- Adults with ADHD often feel misunderstood and judged by others.
- It is difficult for people without ADHD to understand the challenges it poses.
- "Food poisoning" offers an example of an experience most people have had that helps show how something good can be noxious.
I’m a clinical psychologist by trade, specializing in adult ADHD. In this role, I’ve heard clients’ accounts of wide-ranging difficulties and frustrations in the pursuit of various goals and managing other affairs, all of which seem to take more time and energy to manage than they should, accompanied by good amounts of stress due to the effects of ADHD.
Adult ADHD and Feeling Misunderstood
An unfortunate source of stress that comes with ADHD is feeling misunderstood and even judged by those in one’s inner circle of friends and family. Attempts to explain (but not make excuses for) why and how a matter was forgotten, mismanaged, put off until way too late, or any other of the “usual suspects” of ADHD snafus are met with rejoinders that “I don’t want to hear excuses,” “Stop using ADHD as your crutch,” or even questioning the validity of the syndrome. These messages may also be voiced in other relationships, including by professionals sought out for help.
Although many adults with ADHD and their advocates probably are better able to give voice to their experiences than I am, an analogy that has resonated when I have used it with clients is that of food poisoning. Although certainly not conjuring pleasant images, it seems to capture the struggles of living with ADHD that non-ADHD adults take for granted.
What Do Food Poisoning and ADHD Have in Common?
Food poisoning occurs when someone eats a food that they expect to enjoy, but it is somehow tainted or improperly prepared to the degree that it is toxic. The body’s self-protection mechanism kicks in and unleashes a sequence of reactions meant to both inhibit the desire to take any more bites and the expulsion of whatever has been ingested. This includes nausea, vomiting, abdominal pain, fever and sweats, diarrhea… you get the picture. (Lunch, anyone?) Later, when presented with the same (or similar) food item with assurances that it is safe and untainted, the body will instinctively switch into self-protection mode, a sort of “Fool me once, shame on you—fool me twice, shame on me” cautionary mode with a welling up of nausea merely from the sight and smell of the food before the first small nibble.
ADHD has the same effect on many activities of adult life. The seemingly small hassles that most people handle with apparent ease—arriving early for a meeting, handling a boring wait in a waiting room, relatively brief and easy household chores, following through on plans—become bigger and more stressful than they need to be for adults with ADHD. And larger undertakings, such as written assignments and work reports or house repair projects that require diligence over time, and other large projects for which there is no way to do them in one sitting (although, many clients have assured me that, in fact, they have completed such projects via all-nighters or other herculean efforts on the wave of a deadline pressure) very often end up in delays, failures, or disappointments magnified by the knowledge that any product delivered in these circumstances does not match one’s potential.
As insidiously, ADHD interferes with the pursuit of hobbies and enjoyable undertakings. A backlog of undone work makes it feel irresponsible to do something enjoyable; or the anticipated hassles, such as gathering art supplies or getting out for a bike ride create barriers to self-care. These frustrations stem from the same discounting of delayed payoffs that affect all the have-to duties in adult life, in both cases eroding one’s well-being and sense of self. Even well-intentioned exhortations to enjoy learning and take classes on topics one finds interesting is for many adults akin to being offered assurances that this slice of mushroom pizza will not result in stomach-cramping, projectile vomiting from the last slice they had—“trust me.” The visceral response is to avoid and delay, rather than jump right in, with avoidance being one of the main, if not the central struggle of adult ADHD, though it makes sense in terms of past setbacks.
Hope and Understanding for Adult ADHD
Living with and managing adult ADHD is tiring and it is no surprise that outcome studies have indicated that reports of fatigue are common with the diagnosis in adulthood (see discussions of this point in Ramsay ). The encouraging fact is that there are many effective treatments and supports for adults with ADHD. Medications help address the core symptoms and the psychosocial treatments promote the implementation of effective coping strategies. Most adults with ADHD are simply looking for a reasonable sense of cause-and-effect, an expectation that the extra efforts required to manage ADHD will produce reasonable outcomes. So, if a loved one of yours has adult ADHD and is struggling, don’t force-feed obvious suggestions. Instead, try listening for understanding and with empathy.
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Ramsay, J. R. (2020). Rethinking adult ADHD: Helping clients turn intentions into actions. American Psychological Association.