What ADHD feels like for adults

You're forever losing your phone, you're irritable, and you're struggling to focus.

If this sounds like you, stress or even 'COVID brain' may account for your complaints.

But for some people, these are symptoms of attention deficit hyperactivity disorder (ADHD). It's a widely misunderstood condition that is significantly under-diagnosed in adults — and often misdiagnosed as anxiety or depression.

We asked two experts what the disorder looks like in adults, and why it can take so long for women to get diagnosed.

Girls often go undiagnosed

ADHD affects people of all genders and ages. But for women in particular, the disorder can fly under the radar in childhood without a diagnosis, clinical psychologist Maddi Derrick says.

She's the director of an ADHD specialty clinic in Hobart and also lives with ADHD that went undiagnosed until 2018.

Dr Derrick says the condition is often missed in girls because the diagnostic criteria used in assessing for ADHD emerged from research focusing on boys.

"It's been filtered through that lens ever since," she says.

ADHD symptoms can also be less obvious in girls, partly because they mature socially and emotionally faster than boys and are "probably a bit aware and focused on how others are viewing them", she adds.

"You get lots of girls with ADHD who are trying very hard, who are working hard to concentrate [so] what you tend to see is talkativeness; they're very, very chatty and outgoing."

Girls can also show fewer hyperactive, and more inattentive symptoms.

"You see someone who's just sort of daydreamy. It didn't necessarily stand out to a teacher," Dr Derrick explains.

She adds that in some kids, naturally high IQs further mask their symptoms.

There's also some evidence to suggest symptoms of ADHD may intensify for girls during puberty as a result of hormonal changes, she says.

That means a girl who was just "a little bit dreamy" or outgoing might find more intense symptoms emerging in secondary school.

Not just 'a kid running around climbing the walls'

When it comes to adult ADHD, stereotypes and misconceptions are rife — and they can make it harder to spot the symptoms.

"That image you have in your head of a kid running around climbing the walls doesn't fit," Melbourne-based clinical neuropsychologist Nicole Stefanac says.

"In adults, what we see is not so much the hyperactivity; it's more around what we call your executive functions: problem-solving, planning, all those things that sort of orchestrate complex decision-making type tasks."

So what does that look like?

Adults with the disorder can have trouble paying attention to details and following through on instructions. They may have difficulty organising tasks and activities; be easily distracted; be forgetful; fidget with hands or feet; make impulsive decisions; or talk excessively.

Some adults with ADHD also report problems with emotional regulation, getting easily flustered or explosive, Dr Stefanac adds.

ADHD can also involve a sense of "internal hyperactivity", Dr Derrick says.

She herself experienced that throughout her school years, but it took her many years to realise not everyone felt that way, she has said.

"You don't realise that other people don't feel like you do in your mind, where it's all very, very busy, quite noisy, sometimes irritatingly so."

'There are top CEOs with ADHD'

Have you heard people with ADHD have low IQs and can't lead functional lives?

That's a common misconception, says Dr Derrick. But in reality, "there are top CEOs with ADHD", according to Dr Stefanac.

While the disorder does interfere with functioning or development by definition, both experts say it can be well managed with proper diagnosis and treatment.

"It just means that there's a lot more reliance on external strategies — organisational strategies, like using diaries" than other people, says Dr Derrick.

It might also reassure you to hear there are benefits to having an ADHD brain.

Research has linked the cognitive dynamism of the disorder to creativity, energy and drive (Richard Branson is one monumentally successful person living with the condition).

What's more, when interested in an activity, people with ADHD are able to focus intensely on things that interest them for long periods of time.

It's a phenomenon known as 'hyperfocus', and it can be a great strength at work.

Getting diagnosed

For adults, an ADHD diagnosis can be made by a licensed mental health professional — such a psychologist or neuropsychologist, or a physician such as a psychiatrist, neurologist, or family doctor.

Your best starting point is generally to see your GP, who can provide a referral to a psychologist or psychiatrist, says Dr Stefanac.

Once a diagnosis is made, treatment can include medication as well as psychological interventions, says Dr Derrick.

But finding specialists who understand the condition remains a challenge, she warns.

While there's no central register of "ADHD-friendly" practitioners, your best bet is to search profiles of medical specialists to look at the list of "special interests" for a mention of ADHD.

You can find a register of psychiatrists in Australia here, and search psychologists here. You can also call the all the adult ADHD Helpline on (02) 9889 5977.

This is general information only. For detailed personal advice, you should see a qualified medical practitioner who knows your medical history.