ADULT ADHD IS MORE THAN JUST A DISTRACTION

     Adult ADHD is a disorder which is characterized primarily by a poor attention span, distractibiity, forgetfulness, impulsivity, and difficulty completing daily tasks.  Adult ADHD may be diagnosed during the young adult or middle adult years, or it may have been diagnosed during childhood or adolescence.  People with adult ADHD tend to seek help after becoming overwhelmed with academic or work responsibilities or due to problems with relationships.  While much has been learned during the past 20 years about medications for adult ADHD and the frustrating cognitive effects, the negative social and emotional effects of adult ADHD have been largely overlooked.

      In this post, I am explaining how adult ADHD can impact a person’s overall sense of identity and can cause low self-esteem, insecurity in relationships, and shame and doubt in a person’s academic and career performance.  If you experience the symptoms of adult ADHD, you will relate to the situations described in this post.  If you do not have adult ADHD, I hope that this post helps you to increase understanding about how this disorder can affect more aspects of a person’s life than just attention and memory.  The following sections describe how you may think, feel, and behave while dealing with adult ADHD.

FEELING “OUT-OF-PLACE” OR “INAPPROPRIATE”

     As an adult with ADHD, you may feel “out-of-place” in social situations, due to your tendency to interrupt others or to become very confused during even superficial conversations.  You also may have great difficulty processing and remembering information necessary for completing daily tasks or interacting with friends and colleagues.  You often behave inappropriately, due to your brain’s racing thoughts.  You experience the world in a way that others don’t easily understand, and this inner world cannot be easily communicated to others.

     You continually misplace items and forget appointments, which gives the appearance of being irresponsible and incompetent.  You are easily stressed and overwhelmed by even simple tasks, and you face each day with restlessness and fear about keeping your life under control.  If you are a parent, you may have persistent guilt and embarrassment about not being able to stay focused on what your children are saying to you or forgetting about important activities with them.

SELF-ESTEEM

     You live your life in fear and confusion, as if you are always keeping your head barely above water.  Your self-esteem diminishes when you are unable to control the mental distractions which interfere with personal interactions at work, school, and with family members or other significant people.  Your lack of focus and poor listening skills create a “fugue” throughout the day.  When you are interested in an activity, you may hyperfocus and accomplish significant work or academic goals.  However, this hyperfocus often comes at a cost, because you may forget about or procrastinate other activities.  Hyperfocusing may also result in ignoring important people in your life, such as your romantic partner or your children.  Poor time management skills often cause you to be late for important events, such as a college class, a work meeting or work in general, or a family activity.  Being late, getting easily distracted, or forgetting information at work or school gives the appearance of irresponsibility or even having some sort of drug or alcohol problem.

RELATIONSHIP PROBLEMS

     Due to your chaotic thoughts and severe difficulty with following a conversation, you often appear uncaring or insensitive to your romantic partner or to your children.  Due to your impulsivity, you may blurt out unfiltered thoughts and feelings, which can cause hurt feelings or negative reactions in others. This impulsivity can also lead to irresponsible and even self-destructive behaviors, such as infidelity, excessive substance use, and reckless spending habits.

     You have trouble both clarifying and moderating your emotions.  You may lose your temper easily and have trouble discussing issues in a calm and productive manner.  Your partner may feel like he or she needs to walk on eggshells, in order to avoid your emotional meltdowns.  You may feel unloved and unwanted, because your romantic partner, friends, and family members are constantly criticizing and doubting you.  

          You may zone out during conversations, which can make your partner feel ignored and devalued. You may also miss important details or mindlessly agree to something that you don’t remember later, which can be frustrating to your loved one.  You have a strong need for emotional support and acceptance, yet your erratic thoughts and behaviors appear disrespectful to others.  Even when you are paying attention, you may later forget what was promised or discussed.  Your partner may start to feel like you don’t care or that you’re unreliable.  You may frequently be told to “change,” “get it together,” “calm down,” or “focus.”  You would love to comply with all of these demands, yet they only perpetuate your cycle of self-doubt and often result in your strong desire to isolate. 

SHAME AT WORK AND SCHOOL

     Work and achieving career goals can involve confusion from many ideas which seem to float around your brain.  You may have creative and inspiring ideas, but they are often short-lived and may be eclipsed by new thoughts within seconds.  Your poor organizational skills often lead to difficulty finishing work or household tasks or meeting academic deadlines.  You often appear needy and irresponsible, due to your frequent asking for instructions to be repeated or deadlines to be extended.  You may often struggle at work or school to control your emotions and may lose your patience easily.  As a result, you are more likely to struggle with conflict at work.  You also may be particularly prone to jumping between several tasks at once.  ADHD research has consistently shown that trying to focus on several different tasks at once can negatively affect performance, particularly when those tasks are cognitively demanding. 

     You can create this focus through practicing mindfulness and planning each day’s schedule by writing a detailed and time-framed list.  You may have felt “not intelligent” or “not meant for college” due to the daily struggle of time management, memorization, and thought organization required by college students.  You may fear failing classes and may even take a semester off or drop out.  In the workplace, your colleagues may perceive you as unreliable in completing necessary projects and doing effective presentations.  Moreover, communicating in the workplace may provoke much anxiety, due to frequent forgetfulness of deadlines and instructions.  You may also get ideas mixed up when speaking to your colleagues or supervisor and fear being terminated.  All of these work or academic experiences can cause intense shame.

TO MEDICATE OR NOT TO MEDICATE

     Before deciding whether or not to use ADHD medication, it is important to do your own research of the different types and the possible side effects.  If you choose to use medication, you must adhere to the prescribed daily schedule and should ideally supplement it with weekly or bi-weekly talk therapy.  Living with adult ADHD is manageable, but it requires extreme self-discipline, such as making and frequently checking daily lists, learning cognitive-behavioral strategies, and continually reminding oneself (which is NOT an easy task) to stay in the moment with one’s thoughts before they race away!  

     Managing ADHD is exactly like learning a new sport or playing a new musical instrument.  You will have good performances, and you will have setbacks.  This is part of the process.  You will feel in control and will then be haunted by the ADHD mental “fugue.”  If you choose to remain on a medication regimen and stay committed to learning and honing your ADHD management skills, you will transform the insecurity and shame into an empowered and proud aspect of your personality.  A final point to this blog post is that it is important to be honest with friends, family members, romantic partners, and colleagues about your ADHD, so that it is “out there,” and others do not think that you are “out there” mentally, which, from personal experience, I completely understand!

Written by: Rebecca Wang-Harris PhD

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