When you ask someone what they think of when they hear the term “ADHD”, they often say that they picture a boy who is hyperactive. And that’s accurate – there are some boys with ADHD who are hyperactive.
But ADD/ADHD can go far beyond boys who are hyperactive.
There are also boys who are inattentive, girls who are daydreamers, young men who get angry easily, young women who are “too emotional”, and a whole range of other different ‘presentations’ of how people seem when they have ADD or ADHD.
In my office, after completing an assessment, I discuss with a family that their child meets criteria for ADHD (if they do) and I explain more about it. It’s quite a common occurrence for the parent to say something like: “I know about ADHD because my other child has it (or my nephew has it; or I’m a teacher and I’ve had kids in my class with it), and I just don’t see my child having the same thing as the other kid(s) that I know with ADHD.”
I then go on to explain how ADHD can ‘look different’ in different people, and I explain how it is manifesting in their child.
While I’ve always known that ADHD can seem different from one person to another, the extent of the individual nature of ADHD really hit home recently when I was reading to prepare for a presentation to teachers. In the book ADHD in the Schools by Dupaul and Stoner, this point was made very clear. Before sharing Dr. Dupaul and Dr. Stoner’s insights, let me just give a brief overview of how ADHD is diagnosed with the DSM criteria.
The DSM-IV-TR (The Diagnostic and Statistical Manual of the American Psychiatric Association) lists 9 symptoms of inattention, and 9 symptoms of hyperactivity/impulsivity. To meet the criteria for ADHD, one has to have at least 6 symptoms on one or both of these two lists (inattention or hyperactivity/impulsivity).
If one has at least 6 symptoms of inattention, and fewer than 6 symptoms of hyperactivity/impulsivity, then one is diagnosed with ADHD- Inattentive Subtype.
If one has at least 6 symptoms of hyperactivity/impulsivity, and fewer than 6 symptoms of inattention, then one is diagonsed with ADHD- Hyperactive Impulsive Subtype.
If one has at least 6 symptoms on BOTH lists, then one has ADHD- Combined Subtype.
So, to meet criteria for ADHD Combined Type, one has to have at least 12 out of 18 symptoms of ADHD. Of course, one could have 13 symptoms, or 14, etc.
In their book ADHD in the Schools, Doctors DuPaul and Stoner write:
“There are at least 7,056 possible combinations of 12 out of 18 symptoms that could result in a diagnosis of ADHD-Combined Type.”
7,056 different combinations of ADHD symptoms!
No wonder there isn’t one stereotype for kids/teens and adults with ADHD.
And this only relates to the combined type of ADHD. There would be more combinations if we added inattentive only, or hyperactive impulsive only.
And this is just based on the combination of symptoms alone. If we go a little deeper, and look at the individual, and take into account things like:
- Ethnic and cultural background
- Personal life experiences
- Likes and dislikes
- Strengths and skills people have
- Weaknesses and challenges people struggle with
- Personality traits
- The society they’ve grown up in…
- And a whole lot of other varilables
It’s no wonder that not everyone with ADD/ADHD seems to ‘look’ the same, and appear to have the same type of ADHD.
Are there similarities between individuals with ADHD? Of course there are. To meet criteria for the diagnosis, one has to have a relevant number of symptoms, and there are clinical patterns which can emerge.
However, don’t ever dismiss ADHD as a diagnosis just because that one person doesn’t appear the way you think ADHD should look . That person is just an individual with ADHD (with all of their unique individuality).
I hope that after reading this blog post, you’ll share this message with other people about ADHD. One of the first steps to destigmatize and to improve understanding about ADHD in society at large is for people to have the facts. And if we can help people to realize that not every person with ADHD is a hyperactive boy, and we open people’s minds to the fact that people with ADHD can be either gender, they can have a whole range of different symptoms, life experiences and levels of achievement in life, then we can do a lot of good out there.
And once someone has been diagnosed with ADHD, it is important that we focus on their differences and strengths to help them to achieve their best outcomes.
Please share your thoughts and comments below.