ADHD is a diagnosis that a lot of people are talking about, and we would like to add to the conversation, but I am going to do it a little bit differently. I am sure most of you are familiar with ADHD symptoms, so I am going to skip that part and talk about some things a lot of people don’t know; the “missed diagnosis” and misconceptions.
I’ll first start with the name; Attention Deficit Hyperactivity/Impulsivity Disorder. There are many psychologists, teachers, and medical professionals that do not like this label and believe it to be wildly inaccurate. Many would prefer the term deficit to be replaced with dysregulation; as this is a more accurate reflection of the brain patterns, and the removal of the word disorder.
Interestingly, the first mention of ADHD diagnosis described the condition as “an abnormal defect of moral control in children” and later it was labelled “hyperkinetic reaction of childhood” aka; hyperactivity in children.
As society’s understanding grows and more research is gathered our language to describe concepts changes. However, change in language tends to be a little slow, but we are excited for the day the diagnostic name reflects the diagnosis more accurately.
As you would have gathered from ADHD’s previous names there has been, and still is, a lot of misinformation and stigma. There has also been a history of limited access to proper diagnosis and treatment of ADHD.
Previously, assessment of ADHD focused on stereotypical hyperactive/impulsive behaviours, inattentive or internal hyperactivity (often presenting as anxiety) were commonly unnoticed, the difference in presentation across females, non-binary, and POC individuals was overlooked, and until 2013, individuals with ASD were unable to be diagnosed with ADHD. That is a lot of people with ADHD who went unnoticed and unsupported.
With increased research and understanding of ADHD we now know that ADHD is neurodevelopmental, meaning it is not something people “outgrow”, it is a lifelong diagnosis and describes a different way of brain functioning, and it can present differently across individuals.
With changes in diagnostic process and increased understanding it is not surprising that there are many people out there who do not know they have ADHD or are only being diagnosed later in life. Here are some reasons why ADHD has been called the “missed diagnosis”;
1. Inattentiveness is not a common reason people explore assessment. They may write this experience off as being forgetful or lazy, and often have developed coping strategies to manage or avoid situations that require a lot of attention.
2. Hyperactivity presents very differently to what people typically think. In adults we rarely see people running around and climbing trees. Often hyperactivity is internalised and looks like excessive fast thoughts, restlessness or agitation, and many people channel this into busy jobs or hobbies.
3. Impulsivity can also present differently in adults, sometimes it is less obvious and can be someone interrupting conversations or jumping to conclusions.
4. Many people with undiagnosed ADHD attribute their difficulties to other diagnosis, such as anxiety, depression, or even dyslexia, and may not consider ADHD as a diagnosis. And these people have developed intricate masking strategies that make noticing symptoms of ADHD difficult.
5. Gender: Many females only receive a diagnosis later in life. Research has suggested this is due to difference in presentation, social pressures to mask/increased masking, and often internalising hyperactive symptoms, such as sitting still but experiencing anxiety and racing thoughts.
ADHD is a hot topic, many people with and without ADHD identify with some of the criteria. Most people will have experiences that look like ADHD, such as forgetting appointments, lack attention to detail (aka spelling errors), being distractible, or being emotionally dysregulated. However, it is about the frequency these occur, how they impact a person’s functioning, and the intensity in which they are experienced.
Regardless of whether or not an ADHD diagnosis can be given, if you experience symptoms that are distressing or impact your functioning it is important to speak to a psychologist.
At Contemporary Psychology, we are trying to create change in the way individuals and communities view ADHD. We focus on understanding the core of an individual’s experience and have created an ADHD assessment pathway that includes integrates evidence-based assessment within depth knowledge of ADHD presentation across all groups of people. The purpose of the assessment process is not only explore diagnoses but to support an individual learn more about themselves.