Since October 2022, thousands of individuals with ADHD have faced immense difficulty accessing prescribed stimulant medication – the treatment they need to function and lead healthy lives. No relief is in sight.

Make no mistake that the reason for the ongoing stimulant shortage has much to do with how stimulant medication itself is viewed. After all, the Drug Enforcement Administration (DEA) classifies stimulants as Schedule II drugs for their “high potential for abuse” and sets national drug quotas for these substances based on that classification.^{1 2} This drug quota is, arguably, a major factor driving the shortage.³

Like many psychiatrists, I have taken the Schedule II classification of stimulants at face value for most of my career. Prescription stimulants are Schedule II, so they must be very addictive. How do I know? Because they are Schedule II.

This circular thinking has stopped me – and likely others – from noticing the mismatch between this classification and what I observe clinically. And while it may seem like the Schedule II classification is set in stone, it isn’t. In fact, the Controlled Substances Act specifically states that organizations, or even individuals, may petition the DEA to reclassify a substance.⁴ Shouldn’t we at least question whether these medications belong in Schedule II?

Controlled Substances: What We Get Wrong About Stimulants for ADHD

The DEA classifies drugs into five distinct categories depending upon their medical use and potential for abuse or dependency. Schedule V drugs have the lowest potential for abuse, while Schedule I drugs have a high potential for abuse and no current accepted medical use.

[Read: “Stop Treating Us Like We’re Addicts!”]

While working as a community psychiatrist, I used to brace myself for the bad outcomes from prescription stimulants. After all, as Schedule II drugs, they sit way up in the DEA’s scale. But what I found was that carefully prescribed stimulants rarely caused issues, whereas other drugs deemed “safer” often did.

Take benzodiazepines, drugs that are used to treat conditions like anxiety and insomnia. With benzodiazepines, tolerance and dependence are common, the withdrawal syndrome is serious, and overdoses can be lethal, especially when combined with opioids. When used long-term, the taper can be rocky and often requires several months to complete.

Comparatively, standard prescription stimulant treatment has minor problems. Withdrawal syndromes are rare and brief. While I have seen occasional misuse, I haven’t seen prescription stimulant overdoses or use disorders. Rather, I’ve seen people gain control of their lives. They graduate college, they hold jobs, and their relationships improve. Early refill requests are rare.

People who are prescribed scheduled benzodiazepines rarely miss a dose and need no reminders. Most of my patients with ADHD, however, struggle to take medications every day and may forget to fill their medications on time.

[Read: “This Cannot Be the Price We Pay to Function.”]

For All Their Dangers

The stark difference in adherence between benzodiazepines and prescription stimulants likely reflects two things: the symptoms of ADHD itself and the fact that stimulant medications, when taken as prescribed, are much less reinforcing compared to benzodiazepines.

Just ask any child who takes Quillivant, a banana-flavored liquid form of methylphenidate, if they want their morning dose. Many will run, far. Beer and coffee are acquired tastes because the brain pairs their flavors with the good feeling that follows consumption. The ‘drug liking’ effect of alcohol and caffeine reinforces a desire for the taste — a phenomenon that hardly occurs when taking stimulants as prescribed for ADHD. Coffee and alcohol, despite their abuse potential and widespread use, are freely available to most of the public.

Benzodiazepines, for all their dangers, are Schedule IV. Meanwhile, prescription stimulants sit in the Schedule II Hall of Shame, along with fentanyl. Yes, fentanyl – a substance 50 times more potent than heroin and responsible for a majority of the thousands of overdose deaths in the United States in 2023.^{5 6} Surely, there must be a classification error here, right?

National overdose deaths involving prescription stimulants is difficult to track because of a coding issue that lumps prescription stimulants with illicit methamphetamines. Fortunately, one study separated the two by looking at substance-related death certificates from 2010 to 2017. Of the 1.2 million total deaths that involved substances, only 0.7% involved prescription stimulants, often used in combination with other substances. Methylphenidate-related deaths accounted for .02% (295) of all substance use-related deaths, or an average of 37 deaths per year.  Compared to methylphenidate, there were twice as many deaths involving pseudoephedrine (615), which does not require a prescription, and 160 times more illicit methamphetamine-related deaths (49,602).⁷

Stimulants Are Safe – and Life-Saving – When Used as Prescribed

The sparsity of stimulant prescription-related deaths may reflect their essential role in treatment. ADHD is associated with greater risk for accidents, injury, premature death, and suicide.⁸ Multiple studies suggest that treatment with prescription stimulants may lower the risk of these adverse and deadly events.^8-11

Unfortunately, the serious risks of illicit methamphetamine use can drive stigma and fear toward prescription stimulants. Many people with ADHD may be hesitant to start stimulants for concerns about heart problems and addiction. While illicit methamphetamine does cause major heart problems and is highly addictive, appropriate prescription stimulant treatment does not carry this risk.^12, 13 Even in overdose, major cardiovascular events are rare.¹⁴ Multiple studies also show that prescription stimulant treatment for ADHD does not increase the risk of developing a substance use disorder (SUD) and may even have a protective effect.^{15, 16}

Importantly, there are situations, namely non-oral misuse (e.g., snorting, smoking, or injecting), where prescription stimulants do have high potential for abuse. These routes allow stimulants to enter the brain rapidly and cause a rapid spike in dopamine. The faster and bigger the spike, the more intense the “high” or “drug liking” effect that will reinforce use. Oral routes, on the other hand, more slowly deliver drugs to the brain. This is partly why stimulants, when taken as prescribed, hold a much lower addiction potential.¹⁷

Most people with ADHD will never snort or inject their medications. People without ADHD usually won’t, either. Indeed, the Schedule II classification appears to be on behalf of a subset of people, with and without ADHD, who use stimulant medications non-orally. Arguably, a more tailored way to protect this group may lie on the diagnostic side — by taking a careful history, requiring drug screens in adolescents and young adults, and considering non-stimulants when the risks are too high. Many youth will also welcome a matter-of-fact discussion on substance use and harm reduction.

On Stimulant Misuse

A more common issue is oral prescription stimulant misuse — that is, taking someone else’s medication or too much of your own. A 2022 survey showed that 15% of college students reported taking someone else’s prescription stimulant at least once in their lifetime, but most did so less than once a month. Only 0.1% of students reported misusing prescription stimulants more than four times per month.¹⁸

Most college students report misusing prescription stimulants for perceived performance enhancement.¹⁹ The misuse pattern does not tend to escalate and is lower-risk in nature. This is likely because most students who misuse will only do so orally, which is much less addictive, and they are not using to get high. Some of this misuse may also be an effort to self-medicate. A 2010 study showed that prescription stimulant misusers were seven times more likely to screen positive for ADHD compared to non-misusing students.²⁰

To be clear, it is still a bad idea to misuse prescription stimulants. While the health risks do not appear to warrant schedule II classification, that does not mean “risk free.” All prescription medications carry risks, and risks can vary based on factors like dose, route, and the individual. What is safe for one person can be dangerous for another. For instance, someone with bipolar disorder can become manic from a prescription stimulant. Someone who regularly uses illicit methamphetamine may tolerate high doses of prescription stimulants whereas someone else may become agitated, psychotic or go into renal failure at a much lower dose.¹⁴

For those at higher risk for prescription pill misuse, there are also long-acting formulations that were designed to prevent non-oral use. For instance, Concerta (methylphenidate ER) has a hard outer coating that is very difficult to crush.²¹ This will deter most people. In addition, when studied in a group of adolescents with ADHD and an SUD, Concerta rated only one point higher than placebo in “drug-liking” effect.²²

Vyvanse (lisdexamfetamine) is another long-acting formulation that deters abuse. Vyvanse comes as an inactive prodrug and won’t activate until it is converted by an enzyme in the bloodstream. Even if someone snorts or injects it, it will still need to be converted to an active form in the body and will not produce a more rapid effect. Two “drug-liking” studies also suggest lower abuse potential with IV doses not differing from placebo.^{23 24} While a supratherapeutic oral dose had some “liking,” it also measured higher on “drug-disliking.”²⁴

Reclassifying prescription stimulants to a lower tier would more accurately reflect real-world data on addictive potential, health risk, and their public health benefit. Still, any reclassification to a lower tier carries the risk of fueling misconceptions about safety. Some may mistake reclassification as a green light to misuse. Misconceptions on safety may also drive the purchase of counterfeit pills. Make no mistake: Counterfeit prescription stimulants – which can be easily purchased online – kill people. These fake pills are made to look just like real prescription stimulants, but instead contain illicit methamphetamine and/or fentanyl, in unpredictable amounts. Taking even one counterfeit pill can be lethal.²⁵

Prescription stimulant misuse, as a whole, is a problem that deserves our attention. Targeted education needs to occur at the individual, family and school levels. This may include dispelling myths on cognitive enhancement, emphasizing the higher risk with non-oral use, and increasing awareness on counterfeit pills. When young people are taught the actual risks and realities of the current drug landscape, they are given a chance to make safer choices. This strategy is rooted in connecting with at-risk youth and can happen without interfering with the treatment of people with ADHD.

Schedule II Drugs: The Case for Reclassifying Stimulant Medication

Ensuring access to stimulant treatment is essential to the lives of millions of people with ADHD, and it benefits the public at large. While there is widespread oral misuse, the use does not tend to escalate. Non-oral use is higher risk, but less common and rarely fatal, making prescription stimulants an outlier in the Schedule II class.

Prescription stimulants are long overdue for reclassification. For those still on the fence, here is a more conservative approach: Start with rescheduling medications that have abuse-deterring properties, such as Concerta, Vyvanse, and their generic equivalents. By releasing these medications from the chains of Schedule II, more people with ADHD can live their lives.

Do you think prescription stimulants should be reclassified? Share your thoughts in the comments section.

Schedule 2 Drugs and Stimulants: Next Steps

• Read: Who’s Afraid of ADHD Stimulants?
• Read: The Real Reason ADHD Medication Supply Is Lagging Demand
• Read: “The DEA’s Manufactured Crisis”

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹ Drug Enforcement Administration. Drug Scheduling. DEA.gov. https://www.dea.gov/drug-information/drug-scheduling

² 21 CFR Part 1303. https://www.ecfr.gov/current/title-21/chapter-II/part-1303

³ Committee on Oversight and Accountability. (May 14, 2024) Comer, McClain Probe Shortages of Schedule II Drugs, including Adderall. https://oversight.house.gov/release/comer-mcclain-probe-shortages-of-schedule-ii-drugs-including-adderall%EF%BF%BC/

⁴ Drug Enforcement Administration. The Controlled Substances Act. DEA.gov. https://www.dea.gov/drug-information/csa

⁵ Drug Enforcement Administration. Fentanyl. DEA.gov. https://www.dea.gov/factsheets/fentanyl

⁶ Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2024. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

⁷ Black, J. C., Bau, G. E., Iwanicki, J. L., & Dart, R. C. (2021). Association of medical stimulants with mortality in the US from 2010 to 2017. JAMA Internal Medicine, 181(5), 707–709. https://doi.org/10.1001/jamainternmed.2020.7850

⁸ Li, L., Zhu, N., Zhang, L., Kuja-Halkola, R., D’Onofrio, B. M., Brikell, I., Lichtenstein, P., Cortese, S., Larsson, H., & Chang, Z. (2024). ADHD pharmacotherapy and mortality in individuals with ADHD. JAMA, 331(10), 850–860. https://doi.org/10.1001/jama.2024.0851

⁹ Krinzinger, H., Hall, C. L., Groom, M. J., Ansari, M. T., Banaschewski, T., Buitelaar, J. K., Carucci, S., Coghill, D., Danckaerts, M., Dittmann, R. W., Falissard, B., Garas, P., Inglis, S. K., Kovshoff, H., Kochhar, P., McCarthy, S., Nagy, P., Neubert, A., Roberts, S., Sayal, K., … ADDUCE Consortium (2019). Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence. Neuroscience and Biobehavioral Reviews, 107, 945–968. https://doi.org/10.1016/j.neubiorev.2019.09.023

¹⁰ Chang, Z., Quinn, P. D., O’Reilly, L., Sjölander, A., Hur, K., Gibbons, R., Larsson, H., & D’Onofrio, B. M. (2020). Medication for attention-deficit/hyperactivity disorder and risk for suicide attempts. Biological Psychiatry, 88(6), 452–458. https://doi.org/10.1016/j.biopsych.2019.12.003

¹¹ Chang, Z., Quinn, P. D., Hur, K., Gibbons, R. D., Sjölander, A., Larsson, H., & D’Onofrio, B. M. (2017). Association between medication use for attention-deficit/hyperactivity disorder and risk of motor vehicle crashes. JAMA Psychiatry, 74(6), 597–603. https://doi.org/10.1001/jamapsychiatry.2017.0659

¹² Manja, V., Nrusimha, A., et al. (2023) Methamphetamine-associated heart failure: a systematic review of observational studies. Heart, 109:168-177. https://doi.org/10.1136/heartjnl-2022-321610

¹³ Zhang, L., Yao, H., Li, L., Du Rietz, E., Andell, P., Garcia-Argibay, M., D’Onofrio, B. M., Cortese, S., Larsson, H., & Chang, Z. (2022). Risk of cardiovascular diseases associated with medications used in attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. JAMA Network Open, 5(11), e2243597. https://doi.org/10.1001/jamanetworkopen.2022.43597

¹⁴ Martin, C., Harris, K., Wylie, C., Isoardi, K. (2023). Rising prescription stimulant poisoning in Australia: a retrospective case series. Toxicology Communications, 7(1). https://doi.org/10.1080/24734306.2023.2174689

¹⁵ Quinn, P. D., Chang, Z., Hur, K., Gibbons, R. D., Lahey, B. B., Rickert, M. E., Sjölander, A., Lichtenstein, P., Larsson, H., & D’Onofrio, B. M. (2017). ADHD medication and substance-related problems. The American Journal of Psychiatry, 174(9), 877–885. https://doi.org/10.1176/appi.ajp.2017.16060686

¹⁶ McCabe, S. E., Dickinson, K., West, B. T., & Wilens, T. E. (2016). Age of onset, duration, and type of medication therapy for attention-deficit/hyperactivity disorder and substance use during adolescence: a multi-cohort national study. Journal of the American Academy of Child and Adolescent Psychiatry, 55(6), 479–486. https://doi.org/10.1016/j.jaac.2016.03.011

¹⁷ Manza, P., Tomasi, D., Shokri-Kojori, E., Zhang, R., Kroll, D., Feldman, D., McPherson, K., Biesecker, C., Dennis, E., Johnson, A., Yuan, K., Wang, W. T., Yonga, M. V., Wang, G. J., & Volkow, N. D. (2023). Neural circuit selective for fast but not slow dopamine increases in drug reward. Nature Communications, 14(1), 6408. https://doi.org/10.1038/s41467-023-41972-6

¹⁸ The Ohio State University. (2022). College prescription drug study: Key findings. https://www.campusdrugprevention.gov/sites/default/files/2022-06/CPDS_Multi_Institutional_Key_Findings_2022.pdf

¹⁹ Faraone, S. V., Rostain, A. L., Montano, C. B., Mason, O., Antshel, K. M., & Newcorn, J. H. (2020). Systematic review: nonmedical use of prescription stimulants: risk factors, outcomes, and risk reduction strategies. Journal of the American Academy of Child and Adolescent Psychiatry, 59(1), 100–112. https://doi.org/10.1016/j.jaac.2019.06.012

²⁰ Peterkin, A. L., Crone, C. C., Sheridan, M. J., & Wise, T. N. (2011). Cognitive performance enhancement: misuse or self-treatment? Journal of Attention Disorders, 15(4), 263–268. https://doi.org/10.1177/1087054710365980

²¹ Cone E. J. (2006). Ephemeral profiles of prescription drug and formulation tampering: evolving pseudoscience on the internet. Drug and Alcohol Dependence, 83 Suppl 1, S31–S39. https://doi.org/10.1016/j.drugalcdep.2005.11.027

²² Winhusen, T. M., Lewis, D. F., Riggs, P. D., Davies, R. D., Adler, L. A., Sonne, S., & Somoza, E. C. (2011). Subjective effects, misuse, and adverse effects of osmotic-release methylphenidate treatment in adolescent substance abusers with attention-deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 21(5), 455–463. https://doi.org/10.1089/cap.2011.0014

²³ Jasinski DR, Krishnan S. Human pharmacology of intravenous lisdexamfetamine dimesylate: abuse liability in adult stimulant abusers. Journal of Psychopharmacology. 2009;23(4):410–8
https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=8ead4bf37b0e1111a740fe2ce34ebced83085c3c

²⁴ Jasinski DR, Krishnan S. Abuse liability and safety of oral lisdexamfetamine dimesylate in individuals with a history of stimulant abuse. Journal of Psychopharmacology. 2009;23(4):419–27
https://journals.sagepub.com/doi/10.1177/0269881109103113

²⁵ https://www.dea.gov/sites/default/files/2021-05/Counterfeit%20Pills%20fact%20SHEET-5-13-21-FINAL.pdf

We hear a lot about the challenges that ADHD dumps on the backs of those who live with it, and how tough it is to bear the weight of these struggles sometimes. Seldom discussed are the strengths and abilities that ADHD brings — like being incredibly resourceful, resilient, and clever problem solvers.

So we asked ADDitude readers to put their creative ADHD brains to work by brainstorming the most important lessons they’ve learned about living well with ADHD. From the pragmatic — set your clock ahead by 10 minutes — to the profound — guidance on fostering self-compassion — readers offer up hard-won wisdom that they’ve found transformative, in the hopes you might benefit from it, too.

“Grace. Give yourself grace. The everyday mistakes you make can distract you from more important things. Know that doing right by the humans around you is far more important than having your laundry done or being all caught up at work.” —Kate, Texas

“It is essential to find a medical professional who you trust and who is an ally. Do not tolerate doctors who don’t listen to your symptoms or concerns.” —Suzanne, Canada

“Like a fingerprint, ADHD is different for each individual. We can learn from doctors’ opinions and others’ experiences, but we must discover for ourselves how to best deal with our own ADHD.” —Philip, Ohio

[Download: Rate Your ADHD Coping Strategies]

“Find your people! There is nothing that helps more than sitting in a room with a group of others saying, ‘Me too!’ You finally feel validated and less alone as well as understood and accepted.” —Nicky, Scotland

“Don’t resist medication if it will help. It’s not a character failing to take it. On the contrary, it shows your bravery in facing your condition.”  —Richard, Maryland

“Actively search for things to celebrate in yourself and others. It’s natural to be critical but noticing what’s good takes intentionality. The fruit of that is peace and joy.” —Shari, Tennessee

[Watch: “ADHD is Awesome – The Holderness Family Guide to Thriving with ADHD”]

“Write everything down.” —Jennifer

“It’s imperative to learn all you can about how ADHD affects the brain, so you can better understand (and be less judgmental) about your thoughts and behaviors.” —Louis, California

“Find help — and don’t settle for the wrong help.” —Dorothy, Ohio

“Do what you need to do to recharge. I take a 15-minute nap at lunch everyday, which brings up my dopamine so that I’m still productive at work in the afternoons.” —An ADDitude Reader

“Find people who can relate to your struggles and, if you feel safe doing so, share stories of successes and failures. You may be pleasantly surprised by the number of people who feel the same way you do, regardless of whether they have ADHD.” —AJ, Minnesota

“Always divide tasks into very small turtle steps — something that you can easily do.” —Marietjie, South Africa

“The brilliance of ADHD is that our minds and talents can be a playground. ‘Not possible’ isn’t a thing if it is something we are interested in. Want to learn how to build furniture? Done. Make macarons? Done. Run a marathon? Got it. We absolutely thrive when we can chase the dopamine high associated with our areas of interest. I may be awful at adulting, but I wouldn’t want to live any other way.” —Suzanne, Tennessee

“The most important thing I’ve learned is to change my inner monologue of ‘I’m lazy’ to ‘This is just extra hard today.’” —Kendel, Indiana

“Finding what you love may be more important to ADHD people than to non-ADHD people. Being quick to boredom and having quick tempers means if you don’t like your job, you won’t be at it very long.” —Tim, North Carolina

“One trick that changed my world was the concept of a ‘catch-all’ area near the door where I put everything I need to leave the house; and where everything will go once I walk in the door. I have saved so much time over the years not constantly looking for my keys, sunglasses, and wallet.”—Dana, Michigan

“You have ADHD; you are not ADHD. It is an attribute you have but it does not have to define who you are.” —Craig, Oklahoma

“I set my clocks forward 10 minutes. Somehow it always tricks my mind and gives me extra time.” —Karen, Virginia

“I have learned that for every storm, there is a rainbow. My ‘problems’ — sensory gifts, ADHD daydreaming, and deep processing abilities — made me an excellent teacher of 38 years. I have learned to embrace my differences and view them as positives that have enriched my life.” —Jane, California

“Many judgmental people just can’t stand that I am hyperactive, talk a lot, and interrupt without meaning to — but judging others is far, far worse than any symptoms ADHD might cause. Try not to let anyone’s attitude make you feel bad about yourself. You are beautiful. You are valuable. You have been born with your own special talents and abilities that will help to advance mankind.” —Janet, Texas

Self Love, Self Acceptance & ADHD: Next Steps

• Read: You Are Not the Sum of Your ADHD Challenges 
• Read: Self-Compassion – The New ADHD Treatment
• Read: ADHD at the Center – A Whole-Life, Whole-Person Condition

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

This October, ADDitude is shifting the focus from ADHD awareness to empowerment. From educating others to lifting up our own community. From seeking external acceptance to celebrating self-knowledge.

The first-ever ADHD Empowerment Month will kick off October 1 with a live webinar featuring Penn and Kim Holderness of ADHD Is Awesome, who will discuss the new definitions of ADHD proposed by ADDitude community members. The month will continue with exclusive profiles of creative ADHD powerhouses like novelist Rebecca Makkai, stand-up comic Rachel Feinstein, and illustrator Hayley Wall.

Each day in October, ADDitude will highlight a different definition of ADHD brought to life through stories told by our readers, who said ADHD is creativity. ADHD is curiosity. ADHD is solving problems. ADHD is resilience. And so much more. Below are two examples of these powerful community insights.

ADDitude will be sharing messages like these each day in October on social media and at http://additu.de/empowerment, and a free ADHD Empowerment Month calendar is available now at http://additu.de/oct-cal.

“The ADHD community is beyond ready to shift the focus away from dispelling ADHD myths and educating ADHD doubters,” says ADDitude General Manager Anni Rodgers. “Twenty years after the first ADHD Awareness Day, we are deliberately moving from an external focus to an internal one this October, We are shining our spotlight on the incredible stories, reflections, and definitions of ADHD contributed by members of the ADDitude community. Their voices usher in a new era of ADHD empowerment.”

ADDitude Editor-in-Chief Carole Fleck and General Manager Anni Rodgers are available during ADHD Empowerment Month to discuss the important and timely shift from awareness to empowerment, to highlight the insightful reflections from the ADDitude community, and to introduce Penn and Kim Holderness, and other role models profiled on http://additu.de/empowerment

About ADHD Awareness Month

Twenty years ago, the U.S. Senate established a national ADHD Awareness Day to spur greater understanding of the condition that affects an estimated 7 million children (11%) and 8.7 million adults (10%) in America. Over time, ADHD Awareness became a month-long observance with an external mission: dispelling myths, disseminating truths, and advocating for support among neurotypical populations. The campaign was a success. Virtually everyone now knows about ADHD.

About ADDitude magazine:

Since 1998, tens of millions of readers have trusted ADDitude to deliver expert advice and caring support, making it the leading media network for clinicians, educators, parents, and adults living with attention deficit hyperactivity disorder (ADHD). ADDitude is not only the world’s most trusted source of strategies and information about ADHD and related conditions, such as learning disabilities, anxiety, depression, and oppositional defiant disorder. ADDitude is the voice of and advocate for the ADHD community. In 2021, ADDitude joined the WebMD family of health brands.

Here, ADDitude readers share more stories of when they reaped the rewards of spontaneity. Read more.

“If you can tune into your voice and communicate your story, that’s when you’re going to create something nobody’s ever seen before.” — Hayley Wall

“I would not change my son or husband for anything. We’ll bundle up all the positives and challenges, stick them into our family jetpack, and navigate the steps, bounces, stumbles, and freefalls of this shared diagnosis together.” Read more.

“My creativity has blessed me at every stage of my life. My grandkids and I write songs or make videos, and I do sing-a-longs at my mom’s nursing home. Being ADHD is a rollercoaster ride, but I love the thrills along the way!” Read more.

Imaginative, resourceful, and fast-thinking ADHD brains can often solve problems that stump everyone else. Here, readers share their stories of seeing the solution everyone else missed.

Star of the stand-up comedy special “Big Guy,” Rachel Feinstein talks about her ADHD journey, from adrenaline highs to rejection lows (and how she’s always losing her passport). Meet Rachel

“When I get to engage in an adrenaline-filled experience, like jumping off a 40-foot cliff, I take it.” Learn more about the risky, sensation-seeking activities that ADDitude readers crave.

“I sometimes feel frustrated that the things that seem so simple (turning in homework, putting on BOTH shoes, turning off the stove) can be so hard for the ADHD brain. But the things my son’s brain creates leave me in awe.” _ Kim Holderness

Here’s how ADDitude readers answered our question, “How has your (or your child’s) curious ADHD brain fueled innovation, exploration, and/or opportunity?”

“The more I talk to colleagues about my fresh diagnosis (ADHD, inattentive type), the more I see that others grapple daily with different demons. And some of the things that frighten or frustrate them about teaching come as naturally to me as breathing.” Read this blog post.

“You can’t see my constant struggles to stay on top of employment, housework, and personal affairs; you can’t hear my every thought scream for my total attention as I fail to hold onto a single one; you certainly can’t feel the smaller effects of ADHD pile on top of each other to create a web of executive dysfunction.” Read this blog post.

25 positive affirmations to lift up ADHD brains

Rebecca Makkai is a New York Times bestselling author whose books have been translated into more than 20 languages. She is a Pulitzer Prize and a National Book Award finalist. She teaches graduate fiction writing at Northwestern University, among other places, and she has ADHD.

“When your brain feels, sees, and smells everything, it is more likely than the neurotypical brain to notice something no one has ever noticed before. It is more likely to go down a rabbit hole and discover a new path. It’s more likely to see something in a way no one has ever seen it.”

How to live better with ADHD, according to the experts.

ADDitude readers describe the undeniable signs, symptoms, and strengths of ADHD that may be invisible to others. Read more.

“These mottos have helped me practice self-compassion and affirm my own neurodiversity.” Read more.

From the pragmatic to the profound, readers offer up hard-won wisdom that they’ve found transformative, in the hopes you might benefit from it, too. Read more.

“What if my intense drive is because of — not in spite of — my ADHD?” asks Tracy Otsuka, JD

If you could pay a visit to your childhood self, what words of affirmation, advice, or messages of self-love would you impart? ADDitude readers respond here.

These insights on living and (mostly) thriving with ADHD from the Holderness Family will make you laugh, nod in agreement, and feel a little more understood.

Disorder. Condition. Impairment. These are the words commonly used to describe ADHD. Their accuracy is debatable. What’s for certain: they’re insufficient on their own.

What does ADHD mean to you? Adventure. Gift. Advantage. Creative engine. Superpower and kryptonite, all rolled into one. According to ADDitude readers, this is the essence of ADHD.

This October, we move beyond awareness and acceptance. As we step into ADHD empowerment, ADDitude will amplify the myriad voices comprising our community and share their powerful, telling stories.

What is ADHD? It’s whatever you say it is.

ADHD Is . . .

“. . . a kaleidoscope. I see, hear and think in stereo. The beauty of ADHD is how my mind endlessly sees and hears things others around me can’t.” — Jon, United Kingdom

. . .a different gameplay mode, enabled on some brains.” — Mia, New York

“. . . eye-opening.” — Zak, Florida

“. . . like a powerful wild horse — beautiful and strong but untamed. Imagine what it’s like to ride on its back and be taken where it wants to go. You just need to train your horse, and to develop your strength and agility and learn to hold on.” — Giedre, United Kingdom

“. . . complicated.” — Ava, Canada

[Read: Holderness Family Values – 9 ADHD Truths (with a Side of Laughter)]

“. . . an adventure. ADHD is curious. ADHD is playful. ADHD is a roller coaster.” — Emma, Scotland

“. . . exhilarating. There is always something new to learn.” — Erin, Missouri

“. . .wonderfully maddening. Wonderful because of the ability to focus intently on things that interest you and maddening because you’ll need to develop ways to complete tasks that don’t interest you. You have awareness, perspectives and abilities that are likely different from your peers and those skills make you exceptional.” —Becky, Indiana

[Read: 17 Things to Love About Your ADHD!]

ADHD Is . . .

“. . . hopeful. People with ADHD can help create a future that has justice, empathy, curiosity, and creativity as the guiding principles.” — Sara, Canada

“. . . liberating.” — Noreen, Oregon

“. . .an uphill and downhill battle.” —An ADDitude Reader

“. . .a horse without blinders. Someone with ADHD can see so many things at once.” —John, Illinois

“. . .both a superpower and kryptonite.” — Tyra, Arizona

“. . . a channel to dream big dreams.” — Tara, Canada

“. . . is the key that unlocks universes. Wanting to know more about topics I’m interested in is a gift.” — Nicole, Ohio

“. . . a hurdle — one that makes you more resilient.”  — An ADDitude Reader

ADHD Is . . .

“. . .being upside down in a neuro-normative world which is ‘right way up.’” — Rachel, United Kingdom

“. . . a new day every day, sometimes every hour.” — Jana, Tennessee

“. . . differently powerful.” — Betsy, New York

“. . . hyper-focusing.” — An ADDitude Reader

“. . . magical.” — Sam, United Kingdom

“. . . misunderstood.” — Jamie, Tennessee

“. . . multi-faceted and pervasive, affecting all aspects of one’s life.” — Kathryn, Michigan

“. . . something that gives you the energy to accomplish great things. It may be hard to sit in a class, but you are one of the greatest builders of society.” — An ADDitude Reader

ADHD Is . . .

“. . .a mixed bag. At times it really does feel like a superpower, like when I’m writing for fun; the metaphors and creativity flow like water. At other times, it really does feel like a curse, like when I lose what feels like the 50th pair of prescription sunglasses. My biggest asset is simultaneously my biggest struggle.” — David, Oregon

“. . . determination, focus, tenacity, and courage.” — Heather, Alabama

“. . . balance.” — Maggie, Michigan

“. . . a beautiful brain in a challenging environment.” — Dee, Canada

“. . . overwhelming — and empowering.” — Ariel, Wisconsin

“. . . something that can both control you, and be controlled.” — Andrew, New York

“. . . not good and not bad. It just is.”  — An ADDitude Reader

What Does ADHD Mean?: Next Steps

• Read: “ADHD Is Hard, But…” Crowdsourced Advice for the Newly Diagnosed
• Watch: “ADHD is Awesome: The Holderness Family Guide to Thriving with ADHD”
• Read: “The ADHD Characteristics I’m Most Thankful for Are…”

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Wisdom is the hard-won result of experience; there are no shortcuts. But if you could time travel back to speak with your childhood self, what advice would you offer that tiny, still unformed version of yourself? What lessons about living and thriving with ADHD — school, work, relationships, self-love — would you impart? What words do you most wish you’d heard to avoid some headache and heartbreak, and to find more fulfillment and acceptance?

Here, ADDitude readers reflect on ADHD life lessons learned and offer everything from practical hacks to tender compassion. Threaded together, these words form a brilliant tapestry of self-advocacy, self-empowerment, and, above all, self-love.

“Oh, love, hi there! It’s me, your 34-year-old self. I just want you to know that you are wonderful. Absolutely wonderful! I know you feel like people don’t get you and that you have to be perfect to be liked. But, cute one, you are not weird, your brain is just different and you have something we call ADHD. It’s why you sometimes lash out and why you dream for hours. It’s also why you love so many different things. I know it feels safer to hide these things with your fears, but you are hurting yourself by doing that.” — An ADDitude Reader, Netherlands

“Be kind, be kind, be kind. Especially to yourself. It will feel rebellious, maybe even dangerous, to be kind to yourself, but you must try.” — Laura, Louisiana

“You are not lazy. You are not flawed. The world is just not ready for you yet.” — Adrienne, Virginia

[Read: Birds of a Feather – The Joy of Neurodivergent Friendships]

“Take notes, drink coffee.” — Courty, Pennsylvania

“You’re not crazy — you are different. There’s this thing called rejection sensitive dysphoria. It’s real, it explains a lot of what you feel all the time, and it really freaking sucks.” — Chiara, Oregon

“Post-It notes are your friend! Write things down so you remember to do stuff!” — Lisa, Ohio

[Read: Everyday ADHD – Quirky Productivity Hacks for Easily Bored Brains]

“Tell those you trust about how you feel. The sooner you tell someone, the sooner someone can help.” — Sarah, United Kingdom

“Honey, yes, you are different, but it’s a beautiful kind of different. Nothing great was ever accomplished under the umbrella of normalcy.” — Michelle, California

“Get diagnosed now.” — Karon, Colorado

“Never be quiet, keep taking up space until you get the help and support you deserve. It will be better when you’re allowed to make your own decisions.” — Mariah, Illinois

“You are irreplaceable.” — Remy, California

“Keep taking the next right step.” — Anne, Wisconsin

“You will be a great adult. Hold on until you get there.” — Michele, Texas

“Find whatever sparks joy and live your dreams as fully you possibly can.” — Deniz, Massachusetts

“Learn how to apologize.” —Paul, California

“Connect with those who thrill and want to be thrilled … then go home to calm. I have found that people like me are not the ones I like to live with.” — An ADDitude reader in New Zealand

“Don’t drink or do drugs to soothe, it makes things worse.” — An ADDitude Reader

“Choose a trade. You’re creative, enjoy working with your hands, and find satisfaction seeing the end product of your efforts.” — Matt, Canada

“There’s a reason why things that are supposed to be simple feel like they’re written in a foreign language. There are others out there who can understand, appreciate, and see the value in your own unique language.” — Jessica, Texas

“Don’t worry so much about fitting in with others. You will find your tribe along the way.” — Noreen, Oregon

“Bring a fidget everywhere.” — M., Virginia

“Become comfortable with being uncomfortable.” — Jamie, United Kingdom

“Oh, sweetheart, it’s not your fault. Your brain is built a bit differently from other people, and that’s okay. It doesn’t mean you’re a bad student, or a bad person. It doesn’t mean that you’re a weirdo, or unlovable, or a problem.” — Peyton, Oregon

“It’s not you, it’s the world. Keep doing your thing. It’s going to get complicated and confusing but you will develop some amazing strategies and skills to manage it, without even realizing.” — Lucy, Australia

“Learn about your brain. Teach others!” — Wendy, Canada

“Trust your gut. Pay attention to your needs; they’re not lying to you.” — An ADDitude Reader

“God has a plan for you, sweetheart. You are teary-eyed and alone right now, but I promise a whole world of amazing, creative, heart-centered people across the globe will be at a finger tip’s distance from you in the future.” — Erin, Canada

“Work hard at making nutrition, exercise, and sleep as routine and automatic as possible, to serve as a good foundation.” —Beth, Texas

“Figure out what works and what doesn’t, and then design your life around your strengths. Find a job that fires your passions, which means you’ll work hard at it. Find friends who appreciate your spontaneity without punishing you for poor planning and communication. Find a spouse who pushes you to grow as a person and loves you for your good qualities.” — Josh, Utah

Words of Affirmation and ADHD: Next Steps

• Watch: “How to ADHD – An Insider’s Guide to Working with Your ADHD Brain“
• Read: You Are Not the Sum of Your ADHD Challenges 
• Read: ADHD at the Center – A Whole-Life, Whole-Person Condition
• Download: Rate Your ADHD Coping Strategies

Episode Description

To kick off ADHD Empowerment Month, ADDitude asked you (our readers) to tell us how you define ADHD and its impact. More specifically, we asked: “If you were describing ADHD to a newly diagnosed child, how would you portray it in a way that builds self-esteem, hope, and resolve?”

In this webinar, we will share your responses and explore core ADHD strengths such as creativity, curiosity, problem-solving skills, and resilience with Penn and Kim Holderness, authors of the book ADHD Is Awesome: A Guide To (Mostly) Thriving With ADHD. Along the way, we will also celebrate some of the ways our ADHD brains make us undeniably awesome and essentially irreplaceable.

We know having ADHD is sometimes stressful , but the Holderness Family is very good at showing us how to shift our mindset and lean into the aspects of ADHD that make us unique and wonderful. In this webinar, we will discuss…

• Names that better describe ADHD
• Ways to reframe ADHD through a lens of strength to bolster a child’s or adult’s self-esteem
• Real-world examples of ADHD creativity and curiosity
• Favorite stories of ADHD problem-solving acumen from ADDitude readers
• The ADHD ability to bounce back and keep learning in the face of challenges
• How ADHD can help you win “The Amazing Race” (just kidding, but they actually did win!)
• And much more

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

ADHD Empowerment: More Resources

• Free Download: All the Best Parts of ADHD
  
• Replay: ADHD is Awesome — The Holderness Family Guide to Thriving with ADHD
  
• Read: “How My ADHD Makes Me a More Dynamic, Resourceful, Passionate Leader”
  
• eBook: Inattentive ADHD in Adults — An Essential Guide to the Underdiagnosed, Undertreated Subtype

Obtain a Certificate of Attendance

If you attended the live webinar on October 1, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Penn & Kim Holderness are authors of The New York Times Bestselling Book, ADHD Is Awesome: A Guide To (Mostly) Thriving With ADHD. (#CommissionsEarned) They are award-winning online content creators known for their original music, song parodies, comedy sketches, and weekly podcast. Their videos have resulted in over two billion views and over nine million followers. Penn and Kim have been married for 19 years and were also winners of The Amazing Race (Season 33) on CBS.

Throughout all their endeavors, Penn and Kim have never shied away from tackling topics like living with ADHD and anxiety. The overwhelming positive feedback and support from their online community was a major motivation behind their ADHD book. Penn and Kim live in Raleigh, North Carolina, with their children, Lola and Penn Charles, and their dog, Sunny.

For more on The Holderness Family, visit theholdernessfamily.com.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

Listener Testimonials

“Penn and Kim are great, and the webinar was indeed empowering. Thank you so much!”

“Thank you. I liked the added feature (video) to today’s webinar. Great addition!”

“Such encouraging and enlightening information from Penn, but also from the comments sent by participants. Thank you!”

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
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This quote perfectly sums up the pervasive fear among adults and caregivers of children diagnosed with ADHD. And it remains as detrimental now as it was when authors Edward Hallowell, M.D., and John Ratey, M.D., first published it in their book ADHD 2.0 (#CommissionsEarned).

The first-line medications for ADHD are some of the most effective, best studied, most scrutinized, longest known, and safest drugs in all of medicine. They have been safely prescribed to children for decades. Nonetheless, no other class of medications in virtually all of medicine inspires more baseless fears, intentional disinformation, and wild beliefs as do the stimulants used to treat ADHD. Interestingly, these fears are almost entirely an American phenomenon that hardly exists elsewhere in the world.

ADHD and Stimulants: A Disinformation Campaign Begins

In the late 1970s, a public backlash against treating ADHD with stimulant medication began after groups launched nationally organized, and extraordinarily effective, disinformation campaigns. This instilled a climate of fear among physicians, parents, and educators, and sowed anxiety and confusion among the public. Moreover, it planted in the minds of Americans the otherwise nonsensical idea that it was the treatment of ADHD that was dangerous — not the untreated medical condition itself.

It is also important to make a distinction between side effects due to stimulant medications and those unpleasant experiences caused by poor clinician training and experience. Finding a good clinician is much more difficult than it should be. Establishment medical education has failed miserably to prepare clinicians to diagnose and treat ADHD at all ages.

[Free Download: The Caregiver’s Guide to ADHD Treatment]

The goals of medication treatment include:

• Rule #1: The right medication and dosage matched to the right person should be dramatically beneficial and have virtually no side effects.
• Rule #2: Finely tuned ADHD medication should help you be “the best version of you.”

The Dangers of Untreated ADHD

Clinical neuropsychologist Russell Barkley, Ph.D., has demonstrated that untreated ADHD is not just highly impairing, it can be deadly. In fact, having ADHD lowers a person’s estimated life expectancy by 12.7 years.¹ Barkley has noted that most of the contributors to this mortality are lifestyle-related and can be reversed with treatment.

Research shows that untreated ADHD, with its impulsivity and inattention, raises the risks for serious traffic accidents, addiction, unsafe sexual practices, and self-harm, as well as challenges with academic performance, relationship difficulties, financial struggles, and chronic stress for children, teens, and adults.

ADHD and Stimulants: Facts Over Fears

Baseless fears about stimulant medication have scared caregivers away from seeking proper treatment for their children diagnosed with ADHD. The benefits of ADHD medication, based on decades of research and medical practice, used in conjunction with cognitive behavioral therapy, are profound for many people. The risks stemming from untreated ADHD are equally profound.

[Read: What Are the Long-Term Effects of ADHD Medication on the Brain?]

These are the fears I hear most from caregivers about ADHD medication, and my responses:

Fear #1: Will medication change my child’s personality?

The first-line stimulant medications affect a person with ADHD differently than they do a neurotypical person. Stimulant medications calm and soothe the hyperarousal and loss of emotional control associated with ADHD. A neurotypical person on an ADHD stimulant, by contrast, becomes more agitated, jittery, irritable, and unable to slow down.

Fear #2: Are stimulants addictive?

Having ADHD increases a person’s risk of substance use disorder, regardless of whether they take medication. However, one large study of adolescents found that “current pharmacotherapy for ADHD is associated with lower risk for substance use problems as long as medication treatment is maintained, indicating that pharmacotherapy is likely to be a key part of efforts to reduce substance use risk in those with ADHD.²

Fear #3: What if my child loses weight on a stimulant and doesn’t grow?

Appetite suppression is a common side effect of stimulant medications that goes away when the medicine is taken consistently enough to develop a tolerance to it. Most children ultimately gain weight and grow just as they did before taking medication.

For a small portion of elementary school-age children, most of whom were already picky eaters, the side effect of appetite suppression does create a problem. If a child is losing weight, or just not gaining weight for more than one month, the protocol for reversing this is to:

• Lower the dose of stimulant.
• If that does not work, switch stimulant molecules
• If this is ineffective, use the lowest dose of a gentle antihistamine that is FDA-approved for children 3 years of age and older. While this is an off-label use, it often helps to maintain a very beneficial ADHD treatment until the child becomes tolerant of the medication. Antihistamines like cyproheptadine, for example, return appetite to previous levels for about six hours. They are usually taken 30 minutes before lunch and dinner.

Fear #4: What if a stimulant worsens my child’s anxiety?

ADHD shares a high comorbidity with anxiety disorder. Researchers conducted a meta-analysis of 23 studies of children diagnosed with anxiety who had started on ADHD stimulants and found that anxiety decreased significantly in almost all cases.³

Arm yourself with knowledge. Read about the findings from research studies that have investigated ADHD medication. Then you can make a rational, informed decision about what is best for your child and/or yourself.

ADHD and Stimulants: Next Steps

• Free Download: Reader Scorecard of ADHD Treatments
• Read: Treating a Child with ADHD Medication Diminishes His Future Risk of Substance Abuse
• Read: ADHD Medication Side Effects No One Should Tolerate

William W. Dodson, M.D., is a board-certified adult psychiatrist. He was named a Life Fellow of the American Psychiatric Association in 2012 in recognition of his contributions to the field of adult ADHD.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

Sources

¹ Barkley, R. A., & Fischer, M. (2019). Hyperactive child syndrome and estimated life expectancy at young adult follow-up: the role of ADHD persistence and other potential predictors. Journal of Attention Disorders, 23(9), 907–923. https://doi.org/10.1177/1087054718816164

² Schepis, T. S., Werner, K. S., Figueroa, O., McCabe, V. V., Schulenberg, J. E., Veliz, P. T., Wilens, T. E., & McCabe, S. E. (2023). Type of medication therapy for ADHD and stimulant misuse during adolescence: a cross-sectional multi-cohort national study. EClinicalMedicine, 58, 101902. https://doi.org/10.1016/j.eclinm.2023.101902

³ Coughlin, C. G., Cohen, S. C., Mulqueen, J. M., Ferracioli-Oda, E., Stuckelman, Z. D., & Bloch, M. H. (2015). Meta-Analysis: Reduced risk of anxiety with psychostimulant treatment in children with attention-deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 25(8), 611–617. https://doi.org/10.1089/cap.2015.0075

Still, clinicians have the power to improve care for Black patients by taking the time to understand and mitigate barriers. Education and action are the foundation.

ADHD in Context: Unseen Factors in the Room

No two patients, even from the same cultural background, are alike in their medical needs. That said, Black patients are disproportionately impacted by the following factors and contributing health issues, which often go unnoticed or ignored but greatly impact outcomes.

Trauma and Poverty

Black individuals are more likely than white individuals to experience childhood adversity, and children who have these experiences are more likely to struggle in school and have emotional and behavioral challenges.¹ Black children are more likely to live in poverty and in disadvantaged neighborhoods, where poor access to quality foods and close proximity to facilities that produce hazardous waste increase health risks.^{2 3} Poor sleep quality is also linked to poverty.⁴ A patient who has experienced or is experiencing one or many of these factors can absolutely have issues with focus, attention, behavior, and learning — issues that mimic, aggravate, and/or overlap with ADHD.

ADHD Stigma

Negative attitudes toward mental health conditions and their treatment are prevalent in Black communities.⁵ Some individuals believe, for example, that ADHD isn’t a real diagnosis — that it’s been made up by white people to get Black children in trouble. This is a belief I’ve seen in my own practice.

[Read: Evaluating and Treating ADHD in African American Children — Guidance for Clinicians]

I was performing an ADHD evaluation on a young Black child whose teachers and school counselor — all white — suspected that he was showing symptoms. His rating scales indeed indicated that he had ADHD. The patient’s mother told me, a Black clinician, “You think like those white folk.” These negative attitudes can erect barriers around somebody who needs help — even if the news is coming from a clinician of the same racial or ethnic background as the patient. Some communities, in addition, may look to faith instead of the medical system to address and overcome mental health concerns.

Medical Mistrust and Misinformation

Black communities may fear the medical system — and with good reason. Their fears are the lasting legacy of past abuses by the medical system (the Tuskegee Study is a harrowing example) and ongoing medical racism that leaves Black patients with worse health outcomes than patients from other groups.⁶ One of the most common and pervasive myths I have to dispel for my patients is that ADHD medication causes children to become addicts. I’ve also heard families express fears that medication is a mind-control tactic.

Fear of Labels

Many Black individuals and families regard the ADHD label and other mental health diagnoses as the start of the end. Parents fear that their newly diagnosed child will be held back and targeted academically — beliefs that must be viewed from the context of the school-to-prison pipeline, which impacts Black students with disabilities more than other students.^{7 8}

Clinician Bias

Clinician bias can skew evaluation and treatment outcomes. Black youth, for example, are more likely to be diagnosed with disruptive behavior disorders like oppositional defiant disorder (ODD) and conduct disorder (CD) and are less likely to be diagnosed with ADHD.⁹ In my experience, I’ve seen these diagnoses given when ADHD doesn’t respond to medication as expected and when emotional dysregulation, including anger, is present. In other words, many clinicians think, “If we can’t get it right, then it must be ODD or CD.” Sadly, many patients spend years with inadequately treated ADHD when success is simply a matter of increasing, adjusting, or changing the medication for better symptom control.

[Read: Why We Need Clinicians of Color to Normalize ADHD in BIPOC Communities]

Clinician bias also affects how much a doctor invests in treating a patient, an issue that impacts Black patients the most, as doctors are more likely to describe Black patients with negative descriptors (e.g., “difficult,” “not compliant,” “agitated”).¹⁰ When this is the case, patients are cut off from options that can better treat symptoms and improve functioning and wellbeing.

Communication Styles

Some patients and families may communicate issues using a certain vernacular, colloquialisms, verbiage, and/or a dialect that clinicians may misunderstand or misinterpret. Without any clarifying follow-up, there could be a missed diagnosis or misdiagnosis.

Racial Disparities in Health Care: How Clinicians Can Improve ADHD Care

1. Identify your blind spots. We all have them, and it’s our responsibility as physicians to go out of our way to check them regularly in order to better address our patients’ needs. Implicit bias training can help you identify your blind spots. Take the free Implicit Association Test (IAT) to learn about your hidden attitudes and beliefs. As you learn about and acknowledge your blind spots, tell yourself before you start your workday, “I know I have biases, but I am going to go above and beyond for my patients to make sure I do my job correctly.”

2. Don’t be afraid to ask questions. Questions communicate interest, not ignorance. When you ask a patient about themselves, and how their identity and intersects with their health and wellbeing, it shows that you are paying attention to who they are and it builds trust.

3. It’s your duty to get information out of your patient. Recognize that patients may express health concerns in ways you’re not accustomed to hearing. A comprehensive clinical interview is vital for understanding and clarifying your patient’s concerns, including issues that may mimic or co-occur with ADHD. Rating scales alone won’t cut it. Also remember that patients often have to jump through several hoops to make medical appointments; no one shows up to an appointment (a costly one at that if they don’t have insurance or full coverage) because they feel like it. Think twice before you deem patients “noncompliant” or judge their motivations for being there. There are real concerns to be addressed, and it’s your job to uncover those needs.

4. Ensure all medical decision makers are in the room. In some families, a child’s grandparents — not their parents — may be the ones who ultimately decide on treatment. Take time to understand a patient’s family dynamics.

5. Help patients and families understand the benefits of an ADHD diagnosis. Parents should understand that ADHD is treatable, and that a diagnosis will allow their child to get the services to which they are entitled. Families should run to, not away from, special education services and their tailored resources. Explain to concerned parents that all educational services requiring funding — from gifted and talented programs to resources for students with disabilities — go through special education.

6. Obtain consent and ensure transparency. If you believe a patient will benefit from additional medical and wellbeing services, inform them and only put in an order after obtaining their approval.

7. Understand a patient’s circumstances and expectations. Do not assume that your approach, model, or ideas are the best fit. Really listen to what your patient identifies as their top issues, what they expect out of treatment, and what circumstances will allow them to pursue. Then devise a comprehensive treatment plan that covers those needs. Behavior parent training, for example, may necessitate an alternative approach if caregiver schedules and stressors interfere with the consistent application of positive reinforcement and discipline. No matter the plan, ensure that you, your patient, and other decisionmakers are on the same page.

8. Empower patients to advocate for their health. Most ADHD cases are treated by primary care physicians, but there are a host of providers — from nurse practitioners to psychiatrists — who can help. While insurance plans and financial circumstances may limit where patients choose to go, they should still be aware of these options. Comfort and compatibility are key when choosing professionals, so remind patients that there is nothing wrong with seeking second opinions. Often, the best way to find doctors — especially culturally competent providers — is by asking friends, relatives, faith and community leaders, and other trusted individuals for recommendations. BlackPsychiatryDirectory.com is a helpful resource.

9. Commit to ongoing education. As a psychiatrist, I consider myself a social scientist, and I invite all clinicians to take this approach. Be interested in people and cultures outside of your own. Books, news, films, television shows, and podcasts are all great ways to gain exposure to different cultures and identities.

Racial Disparities in Health Care: Next Steps

• Read: Why ADHD Is Different for People of Color
• Read: ADHD Clinicians Must Consider Racial Bias in Evaluation and Treatment of Black Children
• Read: We Need to Talk About ADHD Stigma in BIPOC Communities

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “Health Equity in ADHD: Addressing Racial Disparities in Diagnosis & Treatment” [Video Replay & Podcast #495] with Napoleon B. Higgins, Jr., MD, which was broadcast on March 7, 2024.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹ Bethell, C. D., Davis, MB, Gombojav, N, Stumbo, S, Powers, K. (2017). A national and across state profile on adverse childhood experiences among children and possibilities to heal and thrive. Retrieved from http://www.cahmi.org/projects/adverse-childhood-experiences-aces/.

² Shrider, E., Creamer, J. (2023). Poverty in the united states: 2022. U.S. Census Bureau. Retrieved from https://www.census.gov/content/dam/Census/library/publications/2023/demo/p60-280.pdf

³ Fleischman, L, Franklin, M. (2017). Fumes across the fence-line: the health impacts of air pollution from oil & gas facilities on african american communities. NAACP and CATF. Retrieved from http://www.catf.us/wp-content/uploads/2017/11/CATF_Pub_FumesAcrossTheFenceLine.pdf

⁴ Jehan, S., Myers, A. K., Zizi, F., Pandi-Perumal, S. R., Jean-Louis, G., Singh, N., Ray, J., & McFarlane, S. I. (2018). Sleep health disparity: the putative role of race, ethnicity and socioeconomic status. Sleep medicine and disorders : international journal, 2(5), 127–133.

⁵ Buser, J. K. (2009). Treatment-seeking disparity between African Americans and Whites: Attitudes toward treatment, coping resources, and racism. Journal of Multicultural Counseling and Development, 37(2), 94–104. https://doi.org/10.1002/j.2161-1912.2009.tb00094.x

⁶ Macias-Konstantopoulos, W. L., Collins, K. A., Diaz, R., Duber, H. C., Edwards, C. D., Hsu, A. P., Ranney, M. L., Riviello, R. J., Wettstein, Z. S., & Sachs, C. J. (2023). Race, Healthcare, and Health Disparities: A Critical Review and Recommendations for Advancing Health Equity. The western journal of emergency medicine, 24(5), 906–918. https://doi.org/10.5811/westjem.58408

⁷ U.S. Commission on Civil Rights. (2019). Beyond Suspensions: Examining School Discipline Policies and
Connections to the School-to-Prison Pipeline for Students of Color with Disabilities. Retrieved from https://www.usccr.gov/files/pubs/2019/07-23-Beyond-Suspensions.pdf

⁸ Center for Civil Rights Remedies of the Civil Rights Project at UCLA. https://civilrightsproject.ucla.edu/resources/projects/center-for-civil-rights-remedies

⁹ Fadus, M. C., Ginsburg, K. R., Sobowale, K., Halliday-Boykins, C. A., Bryant, B. E., Gray, K. M., & Squeglia, L. M. (2020). Unconscious Bias and the Diagnosis of Disruptive Behavior Disorders and ADHD in African American and Hispanic Youth. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 44(1), 95–102. https://doi.org/10.1007/s40596-019-01127-6

¹⁰ Sun, M., Oliwa, T., Peek, M. E., & Tung, E. L. (2022). Negative Patient Descriptors: Documenting Racial Bias In The Electronic Health Record. Health affairs (Project Hope), 41(2), 203–211. https://doi.org/10.1377/hlthaff.2021.01423

For decades, ADHD was thought to begin in childhood with many people outgrowing symptoms by adulthood. However, new scientific insights reveal findings that have reshaped the ADHD community’s understanding of how ADHD symptoms evolve, fluctuate, wax, and wane over the lifespan. 

We now know that ADHD may emerge later in life in some individuals, and we have insight into factors that impact earlier versus later onset presentations. We also understand that very few people experience a form of ADHD that is always severe and debilitating. Instead, most people appear to experience a fluctuating course through adulthood in which certain situations may be associated with the flare up or down of ADHD symptoms. 

In this webinar, you will learn:

• About the latest science behind our modern conceptualization of ADHD across the lifespan
• About the difference between late-onset and late-identified ADHD, and whether people can develop ADHD for the first time as adults 
• Whether people can be considered “recovered” from ADHD if symptoms have been at bay for a long time
• About the situations that can trigger flare-ups or lead to an abatement of ADHD symptoms 
• How to decide if a person with mild ADHD-like traits qualifies for a clinical diagnosis, and what happens if they do not meet ADHD criteria but still want help 
• About the implications for diagnosis and treatment, as well as how loved ones can best support individuals with ADHD through ups and downs — and what individuals with ADHD can do to live happy and healthy lives

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the  symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO 

ADHD in Adults: More Resources

• Download: How Common Is ADHD in Adults?
  
• Read: Is Adult ADHD Real? Yes — and Still Heavily Stigmatized
  
• Read: Why We Need U.S. Guidelines for Adults with ADHD
  
• eBook: ADHD After 40: A Guide to Symptoms, Diagnosis & Treatment Later in Life
  

Obtain a Certificate of Attendance

If you attended the live webinar on August 20, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Dr. Margaret Sibley is a Professor of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine and a clinical psychologist at Seattle Children’s Hospital. She has authored over 120 scholarly publications on ADHD in adolescence and adulthood with research funded by the National Institute of Mental Health and the Institute of Education Sciences. She is Secretary of the American Professional Society for ADHD and Related Disorders (APSARD), a Professional Advisory Board Member for Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD), and an Associate Editor of the Journal of Attention Disorders. She is the author of Parent-Teen Therapy for Executive Function Deficits and ADHD: Building Skills and Motivation published by Guilford Press in 2017. (#CommissionsEarned) 

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

Listener Testimonials

“The research studies and their outcomes presented were very informative.”

“Got a lot out of today’s presentation. Thank you!”

“This was very helpful to our understanding of late diagnosed ADHD, and to raise the question of other causes of symptoms that may be involved.”

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ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

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“I attempted to pick up my son from school to take him to the hospital emergency room. The teacher said he had a seizure-like activity. When I arrived at school, he was restrained by two administrators as they escorted him to my car. He became very aggressive inside my car and hit me in the head so hard that I was bleeding. I attempted to call Crisis Response, but the operator said they weren’t available and dispatched police. Two officers arrived. My son has BFRBs (body-focused repetitive behaviors). One officer yelled at my son, ‘Look at me when I talk to you. You think it’s OK to just sit there and pick your nose and nails? You think it’s alright to hit your mom? Boy, if you were a little older, I’d lock you up right now!‘”

“I was arrested at age 21 for spray painting a small stencil of leaping wildebeests on a concrete overpass in broad daylight. I gave zero thought to the implications of spray painting in a public space. It was impulsive and creative. The consequences were huge. I wish that impulsivity were part of the conversation when educating public safety officials about ADHD.”

[Free Download: Common Signs of a Body-Focused Repetitive Behavior]

“When my son was in high school, he had a giant meltdown after a peer incident. The police were called. He’s a large kid and started sobbing. The police told him to stop crying or he’d be handcuffed. Needless to say, he was handcuffed. I wish the police knew more about the mental health aspects of ADHD. It was a humiliating situation for all involved.”

“Before my diagnosis, I was a chronic speed demon. I would often bump into and scuff other cars… My inattention put me and others at risk for harm. I wish law enforcement knew about health care disparities and the under-diagnosis of ADHD. Criminalizing people for a disease is cruel behavior.”

“I was diagnosed with premenstrual dysphoric disorder (PMDD) and oppositional defiant disorder (ODD) in 1993 and 1994. We now know how PMDD can impact ADHD and how untreated ADHD can look like ODD or be comorbid. None of that was considered 30 years ago for a female. I also masked well and was considered a gifted student. I was very quick to challenge adults who I believed were wrong and I was quick to argue with anyone for anything. I got into trouble a lot. I wish law enforcement knew more about neurodivergent struggles with emotional regulation and utilized calm, compassionate methods before reacting.”

[Self-Test: Premenstrual Dysphoric Disorder Symptoms]

Detained by Police? Follow These Steps

1. First, pause. It’s important to not say the first thought that goes through your mind.
2. Tell the officer you have ADHD. Under the Americans with Disabilities Act, you’re entitled to reasonable accommodations, including modified questioning, fidgets and frequent breaks, and access to your medication.
3. Before you answer questions, make sure to have someone you trust, such as a lawyer or a family member, with you to figure out exactly what happened. You must be truthful and accurate with police, so if you are forgetful and have time-blindness, it’s essential to have a lawyer or trusted person with you for support.

Police Training and ADHD Awareness: Next Steps

• Q&A: ADA Information for the Recently Diagnosed
• Read: Crime, Punishment, and Redemption for My Son with ADHD
• Free Download: An In-Depth Guide to Inattentive ADHD

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

At 44, when I was diagnosed with ADHD, my neuropsychologist warned me that telling my family about it, given the personal background I provided, might not be the wisest idea.

Before I brought up ADHD to my family, they never questioned my previous medical diagnoses: migraines, a root canal, COVID-19, two bunionectomies, and two staph infections. My understanding of my health conditions was never challenged until it came to ADHD, when a single family member politely undermined my medical diagnosis, my grasp of reality, and my intelligence.

Why the ADHD denial?

To Deny ADHD Is to Uphold a Fraught Reality

Those who dismiss ADHD, I gather, often do it as an act of self-preservation. To deny ADHD is to avoid uncomfortable truths about opportunity and success.

From the moment small children can comprehend language, adult authority figures tell them that if they follow specific steps, a particular outcome is very likely or guaranteed. “Work hard, and you’ll get good grades.” “Success is no accident.”  “Practice makes perfect.” This rigid, unforgiving logic is the very foundation of the American Dream and a common justification not to help each other. Athletes, actors, musicians, authors, artists, scientists, and other recipients of professional honors, wealth, and prestige will parrot the same talking points.

[Read: Why It Hurts When Neurotypicals Claim an “ADHD Moment”]

My parents and teachers reiterated these adages too. All of my siblings ardently followed this advice, and they were richly rewarded for their legitimate hard work: private boarding schools in England, Ivy League graduate degrees, high incomes, networking with wealthy families, and professional achievements.

Not for me or the other one in 20 children in the 1980s who had ADHD, though.

The people who champion these simplistic platitudes don’t realize or account for the fact that learning isn’t that simple for those of us who are wired differently. If an undetected and untreated developmental disability stymied my academic and professional achievements – instead of my alleged lazy, unmotivated, unintelligent, and scatterbrained behaviors – then the reality for my family and all the other people who genuinely think they worked hard is shattered.

Despite steps to mitigate the effects of disability discrimination, this country still wrestles with the fact that not all opportunities for success are equal, especially in highly competitive, driven environments. Most upsetting is the fact that ADHD runs in families, meaning that “bad” genetics can threaten to upend one’s previously positive self-image and long-held beliefs about intelligence. The inability to accept reality, such as loved ones clinging to stigma over facts, takes hold in families and denies the possibility for compassion, empathy, and proper treatment.

Covert Denial and Faux Concern

I’ll give these skeptics and critics some credit: they know outright denials or rejections of an ADHD diagnosis are no longer socially acceptable. They really don’t want to appear brazenly ignorant by contradicting a widely recognized neurodevelopmental disorder.

[Read: “Is ADHD Really Real?” 6 Ranked Responses to ADD Skeptics]

What’s the “better” response? Very respectful, palatable contradictions that are cloaked in faux concern and passive-aggressive denial. “Being fidgety is normal in children, but now it’s a ‘condition!’” “The inability to focus and concentrate probably isn’t really ADHD.” “All of this ADHD nonsense is only a flashy trend.” “Is the rise in diagnoses social media’s fault?” In my case, I got the question, “Did you take this, um, ADHD test online? Because that’s not how diagnostic testing works.”

ADHD skeptics and critics don’t want to face the fact that one of the driving reasons neurotypical people flourished in life is because academic and workplace environments are mostly set up so only neurotypical people could thrive and prosper.

If there had ever been a proactive, organic nationwide movement to acknowledge and understand disabilities and work to equalize the playing field, then the Americans with Disabilities Act and the Individuals with Disabilities Education Act wouldn’t need to exist. Thankfully, legally mandated disability accommodations expand the chances of success to more people in the workplace, classroom, and other fields. However, with change comes unpredictability. Insecurity and fear drive prejudices and make ADHD accommodations difficult to obtain.

As for my family member who repeatedly attacked the credentials and professional licensure of the neuropsychologist who diagnosed me, I eventually got somewhat of an apology. “I think it’s really good you found ADHD. All of… that seems to be helping you.” I had no idea I had it so good.

ADHD Is Real: Next Steps

• Free Download: How Common Is ADHD in Adults?
• Read: The Definition of ADHD — Myths & Truths
• Read: The Controversy That Was Adult ADHD

Maria Reppas lives with her family on the East Coast. Visit her on Twitter and at mariareppas.com.

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

When we fell in love with the YouTube viral video “Xmas Jammies” 10 years ago, we didn’t know that Penn Holderness had ADHD. Since then, Penn and Kim Holderness, the First Family of ADHD, have regaled us with instant classics including “10 ADHD Lifehacks from Penn,” “Me and My ADHD,” and “How to Listen (Kinda) with ADHD.”

Aside from making us LOL, these witty and endearing videos have showcased the brilliant creativity, mind-blowing energy, and totally unique perspectives that ADHD can bring. ADHD is not 100% awesome, but the Holderness Family is very good at reminding us about the aspects and elements of this condition that do not suck.

In their new book, ADHD is Awesome: A Guide To (Mostly) Thriving With ADHD, Penn and Kim encourage readers to change the narrative around ADHD with something they call Operation Mind Shift. In this webinar, they will discuss…

• How to blow up the maddening myths about ADHD that persist
• How to talk to your loved ones about ADHD in a way that educates but doesn’t blame
• How to reframe your ADHD traits in a way that doesn’t capsize your self-esteem
• How to model ADHD positivity for your children
• How to embrace routine and control your environment while remaining zany and fun
• How to win “The Amazing Race” (just kidding, but they actually did win!)
• And much more

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the  symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO; YouTube 

Living with ADHD: More Resources

• Download: How to Build a Dopamine Menu
• Get: Your Complete ADHD Guide
• Read: 9 ADHD Myths That Perpetuate Stigma
• Read: The Positives of ADHD

Obtain a Certificate of Attendance

If you attended the live webinar on May 13, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Kim and Penn have been married for 16 years. For 7 of those years, they have chronicled their marriage and their family with funny music videos, vlogs, skits, and a podcast. Their videos have resulted in over a billion views and 4.5 million followers across social media.

Penn and Kim honed their storytelling skills with 25 combined years in the TV news business. Today, they own their own company, Holderness Family Productions, where Kim is Chief Executive Officer and Penn is Chief Creative Officer.

As well as creating content for their channels, they also work alongside brands and agencies to shape product launches and marketing campaigns. Their book Everybody Fights about improving communication in marriage was released March 30, 2021. Their new book, ADHD is Awesome: A Guide To (Mostly) Thriving With ADHD was released April 30, 2024.

Listener Testimonials

“I loved this episode so much! It was a great conversation with Penn and Kim, and I loved the song game in the middle. I wish the episode could have been longer! The insights throughout and the Q&A were so helpful.”

“Validation abounds when I listen to the Holdernesses. Finding a way to acknowledge the struggle as well as the triumphs makes it all feel a little less dreadful.”

“That was so helpful and I took a lot away from it with video snippets, notes, and quotes I can use. Thank you for having Penn and Kim on.”

Webinar Sponsor

The sponsor of this ADDitude webinar is….

It’s so easy to beat ourselves up for our ADHD that we often forget about all the great things about neurodivergence. At Inflow, we’re here to celebrate your victories, big or small, and remind you that your ADHD can be a strength. Developed by leading clinicians (and fellow ADHDers!), Inflow’s CBT-based program is your starting point to managing your ADHD and embracing neurodiversity. Get your ADHD score today to kick off your Inflow journey.

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

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Black children and adults with ADHD are less likely to receive an accurate diagnosis and proper treatment due to structural racism, low socioeconomic status, and stigma, all of which can worsen the symptoms of ADHD. Racial disparities in health care are critical to recognize and address because untreated symptoms of ADHD — including learning difficulties, impulsivity, inattention, and hyperactivity — can lead to harsh punishment of students in school, failure to graduate, substance use, and increased risk for incarceration.

In this webinar, you will learn:

• About risk factors for ADHD in Black individuals
• About the facets of racism and the present-day policies that impede proper diagnosis, care, and treatment of ADHD in Black communities
• About the serious consequences associated with untreated ADHD
• What adults and caregivers of children with ADHD need to know to find appropriate providers and ensure proper care and treatment
• How adults and caregivers of children with ADHD can effectively address stigma, build trusting relationships with clinicians, and overcome other barriers to treatment
• About strategies, including Parent Behavioral Training Programs, that can be effective for managing ADHD in families of color

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the  symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO.

Healthy Equity in ADHD: More Resources

• Get: 2024 Scorecard of ADHD Treatments
  
• Read: The Ongoing Work of Normalizing ADHD in BIPOC Communities
• Read: Why We Must Achieve Equitable ADHD Care for African American and Latinx Children
• Download: How Common Is ADHD in Adults?

Obtain a Certificate of Attendance

If you attended the live webinar on March 7, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Napoleon Higgins, M.D., is a child, adolescent, and adult psychiatrist in Houston, Texas. He is the owner of Bay Pointe Behavioral Health Services and Kaleidoscope Clinical Research.

Dr. Higgins is the Executive Director of the Black Psychiatrists of America, CEO of Global Health Psychiatry, President of the Black Psychiatrists of Greater Houston, Psychiatry Section Chair of the National Medical Association, and Past President of the Caucus of Black Psychiatrists of the American Psychiatric Association.

Dr. Higgins is co-author of Bree’s Journey to Joy: A Story about Childhood Grief and Depression, How Amari Learned to Love School Again: A Story about ADHD, Mind Matters: A Resource Guide to Psychiatry for Black Communities and author of Transition 2 Practice: 21 Things Every Doctor Must Know In Contract Negotiations and the Job Search. (#CommissionsEarned)

Dr. Higgins has worked with and founded programs that help to direct inner-city young men and women to aspire to go to college and finish their educational goals. He has worked with countless community mentoring programs and has special interest in trauma, racism, and inner-city issues and how they affect minority and disadvantaged children and communities.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

Listener Testimonials

“Fantastic webinar. The examples really brought home the points and he did a good job of showing how complicated this is to navigate.”

“Thank you for providing info about culturally competent ADHD treatment. Dr. Higgins highlighted what us Black parents have always known — that race matters when it comes to medical and educational resources. I wish this information could be proliferated in every school across the nation!”

“Great speaker, and very insightful. I enjoyed this presentation very much.”

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
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Emotion dysregulation, which research has shown to be a fundamental component of ADHD,^{2, 3} is one such symptom. Another is gender differences, particularly in females who tend to mask or internalize their symptoms.⁴ “There’s some research on whether there might be a completely different presentation [of ADHD], at least in females, with a different time of onset and a different level of severity,” said Dave Anderson, Ph.D., in a recent ADDitude webinar on understanding the evolution of ADHD.

If you could add any symptom to the DSM diagnostic criteria for ADHD, what would it be? The answers we received from ADDitude readers included many familiar ADHD behaviors like rumination, daydreaming, time blindness, insomnia, sensory sensitivity, anger, and anxiety. Some readers even suggested changing the name entirely.

“‘Attention deficit’ seems to be the exact opposite of my experience,” said Amanda, an ADDitude reader in Utah. “I cannot pull myself away from the things I am interested in! And hyperactivity represents such a small portion of diagnosed individuals (primarily boys younger than 12). It is only one of dozens of significant symptoms that affect the greater population.”

Below, ADDitude readers share the symptoms that they feel are central dimensions of ADHD. What would you choose to add? Tell us in the Comments section, above.

[Download: 3 Defining Features of ADHD That Everyone Overlooks]

ADHD Symptoms Not in the DSM

“I would love to see separate sets of diagnostic criteria for boys, girls, adult men, and adult women, because (generally speaking) ADHD can look quite different in each of those four groups. Yes, there is some overlap, but I don’t think it serves girls or adult men and women to compare them to a single ADHD picture, that of the stereotypical hyperactive young boy. The rest of us know that isn’t the only face of ADHD.” — Jen, Missouri

“I think the biggest thing I would like to see is more of a focus on emotional dysregulation and the intense emotions that you can feel as a symptom of ADHD. This is one of the main ADHD symptoms that I personally struggle with, and it was never recognized. I was misdiagnosed with bipolar as a teenager because my intense emotions were more associated with BD than with ADHD.” — Kate, Florida

“I’d make sure that comorbidities are noted more directly with the DSM diagnosis of ADHD.” — An ADDitude reader

“I believe today’s criteria don’t adequately address adult patients. The word ‘adult’ obliquely refers to patients age 17 and older, but ADHD may manifest differently in older adults. Our prefrontal cortex continues to develop into our mid-20s, does it not? Typically, career advances are met with increased responsibility and visibility, and ADHD traits can become more of an encumbrance further up the corporate ladder (as I learned in my 40s and 50s). Clinicians would likely benefit from a subset of criteria for adults 25 and older.” — Greg, Ohio

[Read: A Critical Need Ignored: Inadequate Diagnosis and Treatment of ADHD After Age 60]

“Feeling like you have multiple thoughts at once; thinking spherically as opposed to linearly.” — Sunshine, Colorado

“Apparently, sleep issues are a telltale sign [of ADHD] for young children, yet I read every sleep training book I could get my hands on when [my daughter] was a baby, and not one of them mentioned [ADHD]. I didn’t learn this until she was in high school, which I feel is not just criminal negligence by so-called sleep experts but a huge disservice to parents and to kids with ADHD who could be assessed earlier.” — Kelly, California

“The emotional regulation symptoms of ADHD are sorely lacking.” — An ADDitude reader

“The social impacts of ADHD and how it impacts the ability to maintain friendships is a big hallmark for me. In general, I wish the DSM had a great deal more nuance, especially when it comes to identifying ADHD in girls and adults.” — LeAnn, Wisconsin

“I would differentiate between symptoms that boys have versus symptoms that girls have.” — Tracy, New York

“Anything about sensory challenges. To me, this is actually what ADHD is all about: difficulty blocking out sensory input. ADHD encompasses the challenges and ways people deal with sensory overwhelm. The fact that the DSM — and as a result, many practitioners — don’t understand this is so frustrating. Without this understanding, they are missing so many people who are probably unable to get support.” — Katie, Maryland

“Communication lapses: The tendency [for my son] to think that he communicated something verbally because he already thought it in his mind. We’ve had many incidents where family dynamics were impacted by communication lapses. From his point of view, the communication happened even though nothing verbal was spoken, so the other person wasn’t in the know. This also happens with my spouse (who was diagnosed at 52 after our son).” — Julieann, Ohio

“Clumsiness — anecdotally, this is very common among ADHDers, even being accident-prone. I see this a lot in the chat rooms I frequent for ADHDers.” — Diane, New Hampshire

“If it is not already in there, I believe the aspect of emotional dysregulation and/or rejection sensitivity dysphoria is such a huge component of ADHD that gets so very little attention – especially when it comes to treatment for younger children. But even for me as an adult, when I learned about the term RSD and what it meant, it stopped me in my tracks and totally changed the way I looked at my ADHD.” — Geoff, Rhode Island

“I would add criteria under affective disorders relating to anxiety and personality disorders like BPD/OCD to ensure it isn’t ADHD before making one of those other diagnoses.” — Greg, Canada

“Include not recalling content in a conversation literally right after or immediately after the information is shared. I think my kids are ready to kill me; they have told me that they purposefully don’t talk with me that much because I never remember. It’s awful.” — Shannon, Ohio

“I would make sure that something like survivalist, problem-solver, or despiser of mundane tasks were all in there!” — Blythe, Oklahoma

“A ‘constant state of overwhelm’ would be one. Or ‘takes tons of effort just to exist.’” — Natalie, Pennsylvania

ADHD Symptoms Not in the DSM: Next Steps

• Download: Common ADHD Diagnosis Mistakes
• Read: ADHD in Adults Looks Different. Most Diagnostic Criteria Ignores This Fact.
• Watch: The Grave Consequences of Persistent Gender Role Expectations in ADHD
• Read: ADHD Needs a Better Name. We Have One.

Sources

¹ PsychDB. (n.d.) History of the DSM. https://www.psychdb.com/teaching/1-history-of-dsm

² Hirsch, O., Chavanon, M., Riechmann, E., & Christiansen, H.. (2018). Emotional dysregulation is a primary symptom in adult attention-deficit/hyperactivity disorder (ADHD). Journal of Affective Disorders, 232, 41-47. https://doi.org/10.1016/j.jad.2018.02.007

³ Soler-Gutiérrez, A.M., Pérez-González, J.C., & Mayas, J. (2023). Evidence of emotion dysregulation as a core symptom of adult ADHD: a systematic review. PLoS One, 18(1), e0280131. https://doi.org/10.1371/journal.pone.0280131.

⁴ Young, S., Adamo, N., Ásgeirsdóttir, B.B., et al. (2020). Females with ADHD: an expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry, 20, 404. https://doi.org/10.1186/s12888-020-02707-9