Most people with Attention Deficit Disorder (ADD) have always known they are different. They were told by parents, teachers, employers, and friends that they do not fit the common mould. They are told to assimilate and become like everyone else. The very thing they can't! Lets try to understand ADHD and reduce our confusion of what it is and bust myths surrounding the disorder.
What is ADHD or ADD
Attention Deficit/hyperactivity Disorder (ADHD) is a neurodevelopment disorder marked by an ongoing pattern of attention and/or hyperactivity-impulsivity that interferes with functioning of development. It often begins in childhood and persists in adulthood. We no longer distinguish between ADD and ADHD and are increasingly clubbing it under an umbrella of Neurodiversity as it is not a one size fits all and a spectrum makes the understanding of it easier. It presents differently among different individuals.
The symptoms of ADHD appear to arise, on average, between 3 and 6 years of age and the vast majority of those with the disorder have had some symptoms before the age of 13 years, according to Dr. Russell Barkley, Ph.D. and National Institute of Mental Health
According to DSM-5, ADHD is prevalent across cultures in about 2.5% of adults, which is approximately 3.45 crore adults in India and 8.4% in children that is 2.10 crore children between the age of 10-18 years.
If I was not identified as a child can I have it?
Just because you were not diagnosed as a child doesn't mean you don't have ADHD
How does one identify it?
Impulsive
ADHDers struggle to stop and think before acting; to wait one’s turn while playing games, conversing with others, or having to wait in line; they interrupt and responding quickly; they are unable to resist distractions while concentrating or working and end up opting for smaller, more immediate targets over longer goals with delayed results.
Restless and fidgety
They display excessive movement not required by neurotypicals to complete a task, such as wriggling their feet and legs, tapping things, rocking while seated, or shifting their posture or position while performing relatively boring tasks. Younger children may show signs that look like excessive running, climbing, and other gross motor activity. While this tends to decline with age, even teenagers with ADHD are more restless and fidgety than their peers. In adults with the disorder, this restlessness may be internalised than outwardly observable. It might look like a lot of thoughts being navigated in the head at the same time. An inability to focus on one topic or an inability to shift between topics as a situation might warrant. Many have remarked on their need to use the movement to be an aid for concentration. and the use of mind maps to stay on a topic.
Working memory challenges
Holding information in the mind and retrieve it appropriately. ADHDers find themselves forgetful, unable to retain important information and disorganised in their thinking. They often lose track of the goal and create new ones while on a task. They could be described as acting without hindsight or forethought, and being less able to anticipate and prepare for future events skills which seem to be dependent on working memory.
Time Blindness
Problems with time management and organising themselves for upcoming events are commonplace in older children and adults with ADHD. Getting hyper focused on a task to the extent of tuning out other matters and forgetting to complete a time bound task because they didnt notice time going by. This can look like excessively long showers that were not deliberate, spacing out, forgetting to call someone next week and after 3 months thinking the next week has not gone by.
Emotional spikes
Problems inhibiting their emotional reactions to events as well as others of their age. They seem less able to “internalise” their feelings, or moderate them when they do so as others might. Consequently, they are likely to appear to others as less emotionally mature, more reactive, hot-headed, quick-tempered, and easily frustrated by events.
Those with ADHD find it difficult to activate or arouse themselves to initiate work that must be done, often complain of being unable to stay alert or even awake in boring situations, and frequently seem to be daydreamy or “in a fog” when they should be more alert, focused, and actively engaged in a task.
If I or my child is doing well academically can I have ADHD?
Your intelligence has nothing to do with ADHD. ADHD affects how you think doesn't reduce your ability to think.
A self-report screening scale of ADHD is developed by the World Health Organisation (WHO) called Adult ADHD Self-Report Scale (ASRS). It is a question-based self test which can be done if you think you have some or all characteristics mentioned above.
What are the characteristics that we need to understand?
Executive Functioning
Executive functioning is a cognitive process that reorganises thoughts and activities, one struggles to prioritise tasks, manage time efficiently and make decisions.
There are 12 executive functioning skills majorly. Any person with ADHD will naturally struggle with some (or all) these 12 executive functions. 𝗛𝗢𝗪𝗘𝗩𝗘𝗥 - with the right tools and strategies, it is 100% possible to strengthen a particular executive functioning skill over time.
Is ADHD an executive functioning disorder? Is every executive function disorder also ADHD?
Most individuals with ADHD struggle with executive function in some form. However every individual struggling with executive functioning does not have ADHD.
Diminished problem-solving ability, ingenuity, and flexibility in pursuing long-term goals.
Often times, when we are engaged in goal-directed activities, problems are encountered that are obstacles to the goal’s attainment. At these times, individuals must be capable of quickly generating a variety of options to themselves, considering their respective outcomes, and selecting among them those which seem most likely to surmount the obstacle so they can continue toward their goal. Persons with ADHD find such hurdles to their goals to be more difficult to surmount; often giving up their goals in the face of obstacles and not taking the time to think through other options that could help them succeed toward their goal. Thus they may appear as less flexible in approaching problem situations, more likely to respond automatically or on impulse, and so are less creative at overcoming the road-blocks to their goals than others are likely to be.
These problems may even be evident in their speech and writing. As they are less able to quickly assemble their ideas into a more organised, coherent explanation of their thoughts. And so they are less able to rapidly assemble their actions or ideas into a chain of responses that effectively accomplishes the goal given them, be it verbal or behavioural in nature.
However while these are challenges they are also likely to be the one with the unique perspective and have an uncanny ability to think of solutions no one else would arrive at as they are limited by their logic.
Emotional regulation skills and behaviour
People on the neurodivergent spectrum find it hard to regulate their feelings.
Think of this ability as one to reduce charge. Every time something doesn’t go our way or the ‘right’ way we collect a charge. As these charges build up we start transferring the charge as off track behaviour. It can look like picking a fight, shouting, getting upset or even needing to go to sleep. Those with ADHD find it hard to reduce their charge. So instead of a well regulated system where charges are moving in and out, this is a system that collects them but doesn’t know how to release them.
With the right support you can learn to build better resilience by working through these charges regularly.
Does everyone who struggles with emotional regulation have ADHD?
Most individuals with ADHD struggle with developing emotional regulation skills or practising that behaviour in some form. However every individual struggling with emotional regulation does not have ADHD.
It can change and improve, but it depends on the individual and the factors involved. For instance, emotional self-regulation is rarely elevated as an issue in toddlers. We don’t expect 4-year-olds to manage their emotions very well. But by the time we get into late adolescence, and especially adulthood, we do expect individuals to have developed that second stage of emotional control: top-down executive management (or moderating emotional reactions to evocative events). So we need to first explore is the dysregulation being presented age appropriate?
Can emotional regulation be “trained?” In children, it takes time because they haven’t yet developed the appropriate self-regulation skills that such training would require. Interventions like medication, parent training, and controlling for environmental triggers may be most helpful for this stage. Adults, however, may benefit from Cognitive Behavioural Therapy (CBT) and mindfulness-based programs especially reformulated for an adult with ADHD in recent books, both of which help the individual deal with many aspects of emotional dysregulation.
Understand more about emotional impulsivity and regulation here
Social Skills
We use social skills to interact and communicate with those around us every day. We do this through the use of both non-verbal communication (eye contact, facial expressions, body language) and verbal communication (volume, speed, tone of voice). Children and adults with ADHD can face challenges when it comes to understanding and implementing these social skills.
There are a lot of ways through which social skills can be improved like making a planner to help organise appointments, dates, birthdays, and events along with mindfulness to increase active listening skills.
All in all ADHD is not something to be fixed. It is about understanding and accepting that our ways of thinking are different and the solutions we might use to navigate can be different. With patience, support and understanding we can find ways to create a fulfilling and self actualising life.
This article has been assisted by Cherish Mundhra, an aspiring psychologist and a
budding writer pursuing her bachelors from FLAME University, Pune.
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