Can You Be “Too Smart to Have ADHD?”

High intelligence does not protect you from the effects of ADHD, research shows (more about that below). Yet, it’s too often assumed—from childhood well into adulthood—that high IQ rules out ADHD entirely. In other words, you can be too smart to have ADHD.

When my husband, a molecular biologist, and I started dating, I thought, “Wow, he’s the absent-minded professor in the flesh.”

I asked my friend, a fellow journalist married to a biochemist, “Does he always miss the freeway exit?” She deadpanned: “All the freakin’ time.”

The implication was clear: Scientists live on another plane of existence; don’t expect them to be connected to the mundane realities of life. Just accept it. Appreciate their intelligence in other areas. That’s the common wisdom, and unfortunately, I bet that means that many high-intelligence people with ADHD never get the help they deserve.

Case in Point: My Husband

It would be another two years before I connected the dots from my husband’s many puzzling behaviors to ADHD.  Turns out, my husband got through his doctoral program not because he is a blazing genius—his peers were all smart, too—but because he summoned all that he had in the way of sheer grit and willpower. Plus, he consumed tankards of coffee while wearing earphones in the library basement—and had no life outside the lab.

Still, over 20 years I’ve been told again and again: “Well, your husband is so brilliant because of his ADHD.”  I know where they get this assumption. It’s a popular marketing angle in the “Adult ADHD industry.”  But I find it misguided at best and dangerous at worse.

My husband got through it because he was smart and extremely motivated (he loves his work)—plus, he was terrified at doing physical labor the rest of his life. Back then, he simply did not have the motivation and initiation to do any kind of exercise except cycling.  There was no way he could do physical work every day.

The bottom line is: Earning that PhD was immensely harder for him than it was for his peers. It didn’t have to be that hard.

too smart to have ADHD

If you’re like me, you know several people with ADHD (diagnosed or not) who’ve been trying to finish their Ph.D. thesis for ages. (This is often what brings folks to my Palo Alto  Adult ADHD group: trying to finish a PhD at Berkeley or Stanford.) Do them a favor, and forward to them this post. They might be glad to know that their challenges in procrastinating, prioritizing, and all the other executive functions have nothing to do with intelligence—high or low.

From Dr. Brown:

Psychologist Thomas E. Brown is a preeminent ADHD expert now based in Southern California. While he was still at Yale, he conducted several studies to learn more about high IQ individuals with ADHD. Here is an excerpt from his 2007 newsletter, as true today as it was then.  I’ve updated links to abstracts of the now-published papers.

High IQ Children and Adults with ADHD

Often, high IQ children and adults who suffer from ADHD are told by parents, educators, and clinicians that they cannot have this disorder because they are so bright. Many seem to assume that being very bright protects individuals from having ADHD. Recent research at Harvard and at Yale has demonstrated that individuals with high IQ can and do suffer from ADHD.

In the J. of Child Psychology and Psychiatry (2007, 48: 7 pp. 687-694), Antshel and colleagues at Harvard reported on samples of children with IQ ≥ 120, 49 with ADHD diagnosis and 92 matched controls. They found that in comparison to controls, those children with ADHD:

  • Repeated grades more often
  • Needed more academic supports
  • Had more comorbid psychopathology
  • Were rated by their parents as having more functional impairments

ADHD was also shown to have elevated incidence rates in relatives of those with high IQ and ADHD.

When compared with a group of high IQ children without ADHD and to normal IQ children without ADHD, those with both high IQ and ADHD had a much higher incidence of ADHD among their relatives than did high IQ controls as well as normal IQ controls (23% vs 2.5% vs. 5.9%). These data suggest that the ADHD of those in the high IQ sample cannot be explained as a consequence of their having high IQ.

Brown Et Al Studies: High IQ Subjects with ADHD

My colleagues and I completed two somewhat similar studies at Yale.  In our study of 157 adults with ADHD and IQ ≥ 120, we found that 73% were significantly impaired on at least 5 of 8 measures of executive function (working memory index and processing speed index on the WAIS-IQ test, index score for short term memory of stories just heard; 5 cluster scores of Brown ADD Scale).

In our study of 117 children with high IQ and ADHD (ages 6 to 17 years), 62% showed significant impairment in at least 5 of 8 similar EF measures.

Meanwhile, taken together, these three studies offer substantial evidence to support the notion that ADHD does occur in very bright children and adults.

In some ways, these very bright individuals with ADHD may be at greater risk than many others because their ADD impairments often are not recognized by educators, parents or themselves until they have suffered years of frustration and underachievement in school.

Thomas E. Brown, PhD

How about you?  Did high IQ obscure ADHD for you personally or for a loved one?

—Gina Pera

26 thoughts on “Can You Be “Too Smart to Have ADHD?””

  1. So what can you do when a clinician will not diagnos because of higher I. Q., but you still believe your child has it. I have a very very impulsive fifth grader who scores anywhere from the 60-96 percentile depending on the test. Huge inconsistencies. I believe that it is because sometimes he can’t shut off the other stimuli around him. His father and sister both have ADHD with average IQs so it is easier to detect. I really feel he has it, but am having a hard time finding some one who can see he is not reaching his individual potential because of ADHD because they just expect him to reach average.

    1. Hi Ashley,

      Obviously, can you find another clinician?

      Beyond that, perhaps try being more pro-active in making your case.

      We know the genetic basis for ADHD. The fact that his father and sister have ADHD should be a giant clue to any clinician who knows the first thing about ADHD (many do NOT).

      Also, write down in short bullet points what you perceive as your son’s challenges. Use the diagnostic list of symptoms for ADHD and provide examples for any that fit. Add anything from infancy that suggests physical issues related to ADHD (motor coordination, asthma, etc.)

      To be clear: I’m not suggesting that you “sell” a clinician on your child having ADHD. I’m suggesting that you provide what you see as the evidence, in clear, easy-to-read form (not long narratives, especially verbal).

      Also, ask your child to explain where he feels challenged…though admittedly it’s hard for a child with ADHD who has never been medically treated to know what the difference might be.

      Good luck!
      Gina

  2. I have à high IQ and adhd that i just found out at the age of 38 . Im back on school for small motor mechanics because i cant stand sitting all Day especially in front office à computer especially doing Boring stuff. I tried i litterly go nuts. Except on class when it’s interesting and interactive. Im big on asking questions. I absolutly love learning. I didnt want to try meds at first but then i wanted to be an example to my two adhd boys and after when i work i dont want to ask my boss what did you say too often. It’s hard to accept your adhd when you know your Smart and even surprise your teachers. I asked my past sales teacher and hé Says im an excellent student. And my mechanics teachers have not complained either. Sometimes i wonder if im just too hard on myself and im not adhd even if i am diagnosed and can totally relate with other adhd People and that adhd explains everything i Do différent than others which really amazes me. Knowing other adhd People finally Makes me feel normal. Adhd normal ive lost the reason i was posting but it feels good to express this. Have à great Day

    1. Hi again Another Gina,

      I’m glad you found my blog and have expressed yourself here.

      Congratulations for finding out you have ADHD at age 38. Sooner might have been preferable. But some people don’t learn until they’re 80 or older — and some never learn.

      You are young enough to have diagnosis and treatment make a huge difference in your life.

      You’ve only been on medication a day or two. Give it some time to assess what it might be doing for you.

      Some people with even untreated ADHD do quite well at learning. It’s the application of learning, in a job, that is difficult for them.

      Now, it seems like you might be able to put your excellent aptitude for learning into a job you’ll love.

      Good luck!
      The other Gina

  3. I like this. I have taken myself of meds for 14 days and i want to have an IQ test done as well as an occupational assessment.

    Then i want to go back on 84 as i should and see what the results are.

    Undiagnose i became a principal and a John maxell coach. More interesting is that someone saw the value in a document i wrote in 1997 so as to use the concept on which our current Education system is based on.

    Taking ideas without understanding why it was design will not be a solution if you cannot explain why it was done that way.

    There is more people with ADHD in this world then the people who dont have it.

    Or to rephrase. Everyone has it but only the brave will embrace it and make it work for the benifit of others.

    1. Hi Craig,

      That sounds like an interesting experiment. Please let us know when you get the results!

      Of course you want to be sure that you’re not taking too-high a dose of stimulants.

      best,
      g

  4. My son was diagnosed with Adhd in the third grade always had the supports in high school and did well until he got to college now he wants to succeed but struggles and refuses to get accomodations to help him

    1. Hi Debbie,

      Unfortunately, that’s a too-common story. And, it’s a cautionary tale about overly relying on accommodations and support in the younger years. Once the child leaves that support, he or she can really struggle. Especially if medication has not been part of the childhood strategy.

      But sometimes it happens when children have taken medication as well. They leave home and think they can make their own decisions, and leaving behind ADHD treatment is one of them.

      Some college-entry young people with ADHD do best by sticking close to home, at least for the first two years. The shock of leaving the home supports and being faced with all the distractions of dorm life can be too much.

      Some college students with ADHD don’t want to be accused of “cheating” by getting accommodations, such as longer test time.

      It’s probably easier for everyone if the groundwork is set up before entering college. Otherwise, it can be tricky to intervene later, from afar.

      Maybe if you could investigate the accommodations office for him, that might help him overcome one hurdle.

      Good luck!
      g

  5. I have been diagnosed at age 56. I have a degree and got halfway through an MA, but organising a thesis was ‘too hard’ though the work was easy enough. My career path has been less than stellar and I have lived a life of unfulfilled potential. Yes, I have written two novels and have a collection of writing awards, but there are twenty unfinished books and the ones that are done and out there took half a lifetime to complete. Trying not to regret too much but look forward instead. My husband, undiagnosed but almost definitely ADD too, has a successful professional career but comes home utterly exhausted every night. My biggest regret is that our daughter wasn’t diagnosed until after she imploded in her final year of school, left home to study a non-accademic course but flunked out of college in term 1, and nearly killed herself with ‘self-medicating’. Her psychiatric report, that concluded she had ADD, states she is of ‘above average intelligence’.

  6. This is certainly a factor in why my ADHD was not diagnosed until recently (I’m 37). I was diagnosed with Borderline Personality Disorder as a teen and again in my early twenties, but from early primary school my emotional volatility was always the largest concern for the adults in my life. Back then (and probably still though awareness is improving), a child with intense emotions, especially a girl with excellent grades, doesn’t necessarily signal ADHD in the minds of parents and teachers.

    In hindsight, all the symptoms were there, the classic distractibility and even the less-common-in-girls hyperactivity. But since my dysregulated emotions were so much more severe, that stuff was simply viewed as a secondary effect. They thought I was distractible because I was so distressed, or spaced out because I was so depressed, or hyperactive because I had such intense anxiety. And of course there was always this pervasive attitude that I “just wanted attention”, that somehow all this turmoil and behavior was simply manipulative.

    I’m in the beginning stages of medication for ADHD now for the first time, and so far stimulants are helping relieve my BPD symptoms better than the antidepressants and mood stabilizers I’ve tried before. There are still a lot of kinks to work out, and probably antidepressants to add back in, but I’m cautiously optimistic I’ll be able to live a fuller life now that the ADHD has been caught.

    Basically my therapist and I think at this point that my untreated ADHD combined with being punished for my emotions by confused parents and teachers created the BPD, which is thought these days to be caused by an “innate sensitivity” (which the ADHD would have provided) coupled by a “chronically invalidating environment” (being punished and shamed not only for emotional behavior but for the emotions themselves: being grounded for crying, being told the emotions are fake, etc).

    I try not to think about how different my life would have been if I’d been able to be treated for ADHD at a younger age. However, going forward, it’s really looking like it might make an enormous difference even starting at this later point.

    1. Hi Chloe,

      Thank you so much for sharing your story. In psychiatric forums and at conferences, I often have the occasion to point out the confusion around borderline personality disorder and ADHD, especially in young women.

      There was a lot less skepticism about BPD than there was about ADHD, for example, at the last American Psychiatric Association conference I attended, a few years ago. Honestly, I think many psychiatrists find BPD more “interesting” and more demanding of their “talk” interventions than ADHD. Which is not the case.

      From what I’ve read, Dr. Joseph Biederman shares the theory that you mention — unrecognized ADHD compounded by a “chronically invalidating environment”.

      I’m very glad that you have learned, at age 37, this potentially core contributor to your challenges and can now pursue strategies that are likely to work. That is definitely something to celebrate, because it can make a huge difference in your life going forward.

      Definitely, antidepressants and mood stabilizers will not do much for ADHD-related emotional dysregulation. They can even intensify it. So, it’s not surprising that you find the stimulants more effective with what have been described as your BPD symptoms.

      I wish you continued progress in your treatment.

      g

    2. Wow, Chloe, it sounds like we almost had the same childhood. I had several abusive teachers that said the same things! So did my parents. I survived it and got decent grades due to being absolutely and completely determined to beat both the bullying teachers and kids. They’d make fun of me for crying so back in the classroom, I’d wreck the grade curve by doing the best on all of the tests. By seventh grade, my mother went to speak with the principal about all of the girls who were threatening to beat me up over this issue.

      My social skills still stink. I ran out of gas by college and have never been able to finish even a B.S. due to changing my major 10+ times. Everything (except accounting) is at least briefly fascinating!

      I’m taking Ritalin now so while it’s helping, I am terrified of returning to college for fear it will just happen again…

    3. Hi Robinn,

      thanks for joining the conversation.

      I strongly encourage you to consider returning to your studies. But first, I hope you will look into optimizing your medical treatment. “Taking Ritalin” might not be enough to take you to the finish line.

      I detail how to get best results from medication in my book. It’s really important to self-advocate and not simply depend on the average prescriber for best results.

      Good luck!
      g

    4. Yeah, Robin, I hear you on not being ready to return to college, or maybe not even being ready to even consider returning. I definitely want to be further along before I try, because I’m afraid that another “fail” will make it even more impossible to try again. I want to be on meds a while first and actually experience some smaller tests of confidence first, and I want to do more work in therapy, then maybe break this stuff into chunks. Maybe take one class just for fun, for example, once I’m ready. Even that I would guess is a few years away, realistically? I still don’t like to put deadlines on anything. I’m terrified of failure, so pushing myself to do much of anything still backfires. The medication has been really great though for at least being able to see that more things might be possible down the road, and that is far more optimism than I’ve had in years and years.

    5. I definitely agree on taking it slowly! I am doing the same. Lots of good luck to both of us!!

  7. Gina,
    I’m also married to an absent-minded professor (physics) and for far too long believed that he was simply a typical science guy; he’s actually a typical adult ADD. Several years ago, he was involved in a program at the Fermi lab in Chicago, and had neglected to send in one of the forms required. I called about it and woman in charge of paperwork actually laughed, because missing ONLY one form didn’t qualify as a problem to her – she said that made him one of the more organized physicists involved. Makes me wonder how many “absent-minded” professors are really ADD professors.

    liz

    1. Oh Liz!!!!

      Too true!!

      Over the last many years, throughout my husband’s various jobs in academia, think tanks, and industry, I’ve said many a time, “How much faster could science progress if ADHD were better recognized in the Halls of Science?” An order of magnitude, for sure!

      Seriously! Whatever “gifts” ADHD allegedly brings to any of these individuals, it doesn’t matter when you drive a team into the ground because you can’t meet deadlines to retain grants, meet development goals, etc. Or when you drive away or demoralize productive people because you can’t stay focused in a meeting and instead distract everyone else with random ideas.

      What’s worse is that there is so little “management” — everyone is just expected to work around these people. And when the “absent-minded” one is the boss? Oy.

      There’s always “one” — always — in my husband’s work situations. It’s almost worse for him because he’s very on the ball and he notices when ADHD is “interfering with operations.” Yet, he can’t say anything. No one can. Oy.

      Thanks for your comment,
      g

  8. All throughout my schooling teachers told my parents that I was bright but not applying myself. The phrase “capable of more” was consistently used to describe me. The problem was that I WAS applying myself (even over-exerting myself) and the effort I put in was never commensurate to the grades I received. I was mostly a B student, though, so no one ever thought to have me tested. It wasn’t until I got to college (and found myself taking three times as long as my classmates to get anything done) that I decided to get myself tested. The results were off the charts. The doctor could not believe I was a functioning college student with such severe ADD. All of my struggles in school (and outside of school) suddenly made sense.

    Had I not gotten myself tested, diagnosed, and treated, I never would have made it through school. I recently talked about my experience with ADD on the Wrestling With Depression podcast (ep. 130 wrestlingwithdepression.com), and I have already heard from multiple people who’ve had similar experiences.

    Thank you for addressing this topic.

    1. Hi Liz,

      Thank you for your comment.

      It’s heartbreaking! To think of these legions of children over the years being told to “apply yourself.”

      I was an okay student in grade school, and I don’t have ADHD. But I also sometimes got the “Gina doesn’t apply herself” feedback on report cards. I remember being confused, wondering, “well, what should I do differently? Can anybody give me a CLUE?” No, no one did.

      Now that I think about it, it’s almost a sadistic thing to tell a child.

      I’m glad to hear that you persevered and got yourself tested. Welcome to the 21st Century, and I appreciate your going on to tell your story so others can benefit. I’ll check out that podcast.

      Thanks,
      g

  9. Oh boy did I relate to this! I was in the top 20 of my high school and graduated cum laude from the university in a science based degree. It was fairly easy for me. After graduating I went to work, but couldn’t seem to have any organization or ability to plan. I thought I was just burnt out or in the wrong profession. I tried lots of therapy, changed types of work, etc., and finally got someone who was able to help me figure that ADD was indeed my underlying issue. I have now had several years to try to undo the damage to my self-esteem, thinking I was lazy or crazy. I have been able to help parents see that their kid’s add is not the end of the world, and to celebrate the great things that come with it. I would tell people to address this early, so that the potential brilliance is not lost in the fray. I just hired my first ADD coach. It’s fantastic. Thanks for the blog.
    L

    1. Hi Leslie,

      Congratulations! I’m glad you finally discovered…ADHD.

      It’s just insane to me that something this potentially obvious — and life-changing — is still considered by some to be “controversial.”

      best,
      g

    2. Struggling parent

      Where would you get an Adhd coach? How great is that. My son is 19 and struggles in college with motivation to do whats mecessary to finish .

  10. You better believe you can be bright in reality but “mentally impaired” on paper!
    In nearly every grade up to about the end of the 4th, I was ASSURED that my daughter was “gifted” and that she’d be a shoo-in for the gifted program. Never made it in there because she blew off the standardized tests which are the only criteria for that program in my district – if you believed the numbers, she rated everything from “low average” to functionally retarded. I even had her re-tested using different tests: she sat there jabbering away at the person administering the test, it was everything I could do to not go in there and break it up! Her scores were even worse there than from the ones administered to the entire class a few weeks earlier: again had you not known her, you would have thought she needed to go into the special education program just going by the numbers! The testing format bored her, and she couldn’t see the point in fooling around with the blocks when she’d rather paint or make stuff with clay. And this is a kid who was reading and comprehending on a college level by the time she was in the 4th grade!!!

  11. Hi Gina,

    In fact, I have been working on my thesis for, “well, a long time now.” How did you know? 😉

    My wife is just finishing your book, and it’s my turn next.

    Wish us luck, and thanks for your work.

    Rob

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