High-functioning ADHD often manifests as more “mild” symptoms of ADHD. Typically, people with high-functioning ADHD may appear unaffected by their condition, allowing them to maintain employment or achieve academic success. However, individuals with high-functioning ADHD still meet the criteria for ADHD and can experience a fluctuating range of symptoms.
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What Is High-Functioning ADHD?
“High-functioning” ADHD results in less challenging symptoms of ADHD, and someone with the condition may have found ways to compensate for difficulties with other strengths.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 may 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. They find a way to finish, whereas someone with more debilitating ADHD may get fired because they can’t meet the deadline.
Both kids and adults with ADHD can exhibit high-functioning ADHD. Impairment in functioning exists along a spectrum based on unique brain chemistry and environmental factors. Embracing neurodivergence validates the atypical neurological processing of the ADHD brain without using limiting terms like “abnormal” or “different.”
Signs of High-Functioning ADHD
Signs 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. Some may turn toward workaholism to compensate for perceived deficits, while others may exhibit risk-taking behaviors to boost depleted dopamine levels.
Signs of high-functioning ADHD may include:
Workaholism
Workaholism can be a common issue for high achievers with ADHD. These individuals may use the hyperfocus often associated with ADHD symptoms 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.
Excelling Under Pressure
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 a tendency to procrastinate until the last minute, as they may struggle to sustain their attention and motivation in other situations.
Frequently Taking Risks
Individuals with ADHD often have a higher propensity for risk-taking behaviors, partly due to executive dysfunction. They may struggle with poor impulse control, often leading to impulsive decision-making and a lack of consideration for long-term consequences.
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 brains. While taking risks can be exhilarating and provide a temporary sense of excitement, they may fail to consider the possible consequences and ramifications.
Inability 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.
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Feeling Constantly Burnt Out
The constant demands and challenges of managing high-functioning adult ADHD can result in frequent 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 exhaustion.
High-Functioning ADHD Symptoms
High-functioning ADHD is not a “black and white” diagnosis with strict symptom criteria. Anyone with high-functioning ADHD can experience both good and difficult days, but symptoms may show up as frequent stress, difficulty multitasking, and frequent mood swings.
High-functioning ADHD in adults may be misdiagnosed or overlooked, even though symptoms have been present since childhood. This case is especially relevant to girls with ADHD and women with ADHD who report more inattentive or internalized symptoms.3
Symptoms of high-functioning ADHD include:
High-functioning ADHD symptoms in adults
- Difficulty multitasking
- Getting stressed out easily
- Frequent mood swings
- Time blindness or poor time management
- Racing thoughts or jumping from idea to idea
- 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
High-functioning ADHD symptoms in children
- 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
How Is High-Functioning ADHD Diagnosed?
High-functioning 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.
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While providers do not have a specific high-functioning ADHD test, standardized rating scales can help assess ADHD symptoms. These assessments may measure executive functioning abilities, such as attention, concentration, and impulse control. The healthcare professional will consider overall functioning in different areas of life and the persistence of symptoms over time before offering a diagnosis.
Can Masking Lead to Misdiagnosis?
Masking 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 an anxiety disorder.
Treatment & Support for High-Functioning ADHD
Finding support when living with high-functioning ADHD can be invaluable when coping with symptoms. Both therapy and medication can improve your ability to function, allowing you to show up in your relationships, professional environments, and home life.
Treatment for Adults
Recommendations for adult ADHD treatment typically include a combination of psychotherapy and medication interventions. Unfortunately, many clinical biases exist when treating this condition. 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
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Regardless, treating symptoms is an important aspect of living well with ADHD. Focus on finding a neurodiversity-affirming therapist specializing in ADHD. 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. A psychiatrist can help tailor a medication regime to your goals, as some ADHD medications may be more or less effective for your desired outcome or change in behavior.
Treatment for high-functioning ADHD in adults may include:
- Medications: Stimulants, non-stimulants, and antidepressants 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.
Treatment for Children
Treatment for children with ADHD typically involves a multi-faceted approach of behavioral therapy, parent training, and medication. Behavioral therapy 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 helps caregivers learn to support progress at home and in other settings.
Prescribers may also recommend medications for children over 12 to help reduce symptoms and improve their ability to focus and stay on task. The specific treatment plan will depend on individual 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 helps them understand and manage their thoughts, feelings, and behaviors related to ADHD. This approach focuses on improving executive functioning, developing coping strategies, and addressing challenges like time management and organization.
- Medication: 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.
- Coaching and skills training: Working with an ADHD coach or therapist can help children 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.
- Support groups: Joining a support group specifically for kids 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 a healthy diet, and engaging in stress-reducing activities can help children manage ADHD symptoms and improve overall well-being.
- School accommodations: 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.
Finding Success With ADHD
People with ADHD can be just as successful as those without the condition. While individuals with ADHD may face many challenges, they also possess unique strengths. For example, increased creativity, hyperfocus, high energy levels, and the capacity to think outside the box can be advantageous for many reasons.
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. Success looks different for each individual, and finding the right career path and work environment that aligns with their strengths and interests is crucial.
Coping With High-Functioning ADHD
Coping with high-functioning ADHD involves finding strategies and techniques to manage 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.
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Below are 10 tips for coping with high-functioning ADHD:
- Stay organized: Create systems for keeping track of important tasks, appointments, and deadlines using a planner, calendar, or digital task-management tools.
- Break tasks into smaller steps: Breaking larger tasks into more manageable chunks can make them feel less overwhelming and increase the likelihood of completion.
- Prioritize tasks: Rank tasks based on importance and urgency to ensure you address essential responsibilities first.
- Use reminders: Set up reminders, alarms, or alerts on your phone or computer to remember appointments, deadlines, and important events.
- Minimize distractions: Create a distraction-free work environment whenever possible by turning off notifications on electronic devices, finding a quiet space, or using noise-cancelling headphones.
- Practice time management techniques: Use techniques like the Pomodoro Technique (working in focused bursts with short breaks) or time blocking (scheduling specific activities for set periods) to help manage time more effectively.
- Develop coping strategies: Identify and implement strategies that work for you. For example, visual cues, checklists, or color coding can help you stay organized and focused.
- Seek social support: Reach out to family, friends, or support groups to share experiences, gain insight, and receive emotional support.
- Practice self-care: Prioritize self-care activities to reduce stress and improve overall well-being. Masking can take a toll on your overall health, so remember to prioritize breaks to unmask, embrace your unique characteristics, and explore your identity.
- Consider professional support: Work with a therapist or coach specializing in ADHD to develop personalized strategies, learn new techniques, and address any emotional or psychological difficulties.
In My Experience
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