Adult ADHD 101

Written By Krista Varsakis

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)

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

Krista Varsakis
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ADHD @ Work
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Why Inclusion Matters: Krista’s Story