Seven myths about ADHD in high achievers

In this piece I tackle some pernicious myths about ADHD in ‘high achievers’ β€” people with drive to achieve change in their personal and social worlds.

Since going public about my ADHD diagnosis I’ve had a number of conversations that loosely gather around the theme ‘WHAT, YOU!?’

These are primarily conversations with people who mainly know me in my work persona. If we converse socially or you follow my social media output, you know my train of thought is a pretty scattered affair. πŸ˜…

But seen from the ‘middle distance’ my work life looks pretty organised. I start work on a public-facing webinar six weeks out; I follow an established formula for preparing interviews and briefing participants and promoting the event; I pack an enormous amount of content into every 60- or 90-minute session; and I ask every question and finish the webinar on time (nine times out of ten).

So I understand that it can be difficult for some people to reconcile that pattern of work with the notion that I might be living with inattentive-type ADHD. But that difficulty also reflects a set of stereotypes about ADHD β€” stereotypes that can seriously impact how we respond to people with ADHD who have high drive to achieve change in the world. So let’s get into it!

[Note: I have created a separate post for two sections on language matters.]

Seven myths about ADHD and high achievers

Myth 1: ADHD is always obvious

This is the worst myth of all. So many people are diagnosed late because our presentation of self doesn’t fit the gendered stereotype of ADHD β€” the hyperactive, impulsive little boy.

If you’re a girl, you face intense pressure to conform with gendered stereotypes. Inattentive ADHD may be missed because girls are expected to be quiet and dreamy, while hyperactivity and impulsivity may be rewarded in girls and young fem/me folks if they are seen as being hypersocial.

Similarly, being perceived as a high achiever can prevent timely diagnosis of ADHD (and overlapping conditions like autism). If you are an early reader with a big vocabulary who could finish your homework without effort, you are likely to have been pigeonholed with the backhander ‘gifted but lazy.’

That moral attribution can have deeply felt and lasting effects on your sense of self β€” and it’s just an excuse for teachers and schools who can’t be bothered to provide the mix of extension activities and reasonable accommodations required by smart kids who are neurodiverse.

Myth 2: Treatment is a quick fix

If you’re on social media you’ve almost certainly seen rapturous accounts shared by people with ADHD who are just beginning stimulant medication. These make treatment look simple and miraculous, and it’s hard to reconcile these experiences with the research finding most people with ADHD discontinue stimulant treatments within 2 years of starting.

Stimulant meds are often short-acting β€” the medication I take, known by its brand name Vyvanse, is marketed as long-acting but only lasts for 6-8 hours. Enough duration to be an effective employee but not enough if you want to be functional after-hours, to complete (say) a course of study like a PhD (cough).

There is often significant administrative burden involved in staying on the meds, which is a cruel irony when you have a condition that makes administrative ritual a torturous experience. And right now, there’s a global shortage of Vyvanse caused by irrational war on drugs policy settings in the United States.

Myth 3: ADHDers are disorganised

Remember that I define high achievers as people with drive to make change in the world around them. We often develop highly elaborate systems to compensate for the gap between how our brains function and the functions we need to demonstrate in the social performance of our work and activist selves.

Typically the process of diagnosing ADHD or autism looks for signs of disorder in our day-to-day and week-to-week existence. I argue that it should also check for over-exertion on compensatory mechanisms. These mechanisms often work, so there may not be visible disorder to tip the scale in favour of diagnosis. But they have a hidden cost: the energy you spend on compensatory strategies is energy you can’t devote to other goals and purposes.

Let me give a really personal example. I was so driven to achieve at school and work that I didn’t get a chance to stop and do the identity work needed to get a proper mental health diagnosis until I was thirty-seven years old. Ironically, it was enrolling in a PhD program that gave me the space to unravel β€” and while I’m glad I had that opportunity, it wasn’t great timing for getting the PhD done!

Myth 4: ADHDers lack focus

I’m honest and upfront about the reality that ADHD is a condition that can affect your life in negative ways. But it is a mix of deficits and superpowers. One of the superpowers is often described as hyperfocus β€” when the conditions are right, we can get an incredible amount done in very little time.

The opposite feature β€” tangential thinking β€” is less well-recognised. One of the advantages of being easily distracted is being able to see and pursue all the many tangents and connections that add up to a big picture view of a problem. This is very useful for problem definition, goal setting and crisis responses.

Myth 5: ADHDers lack willpower

Since going public with my ADHD diagnosis I’ve had conversations with many different people about how ADHD affects their lives, their ambitions for change and the way they get things done despite the impact the condition has on them.

A heart-breaking theme recurs in these stories: the way people with ADHD have had to unlearn a nearly lifelong practice of viciously bullying ourselves into getting things done.

This insight came from a conversation with Dr Stephanie Convery, who is a published author, PhD graduate, and inequality reporter at The Guardian Australia. I nearly fell off my chair when she told me she, too, had just been diagnosed, but I also found it encouraging that someone could have ADHD and achieve so much change with it and despite it.

Myth 6: ADHDers are ‘flaky’

People with ADHD are stereotyped as lazy and unreliable. The truth is more complicated. I would explain it this way: in a crisis there is nobody better to rely on than a person with ADHD β€” situations of novelty, urgency and uncertainty can activate our capacities for hyperfocus and tangential thinking and we can execute a fluid and effective response that considers all the relevant possibilities and opportunities.

But the frustrating thing for people with significant drive to achieve change in the world is that social change requires a long-term, strategic, determined effort, and ADHD can create difficulties in executing plans and projects over the longer-term. The problem with hyperfocus is that it is energetically demanding and if you stay in that mode for too long without respite, you will burn out hard.

There are two ways of managing this:

  • A big part of living with ADHD and high drive is continually reworking your perceptions of your workload in order to generate the sense of novelty, urgency, justice and innovation that can trigger periods of focus and motivation.
  • You also need to interweave periods of rest and non-productivity in order to achieve some light and shade and restore your energy.

High achievers with ADHD often display what I call ‘zigzag careers’ defined by a central passion β€” in my case, HIV prevention and positive health promotion β€” interwoven with periods working on other problems β€” such as cancer, health equity, disability, social research, and sexual assault prevention. Taking time to work on other issues makes it sustainable to come back to a field that is emotionally intense and energetically demanding.

Myth 7: Everyone’s a little bit ADHD

Busting this myth brings me back to the problem I foregrounded above, regarding the language we use to talk about conditions like ADHD and autism.

Everyone is distractible and impulsive and inattentive to some extent.

But an ADHD diagnosis acknowledges these things are constant features of your existence and cause significant disorder in your everyday life. That’s what turns an everyday experience (having momentary trouble focusing) into a disorder that deserves treatment and social accommodations.

Notes

Interested in reading more? πŸ‘‰ Language matters, ADHD edition.

Feature image: Alvannee on Unsplash; is the kitten focused or distracted?

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