ADHD Symptoms: Impaired Executive Function-Managing Your Mind
By Dr. Geri Markel, April 11, 2019
ADHD Symptoms: Examples Across the Life Span
ADHD symptoms result in feelings of being overwhelmed, overworked, and stressed. You may feel distracted, disorganized, fidgety, forgetful, or impulsive. Here are some examples:
- Carl, a mid-manager, stares into space during meetings. He seems tuned out and disinterested.
- Phyllis, a resident in Emergency Medicine, feels overwhelmed and miserable. She is unable to multitask, record keep, supervise staff, and study for her boards.
- An obviously bright person, Susan, a VP of Sales, can’t keep track of time. She’s late with expense reports, meetings, and performance evaluations.
- Nic, a preschooler, looks like a whirling dervish. Running, jumping, and fidgeting all day, those around him don’t know what to do.
- During the last months, Marco, an 18-year-old college student with ADHD, ran out of gas, went through a red light, and forgot to pay his auto insurance.
All of these persons suffer from symptoms of ADHD. A few of them don’t even know they have ADHD or ADD. For example, Susan is inattentive, but does not have impulsivity or hyperactivity. Previously, she was an A student and considered gifted. People tend to think that ADHD precludes giftedness. However, there are many adults and children that are both gifted and have ADHD. Even with a diagnosis, other people can mistake people with ADHD as uncaring, lazy, or stupid. For example, how can Susan be gifted when she can’t manage her time or workflow?
Major ADHD Symptoms: Inattention, Impulsivity, and Hyperactivity
Inattention Symptoms:
- Makes many careless mistakes: work is messy
- Difficulty persisting with tasks until completion
- Struggles to listen
- Frequent shifts from one uncompleted task to another
- Fails to complete work at work, school, home, and community
- Difficulty organizing tasks and activities: poor work habits
- Avoids activities that demand sustained mental effort, especially if the task is tedious or boring
- Easily distracted by irrelevant stimuli
- Often forgetful
- Frequent shifts in conversation: not following rules of the games
Hyperactivity Symptoms:
- Fidgets: squirms: rocks chair, bounces knee, etc.
- Doesn’t remain seated
- Difficulty engaging in activities quietly
- Appears “on the do, driven by a motor”
- Talks excessively
Impulsivity Symptoms:
- Difficulty delaying responses: blurts out answers
- Impatient: difficulty waiting for one’s turn
- Frequently interrupts and intrudes
- Fails to listen to directions
- Grabs objects from others: touches things inappropriately
- Accident prone
Remember that ADHD is a complex condition. Children, adolescents, and adults with ADHD may differ in the number, combination, and severity of their symptoms. Even though they share a label, every person with ADHD is an individual. Some persons are easily distracted, but not hyperactive or impulsive. They may appear to be “flaky” or “spacey” like Carl.
Others symptoms include symptoms of excess movement. One mother described her 5-year-old son: “When Ashanti came into the room, everything fell off the shelves.” This still happens, although Ashanti is now 13. ADHD is a lifelong disability. People do not outgrow ADHD. They can learn to manage their symptoms so that the effects are minimal
Although people with ADHD are often distracted, they can exhibit a symptom called, hyperfocus. This intense focus may last for an extended period of time, during which everything else excluded. Usually, it occurs when the person with ADHD is doing something in their area of strength – something that is interesting or challenging.
Recent evidence points to ADHD as an impairment of self-regulation or Executive Functioning. According to research, a person with ADHD symptoms can have deficits in one or more of the following executive functions:
- Trouble inhibiting and regulating verbal and motor responses
- Difficulty with nonverbal and verbal working memory – recalling and manipulating information
- Activating and maintaining attention – can’t begin and stick with tasks
- Modifying one’s behavior to attain a goal and then when the goal is achieved to evaluate and adjust the behavior
- Limiting the interference of negative thoughts and feelings to complete a task
- Sustaining motivation, energy, and effort to complete a task
How Can a Diagnosis of ADHD be Made?
An expert evaluates the symptoms and an ADHD diagnosis is made using criteria listed in the Diagnostic and Statistical Manual of Mental Disorders.
ADHD diagnosis requires that a person meets 6 or more of the criteria and have the symptoms for at least 6 months. Symptoms need to be observed in two different settings such as home, work, or school. A person is deemed ADHD, according to the DSM-V if he or she:
- “Shows a long-term pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development.”
- “Entails symptoms present before the age of 7 years, although many individuals have been diagnosed after the symptoms have been present for many years.”
- “Shows evidence that the ‘impairment interferes with developmentally appropriate social, academic or occupational functioning.’”
- “Is not better accounted for by another mental disorder such as a mood disorder, anxiety disorder, dissociative disorder (e.g. Schizophrenia) or a personality disorder (Bipolar Disorder)”
What is the Difference Between ADHD and ADD?
ADHD is the medical term used by The Diagnostic and Statistical Manual of Mental Disorders (DSM-V). ADD is the term previously used to describe a person who has inattention and distractibility, but not hyperactivity. Currently, if a person lacks the hyperactivity symptom, the term used is ADHD, Inattentive Type. If you are confused about the difference between ADD and ADHD, contact geri@managingyourmind.com.
What Conditions Mimic or can be Confused with ADHD?
ADHD symptoms in adults can be confused with these other difficulties: (http://www.webmd.com/add-adhd/childhood-adhd/tc/adhd-other-conditions-with-similar-symptoms-topic-overview).
- Anxiety
- Depression
- Sleep disorders
- Drug or alcohol abuse
In children, ADHD symptoms can be confused with other problems, including: (http://www.healthcentral.com/adhd/related-conditions-40570-5.html).
- Autism/Asperger Syndrome
- Hearing impairments
- Hypothyroidism,
- Lead toxicity
- Mental retardation
- Sleep disorders
- Seizure disorders.
ADHD symptoms need to be investigated. It is important to seek the professional services of a physician, psychiatrist, or psychologist to assess physical and mental status and screen for possible ADHD. If screening is positive for ADHD, a referral will evaluate the extent of the ADHD and recommend options for further treatments.
Symptoms of ADHD can be managed. If you’d like to discuss services and seek professional support, contact geri@managingyourmind.com and take the free survey below to identify symptoms of ADHD that you may be experiencing.