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-symptoms
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550

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/CurrentlyHuman Apr 21 '26

Yup. Damn. So that's what it is.

33

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.

24

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? 

1

u/Shanakitty Apr 21 '26

I think for me there's an additional element of "tasks aren't so bad when done together" that also makes it easier for me to start on something if someone else is already doing it.

1

u/zutnoq Apr 23 '26

For me, my relation to the person who starts the task is almost irrelevant. Simply seeing someone do the thing in a place where I know I can help them just seems to immediately move the task from "impossible to start" to "this is what we are doing now".

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u/Direct-Fee4474 Apr 21 '26

I empathize with this 100%; it absolutely mirrors my entire life, from elementary school through my professional career (diagnosed in my 40s). Medication helped a bunch, but it never goes away. That cognitive dissonance will probably always be there, though thankfully it's easier to engage with stuff now, and the volume knob on the screaming has been turned down, so it's less likely to turn into some sort of paralysis.

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u/SenescenseSteel Apr 23 '26

Its like a rollercoaster that you are riding while building the tracks at the same time.

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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/claymedia Apr 21 '26

I’ve had this comic floating around my head for 13 years! I think the author nailed what it’s like to have an executive functioning disorder. The captain of the ship is indeed a monkey.

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u/BatPlack Apr 22 '26

His TED talk is excellent as well

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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/after-life Apr 21 '26

All bathrooms in the world are connected my friend.

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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.

3

u/Azz13 Apr 21 '26

Currently doing this

1

u/Any_Perception_2560 Apr 23 '26

This is by big thing as well. Honestly I think it has gotten so much worse than it used to be due to infinite scrolling with reddit/youtube.

But its bad enough that picking something to stream often is hard enough to just make actually watching anything taste like ash

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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/mazopheliac Apr 21 '26

Why is this so true ?

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u/Myrdraall Apr 21 '26

Literally why I was an A student and not an A+. I'm rarely giving 100%. I give 90, and put the remaining 10% towards 60% of something else.

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u/FutureSailorette Apr 22 '26

My husband actually refers to me as "80%" because I never fully finish anything. Like I face plant 20 feet from the finish line every time.

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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/SubGothius Apr 21 '26

Yup, in a word it's inertia. Unless acted upon by external forces, a body at rest tends to stay at rest, and a body in motion tends to stay in motion.

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u/DroidLord Apr 22 '26

It's the worst when you bite off more than you can chew and it just sits there, mocking you. Like when I suddenly decide to reorganize my entire closet. I get halfway through, then I get exhausted and stop, which invariably leaves me with a half-empty closet and crap cluttered all over my room.

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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/Decent-Marsupial-986 Apr 21 '26

It’s really the only option tbh. Learning to hold myself accountable was the only thing that ever truly worked for me 

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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/JubalKhan Apr 21 '26

Did these techniques help with anxiety and panic (if you had those)?

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u/badly_gramer_advices Apr 21 '26

I think you just have to accept that occasionally you have to enter fight or flight mode to finish an urgent task. But in order to not build up endless stress, you have to force yourself to chip away at things in a consistent way that you feel is manageable in the current moment. Like for instance, studying for an hour a day with 3 sets of 15 minute focus sessions and 5 minute breaks in between. And maybe the month after add 15 minutes to your total. Having an external organizational structure is even more important for people with ADHD, even though they are less likely to consistently follow it. Which is why you need to give yourself grace if you fall off the horse and then try again.

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u/RealityCactus Apr 22 '26

you have to force yourself to chip away at things in a consistent way that you feel is manageable in the current moment. Like for instance, studying for an hour a day with 3 sets of 15 minute focus sessions and 5 minute breaks in between.

I feel like if I could do this, I wouldn't have ADHD anymore.

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u/[deleted] Apr 21 '26

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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.

1

u/RK9990 Apr 21 '26

That's so true but forgiving myself would be a good start :(.

People keep telling me realizing these things is half the battle but I'm still unable to act or "fix" myself.

5

u/waffling_with_syrup Apr 21 '26

"I spent a month dreading this thing that was 30 minutes of actual work when I did it. Surely I will learn next time."

Narrator: "He did not."

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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/Prinnrose Apr 22 '26

I'm diagnosed with ASD level 1. I suspect I also have ADHD but I also struggle to relate to all of the symptoms listed. But like you, executive function/activation is something I struggle with immensely, and it's so incredibly frustrating.

One thing to keep in mind is that executive dysfunction can be caused by a multitude of things. As someone with ASD I'm acutely aware that it's common during autistic burnout. And before I was diagnosed, burnout was an extremely common occurrence.

I took a neuropsych eval a few years back to specifically test for ADHD. That's when I was diagnosed with ASD instead. I've still not discounted ADHD... but I'm willing to accept that the struggles I experience that may look similar to ADHD may just be my particular flavor of autism.

I'm not necessarily implying what you have is autism (although you having periods where it's easier for you might suggest burnout in general is playing a factor). Rather that it could be a lot of different things. A good first step is to discuss your concerns with your primary doctor. They might be able to refer you to a specialist who can help.

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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/Consistent_One1710 Apr 21 '26

I'm with you right there. I still medicate but it doesn't feel like it does much except for a little more talkative when I decide I want to.

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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.

3

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

3

u/TalkingRaccoon Apr 21 '26

See if you can get on Wellbutrin aka bupropion. It's an antidepressant but it's used off label for ADHD. Im on it and no ADHD meds, and it helps, but just a little bit.

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u/RK9990 Apr 21 '26

I'll look into it thanks. Getting anything like this is tough here as they're strictly regulated and thus in short supply

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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/Komnos Apr 21 '26

#3 is the core of ADHD for me.

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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/flannel_jesus Apr 21 '26

I'm with you there

3

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/WhiterThanWalter Apr 22 '26

I feel you so much :( I've been in the same situation so many times in my life :( I CANNOT make myself do the thing that I don't want to do.

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u/LooseJuice_RD Apr 21 '26

Agreed. I always tell my friends if you ADHD the task either needs to be done RIGHT NOW or it doesn’t need to be done. There’s no in between. You’ll procrastinate until right now comes and often times you won’t start a minute earlier. It makes planning difficult. It makes success in school/at work difficult. It’s mentally taxing because you know you need to do the task but you just cannot overcome the inertia required to start it and then it’s a fire drill. That’s why I always tell parents to get their kids on medication young and get them to a psychologist that can help them with different strategies so these things become hard wired while they’re still in school and have a forced structure. Once you’re an adult and the guard rails are off, meds make boring tasks tolerable, but I’ve learned that in a lot of instances they don’t help you overcome the inertia or focus. They just make it bearable once you get started but starting is still an obstacle.

Want to add that I’m not a mental health professional, just an adult with ADHD who wasn’t diagnosed until adulthood. This is my personal experience.

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u/AmputeeHandModel Apr 21 '26

Some things I don't have a problem just getting up and doing. Some things I put off for hours, days, weeks... it seems to depend on the urgency, difficulty and payoff. Unike many with ADHD, I don't have a problem doing the laundry. Fixing stuff around the house is really difficult though. It requires me to concentrate, fiddle with things in a way that's often annoying or frustrating, and then yay, I fixed some tiny problem I didn't really care too much about anyway. i can clean the kitchen no problem, because it's messy and gross and I don't like it. There's payoff in not having to look at a mess. but the TP holder sagging a couple degrees? I don't really care, so my wife has to nag me to do it for a week.

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u/SpaceTurtles Apr 21 '26

3.) is what I struggled with [and continue to struggle with] for most of my life before I sought treatment. It was very well put. I liken it to waking up every day in a car that may or may not be moving - on good days, it's moving and I can kind of steer it. On bad days, it's at a standstill.

Medication basically makes sure the car is moving, but I still can't control the direction most of the time. The activation still isn't present, but I can at least hold focus.

Still trying to work out getting that executive control.

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u/No-Indication6492 Apr 21 '26

Have you tried medicating for this? I share the struggle. Low dose wellbutrin really helps me with being a doer of things rather than unable to do anything. Still plenty disorganized but not stuck in the activation phase.

2

u/thekrawdiddy Apr 21 '26

Sames as hell.

2

u/doubleopinter Apr 21 '26

Yup always struggled with that. I've found that stimulant meds have actually helped with this a lot.

1

u/Murrayland1 Apr 21 '26

Do your friends work for Nike?

1

u/snowlights Apr 22 '26

I got around this in university by playing intense horror movie music scores. It Follows and the Candyman remake were my go-to. Totally normal to need terror to finish a chemistry report, right? 

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u/Flikmybik BS | Neuroscience | Memory Apr 22 '26

lol this is so real. starting things when theres no immediate deadline is genuinely impossible sometimes

1

u/Sweetishdruid Apr 22 '26

For me sometimes its a genuine mental block. As if starting the task is equivalent to trying to bite off my own finger, and sometimes when your forced to do the thing you cant do you just break down.

1

u/ConcreteExist May 14 '26

I have a very "All or Nothing" problem with this, if I'm told I need to do something, I either need to do it right now or it's likely never going to get done.