Myths About ADHD

According to the Centers for Disease Control and Prevention (CDC), around 6.4 million children in the United States have attention-deficient hyperactivity disorder (ADHD). The disorder is characterized by a range of behaviors and symptoms that are experienced internally and expressed externally.

These symptoms can make it harder for someone with ADHD to pay attention, stay organized, and complete tasks. A person's ADHD symptoms can also be disruptive to others, such as at home or in a classroom.

ADHD is not strictly a condition of childhood: around 4% of adults in the U.S. have a diagnosis of ADHD. Sometimes, parents only recognize their symptoms of ADHD when their child is diagnosed.  

Despite many people living with ADHD, the condition remains misunderstood by the general public, medical/mental health professionals, and even people who have it. Here's what you should know about ADHD to challenge the most common myths about the condition.

ADHD is recognized as a disorder by the majority of professional medical, psychiatric, psychological, and educational associations and organizations in the United States, including the Centers for Disease Control and Prevention, the National Institutes of Health, the U.S. Department of Education, and the American Psychiatric Association.

One factor that contributes to misunderstandings about ADHD is that no specific test exists that can definitively identify the disorder. Unlike other medical conditions, a doctor cannot confirm a diagnosis of ADHD with a laboratory or imaging test.  

Although there is no definitive medical test for diagnosing ADHD, there are clear and specific criteria that must be met for a diagnosis. Doctors and mental health professionals can use these criteria, as well as an in-depth history and detailed information about someone's behaviors, to make a reliable diagnosis. 

Another factor is that ADHD symptoms are not always clearly defined. ADHD exists on a continuum of behaviors. We all experience problems with attention and focus at times, but for an individual with ADHD, these symptoms are severe enough to affect daily functioning.  

Symptoms of ADHD can also resemble those of other conditions. Pre-existing or undiagnosed medical conditions that could be the cause of a person's symptoms must be ruled out before a diagnosis of ADHD can be made.  

The evidence is mixed on whether ADHD is over-diagnosed. Annual data from the National Survey of Children's Health has shown an increase in ADHD diagnosis in U.S. children. However, the reports also demonstrate that rates of other conditions, such as autism, anxiety, and depression, have increased as well. 

Specific to ADHD, several studies have shown that the condition may be under-diagnosed in cases where symptoms are less noticeable. A particular example comes from evidence that ADHD may manifest differently in female children.  

While girls with ADHD might be less likely to display the hyperactive physical symptoms, they can still have significant impairment with mental tasks and focus. Several studies have suggested that girls are less likely to be diagnosed and receive treatment for ADHD than their male peers.  

Other studies have proposed that ADHD is over-diagnosed in children, but specifically in male children. Higher rates of ADHD in boys could partly be due to stereotypes about male behavior (for example, that boys act out physically). Boys may also be more likely to demonstrate overt and disruptive symptoms of ADHD, which in turn increases the likelihood that parents, teachers, and doctors will notice these behaviors.

Research has shown that racial, ethnic, and socioeconomic factors also influence the disparity in diagnosis and treatment of ADHD. Children in minority groups and those who live in poverty often lack equitable access to health care, including mental health services.

According to a 2016 study published in the journal Pediatrics, white children were more likely to receive a diagnosis and treatment for ADHD. While the researchers acknowledge these findings could imply over-diagnosis, they suggested that the under-diagnosis and under-treatment of African American and Latino children with ADHD was a more accurate interpretation of the data.  

Research has proposed that adult ADHD is over-diagnosed. It's been suggested that an adult might be diagnosed with ADHD due to the "medicalization" of typical life experiences and personality variations. In some cases, other mental health conditions or learning disabilities are misdiagnosed as ADHD.  

Conversely, for adults who go undiagnosed and untreated, social stigma, stereotypes about ADHD, and cultural factors can make someone reluctant to seek (or accept) the diagnosis.  

The main risk associated with over-diagnosis of ADHD in children and adults is unnecessary treatment with stimulant medications. While these drugs can be an effective treatment for ADHD, when prescribed to someone who does not need them, they may be misused.

Parents of children with ADHD may worry that they are somehow to blame for their child's behavior, but the condition is not strictly caused by poor parenting.

While any child, whether they have ADHD or not, can be adversely affected by a chaotic home or parenting that is punitive and critical. These factors can make it more difficult for children and their families to cope with ADHD, but they don't cause the condition.

However, parents may want to consider adapting their parenting style to better support a child with ADHD. Research has demonstrated that kids with ADHD benefit from clear and consistent expectations and consequences, as well as having predictable routines at home. 

The symptoms of ADHD must be present by the age of seven to meet the criteria for diagnosis, but many individuals remain undiagnosed until adulthood.  

It's not uncommon for a parent to be diagnosed around the same time that their child is. As an adult learns more about the condition, they may begin to recognize ADHD traits and behaviors in themselves. Thinking back on their childhood, they may realize that the struggles they had at school were likely the result of attention problems that were not noticed or treated.  

For parents and children, a diagnosis at any age often comes as a relief. Being able to put a name to the symptoms, as well as knowing that there is a way to manage them, can be reassuring.  

Many children diagnosed with ADHD will continue to have symptoms as teens and adults, but the symptoms may change as they get older. For example, hyperactive behaviors common in kids tend to decrease with age, whereas restlessness, distractibility, and inattention may persist into adulthood.

Adults with ADHD that is poorly managed often experience chronic difficulties at work and in relationships. Undiagnosed and untreated ADHD is also associated with anxiety, depression, and substance abuse. 

The "attention deficit" part of the name has led to misunderstandings about the nature of ADHD and perpetuated myths about its symptoms. 

In fact, there are different types of ADHD, including:  

• Predominately hyperactive-impulsive  
• Predominately inattentive  
• Combined  

Hyperactive behaviors occur in the predominantly hyperactive-impulsive type but are not included in the predominately inattentive type. To reduce confusion, this type of ADHD is referred to as attention-deficit disorder (ADD). 

A person with inattentive symptoms may appear daydreamy and easily distracted. They may be disorganized, forgetful, or careless. This type of ADHD is more likely to be overlooked, as it is less disruptive to others than the hyperactive type. However, the symptoms are still distressing to the person experiencing them.

While a child with ADHD won't typically outgrow the disorder, adults sometimes report "growing out of" the hyperactive behaviors they had as children. In some cases, hyperactivity is replaced by restlessness and even apathy.  

Given the condition's name, it can be confusing for people to see someone with ADD/ADHD focusing intently on an activity. It's more accurate to describe the "attention-deficit" portion of ADHD as difficulty regulating attention rather than the ability to pay attention.  

Although people with ADHD typically have trouble focusing on, organizing, and completing tasks, it's not uncommon for them to become absorbed in activities that interest them. In fact, such a sustained level of hyperfocus can be a clue that someone has ADHD.

Medication does not cure ADHD, but it can help manage symptoms when taken as prescribed by a doctor or mental health professional. ADHD is a chronic, lifelong condition. If someone was prescribed ADHD medication as a child, they might need to continue taking it as an adult (though the dose may need to be adjusted). 

People may have the same symptoms as adults that they did as children, or their symptoms may change or even lessen over time. Developmental changes in the brain partly explain these changes, but they can also be a reflection of how someone has learned to cope.

People with ADHD often develop coping strategies and organizational skills that help them live with the condition. They can continue to build and expand these skills throughout their lives and may choose to pair them with medication.  

There is a concern that stimulant medications used to treat ADHD can lead to substance abuse. However, research has shown that untreated ADHD increases a person's risk for substance abuse. 

Anxiety or depression are more likely to develop from untreated ADHD. A person may use illicit substances to self-medicate both their ADHD symptoms as well as those of secondary mental health conditions.  

Research has indicated that the rate of substance abuse is lower in people with ADHD who receive appropriate treatment, including stimulant medications.