How to Tell the Difference Between Common Distraction and ADHD

Do you cut the tags off your clothes? Remember past conversations (and regret)? Do you have episodes of burnout and fatigue? Lose focus while someone is talking? Are you hyper-focused while working on a project? Do you adopt dozens of hobbies? Daydream? Forget things?

According to TikTok, you might have ADHD (Attention Deficit Hyperactivity Disorder). Videos about this psychiatric condition are plastered across the social media app, and the hashtag #adhd has received over 17 billion views to date.

Many feature young people describing their specific (and sometimes surprising) symptoms, such as sensitivity to minor sensory nuisances (like clothing tags) or ADHD paralysis, a type of extreme procrastination.

After watching these videos, many people who were not diagnosed with ADHD as children may question whether they would now qualify as adults.

As with most psychiatric conditions, ADHD symptoms can vary in type and severity. And many of them “are behaviors that everyone experiences at some point,” said Joel Nigg, a professor of psychiatry at the Oregon University of Health and Sciences.

The key to diagnosing the condition, however, requires “determining that it’s serious, it’s severe” and it’s interfering with the person’s life, he said. It is also essential that the symptoms are present from childhood.

Such nuances may not be noticed on social networks, experts say. In fact, a study published earlier this year found that more than half of ADHD videos on TikTok were misleading. If a video (or article) makes you think you might have undiagnosed ADHD, here’s what to consider.

Why is ADHD often undiagnosed in adults?

Approximately 4% of adults in the United States have enough symptoms to qualify for ADHD, but only 1% are diagnosed and treated. By comparison, approximately 9% of children in the US have been diagnosed with the condition, and 75% of them have received medication or behavioral therapy for the condition.

One reason for the underdiagnosis in adults is that when people think of ADHD, they often picture a boy who can’t sit still and disrupts class, said Dr. Deepti Anbarasan, an associate clinical professor of psychiatry at the Grossman School of Medicine. from New York University. But these stereotypical hyperactive symptoms are present in only 5% of adult cases, she said.

Instead, symptoms like forgetfulness, difficulty concentrating, organizational problems and procrastination — what experts call inattentive ADHD (as opposed to hyperactive ADHD) — are more common in adults. “In adults, it’s often not necessarily hyperactivity or impulsivity, but executive functioning problems,” Dr. Anbarasan said. “It’s more subtle.”

ADHD can also be misdiagnosed as another psychiatric condition. For example, it is common for people with ADHD to have problems with emotion regulation; they may get angry quickly or have drastic mood swings. Excessive worry and anxiety can also occur, sometimes because of ADHD symptoms themselves. As a result, many adults may have been diagnosed with depression or anxiety when the real root of the problem is ADHD.

How is ADHD diagnosed in adults?

There are three main questions a psychiatrist will address to help determine whether a person has normal inattention or forgetfulness or ADHD: How many symptoms do you have? Do you have them from childhood? And do they affect two or more parts of your life?

The last two are particularly useful in determining whether someone will be diagnosed, said Dr. Craig Surman, a psychiatrist who directs the ADHD Research Program for Adults at Massachusetts General Hospital. Once established, he said, “you really eliminate a lot of people.”

A person must have five of the nine symptoms listed in psychiatry’s official diagnostic manual to qualify for inattentive ADHD. These symptoms fall into three categories: productivity or performance problems (procrastination at work or failure to finish tasks); memory (frequently losing your phone or keys, or forgetting to buy something on the way home); and organization of objects and time (having a messy house or always being late).

These symptoms must negatively affect two or more parts of life, such as work, home, and relationships. If your home is in disarray but you are successful at work and your personal life is rich and fulfilling, you probably wouldn’t qualify for a diagnosis.

Symptoms must also have been present since before age 12. In the eyes of most doctors, ADHD is a neurodevelopmental disorder, meaning it started when the child (and his brain) was young. This can be the most difficult to determine because people may have received assistance or compensated for their symptoms without realizing it. For example, a parent may have given them daily reminders to finish homework that helped them get through school.

“They’ve probably had the disorder for most of their lives, but they’ve learned to deal with it in a variety of ways,” Dr. Anbarasan said. “These are people who write everything down, or they follow a structure very well and dedicate a lot of time and effort to organize themselves.” Many people don’t recognize that something is wrong until the demands and responsibilities of adulthood pile up and the systems they are using begin to fail.

This can be especially true for women. Boys are approximately twice as likely to be diagnosed with ADHD in childhood than girls, because even at young ages, girls’ symptoms tend to be more inattentive than hyperactive in nature. As a result, girls with ADHD may struggle a little in school or be seen as silent dreamers, but they escape the diagnosis because they aren’t very disruptive in class or at home.

If you’re seriously concerned about your attention but didn’t have ADHD symptoms as a child, your problems could be caused by another medical or psychological issue—recent traumatic or stressful events, changes in sleep or drug use, other psychiatric conditions, or even the early onset of a neurodegenerative disorder – which you might mistake for ADHD.

“There are at least a dozen psychiatric and cognitive conditions that can resemble ADHD, as well as a substantial list of medical conditions,” said Dr. Nigg. “When someone thinks they have ADHD, I recommend a thorough investigation.”

What options are available if you are diagnosed?

The good news is that ADHD is pretty easy to treat. Stimulant medications, such as Ritalin or Adderall, are effective in helping people control their attention. Other drugs, called alpha-2 agonists, were originally developed to treat high blood pressure, but are sometimes prescribed for ADHD as well. These can help people focus without many of the unpleasant side effects of stimulants, such as trouble sleeping or decreased appetite.

Non-pharmaceutical treatments such as behavioral coaching and therapy may also be helpful. These techniques help people understand how ADHD affects their daily lives and provide coping strategies.

Because stimulant medications can be abused, the question of when and how to treat people with ADHD can be tricky for clinicians.

“I see part of the diagnosis as, ‘Are they not healthy because of this?’ which is different than, ‘Are they unproductive because of this?'” Surman said.

If someone meets the diagnostic criteria but the symptoms aren’t causing much distress and they’re generally functioning well on a day-to-day basis, Dr. Surman said he tends to recommend strategies like training and behavioral therapy rather than medication.

Regardless of the recommended treatment plan, it’s important to take ADHD seriously. If left untreated, people with the condition are at greater risk of early death, both from accidents and suicide. They are also more likely to have problems with their finances, legal issues, substance abuse, unsafe sexual behavior and unsafe driving. But with effective treatment these risks are drastically reduced.

Translated by Luiz Roberto M. Gonçalves