How Adult ADHD Goes Undetected

Can’t focus? Hard to sit still? Ever wonder if you have ADHD? No one should self-diagnose, but ADHD is often missed in adults because they don’t know what to look for and miss common warning signs. Our host Sheena Williams is here to help navigate, with help from guests Alice (@the_mini_adhd_coach), @FosterOnTheSpectrum and Megan Anna Neff, Psy.D.
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Find our experts and hosts:
:: Sheena William, RN ::
Twitter: @Keepingitkinky1
Instagram: @keepingitkinky
:: Alok Patel, MD ::
Website: alokpatelmd.com/
Twitter: @AlokPatelMD
Instagram: @alokpatelmd
:: Megan Anna Neff ::
Dr. Neff is a neurodivergent (Autistic-ADHD) clinician, parent, and advocate.
neurodivergentinsights.com/
www.meganannaneff.com/
KZbin: @neurodivegent_insights
:: Alice Gendron ::
Alice is a video producer, educator and author. Her book, "The Mini ADHD Coach," will be available September 26.
www.theminiadhdcoach.com/
Instagram: @the_mini_adhd_coach
KZbin: @theminiadhdcoach
:: Foster Cotton ::
Foster makes great videos.
KZbin: @fosteronthespectrum
Want to Read More?
Diagnostic Criteria
www.cdc.gov/ncbddd/adhd/diagn...
More on Autism/ADHD connection:
neurodivergentinsights.com/mi...
neurodivergentinsights.com/ad...
Why Are Prescriptions For ADHD Rising?
journals.sagepub.com/doi/10.1...
Overdiagnosed or Underdiagnosed in Children & Adolescents?
jamanetwork.com/journals/jama...
Skeptical View Arguing ADHD may be OVERdiagnosed in adults:
www.ncbi.nlm.nih.gov/pmc/arti...
Racial Disparities in Diagnosis:
jamanetwork.com/journals/jama...
Men/Boys Much More Likely to be Diagnosed:
www.nimh.nih.gov/health/stati...
ADHD and Substance Abuse
bmcpsychiatry.biomedcentral.c...
Symptoms Tend to Continue Into Adulthood
www.nejm.org/doi/full/10.1056...
chadd.org/adhd-weekly/grow-ou...
A few resources if you're seeking a diagnosis:
chadd.org/for-adults/diagnosi....
www.aane.org/
Thyroid & ADHD:
adhdonline.com/articles/is-it....
This episode of Vitals is licensed exclusively to KZbin.
00:00 Intro
00:44 The three types of ADHD
02:10 Not just a childhood condition
03:15 "Unofficial" symptoms
05:03 Eight things that get confused with ADHD
06:53 ADHD and autism
07:56 Over- or under-diagnosed?
08:57 Treatment/medication
10:52 ADHD life hacks
11:53 What it meant to get a diagnosis

[@pyrethorn]

I got my diagnosis at 38. It only happened because a friend told me that I had ADHD. I didn't believe it. Then they started listing the symptoms. I hit every single one of them. So I went to the doctor, got a referral to a specialist and got my diagnosis. It made things make sense. I had always thought that I was bad at life. Why couldn't I just do things? Why was it so easy for everyone else? I just assumed that I was lazy. When I finally got medication for it, it was like night and day. Like finding out that life had an easy mode and I'd been playing on hard mode my entire life. Also turns out that all my close friends have either adhd, asd or both. It certainly explained why I gravitated towards neuro-divergent people.

[@kmimiteh]

I feel very related. I am 37 now, and also many of my friends have neuro-divergent brains (not all), and I tgought the same way as u (I am just more lazy, I have no self-discipline,...) and now I can see it more and more clear.

[@MrPrebuttal]

Which meds did you take and how has it benefitted your life?

[@nikalasnalter4431]

mate i feel u

[@abdullakc]

What!. I also took life in the hard way. I quit school for 4 years and graduated late. Then now I graduated from University at the age of 36! With this problem! Never knew.

[@the_synack]

I'm 37 and I just had a similar conversation with my friends. They started listing off symptoms and I was able to tick almost all the same boxes. I'm going to see a doctor as well here soon to find out for certain.

[@ImageFilmersPrivate]

Neurotypical: I can forgive, not forget. ADHDer: Oh, I'll forget eventually, but NEVER forgive.

[@shubhamkori3971]

😮😮

[@johnmoore1495]

To anyone out there who has been struggling with “anxiety” and/or “depression” for 5-10+ years and your life really hasn’t improved through medication and therapy. I would highly recommend looking into ADHD. Yes you may have had anxiety and you may actually get depressed, but if you have ADHD then the anxiety and even more so the depression, will almost always keep returning if the ADHD is left untreated. ADHD fuels anxiety, give someone a brain that’s thinking constantly and combine it with some nervousness and you can see how that gets out of hand. Likewise if you’re someone with untreated ADHD you’re likely going to have many many failures academically and professionally in your adult life which in turn leads to depression as your peers leave you in the dust. The first time I took a stimulant, I can’t explain it, the world was just quiet and I could communicate without thinking about it. The day I took it I also had an Anatomy test (going to school to be a RN), we have to identify ~50 structures with no word bank, it’s all from memory. Well normally I was getting 60-65%, but the day I took the stimulant I got a 94%. My brain was empty enough that I could actually pull the names from memory.

[@lilnarm_smoothblaze]

Yes yes yes this describes me perfectly

[@BSG0005]

Wow thank u for this. Pretty sure this is me!

[@PayterX]

We have almost identical stories, except mine was Paramedic school. I never would have had a chance at passing without treatment. Then somehow everyone at work finds out that you have a prescription for stimulants, so now everyone constantly harasses you for some. I know if most of them would just go talk to a psychiatrist they would more than likely leave that day with a prescription of their own. Ironically it's as if the medical field itself has the highest number of untreated ADD/ADHD adults. At least in the pre-hospital environment, things get crazy enough, often enough, that you have no choice but to pay attention to what is happening, and to fix it now. And the ability to focus on everything all at once is almost a super power on a lot of scenes.

[@johnmoore1495]

@@PayterX yeah I’ve refrained from telling anyone I’m on it besides my mom, just so someone knows incase I have some adverse event. Otherwise I feel like most people in my life would say I’m “cheating” etc etc

[@hunterG60k]

I find it somewhat confusing and immensely frustrating that there is such stigma around ADHD medication; while Drs are happy to hand out antidepressants left right and centre. The ones I'm on are highly addictive to the point where if I miss a *single dose* I will have debilitating withdrawal symptoms. Also, oh what a surprise, when people are medicated properly they don't feel the need to self medicate later in life. Honestly, the world really needs to get itself together when it comes to psychological issues. The general culture and understanding around these things is absolutely archaic.

[@pbsvitals]

Agree! Cultural images and stereotypes often shape the way that medical professionals view different drugs and medications. It's not always conscious...

[@saraleigh5336]

Not to mention the shortages.

[@Demoralized88]

@@pbsvitals It is absolutely conscious because often ADHD is overlooked and ignored simply because most Doctors don't want the responsibility of prescribing to adults. Any chance of misuse often outweighs the obvious indications and benefit and that culture has become increasingly more pervasive since the Rx opioids (and by extension, all controlled subs) media frenzy.

[@CortexNewsService]

Both my sister and I got diagnosed with ADHD in our 40s. Hyperactive for her, inattentive for me. We didn't realize until my niece was diagnosed at 10. My sister asked why because she had the same habits as my niece. The doctor's response was "I'm sure you do." "....Oh. This explains so much of the past 40 years."

[@WiseSquirrels]

This comes up so often when children get diagnosed and adults notice the traits in themselves. ADHD is highly hereditary.

[@emb3863]

So I have a story, when I was like 25/26 someone suggested I go to the psychiatrist so I did and they were immediately after talking to me for like 27 seconds like "um were you ever diagnosed with ADHD?" and I was like oh? ... and then like a year later during the pandemic a friend of my sister reached out and, she did an assessment of me in the early 00s when I was like 10 because she was getting her degree at the time so she asked my parents permission to do some stuff with me and she came to the conclusion I had ADHD but for some reason never mentioned it to anyone and I was so angry for a while after I found out... there was someone out there that did notice that knew and they didn't bring it up like...

[@pbsvitals]

That is pretty frustrating! How did you follow up after your diagnosis? Did it make a big difference for you?

[@eileengale7661]

People still are uncertain and make mistakes. To tackle these things like a neurotypical person would won’t help a neurodivergent person. We have to find our own way to accept what happened and keep finding our best way. The betrayals sit deeper. If that makes sense. It takes practice to let go and move on but it IS possible. Having compassion for ourselves and others is definitely a big help in this.

[@montithered4741]

2:06 And what if it isn’t traceable back to childhood? That seems like a crucial part of the diagnosis. I see potential for harm and neglect here because there may be environmental factors which cause or exacerbate symptoms.

[@ALADDIN22091978]

No more diagnoses. I had a nervous breakdown to get my ADHD detected February 2020, aged 41, diagnosed 6 months later, only given medication. I got diagnosed with dyspraxia aged 33, Aspergers traits aged 25. I got my degree aged 20, 1999, pgdip 2000. I am of Middle Eastern origin. My ADHD was missed , because I was well behaved in school, intelligent and driven. I have underachieved in my life . I feel it is too late , sadly . Moving forward in life is not easy .

[@jso6790]

I have wondered for years if I had ADHD because of my forgetfulness and constant procrastination as various intrusive thoughts enter when I am engaged in a task, but also do not want to trivialize the experience of those who genuinely struggle with the condition. The one time I went to Psychologist, it seemed like I was fine, and my college experience also was more about potential depression than anything else, but now I am reconsidering again. Thank you for you.

[@pbsvitals]

We know the feeling! It can be very tricky to sort out these issues. Good luck!

[@Demoralized88]

Getting taken seriously for Adult ADHD is almost impossible if presenting with depression and/or anxiety. I got diagnosed at 32, and it wasn't until after I realized my cognitive dysfunction was prevalent by middle school and that the depression and generalized anxiety didn't really start until my later teens - almost certainly as a result of my real and perceived failures. From my experience and extensive research, I strongly believe Adult ADHD presents differently with a fully matured brain versus a developing one. The most concrete symptoms in adults tends to be: 1. poor working memory (especially if noticeably declined since young), 2. inner restlessness and impatience (versus hyperactivity/fidgetting when young), 3. inability to focus on non-stimulating activity like reading but not gaming/video, 4. general executive dysfunction and lack of drive/motivation i.e. procrastinating, indecision, brain farts followed by lucidity, lack of energy, feeling overwhelmed with no external pressures. Those are some that became much more noticeable for me by my mid 20s whereas I used to be way more outwardly symptomatic in in to my mid teens. Never hyperactive, but clearly outwardly restless and seemingly not paying attention. The Depression/anxiety symptoms have (some) overlap with mostly my 4th point, and Doctors will focus on that if you do not state that the ADHD symptoms came before.

[@jso6790]

@@Demoralized88 Wow. Thank you so much for taking the time to share so much. I see some things in what you shared that do resonate with me, but also areas where I diverge. I hope that you now have an effective treatment plan and are managing in the best way possible! We all should get to enjoy that peace of mind. (Incidentally, my late elementary school through the end of high school, I used to meditate intensively. My mom at first thought I was becoming a Satanish.. ha, but when I got to college with all that was there, I remember saying consciously "My Iron will got broken". I wasn't sleeping, I was super excited by all the amazing people I was meeting and just this incredible world I had entered into. What is fascinating about that college experience is that I struggled mightily and ended up doing massive course overloads just to graduate with honors. While running non-stop from class to class I didn't have a lot of procrastination time.. though still poor time management skills. Anyway, I largely didn't think about all I had learned until I entered grad school and suddenly I just seemed to "know" things, as in I had learned an incredible amount in college, but just couldn't access it until grad school which was a very different time, where I was pretty lonely and isolated and giving all of my out of school time to the non-profit where I volunteered. I share all this to say that your line about Executive Function really struck and I wonder if that is where my issues were. Again, thank you so very much for sharing thoughtful information. I am sorry for my stream of consciousness response. You have given me a great deal of food for thought... but oh yeah.. I have to finish grading some papers for my Rhetorical Criticism students.. ha

[@WiseSquirrels]

Depression can be a symptom of ADHD.

[@craigparse1439]

5:06 I can relate to this. I got diagnosed about a month ago at age 57. I can clearly remember when I was in Elementary School (in the 1970's), my teachers would often tell me to stay on task and to stop daydreaming.

[@darylcauvin4957]

I'm 40 and very soon I'm getting tested for adhd & autism...this video was fantastic because I really felt like people were describing me...its a peaceful emotion I'm experiencing because of this video. Hopefully that will be an everyday occurance. Thanks

[@drizzy6302]

How can you dont know u have autism

[@skybluskyblueify]

What about "rejection sensitivity"?

[@pbsvitals]

For sure! We couldn't list everything within the episode (Athough Alice alluded to this), but many people mention rejection sensitivity as a common companion to ADHD. It's pretty obvious in friends and family, too.

[@WiseSquirrels]

RSD can be a comorbidity of ADHD, but it's not included in the DSM. At least, that's what I have learned along my journey.

[@HP_Quinn]

Thank you for this video! I was diagnosed with both ASD and ADHD earlier this year at 35 years old (already having major depressive disorder and generalized anxiety disorder diagnoses since early adulthood.) These diagnoses explain so much about myself & my life; it's as though I'm finally beginning to learn about who I am.

[@pbsvitals]

Congratulations on getting some clarity with this. Good luck!

[@Sport-ws6ef]

I disagree with the fact that it's subjective whether or not you've got a difficulty with focus and attention. Neurotypical people can focus and keep their attention when it REALLY MATTERS but it's boring... they can just FORCE themselves! E.g. on a "boring english test" they can still answer all the questions they know the answer to on time! An ADHD person cannot, even if they desperately wanted to! They can easily check this with standardized computer tests instead of silly questionnaires. I have ASD + ADHD and the number of tests on school I have failed due to lack of focus is huge, even if I was highly motivated and intelligent. The listening tests (foreign languages) were the worst, because if I didn't hear the question due to lack of focus or I immediately forgot it due to lack of working memory, I couldn't ask my teacher to replay it or pause it... My reading and comprehension was soooo slow and I kept getting distracted by intrusive thoughts or daydreams, so I just couldn't finish all the questions on time, even if I knew the answers in hindsight. It angers me when people say things like "yeah I also forget a lot of stuff". ADHD is not about forgetting where you put your keys every other day... that is the least of our problems!

[@CB4mo_nofomo]

Love this thank you!! I was initially diagnosed in college and didn’t think much of it but the medication helped me study. Once I was assessed and officially diagnosed with ADHD in my 30’s, I was truly struggling and took the time to learn about it which, like they said in the video, you look back at your life differently and I went through the grieving process but I also joined a support group, began therapy, and medication. I realized it wasn’t just me and I’m not the only one experiencing these things. I’m still learning to cope and find out where I fit in this world but having the knowledge and support that opened up to me through a diagnosis definitely helps.

[@johnmoore1495]

9:52 is misinforming the audience. Non-stimulants definitely need to build up in your system before they work and they definitely need to be taken everyday, especially medications like atomoxetine, bupropion, and viloxazine. Atomoxetine takes 4+ weeks in most studies to show any significant clinical benefit. Non-stimulants are also significantly less effective than stimulants. No doctor in their right mind would prescribe atomoxetine on an “as needed” basis, any benefit would be placebo.

[@skyemiddletonx9006]

Great video, but don't forget, one can have something like Bpd and ADHD at the same time. Also Autism can look like bpd (but you could also have all three at the same time). Also, yes not everyone has hyperactive traits but please remember, some hyperactive traits can be inward, not outwards. I say this as a Hyperactive type ADHDer (maybe combined but closer to H type) person who is also Autistic and has Bpd (for now).

[@brydcsd]

I'm 36. turning 37 this year. all the symptoms listed are ticked. now I am aware that I have ADHD, but I don't have the means to seek professional consultation. I'm anxious, depressed, broke 😢

[@neurodiversitystories5128]

Thank you for sharing

[@eliscanfield3913]

My son was officially diagnosed with ADHD in 1st grade, though it had been suspected since he was in preschool, and lets just say, I wasn't surprised when his teachers suggested it. My little brother has it too, tho without the hyperactive part. We put Son on medication and dear god, the difference it made in his academics. He's still learning how to self-redirect and needs more time to finish his school work than average but he's not far off the median in any subject and is actually a bit above in reading. I kid you not, nor do I exaggerate, when I say he went from reading 2 or 3 words at a time to short paragraphs in TWO WEEKS after his first dose.

[@WiseSquirrels]

What a happy story. Thanks for sharing this.

[@jbug884]

It’s becoming very fashionable to say you have ADHD or autism. In fact I hear loads of people saying out loud “oh sorry, it’s my ADHD” I have it (secretly) and keep it to myself as I don’t want backlash from employers etc. My husband conducts a lot of law interviews in a top firm and told me if he reads that a candidate has ADHD or autism, that CV goes straight in the bin! Be warned, do not put that on your CV. It IS still seen as a disability and a mental health problem. Just a heads up.

[@sorenne3718]

As an autistic person that trend is so infuriating, I pour so much energy and thought into masking. And people who use a disorder for clout will then go on to mock, infantalise, and take advantage of us -_-

[@PayterX]

On one hand it seems like the increased awareness of mental health leads to the perception that having a healthy brain puts you in the minority of the population. So rather than feel left out, everyone now claims to have some mental health problem in order to feel like they fit in. Or on the other hand, maybe it's just the never ending cycle of younger generations wanting an easy excuse to rebel at authority yet push the blame off themselves at all costs. I know I was like that as a teenager. Then there's the cute quirky version of mental health disorders that are portrayed in movies, tv shows, and by their favorite Internet personalities. Like bipolar disorder being portrayed as someone who just goes from happy to mad to happy again within a few minutes.

[@ratlinggull2223]

Your husband's firm is dogshit then.

[@resourceress7]

Where is the link to that Venn diagram that you briefly had on the screen?

[@pbsvitals]

It's in the show description - but here it is: neurodivergentinsights.com/misdiagnosis-monday/adhd-vs-autism Check out the description for more links!

[@Herr_Vorragender]

Very interesting and super important topic. Thank you for adressing it. 😊 Maybe, if there is time to spend, we'd also be interested in SCT (The ADHD opposite)? 🤔😉

[@MsFunkypish]

I do a daily list...tried oostits etc but then forget to look at them....best thing ever for me...alarm app in phone..never miss appointments now. Wish I could get a diagnosis and meds..can't afford private clinic

[@charleshines2142]

It is in written statements and testimonies from my teachers. That and there is mention of it on some forms. I have photo copies of these forms and testimonies. I also had them scanned to preserve them forever hehehe!! They are backed up on numerous drives I have hidden in places that only I know. I may even have one copy with me just in case something happens to the others like a fire or something I still have one in my vehicle or pocket somewhere for safe keeping. I also kept the photocopies and they too are in an undisclosable location.

[@musiclistener28]

One thing not covered here is the barriers to diagnosis. The assessment costs are growing and sometimes thousands of dollars

[@JoeIcke1]

Maybe ADHD is normal and the things we are expected to do for a living are completely un natural for our brain to be doing.. where in evolution did it say we should be staring at computers and doing maths instead of running about in a forest or something

[@_f_6957]

Clicks on this video without finish the one I was just watching because…..ADHD 😂 now let’s see if I can sit through this 13:56 video

[@Avi_Z.]

I was diagnosed at 56.

[@robertabarnhart6240]

I'm 58. They tell me I'm too old to be evaluated for ADHD or ASD.

[@MelanieDPerkins]

😥 I've heard this from other people. Are you able to reach out to other providers to see if they evaluate?

[@ailaniechavarria448]

I have both types, perhaps cause im autistic too

[@amyj.4992]

ADHD vs. Normal levels of distraction

[@amyj.4992]

Bullies and insecure people, are the real victims

[@amyj.4992]

Go to therapy, cuz there are unhealed people out here that feel like they can keep you stuck to your past and tell you to get over it. Break free from the trap✊🏾

[@amyj.4992]

They don't want to admit they have problems they aren't addressing that you can clearly see sticks out like a sore thumb, but are in severe denial of you not sharing the same lack of drive and willpower as them

[@amyj.4992]

Your light catches attention, but your strength irritates their demons.

[@amyj.4992]

I responded better to slow release medication and only when needed

[@Mario_]

Why didn't you take account of the largest systematic scoping review about ADHD overdiagnosis (and over-treatment)? Its title is "Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents" and it has been published on Jama Network Open

[@pbsvitals]

Our episode is about adults but this is a good review and we've added to the links in the show description.

[@Mario_]

@@pbsvitals thanks! Though you talked about overdiagnosis and treatment in general and not only referring specifically to adults. Moreover this study specifically states that it has implications for adults too

[@natalita1528]

Without scanning brains everything is only imagination. Psychiatry is obsolete, a game of guess what. It’s not serious, do ADHD, bipolar, borderline… Can you please look at my brain activity, as ant other specialists. No? Why?

[@Xogroroth666]

How to find out if you have ADHD: Take a line speed. If it calms you, you got ADHD. Simple.

[@jesipohl6717]

ADHD is what you get when you decide to label someone after the worst outcome of the interaction of their personality/neurodiversity and contemporary bigotries. labeling yourself as deficient and disordered moves the blame from those with power (neurotypical people) to those without (yourself). The disease model of mental health has never worked and we can discuss anything we need to and solve any problem we need to without creating a stigma around the person and rather looking at the point of service. ADHD is a fictional disease construct (like so many) that only serves to help neurotypical people feel better about the fact that they continue to build and support a world that is disabling to a completely normal variation of humanity. One day as with homosexuality in 1972 and hopefully soon transgender identity, we can depathologise neurodiversity and repathologise colonial society.

[@melindah9037]

I think it depends on how you claim the title. Sure, ADHD has 'Disorder' within it, but if you are only using the term medically, a disorder only means that something is different from the norm. Those who truly have ADHD genuinely have a different chemical balance in their brain chemistry. This has been proven by multiple, replicated rigorous scientific studies - I direct you to the channel "How to ADHD" for the links as I myself am not a researcher but know that Jessica has many verified studies linked on her videos. This part is not "made up". There is NOTHING WRONG with having that different chemical balance. It is just how someone is born. But it is a difference, and it is currently identified by the label ADHD, and it does effect how we interact with the world. Having a label allows those of us born with this difference to identify ourselves to each other, and understand why we have difficulty interacting with the norms of society. This is, in my opinion, empowering. While I understand your specific point that the world should not be built just for neurotypicals, calling ADHD a fictional construct and minimizing it does as much damage as neurotypicals denying our difficulties exist in the first place.

[@AG-hx6qn]

Used to think that too, until I looked into it more due to my husband havimg these issues...then it turns out, I do too. But i'm used to being told myself and anyone like me doesnt exist. :) hope you choose learning more

[@squirrelsinmykoolaid]

I understand how the deficit model is harmful, but I feel like your perspective ignores the parts of ADHD that can cause severe difficulties outside of communication. Constantly forgetting where important items are, or forgetting to pay bills, not being able to keep up with personal hygiene and cleanliness to the point where it is hazardous to health, increased rates of automotive accidents, and many other scenarios that are common for ADHD-ers do call for intervention and you can't deny that medication or other treatment plans has greatly improved the quality of many lives. Saying it's a "made up disorder" and comparing it to sexuality lacks nuance. I know I'm not broken and a lot of the difficulties I face are because of the ableist society we live in, but even if the deficit model were to disappear completely, that's not going to impact whether I forget to brush my teeth and develop cavities because of the way my brain is wired.

[@CortexNewsService]

And being able to name what is happening to you is a big thing. Now I know what it is, so I can find ways to deal with it.

[@johnmoore1495]

Problem is society keeps progressing meanwhile people with ADHD keep existing. Sure if we could go back to the days where I as a man would’ve ran my own little farm to support my family, I’d probably be fine, I’d be surviving. But in the modern day people like me struggle to conform to what modern day society demands of people. Having to sit at a desk and crank out of a 5 page paper on empathy for an English class in order to progress in my nursing program is borderline impossible for me to do on my own. It’s not that I don’t know how to write, it’s not that I don’t care, I have this mental block until it’s the last minute because I’m not interested and it’s not urgent until it is urgent. It doesn’t matter how important the paper is (without the paper I fail and can’t progress in my program) I just can’t do it without help or without waiting until the last minute.