You’re always late and lose focus easily. Could you have ADHD?

It used to be the case that talking about ADHD would conjure images of a hyperactive child bouncing off the walls. But since the rise in ADHD diagnoses, that’s changing. The neurodevelopmental condition affects around one in 25 adults, among whom symptoms can be more subtle. And while 4 per cent of adults are thought to have it, only 0.3 per cent of adults have actually received a formal diagnosis.

While a string of celebrities being diagnosed has reduced the stigma surrounding ADHD, the endless stream of social media videos covering supposed ADHD symptoms – including having a clean home and being overly apologetic – have caused confusion around what the condition is.

“There’s a lot of misunderstanding – a lot of misuse of language”, says Dr Blandine French, a senior research fellow at the University of Nottingham’s School of Psychology. She specialises in ADHD and has the condition herself, receiving a formal diagnosis at 29.

“The danger with social media is someone saying, ‘Well, my ADHD is like that, and this is what I do’ and people thinking, ‘That’s ADHD’. It’s not. That’s your individual experience of ADHD. On its own, this doesn’t validate a diagnosis.”

Actor and comedian Celeste Barber is among several prominent Australians who has shared her ADHD diagnosis.Credit: Paul Harris

A correct understanding of ADHD is when a person has difficulty regulating their attention, hyperactivity and impulsivity, says Dr Ulrich Müller-Sedgwick, a consultant psychiatrist who has been diagnosing ADHD in adults for more than two decades. These symptoms are thought to be caused by a lack of dopamine in the brain – a neurotransmitter essential for focus, he explains.

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“But it’s not these symptoms alone,” Müller-Sedgwick notes. For an ADHD diagnosis, there must be a record of these behaviours being present from the age of 12 – either in school reports or testimonies from friends and family, he says.

The symptoms must also make daily life difficult – hindering work, caring responsibilities or relationships – and cannot be explained by anything else, whether that’s another medical condition, such as anxiety or a brain injury, or life circumstance.

“For example, you could be going through a divorce and be really forgetful, but there’s a reason for that,” French says.

Here are some of the most talked-about ADHD symptoms, and how you might be able to tell if it’s a sign of ADHD, or whether you’re simply easily distracted.

The symptom: I keep forgetting where I left my keys

“If you are looking for your keys just once a week, that’s not an ADHD symptom,” says Müller-Sedgwick, who is also the ADHD champion at the Royal College of Psychiatrists. “It really has to be more frequent than this. It has to cause problems.”

For example, patients with ADHD may waste a lot of time searching for their keys, to the detriment of their day-to-day life – their partner or family may become irritated and it may get in the way of their work.

“They often also have a long history of losing credit cards and have had to renew them a couple of times, or they have lost mobile phones and had to get new Sim cards,” he says.

Some people are just extremely forgetful but it doesn’t have a strong impairment on their life – they manage at school and work and their relationships are healthy, Müller-Sedgwick notes. “For it to be ADHD, it needs to create some impairment in your life,” he says.

This symptom alone is not enough to diagnose ADHD, nor is any other single symptom, French says. “Everybody loses their keys at one point or another,” she says. “It doesn’t mean you have ADHD. In combination with distraction and forgetfulness, it can be part of the ADHD diagnosis.”

Just because you lose your keys occasionally, it doesn’t mean you have ADHD.Credit: Getty Images/iStockphoto

The symptom: I tend to procrastinate

“Most of us, especially if you have to do things like admin, tend to procrastinate, which means it takes us a while to get started,” says Müller-Sedgwick.

For example, every student at some point has put-off starting an essay, but will ultimately get it done because there’s a deadline and missing it could mean failing a course, he says. Similarly, at work, people will generally complete their tasks on time to avoid it becoming an issue or being brought up in their appraisal, he says.

However, people with ADHD tend to have a long history of struggling with deadlines, he says.

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“They had to ask for extensions all the time, and it’s not because they were partying but because they couldn’t get started or couldn’t finish the work they had to do, even though they really tried hard,” he says. As a result, they may have lost a series of jobs, or moved from one to another – jumping before they get pushed, he explains.

French says that this is because of differences in how the ADHD brain is wired. “It responds very well to quick rewards – things that happen instantly,” she says.

“When you have a big test to do, or a task that’s really hard or boring, you don’t see the reward straight away.”

Conversely, people with ADHD can become hyper-focused and get a task done efficiently if it is something they are interested in, she adds.

We all procrastinate at times but if meeting deadlines is a constant problem, it could be a sign of ADHD.Credit: Getty Images/iStockphoto

The symptom: I can’t stop scrolling on social media

“Social media is engineered so that it keeps everyone’s attention and increases your dopamine,” Müller-Sedgwick says. “They work through the reward mechanisms in the brain.”

People with ADHD are especially prone to being sucked in to spending a lot of time on these apps. “It’s very rewarding, it’s like gambling,” French says. “Scrolling gives quick responses, and your attention is constantly shifted and rewarded.”

It becomes a problem if people spend so much time on their phone that they can’t do the tasks that they need to, or that it interferes with their relationships, Müller-Sedgwick says.

“These are common behaviours. Social media is meant to increase dopamine in all of our brains, but people with ADHD will do it more persistently and will get themselves into more problems from spending time on their phone,” he says.

The symptom: My mind races when I try to sleep

“All of us, after a very busy day, can have a racing mind,” Müller-Sedgwick says. “It’s psychologically healthy to do a kind of mental debriefing at the end of the day.”

“But in ADHD patients, this is going on all the time and it causes problems like not being able to fall asleep, not being able to lie down at the end of the day,” he says. The thoughts swirling around their heads can be both positive and negative and about things that have happened that day, in the past or events coming up, he says.

Those with ADHD often report they have difficulty getting to sleep on almost a nightly basis.Credit: iStock

While this behaviour – often referred to as mind wandering – is not a formal ADHD symptom, it is very common among ADHD patients, he adds.

“Sleep issues affect 50 to 60 per cent of people with ADHD,” French confirms.

“The hyperactivity part of ADHD is often thought about as someone being very active and jumping off the walls – but it can also be constant thoughts that can’t be switched off,” she says. “This is not one bad night’s sleep because you have a presentation the next day and you’re anxious and it keeps you awake. It can happen every night in ADHD.”

The symptom: I always turn up late to appointments and events

“Being late is an ADHD symptom,” Müller-Sedgwick says. “But it’s not just once a week; it’s over and over, and there’s a constant pattern of lateness.”

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Some people with ADHD have learnt to be on time for certain things, such as work, because they know it is important and have realised that there would be negative consequences if they weren’t on time, he says.

Research has shown that this occurs because ADHD patients underestimate the time that it takes to do activities, such as leaving the house, commuting to an appointment or getting work done, Dr Müller-Sedgwick notes.

“They’re very optimistic that they can cram a lot into an already-too-busy schedule and then they are not able to keep up with all the promises that they make,” he says.

For this to be a symptom of ADHD, it has to cause problems in daily life, he adds.

If these symptoms are interfering with daily life, patients can make an appointment with the GP, who can make a referral for an ADHD assessment, if they also suspect it.

For French, a diagnosis explained her behaviours and gave her the confidence to pursue her PhD.

“It gave an explanation behind the way I think,” she says. “It allowed me to go back to university because I realised that I wasn’t stupid, I just learn differently.”

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