8 Reasons Adult ADD Is So Often

Misdiagnosed
Our expert explains why adult ADHD is often mistaken for another condition
or ignored altogether, and the best ways to move forward after a diagnosis.

Adult ADHD: A Difficult Diagnosis

The current diagnostic criteria for attention deficit disorder were made to identify ADHD in
children — not adults. Criteria like "often runs about or climbs" and "often fails to finish
schoolwork" don't help to diagnose ADD in adults who are bright, hardworking, problem-
solvers who have found clever ways around their symptoms, like learning to hyperfocus
on cue. Most ADHD diagnoses happen when kids are disruptive, or being screened for
learning disabilities. People who fly under the radar may never get diagnosed. Our expert
explains the eight top reasons why.

Bad Diagnostic Criteria

Most physicians don't believe that ADHD exists, and even if they do, it can be hard to find
a competent practitioner. 50% of doctors still don't know how to recognize ADHD in
adults — they evaluate using childhood criteria, which doesn't describe adult symptoms
well. They are stuck with the disruptive little boy archetype, and don't recognize the other
ways ADD presents itself. ADHD adults experience insomnia, relationship
disappointment and rejection-sensitive dsyphoria. None of these are even included as
diagnostic criteria. Is it any surprise it gets missed?

Shame
Adults with ADHD have struggled their entire lives. They've been told over and over that
they're not living up to expectations, or that they have "bad brains." Sometimes,
"rejection-sensitive dysphoria" can make adults with ADD experience the withdrawal of
love, approval or respect in a catastrophically painful way. Often, the only reason adults
seek treatment is because a boss or a spouse has said, "Get it under control, or this is
over." This build up of shame can make even walking out the door in the morning an act
of courage.

Misdiagnosis
Doctors often mistake ADHD symptoms in adults for depression, anxiety, obsessive-
compulsive disorder, and other conditions with overlapping symptoms. For adults,
hyperactivity can be turned inward. You may think that thoughts racing 90 miles an hour
is anxiety, when it's really ADHD. It's harder to see the behaviors from the outside. To
diagnose adults, doctors need time to find and put together the pieces of various ADHD
symptoms, but most doctors only have a 15-minute visit. It's just not enough time.
Sleep + ADHD
Insomnia isn't recognized as an ADHD trait, but 40% of adults say it's their biggest
impairment. Adults with ADD describe themselves as night owls who get their best bursts
of energy right before bed, and then can't turn their minds off. They toss and turn, fidget,
and worry. Another 20% fall asleep easily, only to wake in a couple hours with their
minds bouncing around. Especially for women, the hyperactive component arrives after
the sun goes down.

High IQ + Coping Skills = Missed Symptoms

People with ADHD nervous systems are usually much brighter and more creative than
the average neurotypical person. Because of this, over time, they find lots of ways to
compensate for ADHD symptoms and make their way through life. The diagnosis usually
occurs when an adult has a child diagnosed with ADHD, or gets a promotion and the
extra stress becomes the straw that breaks the camel's back.

Fears About Medication

People with anxiety and depression are often concerned about treating ADHD because
they think it will exacerbate their symptoms, or interfere with other medications like
SSRIs. However, studies have shown that stimulants do not make anxiety worse. When
conditions like arrhythmias, high blood pressure, and other disorders are stabilized and
treated, medication is safe. Stimulants don't increase blood pressure unless the dose is
too high.

Self-Medication
When ADHD goes undiagnosed, it can lead to low self-esteem from a lifetime's build-up
of poor job and relationship performance. Many adults self-medicate with alcohol or
marijuana. However, roughly 20% of ADHDers are able to regulate ADHD with exercise.
For every hour of aerobics, you will get about four hours of relief from symptoms. Others
use caffeine, which isn't the best, but works better than nothing to manage symptoms.

Slow Response to Medication

If you don't have an immediate response to ADHD medication, that doesn't mean you
don't have ADHD. The dosage might be off, or another medication might be a better fit. If
you've tried amphetamine and it didn't work, methylphenidate might be the
answer. Cutting out vitamin C, and taking medication on an empty stomach can help with
absorption. Sometimes it takes a few tries to find the right treatment routine.

Further Information
For more resources on the adult ADHD, read the following links:

• Do I have ADHD? A self-test for adults

• The Emotional Impact of Adult ADHD
• Ways to Improve Sense of Time with ADHD
• Avoid Social Slip-Ups
• Liberating, but Late Diagnosis