ADHD may be hard to spot in adults, because everyone can exhibit many of the symptoms, said Roberto Olivardia, Ph.D, a clinical psychologist who specializes in treating ADHD. Many people forget important things, get bored easily, daydream, get restless and fidget, he said.
“What is often overlooked are the extent and frequency of these occurrences,” Olivardia said. Adults with ADHD deal with these symptoms on a daily basis, and they require great effort to manage, he said.
For instance, Olivardia recalled falling asleep in his high school chemistry class because he was so bored. A classmate also thought the class was boring, but said, “not everyone falls asleep when they’re bored.”
“It stands out in my mind as a moment when I realized that my tolerance for boredom was far different than others.”
Below are other subtle signs of adult ADHD along with how to find a reputable professional for an evaluation.
Many adults with ADHD don’t like to read books because it requires a lot of attention, said Ari Tuckman, PsyD, a clinical psychologist and author of Understand Your Brain, Get More Done: The ADHD Executive Functions Workbook.
They “will often find themselves getting to the bottom of a page and somehow their eyes have been reading, but their brain has no idea what they just read.”
They may miss details that make it harder to understand what’s happening in the later pages, which makes reading less enjoyable, he said.
“Websites and magazines are quick hits that don’t require sustained attention so they are more satisfying for folks with ADHD to read.”
Another subtle sign is what Tuckman calls “speak now or forever hold your peace.” Many adults with ADHD don’t have the attention and working memory to hold a thought in their mind while simultaneously listening to someone speak, he said.
“As a result, they’re forced to choose between interrupting or forgetting their comment. Even though they know that it’s more polite to wait and then share their thought, it doesn’t feel like that is something that they can pull off, so they’re caught between two bad options.”
Hyperactivity often is a red flag for ADHD. But everyone with ADHD isn’t hyperactive.
“[S]ome people have the inattentive presentation and were never hyperactive, whereas some who were hyperactive as a kid are much less obviously hyperactive as adults,” Tuckman said.
Symptoms Across Situations
ADHD symptoms are not the same in every situation, said Olivardia, a clinical instructor in the department of psychiatry at Harvard Medical School. If an adult with ADHD has an interesting, stimulating job, their symptoms may not manifest as much as they would in a boring job.
“[L]ots of adults with ADHD can be very successful in their lives because they have been able to create situations that cater well to their strengths, while finding compensatory strategies and workarounds for their weaknesses,” Tuckman said.
Symptoms as Character Traits
People may misperceive symptoms as character traits. For instance, because of symptoms such as impulsivity and a need for stimulation, adults with ADHD may be seen as “immature” or “big kids,” Olivardia said.
They may be viewed as choosing to procrastinate and not pay attention. However, “People with ADHD have a hard time activating and maintaining good attention on tasks that are uninteresting and have a far-off deadline,” Tuckman said.
“[I]t’s not really that they’re choosing to avoid the boring stuff; it’s that it is much harder for them to activate their attention on the boring stuff — fun things are easy — so it takes much more force of will to get going on those things.”
Getting a Good Evaluation
If you think you may have ADHD, it’s important to get a proper evaluation. According to Tuckman, “A diagnosis can be made by a psychologist, psychiatrist, neurologist, counselor, social worker, or general practice physician.”
But what’s really important, he said, is that the person knows how ADHD looks in adults; can rule out conditions that mimic ADHD, such as anxiety, depression, bipolar disorder and learning disabilities (all of which “can affect a person’s attention, memory and ability to get things done”); and can spend at least an hour assessing your current and past functioning.
“Big testing batteries are often overkill, whereas 10 minutes filling out some rating scales at the internist’s office is usually not enough. We want something in between.”
Olivardia also stressed the importance of seeing an ADHD expert, someone who’s worked with many ADHD clients. Ask practitioners how they conduct their assessment, he said.
He also suggested asking others with ADHD for recommendations for good professionals and joining a support group or online forum.
How ADHD manifests in adults really varies by person. As Tuckman said, “Although there are certainly similarities, everyone with ADHD has their own strengths and weaknesses. It’s a matter of looking at the whole person.”
Olivardia noted that even if signs are subtle, it’s important to explore how they work and how to manage them. Some symptoms may worsen, he said.
“But even if they do not, why live with nagging symptoms, if they can be eliminated or minimized? There are many great books, websites and professionals out there to aid you.”