The Mental Health Risks of Downplaying ADHD by Denise

I’m writing this from a combination of both professional and personal experience. I was diagnosed with ADHD as an adult, my partner also has ADHD, and together we have two young children who have also been recently diagnosed with ADHD. I’m a registered social worker and counsellor who has been working with neurodivergent individuals and families for about 15 years. I often feel like I work, live, and breathe this topic.

Incorrect Beliefs About ADHD

Downplaying what ADHD is and the effects that it can have on someone’s life is risky. I think we have all heard some of the common assumptions and judgements about ADHD. It might sound like, “that can’t be ADHD, you don’t seem hyper”, “how can you have ADHD if you can focus while playing video games just fine”, “you don’t have ADHD, you are so successful - you have a stable job and are doing just fine”, or maybe “oh it’s such a fad that everyone thinks they have ADHD these days”. All of these statements contribute to the stigma and misunderstanding of this complex condition.

What ADHD Actually Is

ADHD is a neurodevelopmental disorder that is present during childhood (Franke et.al, 2018). There is some evidence that ADHD tends to run in families genetically, but we aren’t exactly sure how (Grimm et al., 2020). It is not something that happened because you ate too much sugar, it’s not because you watched too much tv, or because your parents were not parenting well. You also don’t need to be hyper to have ADHD.

ADHD affects all areas of life functioning due to struggles with executive functioning (Franke et.al, 2018). This means that neurologically the brain struggles with: completing tasks, staying focused on things that are difficult, switching from one task to another, regulating emotions, problem solving, being able to prioritize what needs to be done etc. These skills are needed in every aspect of our daily functioning at home, in relationships, at school, and in the workplace.

How Mental Health Can Be Affected

In my private counselling practice, as well as in my role with the health authority, I have seen countless people and families who have unnecessarily suffered because their ADHD was ignored, misunderstood, undiagnosed, or labelled in a negative way. These individuals and their families have often been suffering for years. I truly believe that receiving a proper assessment, diagnosis, and a supportive treatment approach can change the trajectory of someone’s life.

Many people feel that mental health diagnoses are just negative labels and then they avoid getting assessed or considering medication. There is absolutely stigma and judgements that are present with any mental health diagnosis. However, consider the alternative. What happens if ADHD goes undiagnosed and untreated?

Imagine you are trying your absolute best to make plans, follow through on those plans, work on life goals, maintain relationships, regulate your emotions, and despite your very best efforts you still fail. You fail at meeting your own and other’s goals. You feel like everyone around you can do things that are “simple”, yet those tasks aren’t so simple for you. Over time you might start to believe that there is something wrong with you, or you receive messages from others around you that you are “lazy”, “just need to try harder”, “just need to focus”, or “need to care more”. What if you really were caring and trying hard, but the daily struggles remained?

Even if you happen to be lucky and look like you have everything in life together, you probably have so much anxiety that it drives you to be a perfectionist and “over-achieving”. Yet, you still suffer because your brain is constantly spinning, you take on too much, and you are on the constant verge of emotional and physical burn out. I personally experienced this for decades.

These are the stories of so many people with ADHD. Not realizing you have ADHD, and not having a supportive treatment plan in place can contribute to depression, anxiety, low self-esteem, struggles at school and work, and fractured relationships. There is evidence that ADHD often goes alongside with substance use disorders, increased risk for violence and incarceration, depression, and anxiety (Franke et.al, 2018).

ADHD and Addiction

Mental health struggles and addiction go hand in hand. We know that people who struggle with ADHD have a higher chance of experiencing substance use addiction (French et al., 2023; Wilens et al., 2022). This is likely due to the brain’s need to seek out dopamine, which is one of the feel-good neurotransmitters in our brains. ADHD prevents the brain from accessing enough dopamine and therefore, people often seek substances or other unhealthy activities to feel good. In addition, people often use substances as a way to cope with stress, anxiety, depression, or trauma. These are all things that people with ADHD may experience because of not knowing how their brain works and the negative messages they receive from their environment.

What Should We Do?

I believe that early intervention is key. Once someone learns how their brain and body works, and realizes that their struggles aren’t their fault or because of lack of effort, it can be empowering. Mental health can then be supported in a positive way. Many people with ADHD thrive and have absolutely fulfilling lives.

Proper assessment, diagnosis, and supportive treatment can help those with ADHD to learn skills and strategies to manage daily life. These can all be protective factors against other mental health and addiction disorders.

There are evidence-based treatments for ADHD, and once the right unique approach is found for each individual, it can feel freeing. People describe that it feels like “a heavy load lifted off” of them, or they may find themselves saying “wow, is this how neurotypical people experience life, it’s so much less distressing?!”. Even if you are well into adulthood, it’s never too late to seek an assessment. If you don’t have ADHD yourself but one of your loved one does, seeking evidence-based information can be one of the best gifts you can provide them. You can be a part of creating a safe and supportive environment for those who need it most.

References

Grimm, O., Kranz, T.M., Reif, A. (2020). Genetics of ADHD: what should the clinician know? Current Psychiatry Reports, 22(18), https://doi.org/10.1007/s11920-020-1141-x

Franke, B., Michelini, G., Asherson, P., Banaschewski, T.. Bilbow, A., Buitelaar, J.K., Cormand, B., Faraone, S.V., Ginsberg, Y., Haavik, J., Kuntsi, J., Larsson, H., Lesch, K., Ramos-Quiroga, J.A., Rethelyi, J.M., Ribases, M., Reif, A. (2018). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. European Neuropsychopharmacology, 28(10), 1059-1088.     

French, B., Daley, D., Groom, M., & Cassidy. (2023). Risks associated with undiagnosed ADHD and/or Autism: A mixed-method systematic review. Journal of Attention Disorders, 27(12), 1393-1410.

Timothy, E.W., Woodward, D.W., Ko, J.D., Berger, A.F., Burke, C., & Yule, A.M. (2022). The impact of pharmacotherapy of childhood-onset psychiatric disorders on the development of substance use disorders. Journal of Child and Adolescent Psychopharmacology, 32(4), 200-214.