I’ve recently come across multiple reels on Instagram that talk about Adult ADHD - people describing its symptoms, experiences of diagnosis (and misdiagnosis), and its various coping skills.
This got me wondering. Is this content actually helping people? Is it increasing awareness so that people can get diagnosed or is it instead creating unnecessary panic over symptoms we might be experiencing simply because of the pandemic?
Turns out there isn’t a simple answer to this.
What’s the connection between the Pandemic and ADHD?
The Attention Deficit Disorder Association, an organization founded in 1990 for adults with ADHD, saw its membership nearly double between 2019 and 2021. This could be due to the fact that without the support of an office environment, we were all forced to actually acknowledge problems concerning our motivation, focus and higher levels of restlessness and anxiety.
While some people may have had symptoms prior to the pandemic, received correct diagnosis and felt understood, others may still be experiencing the symptoms of living in a world engulfed by a deadly virus and are at a risk of being misdiagnosed.
Firstly, what are the diagnostic criteria for ADHD and Adult ADHD?
ADHD is a mental health concern commonly diagnosed among children up to the age of 17 years - the criteria for it includes symptoms of inattention, hyperactivity and impulsivity that has existed for a period of more than 6 months. Beyond the ages of 18, symptoms of ADHD are classified as Adult ADHD. An important criteria for the diagnosis of Adult ADHD is the prevalence of symptoms of ADHD upto the age of 12.
So is diagnosis clear cut and easy?
As with several mental health concerns, the diagnosis of ADHD is complicated and requires close observation. While in certain cases, a child may display clear signs of the disorder and may be able to get the right remedial resources, certain factors may play a role in misdiagnosis or worse, no diagnosis at all.
Dr. Lidia Żyłowska, a psychiatrist at the University of Minnesota Medical School explains “Girls are less likely to be diagnosed than boys, which is part of the reason the prevalence of ADHD among females has typically been underrecognized.” Martin Teicher, professor of psychiatry at Harvard Medical School also suggested that “Some children who are extremely bright can “sneak under the wire” without their ADHD being detected because they are doing well academically, but they will generally have other problems like being very fidgety.”
Is it then possible what you’re experiencing is in fact Adult ADHD which was undiagnosed?
While this is possible, instances of it are rare. Allyson G. Harrison, researcher and associate professor at Queens University, Ontario explains that her team’s diagnosis has found that on screening young adults who have ADHD, only 5% were diagnosed with the condition. Further investigation found that “Their symptoms may be representative of non impairing cognitive fluctuations, a comorbid disorder, or the cognitive effects of substance use. False positive late-onset ADHD cases are common without careful assessment. Clinicians should carefully assess impairment, psychiatric history, and substance use before treating potential late-onset cases.”
This implies that while underdiagnosis of ADHD in children is a very present and real issue, diagnosis of Adult ADHD needs to consider all factors! So if you are planning on getting a diagnosis, make sure your clinician is taking a holistic approach and has all the necessary information.
Is misdiagnosis a very common risk with Adult ADHD?
Allyson G. Harrison, Professor of Psychology and Clinical Director, Regional Assessment & Resource Centre, Queen's University, Ontario has very aptly explained why Adult ADHD is commonly misdiagnosed:
“Just as fever is a medical symptom, problems with attention, focus and concentration — alone or in combination with irritability and restlessness — are symptoms common to a wide variety of disorders. Self-reporting of ADHD symptoms on questionnaires has up to 78 percent false positive rate for ADHD diagnosis. Symptoms alone are not enough to diagnose this disorder.
Even the recall of childhood behaviours is not an accurate way to make this diagnosis. Comprehensive long-term followup studies show that many adults whose records show they did not meet criteria for ADHD in childhood, nevertheless inaccurately recall childhood behaviours similar to ADHD when questioned as adults.
Life during the pandemic has been very stressful for many people. Research from our lab shows that the more anxious, depressed or stressed you are, the more symptoms of ADHD you’ll experience, even if you’ve previously never been suspected of having ADHD. We know that cabin fever has many symptoms similar to ADHD, and social isolation also has many negative effects on brain functioning.”
So what can you do if you are experiencing these symptoms?
Getting a professional opinion is always a good idea, irrespective of what your diagnosis may or may not be. Here are a few other things to keep in mind:
- Ask questions about your diagnosis before you’re even opting for one. What tools are they using? Are they checking for other disorders?
-Book a session with your mental health professional to understand what your diagnosis means.
-Remember that while people on social media may be absolutely honest about their experience, your experience might not be the same.
Our inner worlds can be very confusing and complex, so the treatment they require needs to be nuanced such that they can understand these complexities. However, this confusion is the first step in our journey in taking better care of our mental health, so whatever your diagnosis may be, you can always be in a better mental space with the right help!