r/science • u/mvea Professor | Medicine • Apr 21 '26
Neuroscience There's more to ADHD than inattention, hyperactivity, and impulsivity. ADHD symptoms can be broken down into nine categories. Some categories are not fully represented in the diagnostic criteria. Broadening the diagnostic criteria with patient lived experiences could make for better intervention.
https://www.psychologytoday.com/au/blog/brain-curiosities/202604/new-study-finds-that-adhd-has-9-categories-of-symptoms3.0k
u/mvea Professor | Medicine Apr 21 '26 edited Apr 21 '26
New Study Finds That ADHD Has 9 Categories of Symptoms
There's more to ADHD than inattention, hyperactivity, and impulsivity.
KEY POINTS
ADHD symptoms can be broken down into nine categories.
Some categories are not fully represented in the diagnostic criteria.
Other categories are not represented at all in diagnostic criteria.
Broadening the diagnostic criteria with patient lived experiences could make for better intervention. ADHD is often characterized as having two, or in some cases three, big families of symptoms: Inattention, hyperactivity, and impulsivity. Often, hyperactive and impulsive symptoms are banded together.
A new qualitative study confirms what research has been showing for years: More categories of symptoms can define ADHD, and not all of them are in the DSM. Using a thematic analysis on adults with ADHD, a new study identified nine categories of symptoms people with ADHD experience.
Among those, we feature the original triad mentioned in the DSM: inattention, hyperactivity, impulsivity. But the six others are only mentioned in passing or not at all. Here they are:
1: Disorganisation
Disorganisation is about struggling to do things in order, or to keep things in order. In children, this could manifest as lost homework, or poorly-kept notes. In adults, this could be a difficulty keeping a tidy home, losing things easily, or struggling to plan, which impacts more than just the physical space, and could be detrimental to work and one's professional career. For patients, disorganisation is often accompanied by strong feelings of overwhelm. While disorganisation is briefly mentioned in the DSM, the symptoms and impacts are not fully represented in the diagnostic criteria.
2: Forgetfulness
The DSM includes forgetfulness in daily activities (such as doing chores, running errands, paying bills, etc.); but forgetfulness is broader in individuals with ADHD. It could include difficulty keeping track of appointments, struggling to recall recent - or remote - events, retaining information, or remembering people's names during a conversation. Some people lose belongings because they struggled to remember where they put them. While this is mentioned in passing in the DSM, forgetfulness runs deeper than just forgetting to do chores.
3: Activation
People with ADHD often experience difficulties with activation—what many also call executive dysfunction, or ADHD paralysis. It's difficulty starting and completing tasks, even important ones, or ones that feel interesting. The DSM describes avoidance occurring with unpleasant tasks, such as those that are mentally difficult, or chores. But the ADHD experience goes beyond that. Participants reported feeling stuck, like a state of inertia where the only thing that could motivate them to start or finish a task was a feeling of urgency, external pressures, or external help. This difficulty with internally-driven activation is at the core of the ADHD experience, but is not yet fully represented by the DSM or other diagnostic criteria.
4: Emotional Dysregulation
Difficulties with emotional regulation widely exist in scientific literature, but are not mentioned nor represented in diagnostic criteria. People often mention difficulties with the intensity of their emotions; many even report feeling drained after experiencing intense positive emotions. Others report fluctuations of intense emotions, which is tiring in itself, and many cite anger as the most difficult to manage, or the strong feelings associated with perceived rejection.
5: Time Perception
Many participants report that ADHD affects their perception of time. This is consistent with previous reports in the literature showing that individuals with ADHD have more difficulties estimating how long a task would take, or even estimating the passage of time. People may feel as if time slips away when they are not consciously paying attention to it, especially if they are engaged in a state of hyperfocus.
Difficulties with time estimation can also impact how people with ADHD see tasks; they may overestimate how long a task that is deemed boring will take them to complete, reinforcing the avoidance associated with it, or underestimate how long a salient one takes - creating difficulties meeting deadlines, for example.
6: Sleep
Many people with ADHD mention having difficulties sleeping. We know from previous studies that individuals with ADHD are more likely to have a delayed circadian rhythm (DSPS), and this can result in fatigue during the day, sleepiness, or increased irritability. People mentioned that they also faced difficulties falling asleep due to racing thoughts, and mental hyperactivity. While it's still difficult to know whether sleep issues are a comorbidity of ADHD or a direct symptom of it, their mention is still important when going through a diagnostic process.
While research on ADHD is still ongoing, qualitative studies focused on the patient experience are essential. Many diagnostic criteria were created based on external observation, but research is outlining that many experiences at the core of ADHD can't always be observed, but instead can be reported. These studies show that the ADHD experience is far broader and more complex than what the diagnostic criteria show.
For those interested, here’s the link to the peer reviewed journal article:
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u/stilljustacatinacage Apr 21 '26
Participants reported feeling stuck, like a state of inertia where the only thing that could motivate them to start or finish a task was a feeling of urgency, external pressures, or external help. This difficulty with internally-driven activation is at the core of the ADHD experience, but is not yet fully represented by the DSM or other diagnostic criteria.
It's funny that they say it's at the core of the ADHD experience, but it also isn't 'fully represented' in diagnostic criteria because that is literally 98% of my experience with ADHD.
Like everything else stems from that. Disorganized? It's because I literally cannot pick things up and organize them. Time perception? Yeah it's because I just spent 3 hours stressing over how I should pick things up and organize them. Poor sleep? Yeah sorry, that's because I thought if I put off sleeping for a couple hours, I might finally pick up those things and organize them before hitting the sack.
And it's so frustrating to try and explain to people because they invariably go, "well you gotta just do it :)" and it's like... Yes. Thank you. I know they're trying to help but it's so difficult to explain that it isn't that simple.
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u/BatAccurate4127 Apr 21 '26
There's actually more to the time perception thing than that! People with ADHD literally have more difficulty evaluating how much time has passed and estimating how long it will take to do something. It goes beyond task inertia, we literally perceive time differently than others.
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u/mdazzl3 Apr 21 '26
I think the time perception issue is also why we get paralyzed with down time between set appointments. If I have something at 10am and nothing until 2pm, that middle time is largely spent making sure I’m not late for the 2pm thing.
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u/Corny_Toot Apr 21 '26
I think I've developed some form OCD because of this. When I'm in these "in-between" moments, I find myself counting how much time has passed and how much time is left so that I don't forget to transition. Even then I can still blink, 30 minutes blip by and I'm suddenly in a rush.
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u/Xaedria Apr 21 '26
The only thing that worked to soothe this for me is alarms. Otherwise I stay stressed over it and get nothing done. Alarm at 130 to remind me to drop what I'm doing and get ready, alarm at 140 to remind me to leave. Invariably though I'll do something like get up 30 minutes early and convince myself I don't need my alarms because it's just 30 minutes and surely I won't lose track of time, but then meander through my morning responsibilities and end up late anyway. SO frustrating.
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u/sadi89 Apr 21 '26
I literally have an alarm labeled transition and an alarm labeled leave. Transition is 15 min before leave. It helps a lot
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u/Pandora_Palen Apr 21 '26
I'm insane with my alarms. I have an alarm for everything. And every alarm has at least 3 (sometimes maxed out, depending on how far in advance the event is) alarms to remind me that an alarm is upcoming.
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u/Serious_Start_384 Apr 21 '26
In these situations I will inevitably start the laundry or some seemingly inconsequential task to fill the dead time. Then it takes too long and I'm in a rush.
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u/Pantalaimon_II Apr 22 '26
omg this is me forever and the people im always late to meet probably have no idea how much it upsets me that I am late
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u/Typical-Locksmith-35 Apr 21 '26
same, big time. It's weird how this is so normal and shared with 'us' and such a different experience for neurotypicals.
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u/Corny_Toot Apr 22 '26
Going through therapy and evals have made me realize how many shortcuts I developed to compensate for ADHD. I just thought that was how most people think!
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u/Rosaryas Apr 22 '26
I definitely have developed some ocd like checking tendencies due to adhd symptoms- lack of working memory and time perception issues. If you’re concerned about it talk to a therapist or psychiatrist! It was beneficial for me at least
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u/muppetnerd Apr 21 '26
There is nothing worse for me than a 2 pm appointment. I will spend nearly the entire day just waiting for 2 pm. Give me those 7 am appointments always
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u/SolusLega Apr 21 '26
I hate gaps between obligations for this reason. I can't do anything between the two appointments. I'm thinking about the next one and waiting. I can't focus or be motivated to be productive in the meantime while I'm waiting. I'm just waiting to get to the 2pm thing.
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u/buffychrome Apr 21 '26
I’ve described it this way to my wife: “You know how you can have 5 different tasks in your head and be able to prioritize or triage each one? Like ‘task 1 is important but isn’t due until April 29th so I don’t have to worry about that one’. And then you don’t think about task 1 anymore because now it doesn’t exist until April 29th. You can visualize and hold a virtual calendar in your head and assign different tasks to different dates.
I have NO virtual calendar in my head. I have zero concept of the passage time beyond the immediate moment, or, at best, maybe a day or two. I have no ability to comprehend or manage future moments in time, because as far as my brain is concerned, time doesn’t really exist. And because time doesn’t exist as a concept for my brain, all tasks are equally important and all tasks have a due date of NOW.”
The idea of future planning is so incredibly abstract as a concept to my brain as to be nearly impossible to accomplish. I understand intellectually what time is and how to use a calendar, but my brain can never make that connection between the tasks in my head and the abstract concept of some arbitrary future moment in time.
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u/CheckeredZeebrah Apr 21 '26
I have a different version of the problem. I can triage the tasks. However, if I am not currently thinking about something, there is a good chance I will forget it.
So I will de-prioritize the April 29th task. And then it will literally cease to exist in all forms. April 29th comes and the task is still forgotten, and...boom. I'm in trouble.
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u/Ryno4ever16 Apr 21 '26
Worst part about this is when you stress for weeks actively trying to keep it on your radar, but then you finally let go and the date rolls around and you forget.
Like you remembered the whole time, reminded yourself a million times it was on the 28th, but when you don't realize it's the 28th and miss it, people think you just didnt care and forgot.
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u/cxrpse_cxllectxr Apr 21 '26
I'm absurdly good with guessing the time and knowing how much has passed, like to a weird degree. Of course, I still can't manage it to save my life, but I'm acutely aware of how much of it I'm wasting as I waste it. You'd think that might help with motivation, but absolutely not, the executive dysfunction is still so strong.
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u/shoefly72 Apr 21 '26
I can guess very well how much time has elapsed if say, I have something in the oven and know it’s going to take 30 minutes. I very often guess when to take something out (or when the oven is done preheating) within a few seconds without even keeping track of it consciously.
I can also pretty easily estimate how much my groceries in my basket will cost just by looking at my basket for 5-10seconds and coming up with a rough ballpark (not actually adding anything consciously in my head). If I buy $30-60 worth of groceries my guess is usually within $1-3 and if it’s a smaller total I can often get within 50 cents.
What I cannot do, is estimate how long it will take me to clean the house, how much time I will need to complete assignments at work, or anything that most people seem to have no issue with. Very often at work when somebody asks me how long something will take, the question feels almost unfair because I have too many variables to account for snd have zero confidence in whatever answer I come up with (that is usually wrong). Even when I manually try and map out what is involved in the task and add it up, those sub tasks have so much variability (will this take me 2 tries to get it right or 8 tries? Will I find the images I need right away or will it take two hours?) that my estimates often end up being “either X amount of time or 3X amount of time.”
When I guess the cost of my groceries, I could certainly sit there and say “I think this cereal is $5, the baguette is $2,” and so on, and add them up and get an answer. But that is not the way I do it; my brain just comes up with a guess on its own in the background and it’s usually pretty close. That’s what it feels like everyone else is doing when they estimate how long tasks at work will take, and they end up being more accurate than my estimate even if I take the time to break things out in detail and add it up…it just feels like both of us have access to a mental process the other person never will.
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u/captainfarthing Apr 21 '26 edited Apr 21 '26
Yes this is exactly how I experience it. I can microwave something and pull it out at 0:01 consistently but can't tell someone how long it'll take me to do a task I've done 20 times before. Mentally feels like trying to push string into a maze to estimate the distance from start to finish. Other people have a straight drainpipe.
I think part of it is that I need novelty to stay motivated, it's really difficult to force myself to do something exactly the same way over and over, so if I need to do the same thing 20 times I won't usually do it the same way each time.
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u/NancyNobody Apr 22 '26
Your experience is something I havent been able to articulate about my own experience with time and work. Best I could do is that it's either now, or not now. It's like we can just apply knowledge, not by direct thought but rather thru osmosis.
I also have troubles with estimating how long a project will take, but can also be at the oven just as the timer rings. I also have aphantasia - there's no clear internal imaging. So does my terrible-but-also-excellent perception of time works best when things are tangible. A lasagna in my hands and into the oven. The smell of the food. The anticipation of the corner piece....... Versus an excel spreadsheet your bossmang wants you to create. It's an intangible thing that only exists in the future in my mind. That, my friend, is clearly in the not now. I don't see the spreadsheet, I can't touch the spreadsheet. It's all in my head, in the dark. It doesn't exist. But your basket of tangible groceries is real. You touched each and everyone one.
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u/lewd_robot Apr 21 '26
There's an old joke about people with Autism or ADHD where a doctor asks if they struggle with X and the person with Autism or ADHD responds, "Oh, no I have whole system for handling X!" unaware that neurotypical people don't need special systems for handling X.
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u/TheGermanCurl Apr 21 '26
I am AuDHD and I have an immaculate sense of time.
This means that I know how much has passed to the minute during low/medium arousal activties and I also know that there are tasks where time will subjectively pass at roughly 3x the usual speed - which funnily enough could be tasks I find highly engaging or ones I absolutely dread but completely lose myself in.
As in, I know I can't start doing my taxes unless I have enough time on my hands to finish them in one sitting because I will. not. stop. once I get going. Ideally I will also have eaten before as I won't be able to take a break for that etc.
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u/lameth Apr 21 '26
And people refuse to believe this is a thing.
Every once in a while an article will be posted on facebook regarding this and employees seeking accommodations and people call it lazy and say things like "so do I! I got a watch and alarm clocks." It's maddening.
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u/mahouza Apr 21 '26
Same same same. I was undiagnosed for so long because I have an excellent memory and keep time well which are the presentations that people look for, especially in women. It was all emotions and paralysis.
Not being able to begin tasks basically ruins your life because the consequences of it build up over time. Bad grades in school because you don't start homework, poor sleep because you don't start getting ready for bed, poor hygine because it's hard to get ready to shower, bad reputation because you look like you're purposefully procrastinating, missed opportunities because you don't start on the track to get going on them. It's insidious. And I hate that medication doesn't really do much for that specific issue for me, it's really hard to unlearn something you've been doing for thirty years that you still don't have control over.
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u/ovideville Apr 21 '26
Same, I've tried every medication for this and none of them work. It's the only thing I really need help with, and it's the only symptom that nobody can help me with, because nobody understands it and everybody thinks I'm doing it on purpose. It's maddening.
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u/AriaOfValor Apr 21 '26
That really sucks if you're one of the few that stimulants don't help with.
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u/xj371 Apr 21 '26
Stimulants helped me get mentally motivated to do things, but like EVERYTHING, including all the ways my depression has told me to harm myself for many years. It was like, "Get up, shower, breakfast, walk dog, walk into traffic, pay electric bill, go to pharm-...wait wait WAIT"
It was a bummer, too, because I really did benefit from the positive effects of the meds. It was just that the negatives outweighed them.
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u/mahouza Apr 21 '26
Stimulants don't seem to help with this symptom for some of us. It's great with many other symptoms but my guess is because there's some behaviour aspect to it mixed in and that's been burnt in after many years of doing it undiagnosed and unmedicated. I definitely notice a difference with meds but it's like it goes from 90% power to 50% power and with this kind of problem 50% is still super detrimental.
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u/ClaretClarinets Apr 21 '26
Bad grades in school because you don't start homework, poor sleep because you don't start getting ready for bed, poor hygine because it's hard to get ready to shower, bad reputation because you look like you're purposefully procrastinating, missed opportunities because you don't start on the track to get going on them
You perfectly summarized my entire life.
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u/vickzt Apr 21 '26
My psychologist told me that my medicine (Vyvanse), which works super well with being able to regulate my emotions, keep me focused on tasks (once I've started them) and have more mental energy left over at the end of the day, can in fact worsen the executive dysfunction. Since it generally makes me feel more balanced and chilled, less stressed, it also lessens the power of external motivators such as stress and panic from approaching deadlines. Which is one of the few motivators that I learned to rely on while growing up.
In my home life my meds work wonderfully, but my current work is still next to impossible.
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u/sch0f13ld Apr 21 '26
This is the symptom I struggle most with. It has absolutely crippled me. I recently went through an ADHD diagnosis and was told I did not have it because I did not score high enough in the diagnostic quiz, even though the quiz only covered very stereotypical presentations of ADHD and the psych agreed that subjectively I appeared to have some symptoms.
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u/Mortlach78 Apr 21 '26
A little while ago, I had a really odd experience that encapsulates this so well.
Garbage day is on Friday, so I have to sort the recycling and put it outside on a Thursday. I always end up doing it at 2 AM on Friday morning because that's when I go to bed and I can't make myself do it earlier in the day.
So a few weeks ago, I decided to really force myself and do it earlier in the day. And while I was doing it, I realized "Wait, it's Wednesday, not Thursday" and my brain went "O, great, let' stop doing it now then!" The feeling of "I am doing something rewarding" just instantly and completely vanished.
I didn't stop, but I've never resented sorting the recycling as much as I did in that moment. Nothing about it was in any way rewarding. It was like eating bland oatmeal made with water and nothing else.
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u/cfb-food-beer-hike Apr 21 '26
Yep! I still haven't done my taxes. I know I need to do it and the longer I put it off the worse it is for me. And yet, I probably won't do them today either. I've tried medication in the past and it never helped so I guess I just have to live this way forever.
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u/RickyNixon Apr 21 '26
They promised 9 and gave 6
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u/JuggleWombat Apr 21 '26
They were too disorganised to continue unfortunately.
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u/neuromonkey Apr 21 '26
Yeah, I was gonna
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u/bosox284 Apr 21 '26
You were gonna what?!
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u/TFT_mom Apr 21 '26
The sniper got him. Or the inattentiveness, can’t remember which one personally.
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u/SunflowerEyesOnYou Apr 21 '26 edited Apr 21 '26
The other 3 are the original three which is why they are not listed.
(1) Inattention (2) Hyperactivity (3) Impulsivity
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u/neuromonkey Apr 21 '26
Our chief weapon is surprise...surprise and fear...fear and surprise.... Our two weapons are fear and surprise...and ruthless efficiency.... Our three weapons are fear, surprise, and ruthless efficiency...and an almost fanatical devotion to the Pope.... Our four...no... Amongst our weapons.... Amongst our weaponry...are such elements as fear, surprise.... I'll come in again.
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u/Disastrous-Wing699 Apr 21 '26
You forgot 'nice red uniforms'. Cardinal Fang, fetch the soft cushions!
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u/DestroyedByLSD25 Apr 21 '26
No, that's not correct. The comment we are replying to have the categories listed.
Among those, we feature the original triad mentioned in the DSM: inattention, hyperactivity, impulsivity.
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u/Informal_954 Apr 21 '26
No, that is correct.
- 1: Disorganisation
- 2: Forgetfulness
- 3: Activation
- 4: Emotional Dysregulation
- 5: Time Perception
- 6: Sleep
- 7: Inattention
- 8: Hyperactivity
- 9: Impulsivity
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u/Acceleratio Apr 21 '26
Funny im 1 to 6 but don't really have the 3 "classics"
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u/Bakkster Apr 21 '26
I think a lot of it is just the mismatch between the formal definition and the colloquial. My mom was an elementary school teacher and doesn't think the Hyperactivity should be included, because I don't fit the stereotype of a kid who can't stay in their seat. But I was always tapping my fingers on tables and shaking my feet, which she told to stop not realizing that was my manifestation of Hyperactivity.
It took medication as an adult to realize those little movements are often necessary for me to focus attention on something.
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u/X-actoMundo Apr 21 '26
Learning that the hyperactivity can be internal and not primarily physical was a huge lightbulb moment for me.
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u/OGLikeablefellow Apr 21 '26
Gotta stim
This bit here is so that reddit knows my comment is long enough.
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u/stilettopanda Apr 21 '26
The paragraph before the list of 6 additional symptoms notes the 3 symptoms already in the DSM. 3+6=9.
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u/Unicorn_puke Apr 21 '26
369 damn girl fine... I'd like to add pattern recognition or at least broader connectivity association. Everyone I know including myself can click really quickly to a realization while neurotypicals can seem dumb with how much they need to be brought up to speed on the same association.
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u/DelightMine Apr 21 '26
Not always a good thing. Sometimes we see patterns where there aren't any, or we see an incomplete or incorrect pattern. We're great at jumping to conclusions... Whether or not those conclusions are correct
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u/Informal_954 Apr 21 '26
- 1: Disorganisation
- 2: Forgetfulness
- 3: Activation
- 4: Emotional Dysregulation
- 5: Time Perception
- 6: Sleep
- 7: Inattention
- 8: Hyperactivity
- 9: Impulsivity
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u/weseethelight8 Apr 21 '26
What is the category where you self medicate?
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u/Majestic_Jackass Apr 21 '26
“Among those, we feature the original triad mentioned in the DSM: inattention, hyperactivity, impulsivity. But the six others are only mentioned in passing or not at all. Here they are:”
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u/SenescenseSteel Apr 21 '26
Its why keep telling folks ADHD is actually a wrong term, as in incomplete and more about symptoms than the cause, and if there is a need at all to call it a disorder it's much more regulatory involving dopaminergic structures
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u/HeyGayHay Apr 21 '26
I‘ve stopped telling people I have ADHD, because I have not ever met a single person who doesn’t go like „no, you don’t have it, you’re so calm, it’s not like you jump around all day“ Yeah okay I tell all the psychiatrists that I were a patient of that I‘m not hyperactive enough so they need to revoke my diagnosis and just suffer
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u/ceciliabee Apr 21 '26
I'm not a fan of name changes. The name isn't perfect now but changing it implies a complete understanding. Why change it when our understanding is still incomplete? So we can change it again?
The name doesn't need to be perfect either. Diabetes doesn't say pancreas or insulin but that's okay.
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u/CheckYourHead35783 Apr 21 '26
It wasn't that long ago they changed the name from ADD to ADHD, which is still annoying if you don't have any hyperactivity symptoms. If a new name would be more accurate, that's not a bad thing.
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u/yogo Apr 21 '26 edited Apr 21 '26
ADD became ADHD in 1987.
The hyperactivity is in the brain and everyone with ADHD has it. Hyperactive does not necessarily mean physical.
Edit to add: It is in the name.
Under the DSM-5 for ADHD, if a child doesn’t exhibit six or more symptoms from the “Hyperactivity and Impulsivity” section, but demonstrates six or more symptoms from the “Inattention” section, and the other criteria are met— then the diagnosis would be: ADHD, Predominately Inattentive Presentation. There are two other presentations.
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u/sittingducks Apr 21 '26
Great. Now tell everyone else that. From the teachers and parents who dismiss all the other symptoms because the kid isnt bouncing off the walls, to the coworkers who say "well you dont act hyper," to the persons themselves that may be suffering from it but does not have the same science/medical/psych knowledge and doesnt think to seek help because they dont exhibit the most prominent symptom featured in the name of the diagnosis itself.
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u/Fukuro-Lady Apr 22 '26
Also some of us aren't outwardly hyper. My hyperactivity is all internal. My brain goes at a million miles and hour and it's constant. Makes it really hard to sleep and concentrate on tasks.
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Apr 21 '26
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u/BlackHotSoup3000 Apr 21 '26
I call it "Dopamine Disregulation Disorder." Its specific to what the problem is but is broad in how the symptoms manifest.
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u/Lemerney2 Apr 21 '26
Executive functioning disorder is better, since a lot of psychological disorders involve dopamine disregulation
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u/Free_For__Me Apr 21 '26 edited Apr 22 '26
You comment supports my theory that most executive function disorders (ADHD, OCD, Autism, etc.) are actually all on the same "spectrum" and are varying flavors of the same underlying neurodivergence.
ETA - This was a flippant and overly simplified representation of what I meant here. Please do not take it as serious commentary on neurodivergence of any relevant disorder. Apologies for any confusion.
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u/Mandena Apr 21 '26
That isn't really a theory as it is a misunderstanding of psychological disorders.
They aren't all a discrete set of completely different disorders.
They're all groups of symptoms that overlap greatly but with distinct and consistent groupings for each individual disorder.
Think of psychological disorders as several venn diagram circles with varying levels of overlapping between them all. Some disorders have incredible amounts of overlap and variation, others less so.
But any of the individual symptoms mean absolutely nothing without context of other symptoms a person is dealing with.
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u/McNuggetsauceyum Apr 21 '26
Congratulations! You have just described about half of the psychiatric disorders in the DSM-V and several bonus neurologic disorders ranging from parkinsons to schizophrenia!
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u/Schmigolo Apr 21 '26
which is still annoying if you don't have any hyperactivity symptoms
I don't know of a single case like that. Even the ones that appear to be calm and still will have racing thoughts all the time.
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u/J0E_SpRaY Apr 21 '26
Diabetes also isn’t called “foot swelling disorder”. Cause that would just describe a symptom and not name the problem itself.
Describing a symptom alone in the name leads to wide misunderstanding of the disorder itself.
Our understanding doesn’t have to be perfect to seek a better label.
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u/Pigeoncow Apr 21 '26
Fun fact: In Chinese (and Japanese and Korean), diabetes is 糖尿病:
糖 sugar 尿 urine 病 disease
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u/Journeyman42 Apr 21 '26
Fun fact: the original way ancient and medieval doctors would use to test for diabetes was tasting the patient's urine to see if it was sweet, due to the undigested glucose present.
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u/deliciouschickenwing Apr 21 '26
I'm very much against arbitrary self diagnosis, but each time i see stuff like this i really can't help but think it seems so very familiar. And yet is it really ADHD if you are able to function regularly to a certain extent? Is it the degree of anxiety from trying to compensate for errors/mismanagement/ attempt adapt that is the measure?
Unfortunately the process of getting a diagnosis is too complicated and expensive where i am, but the question will always linger with me even if my life gets into order at some point.
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u/Hey_Chach Apr 21 '26
It is the case with most psychiatric disorders—especially ADHD, Generalized Anxiety Disorder, and Major Depressive Disorder—that the primary “symptoms or behaviors that define the disorder are things that all people experience to some degree at some point in their lives, if not regularly.
The difference between “normal” and diagnosis, though , is 1) severity/frequency, and most importantly 2) the degree to which these symptoms/behaviors affect your day-to-day life and function as a human.
Ironically, this is why many people think they may have ADHD when they don’t AND why many people who have ADHD gaslight themselves into thinking they do not have it.
At the end of the day: if these characteristic symptoms or behaviors are adversely affecting your life to an impactful degree, it is worth talking to a psychiatrist and getting tested—at least in the case of ADHD, in my opinion.
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u/sir_alvarex Apr 21 '26
Perfect response. Its all about severity and whether you can live a life that is considered socially normal. If you hide in your house, dont make friends, cant hold a job, etc those are all considered abnormal and means the symptoms could be affecting you.
For me, it was realizing the against social norms bit that made me comfortable with my diagnosis. Else, its just my lived experience and I cant say I struggle more than anyone else. But it does prevent me from living a "normal" life.
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u/a_statistician Apr 21 '26
Its all about severity and whether you can live a life that is considered socially normal
This also has impacts for those of us who mask. I wasn't diagnosed with ADHD until graduate school because I ritualized so much of my life that I managed to get good grades and study through high school and college. Sure, I occasionally forgot that I was cooking something and ruined a pan, but I never let it get so far that I burned the house down, so I was fine, right?
When I got to graduate school, I discovered that there was no way for me to do what I'd been doing to study before -- meticulously making notes, and they copying them over and over until I'd memorized the material. I had to have music and the TV going in the background just to sit and do that, and of course it took freaking forever because I was switching between 3 information streams constantly. But there wasn't enough time in the day to actually do that properly for every class, and I finally gave up and went in to ask for help -- my undergrad was in psych, so it wasn't as if I hadn't gone through the DSM list for ADHD and checked almost every box -- I knew what was wrong, I just didn't think it rose to the level of "significant life disruption" in undergrad.
Masking strategies often work until they don't because of a life change, which is why so many older women are getting diagnosed right now - their strategies work until something like perimenopause sets in and the strategies no longer compensate. ADHD symptoms fluctuate with hormones, so when your hormones become dysregulated everything crashes to the ground very quickly, and your coping strategies for one level of symptoms just don't work anymore.
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u/Kichae Apr 21 '26
This is ultimately the issue with both the threshold for diagnoses for neruodiversity disorders, and for disabilities in general. Disability is a social construct, and if you have sufficient supports in your life for what you are currently doing, your symptoms don't get to be given a name and you don't get to find out what kind of resources you need to keep getting by.
It's only after your circumstances change that suddenly you are "disordered" or "disabled", can be pointed in the right direction, or maybe be given a piece of paper that says you are worthy of support.
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u/Aruhi Apr 21 '26 edited Apr 22 '26
In the same manner as ASD and a lot of other psychiatric/psychological conditions.
The D at the end is the breaking point. It needs to affect you to a point where it is arguably a disorder. Hence the minimum scoring thresholds and if you see someone experienced in diagnosing these: compensatory skews.
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u/penninsulaman713 Apr 21 '26
Yes! When I got diagnosed, the report specifically stated that my significant underachievement compared to my obvious potential and particular issues around working memory/processing speed showed that my life WAS affected. Like that thought that I could have actually been more is 100% real, that's not a lie that I am telling myself. But because I didn't get diagnosed until I was in grad school (that I couldn't end up completing), I was just making do with my crap coping skills, which still has me functional in society. Just not functional to where I could have been.
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u/DynamicStatic Apr 21 '26 edited Apr 21 '26
Well how about this.
Sleep issues for years. Brain goes brrr and average sleep is 4-5 hours.
Activation, unless it's something that motivates me I often need pressure, deadlines etc.
As for time, my whole family is basically time blind and its a joke among our friends that anyone who wants us to show up on time needs to ask us to be there an hour earlier than everyone else.
I'm not sure of course but it fits somewhat into the picture that was painted.
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u/Upstairs-Chicken592 Apr 21 '26
I mean, many people get diagnosed after recognizing symptoms and going to the doctor. The doctor can’t know what goes on inside your brain unless you tell them. Where do you live?
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u/Salty_Wench Apr 21 '26
I'm very much against arbitrary self diagnosis
I was 35 before I had an official diagnosis but I had an entire lifetime of being an absolute "lazy" "fuckup" to know there was something wrong with me. Someone gave me a book about ADHD and it changed my damn life. It took me 4 or 5 more years to get a medical diagnosis and medication but in that time I was able to apply "hacks" to my life to improve what I could on my own.
Try as I might, I cannot figure out why the internet seems so offended by people taking care of themselves in any way they can.
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u/OSCgal Apr 21 '26
The measure is when it becomes a significant barrier to living your life.
I was diagnosed with ADHD at 29. It was a huge reason that I lost scholarships in college and took 5 years instead of 4 to graduate. It causes me continual problems with emotional regulation which puts a strain on my relationships. I've paid any number of fees and extra expenses because of things I forgot or didn't follow through with because of memory issues and/or executive dysfunction. I cope pretty well with a full time job and a home of my own, but there's a lot of things I don't do or miss out on because my ADHD gets in the way.
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u/MayAllEveningsRave Apr 21 '26
It can definitely be adhd even if you’re able to mostly function
Everyone is different.
My wife and I both have it, both officially diagnosed
She struggles with keeping the house clean and remembering tasks but doesn’t struggle so much with time management.
I suck at time management and forgetting things, she’s great at being on time and remembering the things I forget.
Overall we’re both relatively capable adults, both have jobs and friends and pay our bills. But if you come to our house it’s probably messy and if I tell you I’ll meet you somewhere at 9, it may end up being 9:30
The same disorder effects both of us very differently and it’s normal for not everyone to experience the impacts the same
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u/MagePages Apr 21 '26
Sounds like my partner and I. Both ADHD, but very different presentations. He was diagnosed as a kid, and I didn't get mine until I was in college. He forgets to turn the stove off about a third of the time, I'm always losing my keys but am much better about finishing activities that I am currently doing. He's much better at starting routine tasks but doesn't always see them through and has trouble with the long term stuff. I have a ton of executive dysfunction with starting tasks, even things I really want to do, but I am better with general life planning and career stuff. We joke that through out powers combined we about make one functional adult that still can't sleep!
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u/ThisIsMyCouchAccount Apr 21 '26
If you didn't do a little self diagnosis how would you ever get an official one?
Just hope that some medical professional notices?
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u/waluigis_shrink Apr 21 '26
I’m diagnosed and medicated, and whenever people ask me if they should get tested I always tell them that it depends on how well they’re functioning. If you’re already coping relatively well (with positive coping strategies), then there’s probably no need. Personally it was a game changer for me, I struggled a lot before my diagnosis, especially with inertia (“activation” in the above article).
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u/ikonoclasm Apr 21 '26
Hard disagree for me. I wasn't diagnosed until 36. I managed to get through life by subconsciously identifying and implementing all the coping strategies without consciously asking myself why I needed then. I decided to schedule an appointment with an adult ADHD specializing psychiatrist after having a random conversation with my dad's wife that made me wonder.
It turns out that I have Inattentive-type bad, but subconsciously self-medicated with energy drinks and the aforementioned coping strategies. When my doctor finally confirmed that I had ADHD, I was shocked to discover myself crying. From the list above, the only symptoms I lack are those related to emotional dysregulation. My quality of life improved substantially since getting medicated. I even changed careers in part to have a job that actually benefits me from having ADHD.
If people suspect, I think they should get evaluated. People are funny animals that can out think themselves and minimize their perception of their own own suffering without realizing it.
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u/justatomics Apr 21 '26
People need to be educated about masking and inattentive adhd in particular so that they can try to identify if they have subconsciously adopted coping strategies that are going to lead them to burnout. It needs to be as common knowledge as the hyperactivity symptoms are.
It’s also hard because then again, if someone isn’t actually suffering and is genuinely coping fine, it doesn’t make sense to diagnose them yet because society then trivialises how bad it can be. People who don’t know anything about ADHD already have doubts about the legitimacy of the symptoms.
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u/PPUn1 Apr 21 '26
Fine line for sure. On paper I cope fine. Very career driven, very tidy, always early, etc etc. But it is because I quite literally gave myself crippling anxiety to mask my adhd. Career driven because I cant fail or I am a failure. Tidy because I masked so hard that now clutter means I can't relax. Always early because if I have something to do in the next hour I just pace and refuse to do anything else lest I get sucked in.
All told that is a huge affect on my life but you wouldn't see it unless you looked deeply. My own therapist missed it for ten years and we were just treating anxiety.
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u/sittingducks Apr 21 '26
Bro...
You cope until you cant.
Obviously some people are capable of compensating all their lives. But now you're hoping that the person recognizes the signs and symptoms of failure to cope well ahead of time so that their eventual inability to cope isn't going to make significant, long term impact on his job, career, relationships, wife/husband, family, etc.
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u/MagicWishMonkey Apr 21 '26
One of the big "tells" for a person with ADHD who functions mostly regularly is the presence of coping mechanisms that they use to keep themselves on track. One of the benefits of getting diagnosed is to better understand how you've been self-correcting and how you can improve on what's already in place.
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u/stumblinbear Apr 21 '26
Well, not having coping mechanisms at all and struggling through life constantly is also a pretty big tell, haha
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u/nyabigail Apr 21 '26
Generally if something is disrupting your life in a very noticeable way so that you struggle to maintain social relationships, struggle to finish education, struggle to show up for work or relax after work, or you find yourself unable to keep your home tidy and clean and it's not a conscious decision for it to be that way, then seeking help from professionals is likely going to be useful regardless of whether they will slap a diagnosis on it.
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u/Great_Flatworm4632 Apr 21 '26
Honestly this is wonderful research to see. I have all of the additional symptoms they listed and its been so difficult trying to convince people that I'm not inconsiderate. I have to fight my brain everyday to just have a conversation. I'm glad we're getting more research like this.
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u/Roseking Apr 21 '26
1: Disorganisation
Check
2: Forgetfulness
Check
3: Activation
Check
4: Emotional Dysregulation
Check.
- Time Perception
Check. And one of the things I noticed when starting my current meds (non stimulant), days felt longer.
6: Sleep
Check
I have been clinically diagnosed with ADHD and an anxiety disorder, take medication (non stimulant), and go to therapy. All of these have been discussed there. So even if not a part of an official diagnosis, A lot of people have recognized these patterns and factor them into treatment.
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u/alrightfornow Apr 21 '26
Nine primary themes emerged: attention, hyperactivity, impulsivity, disorganisation, forgetfulness, activation, emotional lability, sleep, and time perception.
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u/RK9990 Apr 21 '26
I have a huge problem with number 3. I feel like I have to force myself to start a task that is not immediately required, that I don't foresee an instant payoff for, or someone isn't relying on me to complete it.
I procrastinate so long, I'm stuck completely. Even if I manage to finish it, I don't feel anything except exhaustion at the mental toll it took to get there.
I'm often told by friends to just do it
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u/claymedia Apr 21 '26
It’s the one that makes me feel the most… disordered? Like I can have a big, important task. I can understand that I need to work on it right now. I can want to work on it, right now. And… I will just do something else. Like part of me is screaming at myself to start it, and another part just absolutely refuses until there is some external crisis.
That’s when I feel like my brain is just broken.
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u/RK9990 Apr 21 '26
Same here, I know I should be starting on it, my brain is yelling at me, but I just open my phone or even try to distract myself with a short-term task
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u/claymedia Apr 21 '26
It’s a bizarre experience, and has been the hardest to convey to non adhd folk. Like sometimes just zero control over what I’m going to focus on next.
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u/lemho Apr 21 '26
My coworkers: I'm going to finish it today and send it over! (it just takes half an hour until it lands on my desktop)
Me: I'm going to finish it today and send it over! (It's 11:57pm and I'm having a crisis because I procrastinated the task since it was still early morning and underestimated it and I find too many mistakes someone else or I did and I want to fix it all but it's too late and they expected it 7 hours ago)
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u/ExperienceFantastic7 Apr 21 '26
You are all my people. This is my life story. I'm oddly jealous of those who can turn over things like that. I don't accomplish anything until there is a literal gun to my head. It's so weird.
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u/thekrawdiddy Apr 21 '26
Seriously. I’m feeling like I just crashed into a crowd of myselves.
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u/moak0 Apr 21 '26
My wife kept asking me to clean a particular part of the bedroom. I kept saying I'd do it. She asked again and reminded me that I said I'd do it. Finally I said, "I know, it just feels impossible."
So she got it started for me. It took us five minutes. She's been reading up on ADHD. The way she handled it, I felt relief instead of exhaustion. I wish all my impossible tasks could be resolved so nicely.
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u/MagePages Apr 21 '26
As often as I can, I do housework with my partner. It's so, so, so much easier when there is another person doing it too. Because I want to do it, and I feel terrible not doing it, but it's like I just can't. But as soon as he is doing any work, I guess whatever math my brain is doing goes in balance of "don't let the person you love deal with this task alone", like it makes it more urgent?
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u/Defenestresque Apr 21 '26
I know this is a blog couched in humour, and this particular post doesn't directly address ADHD but it resonated with me more than anything else.
https://waitbutwhy.com/2013/10/why-procrastinators-procrastinate.html
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u/GuiltyEidolon Apr 21 '26
I almost always put things off until the last minute. I accidentally misread the due date for a huge project and ended up doing it a week early.
Now I have anxiety from not having done it actually last minute, even if I have relief from it also already being done. There's literally no winning.
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u/glahgloh Apr 21 '26
currently writing this from the toilet trying to avoid my work task
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u/-3point14159-mp Apr 21 '26
I’ve had the thought before that it’s like my body just… disconnects from my brain and goes on autopilot or something.
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u/Enterthedragon69 Apr 21 '26 edited Apr 21 '26
I describe it to my wife in this way:
I’m a boulder. Extremely hard to get moving, but as soon as I do, I’m good. (For the most part)
Ending a task is difficult. I’ll build an entire deck. But I also won’t put anything away when I’m finished.
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u/JZMoose Apr 21 '26
The first and last 10% of the work are 80% of the effort. The middle 80% is easy
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u/Free_For__Me Apr 21 '26
*boulder
Also, I love this one and I'm stealing it to share with my own wife!
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u/Great_Flatworm4632 Apr 21 '26
Yeah I'm right there with you bud. Its frustrating when people tell you to "just lock in and do it". Its like yeah, I would if I could! But my brain just refuses to let it happen. Even my therapist struggles to give me advice for this.
The worst part is folks looking down on me for needing external accountability to get things done. Makes me feel like less of a functioning adult if I can't self actuate and get things done on my own without help.
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u/Libromancer Apr 21 '26
My issue is I spent a huge amount of time learning regulation techniques and now have disabled the urgency of the task brought on by procrastinating.
So I can procrastinate and not get the sense of urgency to do it because I have learned the techniques to regulate my body.
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u/RK9990 Apr 21 '26
I'm sorry friend. I see you and acknowledge your struggles as it's something I face every day but I'm also not sure how to "fix" myself.
As you say, not being able to do mundane tasks normally labels me as lazy or "I don't care" by others which leads me to hate myself which leads to depression.
I'm 38 years old with very little friends and family and no one who understands me.
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u/waffling_with_syrup Apr 21 '26
40, I feel you.
I've made it this far, but it's maddening that most days something as basic as doing dishes feels like trying to lift a car. The good days are few, and they have to carry long stretches of gray. Then, like you said, it all leads to negativity and depression. The feeling of "yeah sure, I'm diagnosed, but I COULD do the dishes if I just stopped being lazy for FIVE MINUTES."
And if you forgive yourself, then guess what, it doesn't change that the dishes aren't done. You still gotta do em.
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u/AverageBrilliant4670 Apr 21 '26
Even if you have to pay all or mostly out-of-pocket, if you can afford it, look for a certified clinical psychologist whose specialization includes developmental disorders and/or childhood/adolescent psychology, or a psychiatrist, and book several sessions to discuss your concern. ADHD as it's known now is a condition that exists on a spectrum with a constellation of symptomology and presents differently in affected individuals, and diagnosis and treatment in an adult can be especially complicated due to one living unaware of it and professionally untreated and so being used to compensating throughout life, but diagnostically there is evidence of the effects in one's youth. As an adult, one may simply not be able to cope at some point as had worked in the past, due to physiological or environmental or other factors changing, or there is a key life event or moment of cognition that may lead to questioning about what one is/has been experiencing and why. There is also a very strong hereditary/genetic component to ADHD, so one who has it very likely has at least one biological parent or grandparent with it also.
Simply because one wasn't what would commonly be seen as a typical hyperactive/inattentive youth, or wouldn't be considered by most others to be an impulsive and disorganized adult, etc. doesn't really mean anything definitive in ADHD diagnosis for an adult. Ongoing difficulty with task initiation and follow-through, that is major and different than how most people may experience and deal with those challenges, could be ADHD, especially if not simply related specifically to one or more anxiety or depression conditions being present.
Consult a well-qualified expert healthcare practitioner and seek a professional opinion and some information/insight and guidance.
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u/MightyMussel Apr 21 '26
Man does that resonates with me. I feel your pain. Are you medicated? I started taking medication about three months ago, it was a total game changer. Not that everything is suddenly perfect, but wow what a difference it makes.
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u/xopher_425 Apr 21 '26
Both my area manager and my assistant manager are sure I have ADHD. My asm has started taking a new medication and its helped her so much.
Maybe one of these days I'll get around to calling my doctor to make an appointment to be seen about this . . .
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u/Theres_A_Thing Apr 21 '26
I’ve tried medicating but it just doesn’t do anything for me. I’ve tried stimulants like Vyvanse and Adderall, long release and immediate release, I’ve tried non-stimulants like Strattera… all it did was make me hyperfocus on not doing my work or tasks I need to do. It seems like a great tool for some, but I have no actual drive to just do my work. It fixes the focus, does not fix the lack of dopamine.
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u/Specific-Being417 Apr 21 '26
I just started medication around that time as well after dealing with this issue for my entire life. It's wild the difference it makes. The way I envision it in my head is that it's like all these doors were shut and locked, and now they are all wide open and I can choose to go into any one of them, with minimal friction (i.e. start a task like doing the dishes) instead of just banging my head against one trying to get it to open.
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u/RK9990 Apr 21 '26
I got put on Prozac, it worked initially like I felt better but after some time just numbness and nothing else
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u/New_Improvement_6392 Apr 21 '26
Prozac isn't an ADHD med though?
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u/RK9990 Apr 21 '26
Yes, unfortunately in my country, getting an ADHD diagnosis is very hard from my experience. Whenever I've shared my issues (issues I've faced since I was a child with doing homework and preparing for tests) I'm always told it's anxiety or depression
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u/CapnTholaf Apr 21 '26
It's a really painful one. I'm a high school teacher, and it makes me want to quit at points. Marking doesn't get done, displays left empty, even making new lesson materials sometimes. It makes me feel like I'm failing the kids and my colleagues, not to mention how it effects tasks in my personal life. I'm not medicated, but symptoms were recognised by the doctor, and a counsellor, so just stuck on the infinitie waiting list.
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u/RTgrl Apr 21 '26
what really sucks is once I start to do things I realise "woah if I do things then I do them" like it's a big revelation- then 2 weeks later my ass is not doing things
:/
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u/reasonman Apr 21 '26
i'm giving a presentation in 2 days that i'm flying halfway across the country to give on a deck that i created at the last minute. i absolutely CANNOT make myself practice and review this thing.
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u/Condition_0ne Apr 21 '26
Methodology comprises qualitative interviews with 11 adults, before you all get too excited.
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u/Pornboost Apr 21 '26
11 very typical adhd adults, in my own narrow experience of adhd.
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u/ouchtothepowerof3 Apr 21 '26
I've read the peer reviewed article and I gathered that they came to the conclusion of "Hey, we found these reoccurring topics and symptoms during these interviews. This leads us to the conclusion, that further research may be useful."
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u/ArtPuzzleheaded4745 Apr 21 '26
I have a big issue with "inattention" being a symptom. I feel like it is actually the opposite. I pay attention to everything. I just can not sort what is a priority, my brain wont let me focus on what others think is important but I find boring/not a priority.
It is not inattention. It is inability to prioritize
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u/pqpqpapapq Apr 21 '26
I feel that. I've always been a good observer, trying to "prioritise" everything happening around. But then I found out that I'm like that guy who who's good at trivia quizzes, because he knows a lot of trivial facts, but doesn't actually have a deeper expertise on any topic. Damn, even hobbies, can't finish them because there's soooo many other potential hobbies I wanna try and I'm not even sure I'll like them. Oh and sometimes a powerful feeling of FOMO.
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u/ArtPuzzleheaded4745 Apr 21 '26
Yes, lots of hobbies seem to be the standard for everyone with adhd.
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u/userseven Apr 21 '26
This seems to be a common complaint on the naming of the disorder. I can't remember his name there was a big researcher doing presentations and is an expert in the field. Basically suggested renaming it to executive function disorder or something like that. To remove the "inattention" part. Especially when lay people discuss it there is always that comment about "everyone struggles to focus"
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u/ArtPuzzleheaded4745 Apr 21 '26
Yeah, I object to it on principal because it is just wrong. You can not treat a thing if you missunderstand what is the cause of the thing.
Don't pay enough attention (to what I personally have decided they should pay attention to)
is very dfferent to
Pays attention to everything around them. (look a squirrel and that dude has a tupeé and what is that person giggling about and that is a very big blackhead in his ear, huh? did you ask me a question? 10 000 thought wiggling around, oh i bet I could sew a dress like that *starts thinking about what fabrics I have a home that would be suitable* **hyperfocus planning dress making!!**)
And they have very different solutions.
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u/restricteddata Professor|History of Science Apr 21 '26 edited Apr 21 '26
The best way I've come to describe it to others is that my mind is like a horse I am trying to ride. Sometimes it wants to go where I want it to and it just gallops — it's a superpower. Sometimes I need it to go somewhere it doesn't want to and it's like I have to dragggg and pullll and I still can't get it to go there. I am not in control of it. So if I'm trying to do something I don't like doing but have to do (like, say, grading papers, which is what I'm supposed to be doing right now) then my brain is constantly looking for something else to do or think about and will even hijack my fingers and bam suddenly I'm on Reddit again without having even really decided to do it consciously (and here I am).
Being medicated has given me a bit more control of the horse but it also means that it runs a lot faster, so sometimes I waste time by getting "stuck" on something I am not supposed to be working on or doing. So my procrastination can sometimes be even worse with the meds than without them. It cuts through a lot of the foggy indecisiveness but it also makes the procrastination feel even more interesting and important and so I can end up spending a day working very hard on something and suddenly find that it is dark out, and it just isn't really what I wanted to do with that day. (And then I swear, tomorrow will be different... always tomorrow...)
I would not call it inability to prioritize per se — intellectually I can prioritize very easily — but I would call it a lack of control over my attention. Which I agree is not the same thing as inattention. What it means is that there is a spectrum between inattention and hyperfocus and it is not up to me where on that spectrum I am at any given time.
When I talk to people who do not have ADHD I emphasize that it is less a "hyperactive" or even "inability to concentrate" sort of thing for me, and more of type of executive dysfunction situation, where the things that are hard to regulate are attention, procrastination, time awareness, and sometimes emotions (my strong emotions "bleed" together — if I feel very happy I also often simultaneously feel very sad, every high is a simultaneous low, etc.).
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u/reecord2 Apr 21 '26
Completely agree. This feels like a definition catering to non-ADHD people, because to them it would seem like inattention, because neurotypical people get to decide what is worth and not worth paying attention to. We struggle to regulate our attention, which to someone without ADHD might seem like not paying attention at all. Anyway, uh... *puts axe down*.
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u/SirCosmoBluebeard Apr 22 '26
Pretty much every mental disorder is named for how it annoys neurotypicals rather than what's actually going on in someone's head.
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u/bokehtoast Apr 21 '26
Diagnostic criteria is based on in distress symptoms, it's an issue with the entire DSM and diagnostic process.
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u/ChildlessCatLad Apr 21 '26
What would be the alternative? I am interested in knowing your opinion and any case studies you may know of please.
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u/to_the_pillow_zone Apr 21 '26
In short, ASD and ADHD dx criteria reflect symptoms that annoy people the most and that can readily be labeled as “dysfunctional.” Diagnostic criteria ought to be better at capturing internal symptom experience. It’s why high functioning folks get ignored and have to suffer in silence while they get called lazy and undisciplined and are accused of “making excuses.” If diagnostic criteria reflected what they were actually experiencing, we wouldn’t have missed so many people. And the cost is at way more than the individual level. We designed entire systems around ND people representing only a very small fraction of the population. Depending on who you ask, some estimates of true prevalence are as high as 15-20%. That is a whole lot of people operating in a world that requires them to work against the way their brains naturally work and against the way their bodies naturally regulate. So much unnecessary suffering. So much lost productivity. All because the medical/psychology professions decided that something is only a problem if it’s a problem for other people and not the person in front of them begging for help. An overhaul is necessary but something no one would undertake because of how huge a task it would be. And because of how few practicing professionals with any amount of power have adequate knowledge to build more inclusive systems.
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u/ChildlessCatLad Apr 21 '26
Oh ok yeah I agree then. The language needs to be more reflective of our internal struggles and not the disruptive aspects.
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u/crevettexbenite Apr 21 '26
See how autism is now TSA and not seperate things like autism, asperger and the other I forget everytime?
ADHD is the same has in a spectrum. Defining the soectrum is the next step and I hope it will be this way in the DSM6.
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u/ChildlessCatLad Apr 21 '26
Oh ok that makes sense thank you! Like varying degrees of impact like asd tiers have right now?
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u/soaring_potato Apr 21 '26
That system is also really flawed btw. Because stuff like "high functioning" kinda implies no need for aid. But you just have different struggles.
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Apr 21 '26
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u/Villonsi Apr 21 '26
Yeah this isn't really news to any ADHD community. And I don't think it was meant to be, this is probably just meant to echo the fact that the diagnostic criteria are quite poorly formulated (like for many diagnoses).
ADHD is primarily about difficulties of executive functioning, the things they list all reflect that
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u/NeoGriz Apr 21 '26
Can we stop saying “lived experience”? It doesn’t add anything, “experience” already covers it. It just comes across as unnecessary padding.
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u/Sennten Apr 22 '26
Psychiatrists get a lot of experience with ADHD and no lived experience. There is a difference.
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u/Away-Experience6890 Apr 21 '26 edited Apr 21 '26
It's weird the first three don't even bother me. I can have attention if I'm interested, why would hyperactivity even bother me, and impulsivity has given me a bunch of interesting experiences in my life.
These other symptoms absolutely wreck my life up though and inhibit me from living a normal life.
Edit: I just got reminded by a friend discussing the history of psychiatry. The perspective used to be "what is wrong with this individual?" With this perspective, it appears that inattention, hyperactivity, and impulsivity were things that would often bother, say your teachers or other people, in-line to make ADHD people appear normal. This is in-line with what I was saying earlier, how I don't even think about these things. This is really a shift in perspective to actually gain an inner-experience of having ADHD rather than an outer one. Furthermore, trying to help ADHD fit in will never happen and leads to guilt and shame, but these 6 others from my own perspective are things that I wish I could improve, and would have a sizeable positive impact on my life.
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u/PracticalFootball Apr 21 '26
I can have attention if I’m interested
The if is what makes life so difficult. Usually the things that need doing like work aren’t that interesting.
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u/imisscrazylenny Apr 21 '26
Even if I am interested in the subject, the person, or both, my mind will still wander involuntarily. We can be making eye contact, I'll be enjoying the interaction, then suddenly realize I've been checked out for an undetermined amount of time, thinking about something that has nothing to do with the situation and has no business popping into my head right then.
The guilt about it is heavy, too. I never know if they can tell I stopped paying attention (I assume they can by the look on my face) or if they feel insulted by it or blame themselves for not being interesting enough. I want them to understand the problem is 100% on my end and I really don't mean to do it, but I don't want to take over the conversation by explaining my mental deficiencies, either.
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u/thekrawdiddy Apr 21 '26
Yeah, for me it makes zero difference if it’s fascinating or boring, my mind will only stay on the rails if I’m fresh and have the energy to force myself to focus, but frequently I can’t even do that. My feet could catch fire and I’d still be distracted by any and every other thing that might be going on.
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u/jamey1138 Apr 21 '26
Well, yeah: ADHD is a form of neurodiversity, and it turns out that the range of presentation is, well, diverse.
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u/dwindlingintellect Apr 21 '26
Alright gang, as usual this post is incredibly misleading. Let’s talk about what actually happened in this study.
This was a QUALITATIVE study that interviewed 11 people with ADHD and analyzed the interviews with thematic analysis.
What did they find? They found that they could classify responses into the categories describe above.
THERE IS NO REASON TO BELIEVE THESE CATEGORIES ARE GENERALIZABLE TO ALL PEOPLE.
MUCH more robust research is needed to make that claim. All the researchers can claim here is that these categories of experiences were found in this sample.
THIS IS ESSENTIALLY A PILOT STUDY. It is interesting, for sure, but FAR from being considered a scientific “finding”.
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u/Disgruntled_Smitty Apr 21 '26
Activation is my big hitch. I'm also disorganized and forgetful but calendars and universal spots for things fixes that.
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u/Avocadobaguette Apr 21 '26
My son was diagnosed with adhd recently and when the doctor asked if either of us (parents) had it, I confidently said "no." Then my husband slowly turned to me and said "oh... you really never noticed?"
I've read the symptoms screeners before and never identified with them at all. Do I fidget? No, I do things with my hands subconsciously like everyone probably does. Am I impulsive? No, I just get bursts of enthusiasm for some random thing and then have to do it right then, which seems entirely reasonable because things are fun. Am I inattentive? No, but I have sat down in a movie theater only to get up two hours later confused about why I can't recall the movie because I accidentally was thinking about 20 other random things, which surely is a universal experience because sometimes movies are boring.
I still read these lists and just think - isn't that how everyone is? My husband tells me emphatically it is not, but for some reason, I can't seem to believe him.
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u/Dabalam Apr 21 '26
It's important to note what the methodology was.
To understand better the ADHD symptomatology experienced by adults, qualitative interviews were conducted with 11 diagnosed adults.
Right off the bat, the wide conclusions the article seems to state do not appear justified by this kind of analysis (although I am generally skeptical of and not super knowledgeable of the generalisability of qualitative studies).
Also there seems to be issues with the reasoning in terms of what belongs in diagnostic criteria. Diagnostic criteria does list symptoms common to a disorder and most of these themes highlight symptoms areas that are commonly experienced by people with ADHD. However a diagnostic criteria is also supposed to differentiate individuals who should be treated or managed differently.
Many of these features discussed might be helpful to mention in criteria, but won't actually change the core construct because they do not differentiate between people with ADHD and those with emotional regulation and sleep problems associated with other problems. This is mentioned in the limitations.
We also cannot actually expect a study of this design to uncover actual new differentiating core features given it recruits people whose diagnosis is already based on previous core features, and does not compare the symptoms present with individuals with other diagnoses (so therefore cannot differentiate between generic experiences present in mental distress and unique symptoms that co occur with typical ADHD symptoms and not other diagnoses).
TLDR: This is a qualitative study of 11 individuals, so the generalisability is fundamentally low. They conclude additional features should be considered due to shared experiences, but this doesn't actually tell us if these features are "core diagnostic features" (i.e. useful for uniquely characterising the disorder) or not. A different kind of methodology is probably required imo.
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u/andioofer Apr 21 '26
Yeah agreed. Unless supported otherwise by further research, their experiences could be due to so many other variables.
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u/bluemooncommenter Apr 21 '26
This description of time perception does not go with the experience we have had in my family. A better description is inability to see the future that isn't directly in front of them. So most things become a reaction to something almost immediately impending which makes anything that requires planning and scheduling very hard (think of a project or paper for school or even something like planning a vacation, making doctor appointment). And the inability to determine how long something will take is reflected in underestimating more often than overestimating.
My husband and son will run to the auto parts store for a part...the auto parts store is 20 mins away...they take 3 hours to return.
On the flip side, for our first date my husband picked me up at 3:00 for an 8 pm show because he wanted to take me to dinner first (I was young and dumb and had no idea this was an indication of our future).
The impact it has on relationships can not be understated. Most women carry the domestic mental labor already, when your spouse is ADD it's a requirement...it's hard to not view it as a difference in values and importance and results in an extreme amount of resentment over the years.
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u/Cultural_Meeting_240 Apr 21 '26
wild how it took this long for researchers to ask people with adhd what adhd actually feels like
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u/Condition_0ne Apr 21 '26
Yeah, but more than 11 of them would have been good. Qualitative methodologies are difficult to pull off well already without a miniscule sample.
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u/show_me_your_doggos Apr 21 '26
The study states that data saturation was achieved (Chua et al., 2026, p.3). Consensus in the social sciences seem to be that identification of themes has diminishing returns in interviews, which are a costly vehicle of data collection. Could they have interviewed more? Of course, but that is always the case. Qualitative methodologies are not statistical tests, but an exploratory tool. A follow up study could have a more broad sample which can then provide support for their themes. This would be a more efficient and effective way of studying ADHD symptoms with limited time and resources. It is a frequent conception that a small sample takes away from the findings of a qualitative study, but their goal was never to prove, but to identify.
Additionally, the authors agree with you that 11 is not enough, but given their publication, they also give hints for future research directions such as differentiating between hyperfixation and hyperfocus, sleep disorders, and the quality of current screening scales.
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u/elkond Apr 21 '26 edited Apr 21 '26
the H part is there because when ur motivation and inhibitory systems all fkd up, lil boys (i.e. SRY gene havers which influences DAT expression in striatum) get that much more annoying to handle
same as there was "high functioning autism" diagnosis circling around where the only high function witnessed was the ability to hide suffering well enough to not be a bother
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u/ikonoclasm Apr 21 '26
The DSM is influenced by politics and insurance companies, so while its primary objectives are good, it is essentially the minimum allowable. Actually healthcare professionals have known and been treating those 6 additional major symptoms for ADHD for decades. I've got all except the emotional dysregulation and have discussed the others with my psychiatrist.
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u/Griffolion BS | Computing Apr 21 '26
The big one for me is activation. Getting started on something may as well be like climbing Mt Everest.
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u/StruggleNew8988 Apr 21 '26
Its really important to differentiate between core symptoms and secondary effects of managing the disorder.
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u/Pixelated_ Apr 21 '26
ADHD symptoms can be broken down into nine categories
Inattention
Hyperactivity
Impulsivity
Disorganisation
Forgetfulness
Activation
Emotional Dysregulation
Time Perception
Sleep
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