What is ADHD?

ADHD is a neurodevelopmental disorder that affects people’s ability to exert self-control, also known as executive functioning.

Professor Christel Middeldorp, a UQ researcher into child and youth psychiatry, said ADHD is diagnosed by meeting five symptoms (six for children aged under 17) from a list set out by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V). For adults, the symptoms must have started in childhood, and not be explained by any other disorders such as depression or anxiety.

The symptoms are separated into two categories – inattention, and hyperactivity and impulsivity – and patients must meet the criteria of at least five symptoms in at least one category. If they meet five or more symptoms in each of the categories, this is sometimes described as combined ADHD.

Inattention

• You often have trouble paying close attention or make careless mistakes at work or with other activities.
• You often have trouble keeping your attention on tasks.
• You often have trouble listening when people are talking to you.
• You are easily distracted or side-tracked, and often have trouble following instructions and finishing tasks at work or chores at home.
• You often have trouble organising tasks and activities.
• You tend to avoid or dislike tasks that require sustained mental effort, such as study or time-consuming work tasks.
• You often lose things such as your phone, keys or paperwork.
• You’re easily distracted.
• You’re often forgetful in day-to-day life.

Hyperactivity and impulsivity

• You have trouble sitting still, or often fidget or tap your hands or feet.
• You often feel restless in situations that require you to sit still for extended periods of time, such as meetings.
• You have trouble taking part in leisure activities quietly.
• You feel like you’re always on the go, as if ‘driven by a motor’.
• You often talk excessively.
• You’ll often blurt out answers before the other person has even finished asking the question.
• You find it difficult to wait your turn.
• You often find yourself interrupting or intruding on other people’s conversations.

^{Illustration: Olga Rai/paseven/Adobe Stock}

What effects does ADHD have on everyday life?

For some people, ADHD can take a heavy toll on their ability to undertake everyday tasks, while other people develop coping mechanisms to handle these demands.

For Dr Voogt (pictured), growing up with undiagnosed ADHD meant developing strict self-control.

“From a very young age, I had to school myself and force myself into being very task-driven, very cold, and cut out everything that could interrupt that process and that focus,” she said.

She held an executive position at a large university in South Africa, where she was responsible for both managing duties like tenders and contracts, and running the superannuation fund.

The complex nature of this position, where she undertook work such as determining payouts of death claims and undertaking forensic work, fostered her coping mechanism of shutting down her emotions and being highly task-focused.

“I never realised the energy that I spent on a continuous basis, functioning at those extremely high levels,” she said.

For Ms Pike, the struggle to manage the effects of her undiagnosed ADHD took a severe toll on her self-esteem. She’s not alone – research shows that ADHD is associated with lower self-esteem in adulthood due to the negative messages people with ADHD hear about themselves as they grow up.

“I had a lifetime of being told, or my parents being told, well she’s very bright, but she’s lazy – she doesn’t want to do the work,” she said.

The challenges presented by her undiagnosed ADHD meant it took her 10 years to complete her Bachelor of Arts (Psychology), which she finished in 2000. It took another 3 years to complete her honours, but she then graduated as valedictorian in 2003.

A few years before her breakdown and diagnosis, her psychologist had suggested that there was a an overlap between her symptoms and ADHD, but she dismissed the idea.

“[I felt like] that was just making excuses for myself, making excuses for bad behaviour and laziness, because up to that point I’d had a good 40 or so years of that narrative for myself.”

Professor Middeldorp said this experience is common among people with ADHD.

“There’s not one way in which ADHD influences how you manage your emotions. But of course, because it impacts your daily function, it can impact on your mood and your self-esteem,” she said.

“Sometimes people also self-medicate with drugs or alcohol, to calm down their head or make them more alert.”