It’s not just for kids anymore: An increasing number of adults are being diagnosed with ADHD. Sage sifts through the misconceptions surrounding the disorder.
As a kid, André Brisson didn’t fit the stereotype of a boy with attention-deficit hyperactivity disorder (ADHD). He wasn’t “physically disruptive” in class. Rather, he describes himself as “intellectually disruptive,” questioning everything.
A gifted student, he did well at school, getting an engineering degree and becoming an entrepreneur. He could spend hours on work that interested him, but struggled to finish “boring” tasks. He also had difficulty with working memory, spending “up to four hours a day organizing to make sure I was on top of things.”
In his 40s, he experienced what he calls a “life tempest.” One of his businesses in Ingersoll, Ont., was struggling, and he couldn’t control his emotions. After “screaming at my kids for no reason and seeing the look on their faces,” he decided to get professional help.
“ADHD had been on my radar for 10 years,” he says, “But I never believed it. I could not believe those four letters explained all the hardships I had.” At 44, he was diagnosed with severe ADHD.
Often thought of as a childhood condition, ADHD is a neurodevelopmental disorder that affects five to seven per cent of children and four to six per cent of adults in Canada. It’s characterized by persistent patterns of inattention, impulsivity or hyperactivity that interfere with daily life. It also can cause issues with time management, organization and regulating emotions.
Types of ADHD
There are three types of ADHD: hyperactive-impulsive, inattentive and combined.
Heidi Bernhardt, founder of the Centre for ADHD Awareness Canada (CADDAC), says people with inattentive ADHD often struggle to stay focused and organized.
“The symptom that’s most talked about is inattention, but people with ADHD can over-focus as much as they under-focus,” she says. “If their brain hooks into something they’re interested in, they have difficulty breaking their focus.”
The combined type, which includes challenges with attention and hyperactivity/impulsivity, is the most common. In adults, hyperactivity often shows up as internalized restlessness, talking excessively, interrupting others or fidgeting.
Hyperactive-impulsive ADHD involves near-constant movement and acting without thinking, which Bernhardt says is rare in adults.
“It’s a very complex disorder,” she says. “One person with ADHD may appear quite different than another person with ADHD.”
Different experiences, shared challenges
Pamela, a member since 2021 who asked not to have her last name published, was diagnosed with ADHD in her 60s. Now in her 80s, she says she still starts new projects before finishing old ones, and can get “intensely engrossed in something and work on that one thing for hours without interruption.”
When she was younger, she struggled with impulsivity, saying “the wrong thing at the wrong time to the wrong person and then suffering the consequences.”
Pamela also has rejection sensitive dysphoria, which is linked to ADHD. It causes extreme emotional sensitivity and pain because of perceived failure or rejection. She calls it “devastating” and says she coped by watching how others handled criticism.
“By imitating other people, I learned to [manage my emotions],” she says, “But it took a long time and was very difficult.”
Trying to hide ADHD symptoms is known as masking. Bernhardt says this can work for a while, but can be hard to maintain. It can also prevent people from being themselves, and can lead to feelings of shame or inadequacy.
“The older people are when diagnosed, the greater chance you’ll have other disorders, like anxiety, depression, substance use or suicidal thoughts,” she says.
She adds that ADHD “is frequently misdiagnosed in women as anxiety and depression. Their ADHD isn’t discovered and they get ineffective treatments, sometimes for decades.”
Women are often diagnosed around puberty or perimenopause, as estrogen levels can affect ADHD symptoms.
Other major life changes, like moving, retiring or losing a spouse can also disrupt coping mechanisms and prompt people to seek help.
Rise in ADHD diagnoses
Gurdeep Parhar, a medical doctor and co-founder of the Adult ADHD Centre in Burnaby, B.C., says greater awareness about the disorder means more people seeking a diagnosis. But he cautions that ADHD is more than “a couple of symptoms in a funny TikTok.”
While most people occasionally have difficulty with attention or restlessness, Parhar says, “there’s a set of criteria they have to meet for an ADHD diagnosis, and their condition needs to be significantly disabling.”
An ADHD assessment should involve a thorough physical history and a review of childhood symptoms.
“You don’t wake up at 45 with ADHD,” Parhar says. The symptoms usually start before age 12 and persist through life, causing dysfunction in at least two settings, such as work, home life or relationships.
Other health issues should also be considered, including mental health disorders that commonly co-exist with ADHD, such as autism spectrum disorder (ASD), bi-polar disorder, anxiety and depression.
This was the case for Brisson, who was diagnosed with ASD after finding out he had ADHD.
ADHD is also highly hereditary; Brisson’s daughter was diagnosed, and Pamela believes her mother may have had it, as she had similar challenges managing emotions.
Accessing treatment
The first step in getting a diagnosis is to contact a family doctor, who may conduct an assessment or refer you to a specialist. This can be a challenge, though, says Bernhardt, as there are long waiting lists. Care may also be difficult to access at a reasonable cost for those without extended health benefits.
Parhar adds that doctors need more training on adult ADHD. When he graduated from medical school in 1993, he had “30 minutes of ADHD training, and that was only on children with ADHD.” He diagnosed his first adult with the disorder just 10 years ago.
Pamela is one of the lucky ones. While talking with her doctor about another issue, she said something “convoluted,” and he immediately suspected she had ADHD.
She says medication wasn’t an option for her because the drugs available when she was diagnosed could increase blood pressure.
While Parhar says medication can give some people the focus they need to help manage the disorder, he prefers to try non-pharmaceutical interventions first, such as cognitive behavioural therapy, skills training, coaching, proper sleep, nutrition and exercise.
Medication initially helped Brisson navigate through the challenges with his business, but he says the benefits were outweighed by the side effects, which can include trouble sleeping, nausea, loss of appetite and other issues.
Instead of medication, Brisson established “environment control, habits, routines and personal rules” to create the structure he needs. His office is clear of distractions and he has white boards and notes to help him remember things.
A diagnosis of clarity, not failure Pamela says the diagnosis brought relief after years of feeling as though she was trying to ruin her own life.
She also believes there’s a positive to the disorder, saying she has “an ability to quickly size up problems” and find solutions.
Brisson also found a positive, becoming an advocate for other ADHD entrepreneurs through his podcast, The Impulsive Thinker. After years of believing he was a “bad person,” he understands that he’s just wired differently.
“ADHD is a brain thing, it’s not that you suck or you’re a moral failure,” he says. “You’re not broken.”