Mindpath Health’s Zishan Khan, MD discusses adult ADHD symptoms that are often overlooked. See highlights below or read the full article with sources here. 

10 Adult ADHD Signs You May Not Realize Are Actually Symptoms_Zishan Khan, MD_Mindpath Health

With everything there is to juggle in life, it’s easy to assume that everyone experiences that sinking-in-quicksand feeling as they navigate another busy day. 

But if you find this feeling is paired with extreme levels of disorganization, inattention, and overwhelm, these might be signs of attention-deficit/hyperactivity disorder. 

Roughly 10 million American adults (and over 365 million globally) are thought to have ADHD — and because symptoms can show up differently in adults, realizing you might have the disorder is typically a slow burn, the overlooked signs of which can cause significant strain on your life and health. 

The hallmark symptoms of ADHD — inattention, impulsivity and hyperactivity — typically aren’t as noticeable in adulthood, likely because adults whose ADHD wasn’t diagnosed in childhood have had a lifetime to parse together the skills necessary to compensate for their symptoms. 

In the moment, you might find yourself attributing certain feelings and behaviors to other things — blaming feelings of hype on too much coffee or snapping at your frozen computer on sleep deprivation — when really, they’re symptoms of adult ADHD. 

Here are some of the sneakier signs you might be overlooking:

1. Procrastinating to the extreme

ADHD brains are always on the lookout for activities that will cause a rush of dopamine, a chemical in the brain that leads to feelings of reward and pleasure and that tends to be lower in people with the disorder. 

Because people with ADHD have trouble sustaining enough dopamine during routine tasks that aren’t as interesting to them, they might find themselves doing everything possible to avoid them.

2. Hyperfocusing on the same task for hours

If you have ADHD, starting tasks can be a grind — especially tasks you find daunting or believe will be time-consuming — but once you get started, you might find yourself so absorbed by what you’re doing that other important tasks end up neglected as a result. 

Difficulty switching gears is thought to be caused by low dopamine levels in the brain: The more engrossed you are in a task, the greater the dopamine boost. It’s similar to being in the zone, only in this context, it feels like you’re trapped there. 

“Hyperfocus at its worst can look like writing and rewriting your response to a simple email and being unable to transition to a new task or missing an important event because you’re unable to pull yourself away from a work project,” Louk said.

3. Spending impulsively

Adults with ADHD are more likely to make poor financial decisions — say, making impulsive purchases for that hit of dopamine, putting off the boredom of paying bills or losing track of when they’re due. 

Deficiencies in the basal ganglia — a set of structures in the brain that process how you evaluate emotions, motivations, goals and risks — may be a factor. 

These structures act as a communication highway for different areas of the brain that need to work together to help you learn and form habits (like following a budget), as well as plan and carry out tasks (like saving for the future). 

“In a way, the basal ganglia in a person with ADHD can be found to almost short-circuit when it comes to its ability to manage the signals that are passing through,” Dr. Zishan Khan, a psychiatrist with Mindpath Health, told HuffPost.

4. Losing all sense of time

Better known as time blindness, people with ADHD find it tricky to keep track of time or to know how much time they’ll need to do an activity. 

So far, no single brain region has been identified as the one responsible for time perception, but time estimation seems to be linked to the prefrontal cortex (the part of the brain that assists with executive functioning, focus and attention, as well as organizational skills, Khan said), which relies on signals from dopamine-related pathways to function properly.

5. Experiencing emotional outbursts

From anxious and edgy to happy and chatty to angry and aggressive, people with ADHD can experience emotional dysregulation that causes them to have strong emotional reactions even they don’t see coming. 

“This is related to the difficulties that can come with managing attention and directing energy, as well as finding the appropriate level of mental stimulation,” O’Shea said. “By only focusing on the result — which looks like an emotional disorder — and not the underlying problem, it’s another adult ADHD symptom that’s easily overlooked.”

6. Forgetting to eat

Research suggests a strong link between ADHD and abnormal eating patterns, the more prominent patterns being binge eating and forgetting to eat entirely. 

When the prefrontal cortex lacks the dopamine necessary to function properly, this can mess with your ability to organize, plan and execute healthy meals and maintain consistent eating habits in general. The dopamine drought can also increase the likelihood of your grabbing convenience foods to satisfy the brain’s reward centers and give it the stimulation necessary to focus. 

Meanwhile, the limbic system is in charge of regulating our emotions, in addition to attention, Khan said. As a result, you might use food as a way to unconsciously cope with boredom and emotional distress — or get sucked into a task to the point where you forget to eat for hours, thanks to feeling disconnected from your body’s hunger and fullness cues.

7. Having trouble sleeping

Insomnia doesn’t necessarily mean you have ADHD, but research suggests adults with ADHD may be predisposed to sleep issues. It could be a side effect of impaired activity in the reticular activating system (RAS) — a network of nerve pathways in the brainstem that are essential in mediating a person’s level of consciousness. 

The RAS acts as a screening device that filters through incoming sensory data and sends bat signals to the brain as it comes across important sensory stimuli that need to be addressed. 

Only, for people with ADHD, RAS dysregulation makes it difficult to distinguish between what’s important sensory information and what’s just noise. The result? “Difficulty regulating arousal and sleep-wake transitions,” Khan said.

8. Taking forever to make decisions

“People with ADHD may experience slower processing speeds,” Louk said. Processing speed refers to how quickly you can react to a given stimulus (in this case, a set of choices) within a limited time frame. 

It’s not necessarily a sign you’re indecisive — rather, that you need more time to navigate the decision-making process. 

You might have difficulty with things like putting together the details necessary to see the big picture, foreseeing the potential outcomes of each option, or getting stuck on one idea and having trouble weighing all of the options to make a decision.

9. Feeling perpetually restless

Restlessness tends to be one of the sneakier signs of adult ADHD, largely due to how easily the external behaviors of restlessness can be attributed to other things, like an intense workload or drinking too much coffee. 

Persistent fidgeting of the hands, legs and feet, as well as picking at your skin, can also be subtle signs of restlessness.

10. Rambling and monopolizing conversations

People with ADHD can have trouble tracking a conversation thanks to poor attention control and retaining information in the moment. 

“This can lead to frequent interrupting because they might not remember what they want to say or what the other person said,” O’Shea said. “They can also feel restless and have an urge to jump in with a thought that interests them.” 

Here’s when you should get tested for ADHD

You might want to get evaluated for ADHD if you’re experiencing five or more symptoms of ADHD — and these symptoms have been persisting for longer than six months, are present in two or more settings (say, at work and in your relationships) and are reducing the quality of how you function in your life. 

The diagnosis of ADHD is made by taking a proper history and gathering relevant information and data to help not only diagnose ADHD but also rule out other causes for the presenting symptoms. 

Important aspects of the exam include the collection of details regarding the presenting complaint, a complete psychiatric review of symptoms, and both personal and family psychiatric and medical histories. 

“Psychological testing is typically used in adults where it’s not clear from the history alone that the symptomatology is indicative of ADHD,” Khan said. “This is because a lot of the rating scales and tests to help diagnose ADHD haven’t been studied in adults and therefore can’t be utilized as sole diagnostic tools or proof an adult has ADHD.” 

Once you’re diagnosed with ADHD, what’s next?

An official ADHD diagnosis can be a game changer for so many adults who were struggling all their lives. Having a diagnosis starts a journey to build back confidence and motivation. 

Treatment for adult ADHD is similar to treatment for childhood ADHD and includes medication, psychotherapy focused on improving organization and functioning in your daily life, and treatment for any mental health conditions that you have along with ADHD. 

Zishan Khan, MD

Frisco, TX

Dr. Zishan Khan is board-certified in child, adolescent, and adult psychiatry. Dr. Khan primarily treats children, adolescents, and young adults suffering from ADHD, anxiety, depression, and behavioral issues that often keep them from reaching their full potential. He works with patients of various cultural and professional backgrounds, helping people improve their lives and conquer their struggles. He prides himself on ... Read Full Bio »

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