Introduction
ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental condition that affects both children and adults. The term disorder here simply refers to a collection of symptoms that interfere with typical brain function. However, if you ask most ADHDers, they’ll tell you that the problem isn’t really a deficit of attention.
ADHD is best understood as a difference in how the brain develops and functions, particularly when compared to neurotypical peers. Brain imaging studies have shown structural and functional differences in the ADHD brain, especially in areas responsible for attention, impulse control, and executive function.
People with ADHD often struggle with:
- Sustaining attention
- Regulating impulses
- Resisting distractions
- Managing executive functions (the mental skills needed for daily life and goal-directed behaviour)
These challenges can impact school, work, relationships, and daily routines. However, it is more than just difficulty focusing—it affects how an individual engages with the world and processes information.
What are the symptoms of ADHD?
ADHD is primarily defined by three core symptom categories: inattention, hyperactivity, and impulsivity. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), symptoms are grouped into two clusters: inattention and hyperactive-impulsive behaviours. For this overview, we’ll break them down into three distinct areas.
Inattentiveness
Despite the name, ADHD isn’t an actual deficit of attention—it’s a difficulty regulating it. ADHDers can focus intensely on tasks they find interesting, novel, or urgent (a phenomenon known as hyperfocus) but struggle with tasks that feel tedious, repetitive, or lacking immediate rewards. Unfortunately, many adult responsibilities fall into the latter category.
Because of this, ADHDers often:
- Seek stimulation, which may look like procrastination or a lack of motivation from the outside
- Have trouble starting or persisting with tasks they find boring
- Jump between tasks, projects, and hobbies once the initial novelty wears off
Hyperactivity
Hyperactivity is the difficulty in regulating activity levels based on the situation. It can manifest as excessive, task-irrelevant movement or mental restlessness.
- In adults, hyperactivity often shifts inward, presenting as racing thoughts, inner restlessness, or the need to stay constantly busy. Some adults still display outward signs of hyperactivity, though often in a more subtle way.
- In children, this may look like constant fidgeting, climbing, running, or excessive talking (often at inappropriate times).
Impulsivity
Impulsivity refers to difficulty controlling thoughts, emotions, focus, and actions in alignment with long-term goals. This often appears as:
- Acting or speaking without thinking
- Struggling to delay gratification
- Difficulty with impulse control and inhibitory regulation
Because hyperactivity and impulsivity are both signs of self-regulation challenges, they are often grouped together in the diagnoses.
Other Common Symptoms
Beyond the three core symptoms, many ADHDers also experience:
- Working memory challenges – Difficulty holding and manipulating information in the mind
- Executive function struggles are difficulties with the mental skills necessary to start, follow through, and complete tasks in various spheres of life.
- Emotional regulation difficulties – Experiencing intense emotions. They may also have trouble managing and soothing them so they do not interfere with our actions and relationships.
- Self-motivation and arousal challenges – Difficulty initiating tasks unless they are highly engaging
Who has ADHD
Population overview
ADHD affects both men and women. Current estimates suggest that 3–5% of children and 2–5% of adults have it. Some studies indicate that up to one-third of children diagnosed with ADHD no longer meet the full diagnostic criteria in adulthood.
It should, however, be noted that you cannot truly outgrow ADHD, and it is, therefore, more likely that these people develop suitable coping mechanisms, find environments where their tendencies work, or get enough support that the disorder no longer significantly impacts their day-to-day lives. Additionally, these statistics do not fully account for the ADHDers that are diagnosed in adulthood.
Gender overview
Boys are diagnosed with ADHD more frequently than girls in childhood, with estimates suggesting a ratio of 3 boys to 1. However, in adulthood, this ratio narrows to around 2:1 or 1.5:1. The gender differences and initial gap likely exists because boys tend to externalize their symptoms, making them more noticeable. In contrast, girls often display more internalised symptoms (such as inattentiveness or emotional dysregulation), which can be overlooked.
Furthermore, much of the early ADHD research focused predominantly on hyperactive young boys, which shaped diagnostic criteria and recognition patterns. Fortunately, awareness is increasing, leading to more accurate diagnoses.
What causes ADHD?
Genetics
ADHD is primarily genetic, with studies estimating that up to 80% of cases are inherited. In fact, ADHD has a higher heritability rate than most psychiatric conditions One of the only things with a higher heritability rate that ADHD is height.
Key genetic findings include:
- If a child has it, there’s a 40–50% chance that their parent also has it.
- Twin studies show that if one twin has it, the other has a 75–90% chance of having it as well.
- If an older sibling has it, their younger sibling has a 30%+ likelihood of also having it.
Other Contributing Factors
While genetics play the most prominent role, certain prenatal and early-life factors can increase the likelihood of developing ADHD. These include:
- Toxin exposure (e.g., lead, environmental pollutants)
- Prenatal factors (e.g., exposure to alcohol, nicotine, or other substances)
- Premature birth or low birth weight
These factors do not cause ADHD on their own, but they may increase the risk, particularly in individuals with a genetic predisposition. Some researchers also suggest that certain prenatal risk factors—such as substance exposure—might indicate undiagnosed parental ADHD, as ADHD can be linked to impulsivity and risk-taking behaviours.
Brain Injury and ADHD-like Symptoms
In rare cases, brain injuries, particularly to the prefrontal cortex, can result in symptoms that resemble ADHD. The most well-known example is that of Phineas Gage, who, after a traumatic brain injury at the railroads he worked at, exhibited impulsivity and attention difficulties, symptoms often associated with ADHDers. However, because these cases mimic ADHD rather than being true ADHD, individuals with brain injuries may not respond to ADHD medications in the same way.
When does ADHD appear?
ADHD is present from birth, but its symptoms only become noticeable as children grow and developmental expectations increase. Since young children naturally have limited impulse control, attention span, and emotional regulation, the differences between those with and without ADHD often don’t stand out until later.
Typically, ADHD is diagnosed in childhood when symptoms significantly deviate from age-expected behavior and cause difficulties in multiple settings (e.g., home, school). Some organizations allow diagnosis as early as age four, but most children are diagnosed between ages six and twelve. For a formal diagnosis, symptoms must:
- Be observable in multiple settings (e.g., home, school, work)
- Have been present for at least six months
- Have appeared before age twelve
Late Diagnosis: ADHD in Adulthood
ADHD does not develop in adulthood—symptoms are always present from childhood. However, many adults go undiagnosed as children due to:
- Masked symptoms – Structured environments, external accountability, or supportive routines may have compensated for ADHD challenges.
- Misattribution – Symptoms were labeled as personality traits rather than signs of ADHD. For example:
- Boys with hyperactivity may have been seen as “rambunctious” rather than neurodivergent.
- Girls struggling with inattentiveness may have been dismissed as “daydreamers.”
Many adults seek a diagnosis when their coping strategies can no longer keep up with life’s increasing demands, such as starting college, managing a career, or balancing family responsibilities. When external structure decreases, the symptoms become more apparent.
If someone develops ADHD-like symptoms for the first time in adulthood but had no history of struggles in childhood, another condition—such as anxiety, depression, trauma, or a sleep disorder—may be the cause. This is a lifelong neurodevelopmental condition, meaning it does not suddenly appear in adulthood.
Why Does This Matter?
Understanding ADHD is crucial for several reasons:
- Validation & Self-Understanding: A diagnosis helps individuals make sense of their struggles, giving them the language to express their experiences and seek support.
- Mental Health & Self-Esteem: Many with the disorder grow up feeling like something is “wrong” with them. Recognising it as the cause of their challenges can separate their self-worth from their symptoms.
- Access to the Right Tools & Support: Knowing they have it allows individuals to seek strategies, coaching, and treatments tailored to their brain.
- Accommodations & Advocacy: ADHD is a disability, and diagnosis (formal or informal) helps individuals request necessary accommodations at work, school, and in relationships.
- Improved Relationships: Understanding how it affects communication, emotions, and daily life can help partners, family, and friends adjust expectations and reduce misunderstandings.
While a formal diagnosis can be necessary for accommodations, even an informal understanding can empower someone to advocate for themselves and find effective strategies.
How is ADHD Managed?
ADHD is lifelong, but with the proper treatment and strategies, symptoms can be effectively managed. Managing it often requires a multi-faceted approach, including:
- Medication: Stimulant and non-stimulant medications are the most researched and effective ADHD treatments, improving focus, impulse control, and executive function.
- Psychoeducation: Learning about the disorder helps individuals and their loved ones understand how it affects them and how to manage it.
- Therapy & Coaching: Cognitive Behavioral Therapy (CBT), ADHD coaching, and behavioural interventions often helps to address ADHD symptoms and the emotional impact of the condition on the ADHDer and/or their loved ones.
- Accommodations & Environmental Modifications: Adjustments like noise-cancelling headphones, timers, and flexible workspaces can significantly improve and ADHDers performance by helping them improve their focus and productivity.
- Lifestyle Strategies: Routines, task planning, movement breaks, and fidget tools can support executive functioning and daily success.
The goal of ADHD management isn’t to give someone an unfair advantage—it’s to create a level playing field, much like how glasses help someone with poor vision see the same way people without impaired vision do.
Conclusion
ADHD is a highly heritable neurodevelopmental condition that begins in childhood and affects attention regulation, impulsivity, and hyperactivity. It impacts millions of children and adults worldwide.
Recognising ADHD—whether through a formal diagnosis or self-awareness—can improve mental health, relationships, and access to support. If you or someone you know wants to explore ADHD coaching, you can schedule a free consultation [insert link]. You can also reach me via email or in the comments if you have questions or topics you’d like me to cover.
Thank you for reading, and I’ll see you in the next one!
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