For 25+ years, I was convinced I didn’t have ADHD.
I’m SO organized. I can focus SOME of the time. On the outside, I appear very calm.
The opposite of “ADHD.” So I thought.
Turns out, the stereotype of ADHD only covers a tiny fraction of what it actually is.
After two years of denying the diagnosis, I finally learned how my brain worked. Suddenly, all the stress and overwhelm in my life made sense.
So here’s a breakdown of what we currently know about ADHD. Beyond just the stereotypes, especially if you’re high-achieving and smart.
The Three Types of ADHD in the Wild
ADHD is complex, and most clinicians can’t even agree on the specifics.
However, based on the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), ADHD comes in 3 distinct presentations:
Hyperactive type (ADHD-H)
This is closer to the stereotypical picture of ADHD. Someone who can’t sit still, may be disruptive in class, impulsive, always moving around, jumpy and extra talkative, or generally impatient.
The symptoms are more external, so these people tend to be diagnosed earlier in life.
Inattentive type (ADHD-I)
This is a daydreamer. Someone who is constantly in their head, likely misses details and has difficulty concentrating on longer tasks, but will usually appear very quiet and non-disruptive.
The symptoms are more internal, so these people tend to be diagnosed later in life.
Combined type (ADHD-C)
The person who is extra spicy and has a significant number of attributes from both of the above.
For the full ADHD DSM-5-TR criteria as of March 18, 2022, go here.
Officially, you need to consistently show at least 6 symptoms over a significant time period to get diagnosed.
However, the current criteria include significant gaps.
What the Diagnostic Criteria Misses
If you read any book on how to treat ADHD, there are obvious holes in these diagnostic criteria. A few of them include:
Missing root causes. The criteria only include high-level, observable behaviors. There’s also no mention of executive dysfunction, working memory, or emotional regulation, which are key components of “focus.”
Missing related symptoms. There’s nothing about perfectionism or procrastination, which are disproportionately high in the ADHD population. There’s also no mention of hyperfocus—especially the inability to stop hyperfocusing.
Gender bias. More women tend to have inattentive over hyperactive ADHD. There’s no metric for mental struggle or burnout caused by underlying ADHD. As a result, more women with ADHD tend to be overlooked.
Vague criteria. Most people experience every one of these symptoms, some of the time. Many of the listed symptoms also overlap with other mental conditions like anxiety, depression, bipolar disorder, etc. It’s very common to get misdiagnosed with the wrong condition.
Masking in high-IQ individuals. ADHD if often masked in children with high IQ. Testing environments can feel novel and stimulating for some people with ADHD, which can hide symptoms effectively.
The Hidden Internal Struggle
If you’re reading this newsletter, you’re probably pretty smart. You’ve likely learned how to compensate for your brain, and may even appear like you have it all together.
The question is then, how persistently do these symptoms negatively impact your life, day in and day out?
My first few years at work, I met expectations and got promotions.
But on the inside, I thought I was lazy and stupid.
I couldn’t manage tasks and estimate timelines. Anxiety and panic attacks landed me in therapy.
Just because you CAN meet deadlines at the expense of your mental and physical health does not mean that you SHOULD.
So if you are struggling, step one is to accept and understand your brain.
There is nothing wrong with you, and you’re certainly not alone.
This Week: For You
This stuff is not common knowledge, and a lot of ADHD content on social media distorts things even further. If anything in this email resonated with you, reply back and let me know!
Hi, I’m Kat! Welcome to my newsletter—your weekly dose of strategies to work with your extra-interesting brain, not against it.
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Thanks for reading and chat again soon!
— Kat