High Functioning ADHD: What It Is, Symptoms, & Treatments

What Is High-Functioning ADHD?

High-functioning ADHD refers to individuals who have less challenging symptoms of ADHD.^{1, 2, 3} While the DSM 5 does not recognize high-functioning ADHD as an official diagnosis, clinicians and mainstream culture have adopted the term to refer to people who have found “workarounds” for their ADHD.^{1, 2} For example, people with high-functioning ADHD can complete a work project despite feeling exhausted or burnt out by the task. In contrast, someone with more debilitating ADHD may get fired because they can’t meet the deadline.

High-Functioning ADHD Symptoms

Symptoms of high-functioning ADHD can vary from person to person. People with high-functioning ADHD may have the ability to function well in specific areas of their lives, such as work or school, but still struggle with symptoms behind closed doors.

Symptoms of high-functioning ADHD in adults include:

• Difficulty multitasking
• Getting stressed out easily
• Frequent ADHD mood swings
• Time blindness or poor time management
• Being overly “chatty” in conversations
• Unintentionally interrupting others
• Sensitivity to rejection
• Chronic procrastination
• Difficulty reading for an extended amount of time
• Low self-esteem
• Frequent frustration with self
• ADHD racing thoughts or jumping from idea to idea

Symptoms of high-functioning ADHD in children include:

• Feeling fidgety
• Inability to sit still
• Intense excitement
• Excessive energy
• Drifting or daydreaming
• Difficulty waiting their turn
• Careless mistakes in homework or schoolwork
• Difficulty maintaining attention

High-Functioning ADHD in Women & Girls

High-functioning ADHD is especially relevant to girls with ADHD and women with ADHD who report more inattentive or internalized symptoms.³ Women and girls often mask their ADHD, which allows them to exceed professionally and in school, leading to missed or late diagnoses. Maintaining this high level of functioning can be emotionally exhausting and lead to increased stress, anxiety, or depression.

Negative Impacts of High-Functioning ADHD

Having high-functioning ADHD can be a double-edged sword. While it may seem like extreme multi-tasking or hyperfocusing is a superpower, high-functioning ADHD has its downsides. The constant internal pressure to perform while struggling with ADHD executive dysfunction can lead to burnout and anxiety or even feeling “not good enough.” The ADHD masking or pretending that “everything is fine” could delay a diagnosis or getting much-needed support.

Here are some negative consequences of having high-functioning ADHD:

Feeling Constantly Burnt Out

The constant demands and challenges of managing high-functioning adult ADHD can result in frequent ADHD burnout. The executive functioning difficulties and heightened sensory sensitivity associated with ADHD can significantly drain mental and physical energy, especially for those who engage in ADHD masking to camouflage their symptoms. Sustaining effort to concentrate, stay organized, and manage impulsivity can begin to feel overwhelming, leaving many in a prolonged state of ADHD-induced fatigue.

Feeling Misunderstood & Isolated

Individuals with high-functioning ADHD often excel in certain areas of life, which may lead others to minimize their struggles. The external success hides the intense effort that is experienced internally. This lack of understanding can lead to feeling isolated because those with high-functioning ADHD can’t voice their struggles without feeling like a burden or a complainer. This mismatch of internal reality and external perception can lead to feeling deeply misunderstood and afraid to ask for help or support.

Being Unable to Relax

The inability to relax is a common struggle for individuals with high-functioning ADHD. They may feel a constant internal motor, driving them to succeed and keep busy. Many feel incapable of unwinding or enjoying downtime because they feel guilty or anxious about unfinished tasks or responsibilities. This inability to relax can lead to chronic stress and a sense of being constantly on edge.

Struggling With Workaholism

Workaholism can be a common issue for individuals with high-functioning ADHD. These individuals may hyperfocus to complete tasks and achieve success. They may feel restless or anxious when not working and constantly seek out new projects or challenges to keep themselves occupied. Some individuals with high-functioning ADHD may use workaholism to overshadow unwanted symptoms they feel interfere with their lives, such as disorganization or distractibility.

This dedication and focus can lead to impressive achievements but can also negatively impact other areas of life, such as relationships or self-care. Finding a balance between work and personal life is essential for preventing burnout and prioritizing overall well-being.

Engaging in Risky Behaviors

Some people with high-functioning ADHD may seek stimulating activities or engage in thrill-seeking behaviors to help alleviate boredom or increase dopamine levels in their ADHD brains. While taking risks can be exhilarating and provide a temporary sense of excitement, they may fail to consider the possible consequences and ramifications. If taken to the extreme, this dopamine search can make someone with high-functioning ADHD prone to addiction.

Constantly Reinforcing the Procrastination Cycle

High-functioning adults with ADHD often excel under pressure due to their ability to hyperfocus and effectively manage tasks in short bursts. They may thrive in environments that require quick thinking, problem-solving, and multitasking. However, this can also lead to a reliance on high-stress situations and ADHD-induced procrastination until the last minute, as they may struggle to sustain their attention and motivation in other situations.

Going Undiagnosed or Being Misdiagnosed

Having high-functioning ADHD can indeed lead to a misdiagnosis or delayed diagnosis for individuals with ADHD. Because high-functioning individuals may develop coping mechanisms or strategies to manage their symptoms, their ADHD traits may not be as obvious or disruptive as those with more severe presentations. This “camouflaging” can lead providers to overlook or attribute symptoms to other causes, such as mistaking ADHD for an anxiety disorder.

Coping With High-Functioning ADHD

Coping with high-functioning ADHD involves finding coping skills to manage ADHD symptoms and optimize daily functioning. While the journey may have challenges, success with ADHD is possible through developing effective organizational systems, utilizing time management techniques, and prioritizing activities.

Additionally, incorporating exercise, healthy eating, and stress reduction can all contribute to success in managing high-functioning ADHD. Everyone experiences ADHD differently, and finding a personalized coping regimen may involve trial and error as individuals discover what strategies work best for them.

ADHD Focus Plan Worksheet

A focus plan can help someone with ADHD estimate the time it will take to complete a task and plan out small steps to accomplish the larger goal.

Download

When to Seek Professional Support

Finding support when living with high-functioning ADHD can be invaluable when coping with symptoms. A good clinician will work with you to determine your unique needs and design a plan that may include lifestyle changes and more sources of support.

Focus on finding a neurodiversity-affirming therapist specializing in ADHD. A therapist directory like Grow Therapy is a great way to find a therapist who specializes in ADHD and takes your insurance. There are also many different online ADHD treatment services that can easily provide you with specialized mental health professionals from the comfort of your home.

Getting a Diagnosis of High-Functioning ADHD

ADHD is typically diagnosed through a comprehensive evaluation conducted by a healthcare professional, such as a psychiatrist or psychologist. The diagnostic process typically involves gathering information from multiple sources, including a self-report and interviews with family members or close contacts. Unfortunately, many clinical biases exist when diagnosing high-functioning ADHD. For example, practitioners may falsely assume an adult with a graduate degree or Ph.D. couldn’t possibly have ADHD because they belong to a high-stakes, high-performing profession.⁴

Treatment for High-Functioning ADHD

Recommendations for adult ADHD treatment typically include therapy and medication interventions. The combination can improve your ability to function, allowing you to show up in your relationships, professional environments, and home life.

Treatment for high-functioning ADHD in adults may include:

• Medications: Stimulants and non-stimulant ADHD medication can help lower the severity of symptoms or “take the edge off.” These medications can allow individuals to perform better at work by increasing attention and impulsive control and lowering hyperactivity.
• Cognitive behavioral therapy (CBT): CBT for ADHD allows clients to explore their thought patterns and identify areas that need confrontation to change their behavior. Although ADHD is a neurological condition, individuals can develop tools to learn new, better habits.
• Acceptance and commitment (ACT): ACT aims to increase flexible thinking and decrease distress.⁵ While some people with ADHD may view mindfulness as “hokey,” invalidating, or impossible, working with a therapist to redefine mindfulness can lead to feeling more present without self-judgment.
• Coaching and skills training: Working with an ADHD coach or therapist can help adults develop practical strategies to improve time management, organization, and productivity. They may also provide guidance and support in addressing self-esteem, relationships, and goal-setting. Apps such as Inflow can provide you with an ADHD coach, as well as an online community of people with ADHD who face similar struggles.
• Support groups: Joining a support group specifically for adults with ADHD can provide a sense of community and understanding. Sharing experiences and learning from others can help them gain valuable insights about their ADHD symptoms.
• Lifestyle adjustments: Regular exercise, practicing good sleep hygiene, maintaining an ADHD-friendly diet, and engaging in stress-reducing activities can help individuals manage ADHD symptoms and improve overall well-being.

Treatment for High-Functioning ADHD in Children

Treatment for children with ADHD typically involves a multi-faceted approach of behavioral therapy, parent training, and medication. The specific treatment plan will depend on the child’s needs, and a care team may adjust recommendations as symptoms and circumstances change. Parents should work closely with healthcare professionals to develop a tailored treatment plan that best meets their children’s needs.

Treatment for high-functioning ADHD in children may include:

• Cognitive behavioral therapy (CBT): CBT for kids focuses on teaching children strategies to manage their symptoms, improve their organizational skills, and develop strategies to improve their attention and impulse control.
• Parent training: Parent training helps caregivers learn to support progress at home and in other settings.
• Medication: Prescribers may also recommend ADHD medications for children over 12 to help reduce symptoms and improve their ability to focus and stay on task. Stimulant medications can help manage inattention, hyperactivity, and impulsivity. Non-stimulant medications are alternative options for those who respond poorly to stimulants or wish to avoid the risk of dependence.
• School accommodations: ADHD is classified as a disability, and therefore, the child’s school is required to accommodate for their ADHD symptoms. Identifying and making adjustments at school, such as implementing organizational strategies, adapting environments, or seeking accommodations, can help kids with high-functioning ADHD better navigate their academic lives and optimize their productivity.

Potential for More Success With High-Functioning ADHD

While individuals with ADHD may face many challenges, having ADHD also comes with unique benefits and strengths. For example, increased creativity, hyperfocus, high energy levels, and the capacity to think outside the box can be advantageous for many reasons. These benefits can make people with ADHD more likely to be successful than those without the condition.

Some jobs are especially well-suited for individuals with ADHD because they require quick thinking, problem-solving, multitasking, and creativity. Examples may include entrepreneurs, artists, designers, salespeople, emergency responders, journalists, or entertainers. To be successful with ADHD, individuals can leverage their strengths, create structured routines, set achievable goals, seek support (if needed), and cultivate a positive mindset that embraces their unique qualities and challenges.