Myth #8: Having ADHD Is No Big Deal! Here’s the longer version:
ADHD is only a difference in how you view the world. Why make such a big deal of it—or, worse, pathologize it?
Sure, the ADHD diagnosis might sound trivial to anyone who hasn’t lived with it. Left unrecognized or poorly managed, however, it certainly can be a big deal.
The tendency to minimize ADHD springs, it seems to me, from its highly variable nature:
- It affects individuals, who have variable experiences of this syndrome—and many other aspects to their personality.
- It is widely acknowledged to be polygenetic. In other words, there’s no “ADHD gene.” Instead, “multiple genes of moderate effect are involved in the genetic basis of ADHD” (ADHDgene: a genetic database for attention deficit hyperactivity disorder).
- It ranges from mild to “extra spicy.”
- It has a range of “traveling companions” (75 percent of adults with ADHD have a co-existing condition such as depression, anxiety, bipolar disorder, or substance-use disorder; 50 percent have two or more such co-existing conditions.).
If you know someone with ADHD who is very “high-functioning,” you might assume…hey, no big deal!
Then again, you might not know how hard they work at it.
No Impairment? No ADHD
Consider first: It’s not ADHD if there’s no impairment.
To have the diagnosis of ADHD, a person must be experiencing difficulty in more than one “domain of life.” These domains include work, relationships, financial management, education, and the like.
As explained previously in this ADHD myth series, ADHD symptoms themselves are typical human behaviors. It’s the number and severity that make the diagnosis, along with impairment.
Yet, the ADHD diagnosis is not, as some believe, the harbinger of doom. Instead, it brings the knowledge on how best to reduce or eliminate the impairment. That’s why ADHD is a “good-news” diagnosis.
(For more information on this topic as regards ADHD and relationships, check out my two-part series at the blog I write for CHADD: When a “Good News” Diagnosis Means “Bad News” for the Relationship.)
These impairments can be a very big deal. Research points to poorer life outcomes for adults with poorly managed ADHD, compared to adults without ADHD.
Of course many adults with ADHD do well in life, diagnosed or not. But we’re talking about a generally higher risk of adverse life outcomes. By minimizing the potential for adverse advents, we risk undercutting the legitimacy of ADHD in the public perception, and that’s where political and policy decisions are made.
In other words, if you want your insurance to cover ADHD diagnosis and treatment—if you want students to receive accommodations— know the risk of calling it a “gift.”
Potentially: Most Impairing Outpatient Condition
In fact, many top experts consider ADHD among the potentially most impairing disorders in psychiatry—yes, more impairing than depression and anxiety.
In part, this is because ADHD can affect so many aspects of life: money management, education, driving, employment, communication, sleep, hearing, and even sex.
Yet, do we find The New York Times targeting depression or anxiety with front-page sensationalist stories? No. There would be an uproar.
How about the news reports about teen depression and suicide? Do we find reader comments to the effect of, “I’ll tell you what they did in my day to kids like that—they smacked ’em!” No.
But for ADHD, that’s par for the course.
Research shows that children with ADHD have higher rates of other psychiatric conditions, higher frequency of hospitalizations, emergency room visits and total medical costs, compared to individuals without ADHD (Liebson et al., 2001).
Three Key Areas of Impact
In an interview with Russell Barkley, PhD, for my book
, he cited numerous studies pointing to poor outcomes for people with untreated ADHD (again, as a group) in these three areas, among others:
1. Education: Less likely to finish school
They are less likely to finish high school or college and more likely to be undereducated relative to their intellectual ability and their family’s educational background.
2. Occupation: Job loss, underemployment
“They are seven times more likely to be fired from the job, and will not rise up the economic or employment ladder as quickly as other people without the disorder from the same neighborhood of the same IQ and the same educational level,” Barkley says.
Moreover, they are more likely to change jobs frequently, either from boredom, difficulty meeting deadlines, or interpersonal problems with coworkers, supervisors, or customers.
3. Interpersonal relationships: Discord and divorce
People with poorly managed ADHD burn through friendships and dating relationships faster than average and are more prone to marital discord and divorce.
As a population, adults with ADHD show these patterns:
- Experience much higher incidences of separations and divorce (almost double) compared to a representative sample of the U.S. population.
- Tend to marry more frequently, even compared to other adults who sought an ADHD evaluation but proved not to have it.
- Tend to be more dissatisfied than control groups in their relationships, even more so than their mates. And they often have a harder time parenting effectively and consistently.
Barkley and other serious experts don’t emphasize these facts because they are the Bad News Bears. Instead, they know that public-policy around ADHD—insurance coverage, medication access, and school accommodations—depends on a clear-eyed assessment of what people are up against.
As for psychiatrists who themselves have ADHD and “sell” ADHD as a gift, I have to wonder whose interests they are looking out for: their own financial income or the ADHD community. (And, to tell you the truth, I don’t have to wonder much.). For more on this topic, see Myth #9: Medication Only for Severe ADHD
Conclusion
The point of this myth-busting post is not to paint ADHD with a very dark brush. Rather, it is to emphasize that 21st Century knowledge, strategies, and treatments stand ready to make ADHD less of a big deal. For everyone. But only if we don’t distract ourselves with fuzzy thinking and fairy tales about what ADHD is—and is not.
Some day, science will be able to help us “drill down” into the diagnosis and have more distinctions among the variable experiences.
Until then, none of us likes lumping 10-30 million people into the bucket called “ADHD.” For now, though, it’s what we have to work with. Instead of painting ADHD as a gift, I propose that we work on communicating the great variability in the diagnosis—and the importance of viewing all people as individuals.
I welcome your comments!
—Gina Pera
“creativity cannot be stidlmarnee.”I agree, it takes just as much work and sacrifice to be creative now as it did at any point in the past.I don’t agree, however, that technology puts extra demands on us. Or, at least, it helps us as much as it hinders.Great post, I love your final thoughts!Ryan
Gina,
I loved your book! I enjoy this blog and have learned so much from you!
I have a question for you: ADHD and Aspergers have so many of the same symptoms. What is the difference? Aren’t both on the autistic spectrum?
I have a friend who I believe has both.
Thanks so much for your work.
Joyce
Hi Joyce,
Thanks for the kind words. I’m grateful.
We have no evidence that ADHD is on the autistic spectrum. It’s an entirely different condition, with an entirely different underlying neurobiology.
But this myth seems to be perpetuated because the two conditions (ADHD and Asperger’s) appear to have similar symptoms. For example, ADHD and Asperger’s are associated with certain degrees of impairment in noticing/reading facial expressions. But this happens for very different reasons.
For the person with ADHD, for example, it might be that they are distracted by something about the person’s face (e.g. very hairy eyebrows, or extremely beautiful eyes) — so they don’t notice the overall facial expression.
For the person with Asperger’s, the difficulty with recognizing facial cues seems to have a different cause.
For some people with ADHD, medication can help to improve the ability to read facial cues. This is not so with Asperger’s– though these folks can be trained in recognizing cues and responding appropriately.
To complicate matters further, many people with autistic-spectrum conditions (such as Asperger’s) will also have ADHD. The same is not true for people with ADHD.
I hope that gives you an overview of some distinctions between the two.
best,
g
Hi Gina
I hope you have a great Thanksgiving.
This is so important to recognize.
I’m reminded of childhood days when building fences. The adult would ask us to grab a wood pole to use as a fence rail. we brought it and discovered it was too short. He said “that’s ok, just go grab the pole stretcher” . We took a step away paused, and said “what?”. He just laughed. And so did we.
With ADHD, that number of times I’ve been told, figuratively, to just get a pole stretcher, “buckle up, work harder, relax, pay attention, what were you thinking, your too quiet, you don’t listen, and on and on and on.
Hey Paul,
Great comparison. 🙂 I’ll have to remember that one.
Wishing you a happy Thanksgiving, too, Paul. Stay warm!
g
Hi Gina,
My clear-eyed assessment came when we barely escaped horrendous wildfires and our house which should have burned down, (but didnt) and we and our animals were displaced for months.
Everyone was saying how calm and peaceful I was about the whole thing.
But It was A VACATION, compared to everyday life with my DH!
( He was busy running around doing who knows what)
Sometimes…you can slowly
(but surely) get sucked into the craziest, backbreaking, mind snapping chaos….
till you get a break.
It makes me chuckle to think
The Fires From Hell, was my break from The Insanity.
Ya, ADHD is Not a Gift!
Joy
Oh Joy.
Great article, as usual! As I tweeted I am “extra spicy.”
I have been writing/thinking a lot lately about how ADHD impacts the careers of so many women. (and men)
Have a long and relaxing holiday weekend. I will get back to my job now.
Hi Liz,
Yes, ADHD affects careers, health, financial status, human connections of all kinds. That’s why I take it so seriously. I’ve seen the loss it can create too many times. And I value the lives and happiness of my friends with ADHD.
Wishing you and yours a lovely weekend, too!
best,
g
Hi Gina, as the poster boy for adhd, I can honestly say that having adhd is a big deal, inspire of the fact that I am well educated with undergraduate and two graduate degrees from Columbia university in engineering, the last graduate degree obtained at the young age of 69 years, I have excelled in my career also at Columbia as a Vice President of engineering. Is having add a gift absolutely not I would not wish add on my worse enemy. I was able to deal with it by taking a step back and realize that I hear and see and experience the world differently from my non adhd partner. Every day I wake, I have to consciously make myself aware that what I hear and interpret is not what it appears to be . I have to take a deep breath, calm myself down to realize that my partner really does love, and always has good intentions , and would never do anything to hurt me, because she does care . I have read your book several times , and the first step towards a more rewarding life was accepting the fact that I have it, it will always be there because this who I am, and how I am wired, and it’s nothing to be ashamed off !!. My saviour in all of this is a lovely lady the love of my life who you know” Daisy Elmes, and you know me too, I am Wil Elmes., and on this day thanks giving, I would like to say thank you for the work you do, don’t ever stop. Have a great thanks giving. So in closing I can say with authority, that ADHD is a big deal, and all of us with adhd if we get patience and understanding from our non adhd partners and if “we work hard on our side to be patient and empathetic , we can have a productive and happy life.
Best regards from the adhd posters boy
Wil
Wil! What a delightful surprise to hear from you! And with such a substantial message for ADHD Roller Coaster readers.
I still remember meeting you and Daisy, so many years ago, and it means so much to me to have stayed in touch with you. And to see you both progress in your painstaking efforts to a happier life together.
Your Daisy is an amazing woman—so intelligent, wise and generous with her support. You hold her tight! 🙂
Much love to you both and a very happy, and thankful, Thanksgiving.
xo
g