ADHD Part 1: What is ADHD?
I started to take a special interest in ADHD when my daughter was diagnosed as a pre-teen, this led to me educating myself so that I could understand her better and provide her with the appropriate supports. At the same time, I was seeing clients struggle with certain symptoms (especially the women I was working with) and I felt compelled to learn more. I recently completed my training to become an ADHD-Certified Clinical Services Provider. This does not mean that I am qualified to make a diagnosis, but it does give me a more informed knowledge base about ADHD.
I think it is important to start with understanding the spectrum of symptoms that come with ADHD. I’d also like to note that there is discussion in the ADHD community that ADHD deserves to be re-named, because the name is not an accurate representation of the experience. A suggested re-name I have heard is: Emotional Regulation & Executive Functioning Disorder. I really hope that this happens one day, because it can be quite a debilitating disorder to live with and it impacts many areas of a person’s life.
ADHD is a neurodevelopmental condition involving differences in how brain networks regulate attention, motivation, reward, impulse control, and executive functions, with dopamine and norepinephrine signaling playing
important roles.
Symptoms: How does ADHD show up?
Attention-deficit/hyperactivity disorder (ADHD) can affect:
trouble regulating attention
impulse control
activity level
organization
emotional regulation
executive functioning
It can look very different from one person to another, and it does not disappear simply because someone becomes an adult. Many people with ADHD don't have a lack of attention. In fact, they may be capable of becoming intensely absorbed in something that is interesting, challenging, urgent, or rewarding (hyper focus). They might spend hours on a hobby or project while struggling to begin a routine task that feels boring or overwhelming.
Differences between males & females
It is also important to note that there can be a difference between male and female presentation of ADHD. This is a generalization, but for example the hyperactivity might show up in a male as fidgeting and constantly moving, whereas in a female it might be more internal (hyperactive thoughts). This can lead to symptoms being missed in females because they are not always visible.
Impacted Areas: | Males with ADHD: | Females with ADHD: |
Hyperactivity | Often more physically active, fidgety, or unable to stay seated | May be less physically obvious; can show as restlessness or excessive talking |
Attention | Easily distracted and may have trouble completing tasks | Daydreaming, zoning out, forgetting instructions, and difficulty organizing |
Impulsivity | More likely to interrupt, blurt things out, or act without thinking | Can also be impulsive, but it may be less noticeable |
School behavior | More likely to be seen as disruptive or “always on the go” | May appear quiet, well-behaved, or simply “not paying attention” |
Emotions | Irritability, frustration, and emotional outbursts can be noticeable | Emotional overwhelm, sensitivity, frustration, or frequent worrying may be more noticeable |
Social difficulties | May have trouble following rules, taking turns, or controlling impulses | May have friendship difficulties or feel socially overwhelmed |
Academic performance | Problems may be obvious because of incomplete work or classroom behavior | May work very hard to compensate, so difficulties can be overlooked |
Diagnosis | Often identified earlier because symptoms are more visible | Can be diagnosed later because symptoms may be quieter or masked |
What does executive functioning mean?
Challenges with executive functioning can make it difficult for a person to:
Start tasks
Plan and prioritize
Estimate how long something will take
Remember appointments and obligations
Shift from one activity to another
Resist impulses
Manage distractions
Keep track of belongings
Follow through on intentions
Someone with ADHD may genuinely want to complete a task and understand exactly what needs to happen. Yet, they may still find it remarkably difficult to get started or follow through. Tasks that are immediately rewarding, novel, urgent, or personally interesting can be easier to engage with. While tasks that are repetitive, delayed in their rewards, or require sustained effort may be much harder to initiate.
Not everyone with ADHD is visibly hyperactive. Some people are restless internally rather than externally. Others have learned to compensate so effectively that their difficulties aren't obvious to the people around them. This is called masking. This is particularly important when we think about adults who have developed sophisticated coping strategies. For example, someone may use multiple calendars, alarms, lists, reminders, colour-coded systems, and elaborate routines just to stay on top of everyday responsibilities. From the outside, they may look exceptionally organized, but what we don't see is the amount of effort required to maintain that organization. This can explain why someone constantly feels tired or burnt out.
ADHD & Emotions:
People often associate ADHD with trouble concentrating, forgetfulness, or impulsivity. But emotional experiences can also be a big part of the picture. Some of the emotional symptoms can include:
Becoming overwhelmed quickly
Difficulty calming down after becoming upset
Strong reactions to criticism or perceived rejection (called Rejection Sensitivity Disorder or RSD)
Frustration when plans change unexpectedly
Feeling emotionally “all or nothing”
Difficulty pausing before responding during conflict
When emotional regulation difficulties are happening with longstanding patterns of executive-functioning challenges, they can be an indication that assessing for ADHD could be helpful. When considering the emotional aspect of ADHD, we need to recognize that someone who repeatedly struggles with these things, can experience shame and embarrassed about this. This can negatively impact a person’s self-esteem and relationships.
My role as a therapist supporting someone living with ADHD is to:
help them recognize their patterns/symptoms
support them to seek a diagnosis if they want to pursue this
build skills to support their executive functioning and emotional control
help them understand their needs and possible accommodations
work on separating who they are from the difficulties they experience
Having ADHD does not mean someone is lazy or incapable. It means that certain aspects of functioning may require different strategies, environments, supports, and sometimes treatment. ADHD is so much more complex than being easily distracted or hyperactive. For many people, it affects the everyday systems that help us organize our lives, regulate our attention, manage impulses, and turn intentions into actions. It can also influence relationships, work, education, emotional wellbeing, and self-esteem. Knowing about ADHD can help us understand the challenges of living with it, for ourselves or our loved ones.
Thanks for reading and please reach out if you want to connect. Check back next month for ADHD Part 2: Diagnosis and Treatment,
Lisa xo
ADHD resources: https://www.infocuscounselling.com/resource
Here is a great video that helps explain ADHD:
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