At the age of 13, I was diagnosed with ADHD and put on medication to help manage the symptoms. This was in 1999, when medication was (and largely still is) seen as “the only answer”. Paradoxically as my behaviour improved and grades went up, my moods went the other way. After six months, I refused to take it. I then spent the rest of high school making life difficult for my parents, teachers, classmates, and most of all, myself. By the time I finished, I’d been suspended three times, consistently underperformed, and found myself on the wrong side of substance abuse and the law. My twenties were characterised by chaotic relationships, dysfunctional coping styles and a general life of strife. By the time I was 34, the longest I’d held down a full-time job was six months.
Then I started learning. By seeking out the right help, being patient with treatment, putting strategies into place and learning as much as I could about ADHD, I managed to go from a life of chaos and disappointment to one I never dreamed was possible. What I see now is an ocean of untapped potential for people with ADHD, and some powerful lessons to share.
1. Getting the medication right takes time and patience
There are two main stimulant medications (methylphenidate and dexamphetamine), a handful of non-stimulant medications, different dosages, plus long-acting versions. This creates a multitude of possible dosing schedules, and each person responds differently. On top of this, there will almost certainly be side effects in the short-term that either fade as the brain adjusts, or can be dealt with through a different medication or dosage. This can, and likely will be, a frustrating process, so it’s important to be patient.
2. Medication is effective, but alone it’s not enough.
Contrary to what you may have read, heard, or feared, stimulant medication is incredibly effective for 70-80% of children and teens diagnosed with ADHD and 70% of adults (Advokvat & Scheithauer, 2013). It has been used since the 1930s, and while there may be some side effects and groups for whom it is contraindicated, it is very safe for the majority when used as prescribed. However, it’s only one piece to the puzzle.
It’s more helpful to view medication as a mechanism to stabilise the brain chemistry enough to learn, implement and routinise behaviours that are often second nature to others. This includes planning and scheduling, time management, regular breaks, healthy eating patterns, impulse control and more. Learning these behaviours tends to require the help of a counsellor, coach, psychologist or psychotherapist – with a non-medicalised approach to thinking about and coping with ADHD being incredibly helpful to figuring out what works.
3. The mind-body connection is critical
If you could put the mental health benefits of exercise in pill form and sell it, you’d be the richest person alive! This is especially true with ADHD. Exercise increases dopamine and norepinephrine in the brain, reduces hyperactivity and improves attention. Any activity which creates a stronger mind-body connection, such as martial arts or yoga, is particularly useful. People with ADHD also tend to accumulate a lot more tension in the body, which can exacerbate symptoms, so a few minutes of stretching can go a long way. In fact, stretching during study, work or even at school (with the teacher’s permission) has been shown to have positive outcomes across the population (Maté, 1999).
4. Positive reinforcement is one of your most effective weapons
Praise is more effective than criticism. This is even more true for those diagnosed with ADHD, who will have heard an average of more than 20,000 pieces of negative feedback than their neurotypical counterparts by the age of ten (Dodson, 2022). People with ADHD tend to have a higher sensitivity to both criticism and approval, which can work to their advantage and yours (Hallowell, 2022). However, avoid offering empty platitudes for the sake of self-esteem building – praise needs to be specific and genuine.
5. There is a world of hidden symptoms we don’t usually hear about
Can’t sit still, can’t focus. Big deal, right? It’s much deeper than that. Memory problems, sleeping problems, intense procrastination, emotional regulation challenges, low organisational skills, low self-esteem, high co-morbidity with other mental health issues, a strange phenomenon known as “rejection sensitive dysphoria”, and a really poor sense of time (generally falling into the categories of “now” and “not now”) – these are all characteristic of ADHD.
However, there is an upside. ADHD-types tend to be higher in energy, creativity, agreeableness, empathy and a willingness to assist others, as well as have an ability to hyper-focus on areas of interest (Sedgwick, Merwood & Asherson, 2019). When channelled correctly, these divergent traits can lead to profoundly positive outcomes, which leads to my next point.
6. Extreme traits lead to extreme outcomes
Due to missed diagnoses, misunderstanding of ADHD, or lack of support, people with ADHD over-represent the prison population by five to ten times the rate of the rest of society (Tully, 2022), present with more than double the rate of substance use disorder, have a 60% higher rate of divorce and a 30% chance of chronic unemployment.
However, people with ADHD are also twice as likely to become professional athletes (Dutton, 2022) and twice as likely to become entrepreneurs (Lerner, Verheul & Thurik, 2019). Michael Jordan, Richard Branson, Bill Gates, Jamie Oliver and Dave Grohl all have ADHD, and if they were alive today, JFK and Albert Einstein would almost certainly have been diagnosed as well. These examples can encourage those who may fall into a victim mindset or use the disorder as an excuse.
7. The gender difference is probably much smaller than we think
Picture a classroom of 30 students. Two of them, one boy and one girl, have ADHD. Consistent with other mental health conditions, which girls tend to internalise, the girl is staring out the window. The boy, consistent with the tendency to externalise, is causing a ruckus. Who is raising more eyebrows?
For a long time, it was believed that boys outnumbered girls 4:1 (Faraone et al., 2015) in ADHD diagnoses, but recent studies have suggested this was largely due to girls (who present more with inattentive types) going undiagnosed compared to boys (who present more with hyperactivity). This is changing, as more girls are being diagnosed and the ratio is now closer to 2:1 (Youmshajekian & Timms, 2022).
8. It is more of a “regulation” than a “deficit” challenge
Most parents of teenage boys with ADHD will tell you they have no problem engrossing themselves in video games for eight hours straight, while adults with ADHD may find themselves obsessing over a work project well into the night. This is a phenomenon known as “hyperfocus”, which can sometimes be a good thing. The problem, however, is when it comes at the expense of everything else – including focus and motivation on the exact same task the following day. The key is to moderate intense focus with breaks (the pomodoro method is brilliant), to find ways to make the mundane more attractive and to set timers as a reminder to stop (Hallowell, 2022).
9. The very best thing you can do to support someone with ADHD is to learn about it
The opposite of judgement is curiosity. Learning about ADHD will help you build empathy, understand what is happening and why, and discover practical tools to help. My two favourite books are Ed Hallowell’s Driven to Distraction (full of brilliant practical advice) and Gabor Maté’s Scattered Minds, a powerful insight into ADHD trauma and healing. TED speaker Jessica McCabe also has an incredibly engaging YouTube channel with 5-10 minute videos called “How to ADHD”, while ADDitude is a website with scientific and medical advisory boards offering articles, webinars, an online community and plenty more.