Many people with ADHD aren't aware they have it. They will be aware however that everyday tasks seem more difficult for them than for others. Typical symptoms are finding it hard to focus, missing deadlines and trouble controlling impulses, ranging from impatience to mood swings and outbursts of anger. Other symptoms include:
The above list may be familiar to most people at different times in their lives. If these symptoms occur only occasionally, they probably don't have ADHD. A doctor usually diagnoses when someone’s symptoms cause problems that stop a person working, finding stable housing, or living normally and safely.
Diagnosis of ADHD in adults is often trickier because the same symptoms also occur in mental health conditions, such as anxiety or mood disorders. Many adults with ADHD also have at least one other mental health condition (depression and anxiety are the most common).
Symptoms usually start before the age of 12 and continue into adulthood.
ADHD is a lifelong condition, though it often becomes less marked in adulthood. But it can be effectively managed. The first step is to see a doctor and start seeking a diagnosis.
In the UK, the incidence of ADHD in school-aged children is thought to be between 3 and 5%. In adults it is between 3 and 4%.
We still don’t know for sure. An enormous amount of research is focused on finding the causes of ADHD. Factors that may be involved include:
The risk of a person developing ADHD may increase if:
ADHD has been linked to:
Making the diagnosis normally includes:
ADHD is normally treated through a two-pronged approach:
Doctors might prescribe stimulants for ADHD – which might seem counterintuitive, but has a strong evidence basis for regulating brain activity.
Some ADHD patients might also benefit from antidepressants or other medication, but in every case a doctor is best placed to advise on what to take.
Psychotherapy is indicated for people with ADHD but behavioural therapies can also help manage traits that make people with ADHD disorganised, and teach useful skills as well.
NHS Choices provides information about the signs, symptoms and treatment for depression.
For people with an ADHD diagnoses, this charity provides resources and advocacy.
Aimed at young people, this profile of ADHD explains what it is, how to seek treatment and mental health concerns for people with ADHD in a clear and straightforward way.
When a person feels ‘on edge’ in a role or relationship, about to be uncovered as a fraud or undeserving, they might feel like an imposter. ‘Imposter syndrome’ is a recent term to describe feeling unworthy of a position. It differs from humility (when a person is open to learning and making mistakes in a new role or relationship, but acknowledges the skills or experience that make them a good fit).
Vulnerability can be a positive quality, but a person with low self-esteem is at higher risk of being abused, and in rare cases of abuse or bullying others. People with low self-esteem might also be more socially isolated.
Some of the symptoms of depression include feeling bad about yourself, that you have failed somehow or let loved ones down.
We all have standards which we’d like to live up to. But when standards – for oneself or for others – are very high, it can lead to self-isolation, anxiety and depression. Therapists often flag perfectionism as a symptom or risk factor for disordered eating.
Self-esteem problems might stem from feeling unsure or uncertain about one’s worth. Insecurity might also come from a lack of stability in circumstances, for example, if a person worries about their sense of belonging when their family changes, or they move house or change school.
Relationships are vital to our wellbeing but when our self-esteem relies on someone else, such as a child or a partner, it stops us experiencing our own worth. Co-dependence is a particular risk for partners, friends and family of people with alcoholism or substance abuse problems.
When a person appreciates their skills, experience and expertise, it creates self-esteem. A sense of belonging also gives people a sense of self-esteem. Self-esteem from what people can do is known as intrinsic worth. Self-esteem from being seen, heard and loved is known as extrinsic worth.
It is normal for one’s self-esteem to rise and fall a little in line with everyday achievements and failures. Failure and rejection are universal experiences and in themselves are not mental health problems.
People with low self-esteem have trouble appreciating their good sides and difficulties accepting their bad sides. This might lead to rumination. Low self-esteem might also erode relationships.
A person might have low self-esteem if they believe, or are told, that failure or rejection they experience is personal.
It might be that someone’s self-esteem declines because of mental health problems, such as depression or anxiety. Mental health problems are still stigmatised, and mental health symptoms impact on a person’s ability to live and work normally, and to feel a sense of belonging.
Experiences of trauma, abuse and bullying can also undermine a person’s self-esteem.
Sometimes when a person loses their sense of belonging through loss of a job, relationship or community or through bereavement, their sense of self suffers. Likewise, a perceived failure or rejection can make a person question what went wrong, and why they didn’t make the grade.
In many cases, a person can recover their sense of belonging, and weather failures on their own or with the support of people around them. But sometimes, a loss or failure feels more personal, or more painful.
Low self-esteem might feel depressing, sad, bleak or bitter. It might lead to more rumination over past events, and more self-judgement.
Self-esteem makes life more enjoyable and rewarding. When people know their worth it protects them from exploitation. Having a sense of intrinsic worth also helps people recognise that their value does not have to be earned or worked for.
Therapists are ideally placed to help people recognise, treat and recover from periods of low self-esteem.
In therapy, a person with low self-esteem might be encouraged to take small steps to challenge low self-esteem. Spending more time with friends, family or like-minded people might give a person a greater sense of belonging. Learning new skills might increase confidence, remind the person of their abilities and values, and demonstrate a commitment to oneself.