IMR: An Overview of ADHD

THE INTRO-NOT-INTRO

ADHD and escapist tendencies have a lot to do with each other. (I almost posed a rhetorical question there, but wouldn’t that count as an introduction? This is IMR! Onward!) For instance, my interest in studying ADHD and writing a giant article about it to escape from the everyday grind. What else do you do with a Friday, right? 

(Please forgive me for not tying this article directly to my blog theme. I’d like to argue it’s linked in a few ways: First, because ADHD-ers are so often escapists, and second, because doing research is one of my own methods of escapism.)

THE TYPES

From what I’ve seen online and in my own life, a huge number of girls and women live with undiagnosed ADHD. I think that’s because inattentive ADHD can be so subtle, passed off as personality “quirks” even when symptoms are impacting someone’s quality of life. I’m getting ahead of myself, though. First, let’s talk about the major types of ADHD. 

1. Hyperactive-impulsive type. This is the diagnosis with the more stereotypical symptoms; a boy bouncing off the walls like he’s eaten a bag of candy might come to mind. Though that’s a big generalization, it’s true this type affects boys more often than girls. Major symptoms include:
   1. Fidgeting, trouble sitting still, always wanting to be moving or active
   2. Talking a lot, blurting out comments, interrupting in conversations
   3. Impatient/impulsive behavior, “dopamine addiction,” acting without thinking
2. Inattentive type. This is the lesser-known subtype, and it’s seen in girls more often than boys. There are many more symptoms than these, but this is a general overview.
   1. Spaciness, easily distracted, trouble focusing, dislike of mental effort
   2. Easily losing track of items/assignments/obligations, poor organization skills
   3. Forgetting about basic tasks (eating, drinking, and sleeping) or commitments
3. Combined type. This is by far the most common type of ADHD; in fact, most people with ADHD have symptoms from both the hyperactive and inattentive pools. I know I do!

THE CAUSES

Oddly enough, there’s no conclusive evidence on what exactly causes ADHD. There hasn’t been a ton of research, though, especially for ADHD in women. ADHD is thought to be a mostly-genetic illness; almost all children with ADHD have at least one parent with symptoms. (I can confirm this. When I told my dad I’d gotten diagnosed and asked if he ever experienced any ADHD-like symptoms, I got the classic, “Isn’t everyone a little ADHD?” So, yes.)

Plenty of people point the finger at TV, smartphones, and tablets. Still, there’s been some research and no one’s found any strong evidence that electronic use causes ADHD. So maybe point the finger at your own genes first!

Or at environmental toxins. There’s some proof that childhood exposure to lead, or a mom-to-be drinking or smoking while pregnant, can cause ADHD. Premature birth, too, has been linked. It’s still sort of a mystery!

THE COEXISTING CONDITIONS

A huge part of the reason ADHD can go undiagnosed for so many is because some symptoms line up with a plethora of other conditions. A lot of people, especially girls and women, suffer from mental illnesses alongside ADHD that exacerbate it! There’s a high frequency of depression, anxiety, and low self-esteem in females with ADHD. Here’s a list of some coexisting conditions, though there are more than what I include here:

• Oppositional defiant disorder or conduct disorder
• Substance abuse disorders (sometimes stemming from ADHD impulsivity)
• Anxiety disorders, including OCD
• Mood disorders, including depression, bipolar disorder, or BPD
• Learning disabilities
• Autism spectrum disorder

As you can see, there can be a significant overlap in symptoms from condition to condition. Depression can cause the forgetfulness and demotivation seen in inattentive ADHD. Autism and ADHD have many similar social effects, depending on where on each spectrum you fall. ADHD causing difficulty focusing or hyperactivity can appear like a learning disability, or vice-versa—someone with a learning disability could be diagnosed with ADHD and given improper treatment! It’s difficult to give the right diagnosis without deep knowledge on the disorders; it takes a lot of cooperation between doctor and patient. 

THE MEDS

A joke among ADHD-ers is we need to microdose meth to get our brains to work right. This is sort of not a joke too, at least for those of us who take stimulants.

1. Stimulant medication, also called psychostimulants. These meds contain tiny amounts of amphetamine or methylphenidate. Brand names for these include Adderall, Concerta, and Ritalin. Stimulants work faster than nonstimulants, and you can decide to use immediate release, sustained release, or extended release. Make sure you check on the potential side effects of a medication before you start it.
2. Nonstimulant medication. I take a nonstimulant because of a coexisting condition, which is one of the main reasons you’d pick a nonstimulant. You also might decide to take this kind because the side effects are less intense. Nonstimulants can take eight to twelve weeks to take full effect. Brand names include Strattera (mine), Tenex, and Intuniv. 
3. Antidepressants or antianxiety medication. These can work especially well for people treating depression or anxiety alongside ADHD. Antidepressants especially can be effective in treating some symptoms of ADHD without using stimulants or nonstimulants. 

OTHER TREATMENTS

Some people might not want to go on a medication. Some women choose not to because it can affect their hormonal cycle (which I definitely understand and have experienced those effects myself). Some people are diagnosed young, and their parents feel they’re too young to be medicated. (You can start as early as age six, studies find, without having any adverse effects later in life.) Still, there are lots of options to treat your ADHD without medication. Here are a few!

• Therapy, including CBT and other treatments. For anyone struggling with a mental illness or mental difficulty like ADHD, therapy is a great option. Many people struggle with relationships, work, and academics as a result of ADHD, and talking regularly with a therapist can help them gain tools and skills to make their lives easier.
• ADHD coaching, career guidance, or parent training. There are a lot of options for ADHD-ers in any position, whether as a parent or a professional, to be guided and trained to moderate their symptoms. This can be expensive, but worth it if there’s serious difficulty maintaining a regulated life because of ADHD.
• Lowering overall stress levels and simplifying/setting a daily schedule. Some people with ADHD thrive with a set routine, and some hate it. Figuring out which approach works best for you is a good step to lessen stress. It may also be smart to let go of commitments where it’s possible, as ADHD symptoms can intensify under stress.
• Create “systems” that work for you to deal with the effects of ADHD. Many people who have gone undiagnosed have these systems already, and don’t even know it. Systems make tasks physically and mentally easier. Some people have “organized chaos” to keep track of their belongings. Some carry around fidget toys or jewelry to keep their hands active at work or school. Some people have study and work routines tailored to help them focus and settle in. Finding what works best for you can take a while, but it’s worth it!

THE END

My diagnosis was a long, long road. As a kid, I was a classic inattentive type: hyper-forgetful, really spaced out, always reading and not paying attention in class, never focusing on anything that didn’t interest me. My parents and teachers told me I was just lazy, and I needed to actually try to apply myself. So I did try, in my own way, though I never got amazing grades in middle school or high school.

And then I came to college and met my roommate, whose ADHD is more of a mixed type. In fact, her diagnosis was the impetus for me getting mine. (This is a common story, in my experience, for girls with ADHD. Almost always, a friend’s diagnosis makes them think about whether they could have it too.) I started to see my systems: the planner I kept practically attached to my hand, the piles of clothes by type and number of wears, my comfort foods I always kept around… and now that I’m finally medicated, I’m refining those systems even more. I use alarms to organize every event I might forget, a planner with a calendar, and a checklist of every day of the week so I can always look at my schedule. I even use an app for my morning routine! And it helps. It really does.

If you’re reading this because you think you might have ADHD, turn off that escapist brain. Turn off that escapist brain that might say “nah, I’m just lazy,” even if a lot of the symptoms resonated. Think about it. Do some research. Maybe talk to your doctor. You might be surprised at how many things are “magically” easier once you get treated. I know I was.

---

THE ARTICLE SOURCES

https://my.clevelandclinic.org/health/diseases/15253-attention-deficit-disorder-without-hyperactivity-add-in-adults

https://chadd.org/for-adults/women-and-girls/

https://www.webmd.com/add-adhd/childhood-adhd/adhd-hyperactive-impulsive-type

https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889?utm_source=Google&utm_medium=abstract&utm_content=Attention-deficit-hyperactivity-disorder&utm_campaign=Knowledge-panel 

https://www.webmd.com/add-adhd/childhood-adhd/adhd-kids-med-use