The title Attention-Deficit/Hyperactivity Disorder (ADHD) is misleading because neither of the descriptive words in the title convey the criteria necessary to receive the official diagnosis. Additionally, some key features of the diagnosis are excluded from the title. This is confusing and has led to some of the stereotypes that we think of when we picture the behavior associated with ADHD as a society.
What exactly is wrong with the name, ADHD? Let’s break it down…
1) ADHD is characterized by inconsistencies in one’s ability to sustain attention over time. There is not a total lack of attention in the disorder. Attentional abilities in ADHD can vary from distractible to overly focused, leading to inconsistency in the individuals' attention.
2) Hyperactivity is not necessary but is possible as part of the diagnosis. Some people meet the criteria for ADHD and do not demonstrate hyperactive behaviors, but instead exhibit exclusively inattentive symptoms. Additionally, hyperactivity can look different in various people. For example, for many women, hyperactivity manifests as rapid thinking. For others, hyperactivity can manifest in skin-picking or a need to fidget that leaves the individual compelled to act. And still for others, hyperactivity can be experienced as a need to keep busy.
3) Emotional dysregulation is a key hallmark of ADHD; however, this experience has been removed completely from the list of criteria necessary to receive the diagnosis. Emotional dysregulation is rarely explored during the diagnostic process. This leads to a lot of misdiagnosis and therefore, mistreatment.
If ADHD is not what it seems, what is it then? When evaluating for ADHD, I am always sure to cover four areas. Cognitive performance markers, executive dysfunction, emotional dysregulation, and functional impairment. By understanding how an individual functions in each of these categories, I am better able to see if ADHD is at the root of their distress. If you’re seeking an evaluation for ADHD, be sure that your provider includes these four areas during your assessment.
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