Just like the myriad of possible symptoms, the reasons for ADHD are also several.

“Genetics, low levels of dopamine in the brain, premature birth, being underweight at the time of birth, head trauma, etc., are some of the reasons,” explains Dr Arun B Nair, professor of psychiatry at Government Medical College in Thiruvananthapuram. 

He notes that people with ADHD often get misjudged as lazy, inefficient, or irresponsible. He also has a word of caution on addiction. Recently, an IT professional, who was suffering from methamphetamine addiction, approached Dr Arun. 

“During lockdown time, he had started depending on the digital world to pass the time. But when he returned to his office, he couldn’t concentrate on tasks. He started making many mistakes during coding. Then, apparently, his friends suggested that he try meth as a stimulant. Unmindful of the perils, he started using the substance, and, over time, became an addict.” 

Dr Arun found that the patient had been primarily suffering from ADHD. “As therapy and medication started for ADHD, he started improving. Now, he has gotten over the addiction and his quality of life has improved,” he adds.

“That said, it does not imply that all addictions are due to ADHD. However, if untreated, ADHD can be a cause for addiction — be it digital, alcohol, or drugs.”   

Dr Xavier P J, senior psychiatrist at VPS Lakeshore Hospital in Kochi, concurs, adding that the precise diagnosis is vital. “Many adults who display symptoms of hyperactivity may be presenting with addiction, rather than ADHD,” he says. 

“For instance, they will not be able to keep track of a conversation, jump from one topic to another, and may appear restless. Recently, a male nurse came to me, seeking help for ADHD. Later, however, it was found that he was addicted to meth.”    

Aparna Rajeev, a psychology professor at Chinmaya Vishwa Vidyapeeth, explains that there is no specific test for diagnosing ADHD.

“Usually, diagnosis is made using a detailed medical exam, which helps rule out other possible causes, evaluating information such as the medical history of the patient and family, childhood behavioural issues, and work performance,” she says.

Another gap that contributes to underdiagnosis is the difference in symptoms displayed by girls and women, says clinical psychologist Sreeja Pillai. “It is generally said that ADHD is more often found in boys rather than girls. That is because often girls mask the symptoms,” she says. 

“Symptoms such as lack of attention and focus, daydreaming, rapid speaking, impulsivity and moodiness are often brushed aside as girls or women being shy, timid, or not studious. Since physical hyperactivity is easily noticeable, it is easy for parents and teachers to notice the symptom in boys.”

Sreeja, however, notes a positive trend of more people coming forward to seek medical help. “Some approach with self-diagnosis, and the actual issue might not be ADHD. But it is always better to self-diagnose and consult a doctor, rather than totally ignoring the symptoms,” she says.

‘Understanding ADHD helped me’

Manasa R, a journalist, was diagnosed with ADHD in her mid-20s. Soon after, she discovered she had autism, too. “Only then was I able to understand the challenges and difficulties I experienced all my life. With late diagnoses, there is additional trauma from all the negative life experiences,” she says. Manasa faced associated conditions such as anxiety and depressive spells. However, by understanding herself better, she was able to manage her symptoms. “Now that I have the knowledge, tools to help myself and support from people, it’s become easier to navigate the difficulties. It doesn’t mean the challenges have gone away. It is still very, very, very difficult to be a neurodivergent person in a world that has set neurotypical, ableist norms,” she says. “Reading about my condition and talking to people dealing with similar symptoms have immensely helped me manage my condition better. Knowledge is empowering and reduces the shame we have lived with all our lives.” 

Adult ADHD symptoms

• Impulsiveness

• Disorganisation and problems prioritising

• Poor time management skills

• Problems focusing on a task

• Trouble multitasking

• Excessive activity or restlessness

• Poor planning

• Low frustration tolerance

• Frequent mood swings

• Problems following through and completing tasks

• Hot temper

• Trouble coping with stress

Courtesy: Mayo Clinic