Is ADHD Real? Facts & Myths

Is ADHD Real?

The diagnosis of attention-deficit/hyperactivity disorder (ADHD) and its existence is recognized as a psychological and medical condition. Despite debates in research around the legitimacy of ADHD, empirical evidence supports the existence of ADHD as a real and valid mental health disorder.¹

Like most mental health disorders, ADHD as a diagnosis is complex and multifaceted, not to mention that our ideas of medical and mental health conditions are constantly changing and growing with expanding research and advances in technology that assess mental health and medical conditions.

Why Someone May Think ADHD Is Not Real

There are many deeply culturally embedded reasons why the legitimacy of ADHD, along with many other mental health disorders, is questioned. We live in a culture that tends to stigmatize and invalidate mental health conditions. It is only in recent years that we have begun to recognize the widespread impact of mental health disorders on the well-being of most people in the population. With studies emerging, like the famous ACES study, which examined the impact of adverse childhood experiences on individuals’ mental health, risk of suicide, and even mortality, it is becoming more and more clear that mental health is an integral component of human existence that must be acknowledged.²

Here are some common myths that can make someone think ADHD is not real:

• ADHD is just an excuse for laziness: Many people believe that ADHD is just laziness. The concept of laziness largely reinforces the idea that the value of human life exists in how productive someone is and how well they can fit into stereotypical societal norms.
• ADHD is an internet fad: The wealth of information readily available online is both a blessing and a curse. With self-diagnosing on the rise, it can be easy for people to make interpretations about their mental health conditions without consulting a professional. It is important to remember to consider your sources when seeking information on the internet about the diagnosis and treatment of any mental health disorder.
• People have control over their ADHD symptoms: Often, individuals living with ADHD feel like they are out of control or don’t have a choice to behave the way that they do. It generally takes an individualized treatment plan in a behavioral therapy setting and possibly medication to help people manage their ADHD symptoms.
• All cases of ADHD look the same: ADHD manifests and presents itself very differently from person to person. Formal testing, which pinpoints an individual’s specific experience and intensity of symptoms, can be beneficial in the process of treating ADHD.

Can Adults Have ADHD?

Attention to adult ADHD has been increasing in recent years, and it is important to recognize that there is a high incidence of ADHD in adults. Adult ADHD was previously overlooked because, generally, ADHD was considered a disorder that primarily affects school-age children, mainly boys. Over time, we are learning that gender and age play less of a factor in determining if someone has ADHD or not. Furthermore, symptoms of ADHD in adults can look different from ADHD in children. For example, symptoms of hyperactivity can decrease over time as symptoms of inattention and difficulties with focus tend to increase in adulthood.

Is ADHD Overdiagnosed?

Despite what information on the internet might convey, research does not support the assertion that ADHD is systemically overdiagnosed.³ As with many mental health and medical disorders, the definition and conceptions of the way disorders present and are defined are constantly changing and evolving. This is one reason people might think that a disorder is overdiagnosed because of the understanding that the way that disorder presents might change over time.

For example, the fact that ADHD was previously considered to be a diagnosis assigned in childhood primarily to boys has already been altered. Furthermore, because we live in a society that largely stigmatizes mental illness, there is a great deal of pushback around validating and legitimizing the existence of any mental health condition. Ultimately, overdiagnosis of ADHD and other mental health disorders is not a problem; instead, cultural stigmas around the existence of mental health disorders and misinformation about the presentation of mental health disorders (e.g., self-diagnosing online based on information in a TikTok video) are areas of current concern.

Why Is ADHD Misdiagnosed?

ADHD may often be misdiagnosed when not properly assessed. There are evidence-based- and research-based methods for assessing ADHD in individuals that provide more accurate diagnoses and results. If ADHD is assessed through self-diagnosing, invalid measures that have not been empirically supported, or even by medical or mental health professionals who do not specialize in ADHD diagnosis and treatment, misdiagnosis is possible.

For accurate diagnostic information, it is important to seek professional testing and assessment through providers who specialize in ADHD diagnosis and treatment and those who have access to empirically supported tests that assist in the diagnosing process. While no concrete data provides the rate of misdiagnosis, one study suggests that the variance of the prevalence rate of ADHD being between 8%-12% of the population could be explained by misdiagnosis or inconsistent diagnosing of ADHD.⁴

Mental Health Conditions That Mimic ADHD

Another reason why ADHD might be misdiagnosed is because of the overlap it shares in terms of symptoms presentation with other mental health disorders such as depression, anxiety, PTSD, and bipolar disorder. Often, individuals may mistake the hyperarousal that comes with anxiety as hyperactivity. Impulsivity associated with mood swings in bipolar disorder might also mimic behaviors common to those with ADHD. Dissociation common in PTSD may look like inattention and difficulty with focus. The overlapping symptoms among various mental health conditions is another reason why formal assessment is important, as this process will assist an individual in ruling out other possible mental health disorders that better explain their symptoms. Misdiagnosis is dangerous because it prevents an individual from receiving appropriate treatment for their symptoms.

Conditions that may share symptoms that overlap with ADHD include:

• Bipolar disorder: An example of how bipolar and ADHD symptoms can be similar is variation and fluctuation in mood. In terms of bipolar I or bipolar II, manic episodes common in bipolar 1 disorder may be misinterpreted as impulsive behaviors that are a feature of an ADHD diagnosis.
• Anxiety: At times, anxiety and ADHD symptoms can be similar and can lead to anxiety being misdiagnosed as ADHD. There is a type of anxiety that might mimic hyperactivity and difficulty sitting still, which may be frequently misunderstood as ADHD.
• Autism: Sometimes, individuals may confuse autism and ADHD because of the divergent neurological processes common to both disorders. For example, individuals with ADHD and autism are both likely to hyper-fixate and struggle with some lack of cognitive flexibility. It is important to rule out autism as a possible cause for these behaviors when they exist in an individual living with ADHD.
• Low blood sugar levels: While this is a medical condition rather than a mental health condition, low blood sugar levels symptoms can be similar to ADHD symptoms in terms of mental slowness and brain fog that can cause difficulties with attention and focus. It is always important to also be evaluated for possible underlying medical conditions when seeking an ADHD diagnosis.
• Sensory processing disorder: While sensory processing disorder (SPD) is not formally recognized in the DSM, symptoms can be similar to ADHD and autism spectrum disorder symptoms in terms of sensory sensitivities.
• Insomnia: Insomnia is commonly co-occurring with ADHD and anxiety. Symptoms of insomnia and ADHD can be similar in the way that they impact a person’s ability to focus and pay attention.
• Hearing problems: Hearing problems could be mistaken for inattentive ADHD with a focus on auditory attentional issues. A medical evaluation to determine this difference is highly recommended.
• PTSD: Post-traumatic stress disorder, or PTSD, can often cause an individual to dissociate, which can look like inattention or “spacing out.” It is important to have this diagnosis ruled out if an individual has recently experienced a traumatic event or has a history of trauma.

How to Know If Someone Really Has ADHD

The best way to know if someone has ADHD is to be formally evaluated by a professional who specializes in ADHD assessment and has access to empirically supported, valid, and reliable assessment methods. Generally, primary care providers and therapists can make a referral to a specialist if someone is interested in seeking a diagnosis.

What to Do if You Think You Have Been Misdiagnosed

It is always possible to seek evaluation and assessment from another provider if you believe you have been misdiagnosed as having ADHD or misdiagnosed as not having ADHD. A second opinion can never hurt, and knowledge is power, so having more information about your mental health is never bad.

Here are steps you can take if you think you have been misdiagnosed with ADHD:

• Contact your primary care provider: Ask them if they have any recommendations for professional ADHD testing in your area.
• Contact your psychiatrist: Psychiatrists may be able to make a more accurate referral or assess for ADHD if you are worried you have been diagnosed because their training is generally more comprehensive in terms of mental health than primary care providers.
• Get a second opinion: See if there are additional ADHD experts in your area and get a second opinion if necessary.
• Get re-tested: You can also get re-tested if some time has passed and you are still unsure if you’ve been misdiagnosed.
• Work on an individualized treatment plan: If you are seeing a therapist already, you can incorporate recommendations from test results into your existing treatment plan and see whether these recommendations help reduce the severity of symptoms.
• Try different things: Remember to be patient and that no one treatment is a miracle drug for curing any diagnosis, and ADHD is no exception. It may not be that you’ve been misdiagnosed; instead, you may need some time to try different interventions to see which one works best for you.

When to Seek Professional Support

It is important to consider seeking professional support for ADHD, particularly when symptoms are causing problems at work, at home, in relationships, and other important areas of life. You can find a neurodiverse-affirming therapist on an online therapist directory or online therapy platform. When seeking support through medication, online psychiatrist options are a good choice for finding ADHD medication management.