High-functioning ADHD

Attention deficit hyperactivity disorder (ADHD) is a neurological disorder characterized by excessive hyperactivity and impulsive behaviors.

High-functioning ADHD is not a formal disorder. It is a term attributed to people whose daily lives are less impacted by their ADHD diagnosis ^[1].

There are numerous ways of managing the condition, ranging from medication and counselling to self-care measures you can implement in your everyday life.

What is high-functioning ADHD?

High-functioning ADHD is a phrase used to describe someone who has found a way to offset their shortfalls, related to their ADHD diagnosis, with functional workarounds.

To an outside observer, they can appear to be thriving, but in reality, they struggle with their ADHD on a daily basis.

For example, a 47-year-old dentist who struggled to concentrate at school, did not follow rules and was even expelled from one school ^[2]. He claimed he always felt something deviating him from his focus, and he always had to put a lot of effort into controlling his behavior ^[2].

Psychiatric evaluation pointed to ADHD; however, this man never failed his exams and was able to become a highly skilled professional ^[2].

Diagnosing ADHD

Identifying high-functioning ADHD requires an initial diagnosis of ADHD.

If you believe you show symptoms of having ADHD, it can be helpful to seek a medical referral from a social worker, school counsellor or a licensed therapist. Then, a healthcare professional, such as a physician or psychologist, can provide a formal diagnosis for ADHD.

Being diagnosed with ADHD can be bewildering but also extremely validating, as you can work together with mental health professionals and loved ones on how to cope going forward.

Referring to the American Psychiatric Association’s recommendations for ADHD diagnosis, symptoms can be categorized under 2 sub-sections, inattention and hyperactivity & impulsivity ^[3].

Inattention

• Has difficulties holding attention when completing tasks or activities
• Struggles to provide attention to detail in schoolwork or in the workplace
• Appears to not be listening when spoken to directly
• Easily distracted
• Has difficulty with organization in daily tasks and activities.
• Often forgetful in daily activities (e.g., keeping appointments)
• Often loses equipment required for daily tasks and activities (e.g., school stationery, wallet, keys)
• Often shows apathy or disinclination towards tasks which require sustained mental energy

Hyperactivity & impulsivity

• Often fidgets with or taps hands or feet – or squirms in seat
• Has trouble waiting their turn
• Often leaves seat in situations where it is expected to remain (e.g., in classrooms or work)
• Often runs around in situations where it is inappropriate
• Often unable to participate in activities quietly
• Uncomfortable being still for extended periods of time
• Talks excessively
• Often blurts out an answer before being prompted
• Often interrupts or intrudes on others (e.g., interjects in conversations, games or activities or uses people’s things without consent)

For children, 6 or more of the symptoms, perceived as disruptive to the child’s development, must have been present for over 6 months.

For adolescents aged 17 or older and adults, 5 or more of the symptoms, perceived as disruptive to the child’s development, must have been present for over 6 months ^[3].

Signs of high-functioning ADHD

Life poses daily challenges, and sometimes it can feel overwhelming, though you’re not quite sure why. Do you struggle with staying focused, managing time, or keeping deadlines at school or work? Do you feel like you must work much harder to compensate for these issues just to get through the day? These are telltale signs of high-functioning ADHD.

Below are some indicators of high-functioning ADHD.

1. Poor time management – You struggle to keep appointments and make it to meetings or lessons on time. To compensate for this, you end up arriving excessively early to avoid lateness. You could be experiencing a common sign of high-functioning ADHD: time blindness – an inability to measure time accurately. Time blindness can also lead to you struggling to determine how long a task will take. This can lead to missing deadlines, over-promising to superiors, or taking on too many tasks at once.
2. Interrupting and struggling to listen – ADHD makes it difficult to listen. If you find yourself regularly fighting the impulse to interrupt others in conversation, this could be a sign of high-functioning ADHD.
3. You do not like disorganization – Disorganization is a chronic and challenging aspect of ADHD. It can manifest itself in many ways including lots of clutter, difficulty maintaining a routine, and struggling to tell coherent stories. People with high-functioning ADHD rely on systems of organization to feel calm and in control of their surroundings. If you are excessively upset by a messy workspace or a sudden change to your schedule, this could be a sign of high-functioning ADHD.
4. Sitting still – People with ADHD struggle to sit still. If you fidget persistently whilst sitting in class or in a work meeting, this is a way of expending excess energy. It can be disruptive for both you and others around you. If you have high-functioning ADHD, you may have chosen a job that requires lots of physical activity. Or you may find a thorough and regimented daily exercise routine has helped use up your spare energy.
5. You experience anxiety or depressive symptoms – Constantly managing your inattention, hyperactivity or impulsivity can feel exhausting and demoralizing for people with high-functioning ADHD. It is draining constantly having to work harder than everyone else to get your work done.
6. Sensitivity to criticism – You may feel like life is a balancing act at times, with you striving not to make mistakes. It’s reasonable that you have heightened sensitivity to criticism, because you may feel others don’t see the extra effort you put in.

If you feel any of the above apply to you, seek medical advice to receive an ADHD diagnosis. There are many different treatment options which can help.

Causes of high-functioning ADHD

The causes of ADHD are not wholly defined yet, though research has shown that genetics play a role. Offspring of people with ADHD are at higher risk of developing ADHD ^[4].

Experts also believe the following could be risk factors:

• Brain injury
• Alcohol or tobacco use during pregnancy
• Premature birth
• Low birth weight
• Exposure to environmental threats during pregnancy or infancy

Treatment for high-functioning ADHD

ADHD treatment usually consists of a combination of therapy, medication and self-care. Younger children can receive educational and behavioral support whilst at school; adults may consider letting their employer know about an ADHD diagnosis to ensure they receive the support required to do their job.

Therapy and support groups

There are a range of therapies that can be used to treat high-functioning ADHD. Cognitive behavioral therapy (CBT) is usually the first port of call. Alongside their physician or psychologist, patients can identify harmful thought patterns and work on eradicating them.

Support groups can also be useful for both children and adults with ADHD ^[4]. There are numerous support groups such as Children and adults with ADHD (CHADD) and Adults with ADHD (ADDA). These provide a valuable and affordable way for individuals to learn about ADHD ^[4].

Medication

Stimulants and non-stimulants are the two main medications used to treat ADHD. They work to stimulate focus and attentiveness, whilst limiting impulsivity. Your clinician will determine what the best course of these would be for you.

Antidepressants can relieve anxiety and depressive symptoms brought about by ADHD. However, whilst they have demonstrated benefits in tackling ADHD behavioral symptoms, they are best used as a second-line medication behind stimulants ^[5].

It is essential to discuss any course of medical treatment with your clinician. Be honest and open about your personal circumstances and symptoms, and together you can devise the most effective plan for managing your ADHD.

Self-Care

Self-care, in this instance, refers to the different techniques you can use to manage your ADHD.

• Take frequent, scheduled breaks – Organizing regular breaks can break up tasks, making them feel more manageable. Perhaps you can go outside for a walk or catch up with a friend on the phone.
• Sleep well – Adults with ADHD may struggle to fall asleep easily. It can help to implement a regimented sleep schedule. Keeping your bedroom dark and quiet can facilitate a restful night’s sleep.
• Developing copings habits ­– Try some of the following. Eliminate clutter from your home and workplace, use technology & planning tools for organization, create to-do lists, and break down bigger tasks into smaller, manageable tasks. Doing this can help you feel better equipped to cope with the challenges you face managing your ADHD.
• Ask for support – Inattentiveness and acting on impulse can make it hard to relate to friends, family members, or colleagues. Be open with others about your ADHD and the steps you’re implementing to effect positive change. If they are worth your time, they will support you.

FAQs about high-functioning ADHD

My child has ADHD – how can I help?

Implement and adhere to a routine for your child, e.g., a typical school day, so they know what to expect from everyday life.

Be clear and concise when asking your child to do something. Instead of asking: ‘Can you do your homework?’, try ‘Please do your homework’. Ensure you make it clear how pleased you are when your child listens, thus reinforcing patterns of good behavior.

Develop a plan to manage your child’s ADHD teachers and support staff at their school. Doing this as early as possible can give your child the best chance of academic success.

Is ADHD curable?

No. ADHD is a lifelong medical condition.  However, with treatment, symptoms can be successfully managed.

Can I be successful with ADHD?

Yes, you can certainly be successful with ADHD. There are countless examples of people with ADHD. Celebrities include Justin Timberlake, Simone Biles, Michael Phelps, Adam Levine and Emma Watson.

Management of your ADHD symptoms with a medical professional, combined with self-care techniques, will set you well on your way to living your best life.