Navigating Life with ADHD

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder.

People with ADHD have an “interest-based nervous system”, a term coined by Dr. William Dodson, a psychiatrist specializing in ADHD. There are 4 factors that help people with ADHD focus : urgency, novelty, challenge and interest.

Some common signs of ADHD :  

• Lack of motivation & procrastination

• Inattention & forgetfulness

• Impulsivity & emotional dysregulation

• Hyperfocus & difficulty with transitions

• Difficulty with time management

• Sensory sensitivity

ADHD means that you might overlook details and make careless errors, especially on administrative tasks. A tip is to have designated places around your home for specific objects - putting everything in the same place every single day, because once you don’t see it, you might forget it is there. 

Emotional dysregulation

It's common for people with ADHD to have more of a quick-temper since emotions are more difficult to manage. It is common for people with ADHD to have what is called Rejection Sensitive Dysphoria (RSD) which causes emotional dysregulation and intense fear when there is a perceived cause of rejection, exclusion, or criticism. An association has also been found between insecure attachment and ADHD. 

Women 

Women show symptoms differently than men, especially as children. Symptoms in girls are often internalized (anxious thoughts, daydreaming, insomnia etc.) due to socialization. Some women will mask and compensate for their symptoms by falling into being “over-productive”. Perfectionism tendencies can also show up as a comorbidity in eating disorders. 

Women with ADHD are particularly sensitive to changes in hormones. Before their period they might experience severe symptoms of PMS (Premenstrual syndrome) and they are at higher risk of having PMDD (Premenstrual dysphoric disorder). They might get more irritable and emotional, and their other symptoms of executive functioning might also be exacerbated in that time. When you’re going through hormonal changes such as during pregnancy and menopause, that can be accompanied by mood swings, severe anxiety, and depressive symptoms. Many women find it harder to manage their ADHD symptoms when they are experiencing Premenstrual syndrome (PMS) since estrogen influences the same receptors in the brain that release dopamine, serotonin, and norepinephrine. 

A study on young girls with ADHD by Stephen Hinshaw’s found that those who were misdiagnosed had higher incidences of suicide, self-harm, unplanned pregnancies, and sexual abuse. Women with ADHD are also more at risk of experiencing abuse in romantic relationships. 

Executive functioning

You can have difficulty with finding solutions or anything that is task oriented, with too many details or instructions. People with ADHD often struggle with disorganization as well.

When you have ADHD, you might experience what is called “choice paralysis”, also referred to as analysis paralysis, which means you feel overwhelmed when you have too many choices, there’s an overload of information or there’s pressure to make a decision quickly. Part of the executive dysfunction that people with ADHD also experience is the difficulty to prioritize, have difficulty with coordination and orientation in space.

Hyperfocus & hyperfixations 

Transitions of focus can be difficult for people with ADHD. Additionally, many people with ADHD struggle with flexible thinking and might have a tendency to think in black-or-white. 

People with ADHD can focus, it’s just not as consistent as someone without the condition.

Many people with ADHD develop a hyperfixation on certain things for a certain period of time. This can be food, hobby or interest, people, topics etc. Those hyperfixation can stay for days, weeks or months. Eventually, they will wear off (however they might come back again later), and when this happens they have a complete disinterest in continuing it. 

Sleep

Most people with ADHD have a delayed circadian rhythm, which means their internal alarm clock for sleep and wakefulness is different from people with neurotypical brains. Individuals with ADHD might describe themselves as a “night owl”, they have difficulty waking up in the morning, have daytime sleepiness and they go to sleep late at night. Delayed sleep phase syndrome (DSPS), chronic sleep deprivation and short sleep duration have also been associated with ADHD.

People with ADHD are also more at risk of developing seasonal affective disorder (SAD). Delayed sleep onset time in ADHD may explain the increase in SAD symptoms.

Nutrition

Research shows that nutritional deficiencies have been associated with ADHD in children. This includes: magnesium, iron, zinc, Omega-3 Fatty Acids, Vitamin D and Vitamin B. Many people with ADHD have trouble processing and regulating their emotions. They may turn to binge eating to find comfort and relief from difficult emotions. People with ADHD may be up to 18 times more likely to have an eating disorder. This is due to a dysregulation in the dopamine system, poor interoceptive awareness of hunger and satiety cues, and impulse control deficits may play a role in binge eating tendencies. People with ADHD often have delayed appetite and an increased risk for binging later during the day due to the effects of medication.

Time management

Scheduling and planning can be difficult for people with ADHD.

Using recurring alarms can be helpful in keeping track of time (every 30-60 min.) and automating payments can’t help avoid accumulated debt. Another tip is to write down the date of the food you eat, and posts-it for reminders might become your best friend.

Hyperactivity

There are fewer symptoms of hyperactivity in adults than in childhood. Adult hyperactivity may be internalized as inner restlessness and intrusive thoughts, which can cause anxiety. It might also appear as external behaviours. 

What can be found useful is to exercise. You can try to avoid eating too much sugar and drinking coffee late in the afternoon as it exacerbates the symptoms. Meditating before bed can also be helpful. 

Sensory sensitivity & overstimulation

When you have ADHD, chances are you also have some type of sensory sensitivity which can lead to sensory overload. Sensory processing disorder (SPD) is associated with neurodivergence. This also includes food sensitivity, which is why eating disorders are much more common amongst the neurodivergent community. 

Tip : use sunglasses, noise-canceling headphones, minimize having multiple sensory input at once if possible. 

This sensitivity can also show up as interoception, meaning a hyperawareness of internal bodily sensations such as hunger, thirst, breathing or body temperature. Some research shows that people with ADHD are more sensitive to pain.

Dopamine-seeking

ADHD is characterized by impulsivity, hyperactivity, and inattention due to a dysregulation in dopamine levels which regulate our attention, motivation, and reward system.

Dating can boost dopamine levels, which can increase ADHD traits like impulsivity, emotional sensitivity, and hyperfocus. 

If you have ADHD, you might be more likely to engage in binge eating, speeding, shopping, gambling and other addictive behaviours since those can all be a source of dopamine.

Health issues

If you have ADHD, you might be struggling with nutritional deficiencies such as magnesium, iron, zinc, Omega-3 Fatty Acids, Vitamin D and Vitamin B. According to research, food that can help your ADHD symptoms are lean protein, complex carbohydrates & omega-3 fatty acids. High amounts of fruits, vegetables, fish and seafood, or nuts can be beneficial. Food containing EPA, DHA and vitamin C as well as probiotics have been found to improve symptoms of ADHD in diverse studies. It is recommended to do some bloodwork and follow-up with your doctor.

ADHD in females is associated with sleep disorders and autoimmune diseases such as psoriasis, asthma, Crohn’s disease and ulcerative colitis. Studies suggest that there is an association between ADHD and IBD. People with ADHD more frequently suffer from physical conditions associated with pain, such as inflammatory diseases. Adults with pathological pain conditions, such as fibromyalgia, have a very high prevalence of ADHD. ADHD and systemic autoimmune diseases (allergies and atopic diseases) have also been linked. The presence of ADHD has been found to worsen pain symptoms due to higher pain sensitivity (i.e., central sensitization). Individuals with ADHD often develop chronic illness and pain, and autoimmune conditions. 

ADHD is often comorbid with other mental health and neurological conditions such as anxiety and depression, eating disorders and substance use disorder, learning disabilities and autism. 

Sleep, exercise, nutrition and meditation are ways that can help manage ADHD symptoms.

Medication

In Canada, two types of non-stimulant medication are indicated for the treatment of ADHD: atomoxetine and guanfacine XR. Psychostimulants can aggravate certain anxiety disorders. Several antidepressants act on norepinephrine or dopamine and can also help ADHD symptoms. ADHD medications have an efficacy rate of 50-70%.