What Is It Like to Have ADHD?

Ask a Doctor

I’m 23, and over the last year, I’ve started to have difficulty concentrating at work, paying attention to conversations in social situations and other attention problems. I’m worried I might have adult ADHD. What does it feel like to have that disorder? What happens in the brain of someone with ADHD?

Doctor's Response

Although some adults with attention deficit hyperactivity disorder may not meet the full criteria used to diagnose ADHD in children, they may still experience significant impairment in certain aspects of life. Depending on their professional or domestic situation, these adults may need to deal with more complex abstract issues that can be difficult depending on the severity of their ADHD. Consequently, a given individual's perception of his or her own degree of impairment may vary.

Biologically, ADHD is a neurochemical and neuroanatomical disorder, meaning that specific brain chemicals and brain regions are affected. People with ADHD are thought to have several chemicals (still to be determined) in the brain that are not present in the right quantities in the right places at the right times. Both dopamine (DA) and norepinephrine (NE; noradrenaline) are brain chemicals involved in regulating both attention and reward pathways in the brain and are thought to be affected by ADHD. Many of the medications used to effectively treat ADHD alter brain levels of DA and NE, adding support to the hypothesis that ADHD is related to their function.

Neuroimaging research has shown both that children with ADHD show differences in how their brains develop, as well as identifying areas in the adult brain that seem to function differently. Although brain images are helping us to understand these disorders, an MRI or CT scan cannot be used to establish a diagnosis of ADHD.
Symptoms of attention deficit hyperactivity disorder (ADHD) in children and adolescents are predominantly external and easy to observe, such as physical hyperactivity. An exception is predominantly inattentive ADHD, formerly referred to as ADD, which is more common in girls. With age, a decrease in observable symptoms of ADHD seems to occur.

Adults with ADHD have a longer delay before refocusing when their attention is misdirected, and they have difficulty switching tasks. The hyperactivity and impulsivity of adult ADHD are often more subtle than those symptoms types in children. For example, while hyperactivity may result in children being fidgety and frequently getting up from sitting, this symptom in adults may involve the adult getting bored easily and being unhappy about having to sit still rather than having to frequently change their position. On neuropsychological tests, these individuals often have trouble with sustained effort, planning, organization, visual tracking, and listening attentively.

ADHD is characterized by a long-term history of inattention, impulsiveness, and variable amounts of hyperactivity. Remember that all of these symptoms are normal human characteristics, so ADHD is not diagnosed solely based on the presence of these normal human behaviors. ADHD is determined by the degree of these behaviors and their interference with important areas of life. People with ADHD have these normal human characteristics to an excessive degree, with a poor ability to easily control them.

For more information, read our full medical article on adult ADHD.

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ADHD Practice Guideline for the Diagnosis, Evaluation and Treatment of Attention Deficit Hyperactivity Disorder in Childhood and Adolescence. Subcommittee of the American Academy of Pediatrics: Steering Committee on Quality Improvement and Management. Pediatrics 128 (2011): 1007.

Biederman, J., et al. "Do Stimulants Protect Against Psychiatric Disorders in Youth With ADHD? A 10-Year Follow-up Study." Pediatrics 124.1 July 2009: 71-78.