of law in your jurisdiction.

“I’m really struggling with my ADHD at work.”

It is not uncommon for adults with ADHD - even those who previously were able to keep up - to suddenly struggle with the demands of a new role.

With increased expectations yet often less structure or ‘“external scaffolding” to keep you on track, managing work with ADHD can feel overwhelming.

Start by reflecting on the specifics of your role.  

• Do you understand what is expected of you?

• Do you have a clear goal to work toward or deliverables for your role? 

• Is your role the same day-to-day or does it vary?

• Do you have all the information and resources you need? 

Identify your core Executive Function (EF) challenges and strategies.

• Although EF challenges can make it difficult to get work done, each person’s situation and strengths/weaknesses are unique.

• What specifically are you struggling with?

• Do you struggle with Time Management? Planning? Organization? Execution? All of the above? 

• Pick one thing at a time to work on shifting. It’s tempting to try everything at once (thanks ADHD!) but it’s rarely effective or sustainable

Reduce the gap between your current work environment and how you work best where possible.

• Frequent interruptions when doing focused work can be incredibly frustrating for those with ADHD and reduce productivity while increasing burnout.

• Figure out ways to reduce interruptions from other sources of distraction if possible like communicating to colleagues that you prefer not to be interrupted through the use of headphones / a “Do Not Disturb” sign at your desk or ideally,  removing yourself from open areas during focused work. 

• Similarly, sensory sensitivities like temperature, smells, sounds, and lights can play a big role in undermining or supporting productivity for neurodivergent folks at work.  

• Figure out sensory supports that can reduce sensory overload. Examples include headphones to reduce ambient noise, coloured/tinted glasses to reduce brightness of artificial lights and even comfortable clothes that don’t distract you from your work.

• Many people with ADHD are visual learners and do best when information is presented in written form. If you struggle with Auditory Processing issues, this is even more important.

• Don’t hesitate to ask colleagues to write down key information for you if possible or for you to jot down at least keywords when they are relaying important information

Krista, RSW has experience working on Executive Function and Sensory Challenges with
people just like you.

If you would like 1:1 support and are a resident of either BC or Ontario, please get in touch.

“I have a hard time sitting still during meetings at work.”

The three core characteristics of ADHD, Hyperactivity, Impulsivity, and Inattention. can make it tough to sit through low-dopamine meetings.

Below are common challenges and strategies for each:

Hyperactivity

• Challenges

  • Difficulty staying in your seat for duration of meeting

  • Fidgeting and/or restlessness

• Strategies

  • Use a fidget toy or doodle on paper to release restless energy

  • Practice Box Breathing / taking slow, deep breaths

  • If you are really struggling, use a bathroom break to justify getting up from your seat (I recommend you use this sparingly!)

Impulsivity

• Challenges

  • Blurting things out or interrupting others

  • Feeling reactive to dynamics in the room or feedback

  • Committing to unanticipated / extra work on the spot without considering capacity due to peer pressure

• Strategies

  • If possible, take medication before meeting as ADHD medication is meant to reduce impulsivity

  • Instead of blurting out information, try to focus on taking a big breath in and out

  • Accept that you will occasionally speak out of turn and apologize if needed

  • Avoid committing on the spot if possible to unanticipated / extra work by stating you’ll need to assess your capacity first and then get back the person making the request after

Inattention

• Challenges

  • Zoning out

  • Daydreaming

  • Doomscrolling

• Strategies

  • If possible, take medication before your meeting as ADHD medication is meant to help with focus

  • Ask to shift meetings to times of day you are more likely to be focused if possible. For example, if you know you do better at 11am than 3pm, ask to meet at 11am

  • Take notes on paper during meeting to help you stay engaged avoid without online temptations

  • Ask questions when appropriate to stay focused on the content

  • Record meeting with permission to listen back later

Adult ADHD 101

Hello there!

Krista, Registered Social Worker and ADHDer/HSP here.

In Adult ADHD 101, the first part of a two part series, I answer some of the most common questions about “adult ADHD”.

Stay tuned for the next part of the series, ADHD 201 where I debunk common myths about adult ADHD. Are there any common questions to ADHD you’d like answered? Let me know in the comments below or get in touch here.

What is ADHD?

• ADHD stands for Attention Deficit Hyperactive Disorder and is listed as a disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V)

• ADHD is a neurodevelopmental disorder characterized by symptoms first appearing in childhood

• Many prefer to view ADHD as a form of neurodivergence and choose language like “characteristics/traits” instead of “symptoms” which is considered to be stigmatizing

Is ADHD a disorder, a disability or a neurotype?

• To answer this question, it’s important to understand the difference between the Medical Model vs Social Model of Disability

• The Medical Model treats people with ADHD as impaired and focuses on limitations and barriers. This is reflected in how ADHD is diagnosed at present. For someone with ADHD, impairments and limitations could include mental, physical or sensory challenges. The Medical Model focuses heavily on these differences as deviations from the norm.

• The Social Model states that disability is created through the way society is organized rather than a person’s specific characteristics. The Social Model emphasizes inclusion of all individuals and has been instrumental in the push to celebrate neurodiversity. The Social Model also rejects the idea that people with ADHD need fixing and generally dislike terms like “symptom” when describing their characteristics.

• Many people with ADHD do report the symptoms/traits of their ADHD to be disabling based on how current society is set-up, especially without the right supports in place. These same individuals may view their ADHD as disabling while others may reject the idea of ADHD as disabling but rather celebrate ADHD as part of their neurodiversity. All of these perspectives are valid and welcome!

• Because the ADHD assessment process is based on the Medical Model’s view of ADHD, the term “symptom“ is used in this article for clarity only

What causes ADHD?

• At this time, our understanding of what causes ADHD remains limited despite numerous studies

• There is general consensus that ADHD is genetic and it’s not unusual to see many generations of a family with ADHD

• The role of our environment in the genetic expression of ADHD, known as epigenetics, remains unclear. We do know that at minimum environment can play a role in how symptoms present and for many people environmental shifts can reduce how intensely we experience ADHD

• Some experts argue that ADHD can be attributed to trauma although at this time information is limited in this area. We do know ADHD symptoms can be worsened with trauma but at this time it remains unclear if the trauma is a cause.

What are the hallmarks of ADHD?

• Based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnostic criteria for ADHD, symptoms fall under three areas:

  • Inattention

  • Hyperactivity

  • Impulsivity

• To meet the diagnostic criteria, an individual must experience limitations for at least 6 months in multiple environments (i.e. home AND work, home AND school) and have considerable impact on how a person' functions

• Many people with ADHD report other limitations or barriers including Emotional Dysregulation, sensory sensitivities, challenges with Executive Function but these are not part of the official diagnostic criteria at this time

Are there different types of ADHD?

• There are currently 3 categories of ADHD based on symptom presentations:

• Predominantly Inattentive Presentation

• Predominantly Hyperactive/Impulsive Presentation

• Combined presentation (Both Inattentive / Hyperactive Presentations as above)

• Each presentation of ADHD has different characteristics. To learn more about each in greater depth, please visit the CHADD website.

What’s the difference between childhood and adult ADHD?

• ADHD is considered to be lifelong and for this reason, symptoms of ADHD continue into adulthood

• From a diagnostic perspective, because ADHD is clinically evaluated based on symptoms in childhood, all adults diagnosed with ADHD must have experienced symptoms as children to meet criteria to qualify for a diagnosis of ADHD

• Many adults with ADHD report a decrease in hyperactive symptoms compared to childhood. It is not uncommon for hyperactive children deemed disruptive for climbing and jumping around at school to become restless adults who have a hard time sitting still during long meetings and presentations at work

• Many erroneously believe that ADHD goes away with age or that someone can just “grow out of it” but experts generally agree this is not true. Although the symptoms of ADHD may become more internalized with age, this does not mean that ADHD “goes away”.

How does the ADHD diagnosis process work for adults?

• Regardless of the age of the individual being assessed (whether they are 30, 40, 50 or beyond) current ADHD assessment criteria gathers information based on childhood history and presentation

• New formal clinical guidelines to better assess adults with ADHD are anticipated in the coming years

How does ADHD manifest in adults? 

• This is a tough question to answer because ADHD can impact so many areas of our life!

• For adults, common issues include (but are not limited to)

  • Poor self-image/negative self-talk

  • Challenges keeping up with work and school responsibilities

  • Difficulties with interpersonal relationships including romantic relationships and friendships

  • Difficulties maintaining routines and keeping up with day-to-day tasks

  • Intense emotional experiences

  • Financial impulsivity

  • Risk-taking while driving, in sexual relationships and other areas

• At the same time, many report ADHD characteristics that are beneficial and help them to be more creative, more spontaneous and more curious about the world around them

• Many adults with ADHD are able to function well with the right supports and strategies in place, however when seeking support it is important to work with a neuroaffirmative practitioner (like Krista!) who ideally have lived experience and truly understands ADHD

What does adult ADHD commonly get mistaken for? 

• Adult ADHD often gets misdiagnosed as a mood disorder such as Anxiety & Depression, particularly for women who have largely been invisible

• Although Anxiety & Depression are often comorbid (meaning they show up together) with ADHD, many adults report that ADHD was missing as a potential diagnosis. Sadly this means that many with ADHD miss out on relevant treatment and suffer unnecessarily. Fortunately, there is more awareness of ADHD these days and it is never too late to begin treatment

• Another common overlap with ADHD is Autism Spectrum Disorder (ASD). It is very common for Autistic people to also have ADHD. Conversely, many folks with ADHD report having Autistic traits as well (often referred to as AuDHD). Please visit ADHD Aware to learn more about the overlap between ADHD and Autism.

• Much effort is being made to raise awareness around the validity of ADHD as a diagnosis and the legitimate challenges associated. However, there is still stigma around ADHD and unfortunately ADHD is sometimes mischaracterized as laziness or simply lack of willpower of a particular individual

• We know that many people with undiagnosed ADHD can be successful, often relying on high intellectual capacities, but this “success” comes at a huge cost to the individual

How do I get diagnosed?

• An ADHD diagnosis should first start with an ADHD assessment from a qualified professional who follows sound diagnostic practices

• To prepare, many adults choose to use the Adult ADHD Self-Report Scale (ASRS-v1.1 ) Symptom Checklist to screen themselves for ADHD. If you are interested in this, please visit my blog post  How To Screen Yourself for Adult ADHD. While ASRS does not formally diagnose ADHD, it is an effective screening tool

• The easiest place to start the process of an ADHD assessment is your Primary Care Provider who is usually a Physician or a Nurse Practitioner. For those who do not have access, there are other providers who can assess and diagnose including

• In BC and Ontario where I practice, other regulated professionals qualified to assess for and diagnose ADHD include Psychiatrists, Psychologists, and Clinical Social Workers

Why Inclusion Matters: Krista’s Story

This year’s theme for International Women’s Day 2024 is Inclusion!

As a Registered Social Worker I’ve spent my career challenging systemic barriers and advocating for inclusion.

In honour of IWD 2024, I share my own journey from undiagnosed ADHD to where I am now. I also connect the dots on why inclusion is so important for women with ADHD.

Listen to the audio below or read the transcript.

TRANSCRIPT OF AUDIO

Sitting down to record this piece for International Women’s Day 2024 I’ll admit that I battled many of the familiar challenges for those of us living with ADHD - perfectionism, negative self-talk and overwhelm.

And yet I persevered because I know what I have to say matters too. This year I decided to not let my ADHD hold me back because the theme of International Women’s Day 2024 is Inclusion and I have something to say about it.

As someone who has essentially built my entire career around themes of inclusion and breaking down systemic barriers, this is a topic that is very near and dear to my heart.

Before I get any further I should probably introduce who I am. My name is Krista Varsakis and I am a Registered Social Worker here in beautiful British Columbia and I am also registered to provide services by telehealth in Ontario. 

For those who don’t know, I run a practice called Live Heart Forward where I help educate adults with ADHD on ways we can live more joyfully using a mix of ADHD psychoeducation, self-acceptance and mindfulness practices to name a few.

Krista’s Story: From undiagnosed ADHD to now

That's actually not what I wanted to focus on today though, I wanted to share a bit of my own story as a woman with ADHD.

I am someone who identifies as having multiple barriers myself. That’s basically just a fancy way of saying I have faced challenges related to my neurotype and a few other (barriers) too.

On the outside looking in I don’t think many people would think that I have struggled. I have managed to go to fancy universities for a long enough time to get to where I am now in some pretty competitive environments  

I also have worked in some very demanding environments at a high level 

In fact I was only diagnosed with ADHD at the age of 40 but I have a lifetime of struggling under my belt

So I know what it’s like when people on the outside look in may think  “hey you’re successful!” but the truth is only I know the toll it has taken on me to get here

Why am I sharing this? Well the truth is there are many aspects of my experience that I just don’t think are unique to me, but unfortunately there isn’t enough awareness yet out there of the true cost of ADHD and especially on the toll it takes on women in our society

That’s why I was so excited to find out the theme of International Women’s Day 2024 is Inclusion because Inclusion is critical! And I am proof of that!

Women make up approximately half of the world’s population, and on average do much of the emotional labour and caretaking in society while receiving much less support and acknowledgment than men just to name a couple things. We know there’s more to it.

I know firsthand from experience that watching the women around me who shaped me into the person I am today, women often have to overcome so much at great personal cost and yet we persevered.

Women with ADHD are having a moment where we are certainly being diagnosed much more frequently than before, and at the same time I also know from my work with clients many women continue to be taken less seriously or even dismissed by healthcare providers when seeking support for their possible ?ADHD and are often told things like “You couldn’t have ADHD, you have a degree!”

In fact sometimes it’s the people closest to us who say things like that too without recognizing how invalidating this really is

Although I do think there are lots of reasons why someone with undiagnosed ADHD might be able to make it through a gruelling academic program or a high-performing position, it undeniably comes at a great cost and very often leads to ADHD burnout

How do I know that? I have talked to a lot of clients about this but the truth is I am living proof

I’ve had to mask much of my life to get to the point I’m at now. And while again, I don’t think my story is unique I do occupy a pretty cool position as a Social Worker and practitioner who has the privilege of working with other women with ADHD who have similar stories and I have the immense privilege to recognize that many of the barriers I faced are not my creation but I’ve still have to deal with them…

My background is actually in non-profit land as well as local government where I have worked both overseas and here in Canada. Environmental Sustainability and Social Justice work have always been my bread and butter and then I went back to school to become a Social Worker in my 30s so I could continue to advocate for inclusion.

As a baby Social Worker I cut my teeth so to speak working in the Downtown Eastside neighbourhood in Vancouver for a social enterprise that focused on inclusive employment practices as the Employment Support Worker. 

For those who may not know, Vancouver’s Downtown Eastside is notorious/famous because there are a lot of folks who do end up in that community who face multiple barriers and an enormous amount of stigma. And it is also a really resilient and beautiful community if you get to know the folks down there

Working down there for an organization that focuses on inclusive practices as the Employment Support Worker I really honed my abilities to support folks through hiring and retention practices that reduce barriers so I know what it looks like boots on the ground to be inclusive 

I’ve also completed Disability Applications for the Province of BC and during my time working as a healthcare social worker working amongst Doctors, Psychiatrists, Nurses, to name a few I gained an in-depth understanding of the realities and polarities of the health care system and how people with mental health challenges and the social determinants of health are impacted significantly by internal and external factors

Back to me though. Layering on the stress of the nature of public healthcare social work in a hospital during the COVID19 Pandemic while essentially doing some of the hardest work I know of, I was battling my own undiagnosed ADHD and characteristics as a Highly Sensitive Person (HSP) which has led to spectacular burnout

To be candid, I am still emerging from that level of burnout and that is why I am so passionate about the work I do because I am part of the community I serve and I have gone on a personal journey to better understand ADHD and my own lived experiences - that continues today. 

Although sometimes I think people expect their therapist or Social Worker to be perfect, I think it’s super important to be honest about our experiences and frankly I prefer to work with someone who I know gets it.

The majority of my clients I work with are women and that is my specialty area although men and non-binary folks are welcome too and I would never turn anyone away.

That said, I know so many women - both clients and even those in my own life - who on the outside are high-performers but under the surface are plagued with self-doubt, battling perfectionism and negative self-talk stemming from ADHD. We know that over time can lead to a host of mental health issues like Anxiety and Depression, and eventually the lack of participation from these very capable individuals in society

I really believe that is a net loss for us all and so inclusion is the only way forward. I hope you’ve enjoyed this brief overview of and learning a little bit about me and why I am so passionate about International Women’s Day. 

I would love to hear more from you about your story - feel free to reach out and leave a comment and let’s continue to the conversation…