What is ADHD ?
“What is ADHD?” is a question I’m frequently asked, and while it seems straightforward, the reality is far more complex. ADHD is a neurodevelopmental condition that affects people in different ways depending on factors like gender, age, and individual circumstances – even within the same family.
Although we have come a long way in understanding ADHD, there is still much we do not fully grasp. Here is a simplified explanation and answers to some of the most common questions I’m asked.
Getting Diagnosed with ADHD
ADHD is officially diagnosed using the criteria outlined in the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision). This can feel frustrating if you have come across ADHD-related content on platforms like TikTok and found it relatable. Because much of what is popular on social media does not align with the official diagnostic criteria in the DSM.
For example, emotional dysregulation and rejection sensitivity are often discussed online as ADHD symptoms, but they are not in the DSM criteria. That is because traits like rejection sensitivity or difficulty in managing your emotions can arise from a variety of experiences and mental health conditions. They are not just in an ADHD profile. For instance, you might develop rejection sensitivity due to difficult relationships that have undermined your self-esteem or because you are socially anxious. You might have difficulty managing your emotions because you have trauma, thyroid issues or because you never learned the skills of emotional regulation. Mental health is complicated, and everyone has a unique set of symptoms, within a life context that is also unique to them.
As a clinician, I value the part social media can play in reducing stigma and building awareness. However, in my clinical psychology work at Mindworx Psychology, the team and I need to:
- Differentiate between popular ideas v’s evidence-based diagnostic criteria.
- Recognise that clinical criteria are constantly evolving as scientific understanding advances.
As both an ADHDer and a neuro-affirming psychologist, I recognise the importance of DSM – it is the shared language of my profession. At the same time, I am fully aware that the DSM itself is far from neuro-affirming: Its language frames ADHD as a neurodevelopmental disorder and as a disability, which has a significant impact on how ADHD is perceived. Because the DSM isn’t updated each year, our understanding of mental health can be different to what is defined inside its pages. Labels are useful, but given our understanding and definitions of mental health evolve and change, it’s incredibly important we don’t get stuck on them.
More recent publications such as the Australian ADHD Diagnostic Guidelines help shift us towards a more neuro-affirming understanding of what ADHD is, and isn’t. Like the DSM, it highlights that ADHD is a lifelong condition, and one that can significantly affect academic, occupational, and social outcomes if left unmanaged. That is why knowledge, understanding and good science matters.
What are the Criteria for Diagnosis of ADHD?
According to the current DSM, ADHD is a neurodevelopmental disorder characterised by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning or development. Symptoms must be present across multiple settings – such as home, work, or school – and begin before the age of 12.
ADHD is classified into three main presentations based on symptom patterns:
- Predominantly Inattentive Presentation
- Predominantly Hyperactive-Impulsive Presentation
- Combined Presentation
Symptoms of ADHD
Here is a summary of the key symptoms and diagnostic criteria for ADHD:
Inattention Symptoms (6 or more for children, 5 or more for adolescents/adults)
- Fails to pay close attention to details or makes careless mistakes.
- Struggles to sustain attention in tasks or activities (e.g., lectures, conversations).
- Often seems not to listen when spoken to directly.
- Frequently fails to follow through on instructions and does not finish tasks.
- Has difficulty organizing tasks and activities.
- Avoids or dislikes tasks requiring sustained mental effort (e.g., homework, reports).
- Often loses things needed for tasks and activities (e.g., keys, phones).
- Easily distracted by extraneous stimuli (or unrelated thoughts in adults).
- Frequently forgetful in daily activities (e.g., paying bills, keeping appointments).
Hyperactivity-Impulsivity Symptoms (6 or more for children, 5 or more for adolescents/adults)
- Fidgets with hands or feet, or squirms in seat.
- Often leaves seat in situations where remaining seated is expected.
- Runs about or climbs in inappropriate situations (feels restless in adults).
- Unable to play or engage in leisure activities quietly.
- Often “on the go,” acting as if “driven by a motor.”
- Talks excessively.
- Blurts out answers before a question is completed.
- Has difficulty waiting their turn.
- Interrupts or intrudes on others (e.g., butts into conversations or games).
The most common diagnosis is often a combined presentation. That means meeting the criteria for both an inattentive presentation and a hyperactive-impulsive presentation. If you take a look at the hyperactive-impulsive symptoms, it’s quite easy to see why young boys were often diagnosed more often than girls, and prevalence studies show us there are many more boys with ADHD diagnoses than girls.
Is ADHD On The Increase?
Many adults are only now being diagnosed with ADHD and AuDHD for the first time. This can create the impression that ADHD is becoming more common, but in reality, it reflects a growing awareness and understanding of these neurodivergent profiles, as well as better diagnostic practices.
We now understand that ADHD presentations vary widely, and our awareness of masking has significantly increased. As understanding of neurotypes has improved, we have learned that that girls with ADHD often present differently from boys. For example, traits like excessive talking or being perceived as bossy (interrupting or intruding on others) were often dismissed as ‘normal girl behaviour.’ Similarly, many individuals with an inattentive presentation – both girls and boys – had their symptoms overlooked, being labelled as ‘daydreamers’ instead. ADHD was and still is frequently underdiagnosed when behaviours don’t significantly disrupt others or cause noticeable learning challenges.
A common experience for many adults with undiagnosed ADHD is having school report cards filled with comments suggesting they could achieve more if they would just ‘try harder.’
Our expectations of how children ‘should’ behave, how we interpret behaviours, and what we consider ‘normal’ are constantly evolving. I love that we now understand ADHDers are often trying harder than anyone else – especially when they’re striving to sit still and conform to expectations – despite their brains needing movement to function at their best.
Doesn’t Everyone Have a Bit of ADHD?
This is a pretty common question. Honestly, I’ve yet to meet an adult who does not occasionally exhibit behaviours that align with ADHD symptoms – it is easy to recognise these traits in yourself or others.
However, context matters. For example, what feels like a “normal” level of energy or restlessness may depend on your upbringing or cultural norms. Growing up in a lively, energetic family of ADHDers might make constant busyness feel typical, whereas someone raised in a more structured, calm environment could view the same behaviour as excessive. Similarly, cultural expectations vary. What is considered typical in Japan may look quite different in Italy.
Here’s the thing: experiencing occasional forgetfulness or restlessness does not mean you have ADHD, just like being nervous before a test does not mean you have an anxiety disorder.
Meeting the Criteria for ADHD
To diagnose ADHD, clinicians use a process called differential diagnosis to ensure the symptoms are consistent, pervasive, and not better explained by something else. Here is what we consider:
- Duration and Early Onset: Symptoms must have been present since before age 12 and persisted over time.
- Rule Out Other Causes: We check whether the symptoms might stem from other conditions, such as anxiety, depression, learning disabilities, physical conditions like thyroid issue (so you will need a physical checkup as well as a psychological evaluation), or even environmental factors.
- Impact on Functioning: This is crucial. According to the DSM-5-TR, ADHD symptoms must significantly interfere with or reduce the quality of social, academic, or occupational functioning. For high-functioning individuals, this can sometimes be a barrier to diagnosis, as they might mask their struggles or compensate in ways that make their challenges less visible.
In short, while many people can relate to occasional ADHD-like traits, a diagnosis is based on specific criteria and the significant impact of symptoms on everyday life. ADHD is more than just “a bit of forgetfulness” or “being busy.” It is a complex neurodevelopmental condition that requires careful evaluation.
What causes ADHD?
ADHD is not caused by poor parenting or behavioural choices. Instead, it stems from a complex interplay of neurological, genetic, and environmental factors that we are still working to fully understand.
These factors affect how the brain produces and processes key neurotransmitters, such as dopamine, serotonin, and noradrenaline, which play crucial roles in regulating attention, motivation, and emotional responses.
Research has also found structural differences in the brains of people with ADHD. Areas responsible for executive functioning – such as the prefrontal cortex, cerebellum, and basal ganglia – are often smaller or less active. These differences can directly influence behaviours like planning, organization, and impulse control.
What is an ADHD neurotype?
Put simply, ADHD brains and nervous systems are wired differently. This wiring means people with ADHD process information differently, shaping how they perceive and interact with the world. This distinct neurological makeup is referred to as an ADHD neurotype.
Understanding these differences helps to reframe ADHD as a neurodivergent way of functioning rather than calling it a disorder.
As an example, I don’t view my capacity for creative problem-solving, heightened visual awareness, or ability to hyper-focus on work for extended periods without tiring to be problems. Like many high-functioning ADHDers, I recognise that my ADHD neurotype brings challenges, but it also gives me strengths I wouldn’t trade. Yes, my forgetfulness can be frustrating, but I’d rather live with that than lose the unique advantages that come with my creativity, drive, and hyper-focus.
Is ADHD a Disability?
Yes, ADHD is recognised as a disability under Disability Discrimination Acts in many countries.
Ouch! Stigma! What happened to being neuro-affirming?
While some people with ADHD are high-functioning and embrace their “ADHD superpowers,” others face challenges that are profoundly disabling, significantly impacting their ability to navigate daily life.
This complexity is often overlooked in social media content. While platforms like TikTok can help reduce stigma and build community, the way algorithms curate content can lead to skewed perceptions. Many of my clients arrive with overly light-hearted or overly bleak ideas about ADHD and what a diagnosis means.
Some social media posts, while well-intentioned, unintentionally minimize the struggles of those with severe impairments. This can leave people feeling inadequate or pressured to “do better.” On the other hand, high-functioning individuals may fear stigma and hesitate to seek support, worrying their challenges will not be taken seriously.
And there is another layer to this conversation: the role of effort, grit, and resilience. While an ADHD diagnosis can provide clarity and access to support, some people may seek a diagnosis as a way to avoid addressing underlying issues like low resilience or a lack of effort in certain areas. It is important to differentiate between genuine ADHD challenges and situations where effort and coping strategies need development.
Appreciating the complexity of mental health and neurodivergence allows us to get appropriate support when we ask businesses and schools to adapt the environment or put special accommodations in place for employees or students.
ADHD is not a one-size-fits-all condition. Acknowledging its diversity and complexity is essential to fostering empathy, understanding, and meaningful support, while also encouraging personal growth and resilience where appropriate.
My Summary of all this ADHD information
ADHD is a complex and multifaceted neurodevelopmental condition that manifests differently for everyone. While social media has helped to raise awareness and reduce stigma, it is essential to balance information with evidence-based understanding and appreciation of the diverse experiences of those with ADHD.
Whether you’re seeking a diagnosis of ADHD for your child, wondering about diagnosis of ADHD for an adult, navigating daily challenges, or embracing your ADHD neurotype, acknowledging the condition’s unique strengths and struggles is key to meaningful support.
If you’d like to learn more about ADHD, its symptoms, or strategies for managing it, feel free to explore the resources on this site, join my online ADHD programs, or reach out for professional guidance.