By Karen Tang
This month’s theme at the YCRH is Brain Health and Neurodiversity. Neurodiversity can be understood as a framework for understanding how brains work and that diversity in cognitive functioning should be embraced. Currently a range of mental health conditions fall under this neurodiversity umbrella; they include: Attention-deficit/hyperactivity disorder (ADHD), Autism Spectrum Disorder (ASD), learning disabilities, among others.
For this blog, we will focus on one aspect of neurodiversity, which is learning more about and understanding ADHD, particularly the crucial fact that it is oftentimes underdiagnosed in adults and individuals who are women. As a clinical psychologist trainee, I completed an assessment practicum that allowed me to complete a number of comprehensive assessments for ADHD in adults. Here are two main things I gleaned from my clinical experience:
ADHD in Adults
Firstly, ADHD is underdiagnosed in adults. I observed in my clinical placement working exclusively with adults, that these individuals typically coped well enough to “fly under the radar” while in their schooling years. Interestingly, it was their experiences during the COVID- 19 pandemic that led them to seek out an ADHD diagnosis, as many of their coping and management skills were no longer sufficient. For example, the switch from working in-person to completely working remotely from home due to pandemic restrictions led many clients to experience significant drops in mood and increases in anxiety. In turn, they were no longer experiencing the joyful motivation they derived from going to work (as they were previously thriving off of social interactions at work), leading to significant impacts in their work and productivity. Similarly, pandemic restrictions imposed led a number of my clients to start experiencing greater conflict in their interpersonal relationships given the higher demand of day- to-day responsibilities (e.g., supervising children while they attempt to do online schooling; not completing the greater number of tasks at home), to the extent that oftentimes, it is the client’s partner who might be urging them to seek an ADHD assessment. Additionally, a women may end up requesting an assessment for ADHD if one of their children receives a diagnosis, as she may start recognizing she has had the same experiences and symptoms.
Although ADHD has typically been regarded as a childhood condition, it is now recognized as a lifelong condition that can persist well into adulthood. ADHD symptoms in adults are similar to those in childhood (e.g., inattention, impulsivity), however, the intensity of certain symptoms, such as hyperactivity, is known to decrease over time for many.
ADHD in Women and Girls
Secondly, ADHD is often underdiagnosed in women and girls. In the past, ADHD was predominantly considered a condition in men and boys (think: the hyperactivity, impulsivity, and “bouncing off the walls” observed in the classroom). As such, this led to women and girls historically being underdiagnosed with ADHD, as many individuals were often the inattentive type (think: day-dreaming or staring out the window but not being overly disruptive to the classroom) yet still received good grades, thus, teachers were not flagging this for ADHD. As such, girls were being diagnosed with ADHD at half the rate that boys were, however, this diagnostic difference is made up in adulthood, when both women and men are diagnosed with ADHD at the same rate.
From my clinical experience, I had a number of women seeking ADHD diagnosis when they were in adulthood—oftentimes, it was because they were struggling with post-secondary schooling and responsibilities with emerging adulthood and their usual coping styles were not helpful anymore.
What do I do if I suspect I have ADHD?
If you think you have ADHD or other types of neurodivergence, I suggest you reflect on whether these symptoms are problematic and having a negative impact on your life. Oftentimes, once you’ve reached adulthood, you have developed skills and strategies to compensate or cope with these symptoms. Furthermore, a diagnosis can only be achieved if it can be demonstrated that these symptoms are significantly impairing or impacting aspects of your life.
If you do end up seeking a comprehensive ADHD assessment, find a licensed mental health professional (e.g., clinical psychologists, clinical social workers) or physician (e.g., psychiatrist, family doctor). Regardless of the professional selected, ensure you inquire about whether they have the training and expertise in working with adults with ADHD. It is important to find a qualified professional (particularly as comprehensive ADHD assessments for adults are quite a niche competency in clinical psychology!)
Resources and further reading on ADHD:
Canadian ADHD Resource Alliance (https://chadd.org/)
Children and Adults with Attention-Deficit/Hyperactivity Disorder (https://chadd.org/)
How to ADHD YouTube Channel “The Smart but Scattered Guide to Success: How to Use Your Brain’s Executive Skills to Keep Up, Stay Calm, and Get Organized at Work and at Home” (2016) by Peg Dawson and Richard Guare
“Taking Charge of Adult ADHD” (2010) by Russell Barkley
“The Gift of Adult ADD: How to Transform Your Challenges & Build on Your Strengths” (2008) by Lara Honos-Webb