10 Myths About ADHD: Perspectives of a Clinical Psychologist

Although Attention-Deficit/Hyperactive Disorder (ADHD) is a household word, there are a lot of misunderstandings and misconceptions about the disorder.  Here’s 10 myths about ADHD that I frequently encounter in the media and when working with families.

1.     ADHD is a straightforward diagnosis.  Based upon the prevalence of ADHD in the U.S., one might be tempted to think diagnosis is uncomplicated, simple, or quick. In fact, the opposite is true. ADHD is a highly complex disorder, and diagnosis should only be made after careful evaluation by a psychologist or other qualified professional.  The abundance of ADHD diagnoses has led many to ask whether the disorder is being been handed out too lightly.  Others suggest that ADHD is being “under-diagnosed” – that many with the disorder are going undiagnosed. In fact, both arguments have their merits.  In the absence of a comprehensive assessment by a qualified professional, the risk of ADHD misdiagnosis is a legitimate concern. 

2.     ADHD is a behavioral disorder.  While ADHD is well known for its behavioral symptoms, the underlying cause and mechanisms of the disorder are neurological.  Therefore, the diagnostic process should take into account not only an individual’s behaviors, but his or her an overall neurodevelopmental profile.  While behavioral checklists are a good first step, results to not ensure accurate diagnosis.  Checklists should be supported by clinical interview and neuropsychological assessment by a psychologist or other professional with expertise in diagnosing ADHD.

3.     ADHD is an attention deficit problem.  It is an attention regulation problem.  In fact, many individuals with ADHD demonstrate the tendency to “hyperfocus” on a topic of interest for long periods of time.  Their problem is not that they cannot sustain attention to the task; it is that they cannot regulate their attention.  Sometimes their attention is fleeting, while other times it’s laser-focused.  The possibility of ADHD should not be discounted in individuals who demonstrate the ability to work on a project of interest or play video games for hours at a time.

4.     ADHD only affects attention.  If undiagnosed or ignored, ADHD can lead to other problems like anxiety and depression.  Indeed, the effects of the disorder can be enormously damaging across an individual’s social, academic, and professional lives.  Having ADHD is like walking across a minefield every day of your life.  It’s not a matter of whether you will step on a mine; it’s simply a matter of when.  Years of living with fear of making mistakes and “screwing up” is not only frustrating and confusing, it’s possibly traumatic.  It’s little surprise that the disorder has been correlated with low self-esteem, anxiety, and depression in both kids and adults. 

5.     Behavioral symptoms are sufficient for diagnosing ADHD.  Just because an individual exhibits the symptoms of ADHD does not mean he or she actually has the disorder. ADHD shares many behavioral symptoms with other problems like anxiety, depression, stress, impaired executive function, auditory processing disorder, visual processing weaknesses, and other neurological pathologies/abnormalities.  An evaluation that takes into account an individual’s neurodevelopmental profile – and not just his or her behavioral symptoms – will improve the probability of accurate diagnosis.

6.     ADHD looks the same in everyone.  We are each unique in our circumstances, temperaments, interests, abilities, skills, strengths and weaknesses.  Not surprisingly, ADHD impacts everyone differently.  Inattention, hyperactivity, and impulsivity can manifest in different ways and at different times for different people.  For example, extroverts with impulsivity may display more obvious symptoms than an introvert who works to hide these symptoms.  Some kids appear hyperactive, and others seem quiet and reserved.  Some students struggle more with ADHD when they are overstimulated, while others struggle when under-stimulated.  Alternatively, visual-spatial learners can appear inattentive for reasons that have nothing to do with ADHD. And whenever environmental and learning environments are a “poor fit,” ADHD symptoms typically worsen.     

7.     There is a single test for diagnosing ADHD.  Because ADHD is so complex – and it affects everyone differently – the ADHD diagnostic process should incorporate not only behavioral checklists and patient history, but also neuropsychological assessments.  ADHD “profiles” can be gleaned from tests that measures IQ, attention, memory, and executive function.  Developing a comprehensive profile of the “entire” individual can help confirm the presence of ADHD whether behavioral symptoms are obvious or not. Comprehensive assessment also supports differential diagnosis – in other words, the process of “teasing out” other factors that may be causing ADHD-like behavioral problems.

8.     A diagnosis of ADHD guarantees a prescription for medication.  Medication is a highly individualized choice, and it’s not for everyone who has ADHD. Depending on personal preference and circumstances, medication may not be desirable or even effective.  Furthermore, there are other ways to support, treat, and embrace ADHD – for example, behavioral interventions, lifestyle changes, family supports, and skills-building approaches can be effective.  Don’t be afraid of an ADHD diagnosis simply because you think it means you’ll have to take medication.

9.     ADHD is all bad.  There are many upsides to ADHD.  One of the greatest gifts is creativity.  The ability to jump from idea to idea, to synthesize seemingly unrelated topics, and to wander inside a world of imaginative creativity has probably contributed to the success of some of history’s great entrepreneurs, artists, inventors, scientists, teachers, and others. 

10.  ADHD is an excuse for unruly behavior.  No one chooses whether they have a disorder like ADHD.   But while having it may not be anyone’s fault, managing ADHD is ultimately the individual’s responsibility.  Successful living begins with self-awareness and understanding, and is supported by an accurate and clear diagnosis of ADHD.  Next, coaching and skill-building can scaffold ownership of ADHD by helping an individual understand the disorder and how it affects him/her.  By developing strategies for circumventing limitations and designing a lifestyle that capitalizes upon advantages, ADHD becomes just another part of life – and it is what you make of it. 

– Dr. Katen

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