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The Complexities of ADHD

by Cheri Spiczka, MA, LCPC

ADHD is about more than attention. Attention Deficit Disorder is a neurological disorder that is diagnosed as one of three different types: inattentive type, hyperactive type, or combined type. In addition to issues with distraction, ADHD has been shown to contribute to low self-esteem, social issues, and difficulties with school or work.

Patience is key. Both with yourself, if you have ADHD symptoms or diagnosis, and/or if you have a loved one who struggles with it. Mistakenly, many people focus only on the distraction associated with the diagnosis, but there are many more facets to understanding and managing ADHD.

People with ADHD have deficits in the frontal lobe connections in their brain. Our executive functioning skills are housed in the frontal lobe and include: the ability to focus, task initiation, response inhibition, emotional control, planning, organization, time management, flexibility, prioritization, working memory, and metacognition. 4.4 percent of the adult US population has ADHD, but less than 20 percent of these individuals seek help for it. Many people struggle with variables related to these functions every day and do so amazingly well given the amount of effort, tools, and practice it takes to overcome this dysfunction within the brain.

A confusing part of ADHD is that most people with it can focus extremely well on things they are interested in or passionate about. This can make some people rule out a diagnosis of ADHD as a problem because the person can work on things they enjoy for hours on end. It’s really the everyday, mundane tasks such as homework, personal hygiene, household chores, etc., that are difficult for those with executive function deficits.

An aspect that is not widely known is the aspect of a maturation lag. Most parents would probably give their child another year in preschool or longer to practice learning to drive if they understood their ADHD child is approximately 3 years behind their same-age peers when it comes to maturity and impulse control. This should also be taken into account by educators who have ADHD children in their classrooms. Teachers, parents, and peers need to make adjustments in the expectations they have for these young people to be able to perform in the same way that neurotypical kids do. Although they certainly can rise to the same challenges other kids can, they may need more reminders or help with organization and other executive functions along the way.

Some think that missing social cues and awkwardness is primarily linked to autism spectrum disorder. The truth is these things affect ADHD people as well. The struggle for self-control when experiencing intense emotions can be overwhelming, especially when paired with problems with flexibility and/or impulsive responses. People with ADHD often don’t notice how their behavior affects others. They can be very intense and demanding without realizing it. It is common for them to lose the thread of a conversation, leading to frequent misinterpretations and being distracted by unrelated thoughts.

All these variables bring to light a complex myriad of issues that a person with ADHD must learn to manage and overcome. Treatment with a therapist must address all of the variables mentioned in this article and how they interact with one another. A referral for a medication evaluation may also be recommended if the ADHD symptoms are unable to be managed, or controlled, in a way for the person to effectively function in their everyday lives. Our expectations for people with ADHD must be adjusted as the brains operate differently than those of neurotypical peers. It requires continuous collaboration with clinicians, family, and educators. It takes patience, diligence, support, and dedication. ​Those with ADHD have unique traits and abilities that make them more creative, spontaneous, caring, and energetic, and they lead highly successful and fulfilling lives. ​With the right treatment and management skills in place, a person with ADHD will be exceptional!