“Could It Be ADHD?” Common Signs People Often Miss
One of the questions I am asked most frequently is whether someone can have ADHD without being particularly hyperactive.
The short answer is yes. Many people still picture ADHD as a young boy who cannot sit still, interrupts constantly and is always on the move. While some individuals with ADHD certainly present in this way, many do not.
In fact, some people reach adulthood before ADHD is even considered as a possibility.
It Is Not Always Obvious
ADHD can look very different from one person to another. Some people are physically restless and visibly impulsive. Others appear calm and quiet but struggle with racing thoughts, forgetfulness and disorganisation.
Parents sometimes tell me that their child can focus for hours on a favourite hobby but cannot concentrate on homework for more than a few minutes.
Adults often describe having dozens of unfinished projects, constantly misplacing important items or feeling as though they are always rushing to catch up with life.
Because these difficulties can develop gradually over many years, people often assume that this is simply part of their personality.
“I Thought Everyone Felt Like This”
This is something I hear surprisingly often during assessments. Many adults have lived with ADHD-related difficulties for so long that they assume their experiences are normal.
They may not realise that other people do not constantly lose their keys, forget appointments, miss deadlines despite good intentions or struggle to organise simple tasks.
Often it is only after speaking with others who have ADHD or reading about the condition that they begin to recognise similarities in their own experiences.
The School Report Clues
Looking back at school reports can sometimes provide useful clues.
Comments such as the following do not automatically mean a child has ADHD:
"Has great potential but does not apply themselves consistently."
"Easily distracted during lessons."
"Needs frequent reminders to stay on task."
"Talkative and easily distracted by peers."
"Forgets equipment and homework."
However, when similar themes appear repeatedly over many years, they can sometimes form part of a wider picture.
Many adults are surprised when they revisit old reports and realise that signs were present long before anyone considered ADHD.
The Emotional Side of ADHD
Attention difficulties are only one aspect of ADHD. Many people also experience challenges with emotional regulation.
They may become frustrated quickly, struggle with criticism or find it difficult to manage strong emotions.
Children can appear to have sudden outbursts that seem to come from nowhere.
Adults may describe feeling overwhelmed by relatively small stresses or finding it difficult to switch off after a difficult day.
These experiences are often just as significant as the attention difficulties themselves.
ADHD Does Not Mean Lack of Effort
One of the biggest misconceptions about ADHD is that people simply need to try harder.
In reality, most of the individuals I assess have been trying extremely hard for many years.
Many have developed elaborate systems to stay organised. Others rely heavily on family members, partners or colleagues to compensate for difficulties that nobody else can see.
The issue is rarely motivation.
More often, it is a difficulty consistently regulating attention, organisation and self-management.
When Should Someone Seek an Assessment?
There is no single test that can determine whether somebody has ADHD. An assessment is usually worth considering when attention, organisation, impulsivity or emotional regulation difficulties are having a meaningful impact on daily life.
This might affect education, work, relationships, self-esteem or general wellbeing.
Not everyone who experiences these difficulties will have ADHD. There can be many possible explanations.
The purpose of a comprehensive assessment is to understand the full picture and determine what may be contributing to the challenges someone is experiencing.
A Final Thought
Many people spend years wondering why certain aspects of life seem harder than they should. Sometimes there is a simple explanation. Sometimes there is not.
If you have ever found yourself repeatedly asking, "Why does everyone else seem to find this easier than I do?" it may be worth exploring further.
Understanding the reason behind lifelong difficulties can often be the first step towards finding effective support and developing strategies that genuinely work.
Dr James Glass
MBChB MRCPsych
Medical Director, WMI Psychiatry
