How ADHD Affects Adults

Our brains are all wired differently. Lengthy Sunday dinners bore me, as do meetings over 40 minutes, and going to see films where there’s more than five main characters is enough to make me leave the cinema screaming. I’d rather hike, bike, or run – anything to burn off all that energy. Most people think ADHD (attention deficit hyperactivity disorder) is a disorder that only kids suffer from (and grow out of), but I was diagnosed in my 20s. While among children, ADHD symptoms can result in hyperactivity, difficulty focusing, and a perceived cheekiness, having ADHD as an adult means I am impulsive, forgetful, and occasionally inattentive. The NHS says the exact cause of ADHD isn’t completely understood, but studies suggest that those with ADHD might have an imbalance in the level of neurotransmitters in the brain, or that these chemicals don’t work as well. What causes it on a non-genetic level is disputed, but premature birth and smoking during pregnancy are thought to contribute. Adults with ADHD have a tricky path to navigate. Those now in their 20s diagnosed with the disorder will have grown up during the noughties when newspapers were splashed with pictures of kids snorting Ritalin (a drug often used to treat ADHD) at school. 'ADHD is just a scapegoat for bad parenting' was a view frequently bandied about and I remember thinking of it as a disorder reserved for “problem kids” because this is what I was told. In fact, it’s only really recently that adult ADHD is being widely talked about. Two recent studies have explored how symptoms of ADHD manifest differently in adults. One of the studies, conducted by King's College London, found that nearly 70% of young adults who tested positive for ADHD in their study didn’t appear to have the disorder as children. Interestingly, most adults diagnosed, 55% according to both studies published in JAMA Psychiatry journal, also turned out to be women. The study suggested that those diagnosed as adults were likely to have higher IQs: "Symptoms may not become impairing until the increasing challenges of later, more demanding schooling.” And yet, because the disorder makes it tough to focus and settle down, it can be harder for people with ADHD to succeed in education and in their careers.

Dr Russell A Barklay is an expert in ADHD and clinical professor of psychiatry at the Medical University of South Carolina. In a recent article he explains how ADHD symptoms change with age: “By adulthood hyperactivity is pretty much gone. Some people feel inner restlessness, but they aren’t climbing furniture or sliding down bannisters.” A spokesperson for ADHD charity ADDISS explains that adults are usually diagnosed with ADHD after a burnout. “People with ADHD have had to put 500% in throughout childhood and exams and just assumed everyone had to work as hard as they did. When they leave home, they suffer from a sort of burnout. Often, they’ve been propped up by their parents but when they leave that support structure, their ADHD symptoms pop up.” Laura Ho, 26, is now a pharmacist, and was labelled ‘gifted’ during her secondary education. At 21, she went to see a university counsellor as she was suffering extreme anxiety when it came to test taking. “We figured out it was stemming from ADHD. Being in a large room with over 300 students at the same time made for lots of minor distractions and it felt impossible to sit through exams. I found out later that there were many signs that pointed to ADHD – for example I’m always running late and I’m very forgetful." Being an adult with ADHD can often mean coping with these issues alone; there’s no parent there 24/7 hand-holding you, pointing you to your shoes, then your coat, then the door keys. I get locked out of my apartment more than anyone else I know. I leave my passport on planes, lose business cards even when they’ve just been handed to me, and on flights leave my bag right in the rack. As a waitress, I delivered food to the wrong tables, or bounded through the restaurant with enthusiasm only to find out I’d hit the till too enthusiastically and now table 12 had eight bowls of spag bol coming their way. Up until the age of 22, employers told me I was friendly and intelligent, but essentially, too disorganised to hold down a part-time job. ADHD doesn’t just affect employees engaged in manual jobs, either. If anything, holding down a graduate career with ADHD can be even harder. Emily Jones, 27, was diagnosed with ADHD in her 20s after finding reading challenging. “There were things I wanted to know, things I was interested in, things I really wanted to read, but I just couldn’t. When I found myself sitting in a coffee shop holding a book I wanted to read and crying in frustration because I just couldn't, I realised something was up.” ADHD manifests in a serious inability to concentrate. Laura found the condition affected her career dramatically, which, when you’re starting out on the bottom rung after graduation, is the last thing you need. “I'm a pharmacist now, so I verify up to 350 orders a day. Each order requires only a short burst of focus before I move on to the next one so it’s a great job for me. Prior to that I worked a corporate job in pharmaceuticals, which had a lot of longer, project-based tasks and that was the absolute worst!”

BMC Psychiatry Journal published research suggesting career success could be compromised by having ADHD. Studies have found that those careers requiring organisational skills or attention to detail, such as administration, could be hampered by the disorder: “It could be hard to hold down admin jobs because of symptoms of inattention, impulsivity and hyperactivity,” while motor coordination problems might harm physical occupations. Increased absence days and less job stability are trends among those with ADHD, and considering the amount of energy needed to conduct day to day functions, this is unsurprising. For Emily, who works for the UK government, being at her desk bores her. She coped far better having a high-octane role where the phone was always ringing and she was having to run around. "Although that's not great long term for anyone because it’s stressful!”. Emily says that ADHD also gave her a crisis of confidence. She thought everyone around her knew more because they could just read, or listen: “I used to have to pretend I’d read what they had which made me feel like an impostor.” Ritalin is often prescribed for ADHD sufferers, but side effects can be extreme and headaches, hot flushes, nausea, shaking, palpitations, and exhaustion are common. Emily says she once had to rush out of an important meeting to be sick. Laura was told by her therapist that exercise acts as an outlet to help ‘burn off’ that extra ADHD energy. And similarly, if I don’t run, swim, or workout before settling down to work for the day I can keep going for about an hour before I start fidgeting. Looking back on my early 20s I realise that if I’d only had the confidence to tell my bosses that yes, I could get this done, I just needed to sit somewhere quiet, those years could have been quite different. This is why greater awareness of ADHD in adults is essential, especially for those juggling a career, social life and a relationship. We might forget our keys from time to time, but most people diagnosed with ADHD as adults are bright enough to have got through their university exams without meds or support. Let’s make it ok for us to tell our employers or dates about it without being worried about the implications of being fired or not getting a second date. ADHD is not a joke, with the right understanding and patience, we can cope with everyday life just like anyone else... and, no, we won’t jump up and down on your sofa.