Attentional difficulties in adults with ADHD

It is estimated that between 3-5% of adults suffer from ADHD. This means that a portion
of the adults around us show several of the symptoms of this disorder, and, that they had
them since childhood.

In order for adults to be diagnosed with ADHD, they not only have to present hyperactivity
or inattention symptoms, but they also had to show them during their childhood. When
they were kids, adults with ADHD probably had trouble graduating from school due to
difficulties concentrating, being easily distracted by irrelevant stimuli, or having trouble
staying still. They might have also experienced difficulties in interacting with peers during
their childhood and adolescence, potentially affecting their self-esteem and self-image
due to the several failures they faced throughout their lives.

Remember that a person who starts showing concentrating problems, forgets their
personal belongings, or presents organization and work difficulties, does not necessarily
have ADHD. If the symptoms did not appear early in their childhood, most likely, this
person is just going through a lot of stress, exhaustion, or psychological problems.

Adults with ADHD display a series of symptoms that affect their performance in different
settings, like work, school or college, social gatherings, and leisure activities. Although
some of these symptoms are similar in children with ADHD, adults show a series of specific
symptoms that differ, since they have different obligations in different settings.

Even though we mention that adults with ADHD must have had symptoms in their
childhood, this does not mean that this disorder cannot be diagnosed during adulthood. In
fact, many authors point to an increasingly frequent problem: the overdiagnosis of ADHD
in adulthood, i.e., people who do not have ADHD and are diagnosed as such. The reason
for the increased prevalence of ADHD in adults is related to the lack of specific diagnostic
tools, such as tests, questionnaires, and professional expertise, and access to medication
that helps them concentrate, reducing psychological stress and sometimes even used as
recreational drugs. This has been studied in university settings, mainly in the United
States. On the contrary, other studies suggest that the disorder is underdiagnosed due to
the stigma of having a neurodevelopmental disorder. In both cases, it is extremely
important to recognize the symptoms in order to facilitate access to adequate treatment
for people with and without ADHD.

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Next, we will discuss some of the symptoms that adults with ADHD show in different
settings.

Work and academic difficulties

Not all adults with ADHD are able to keep a job. Others may have a lot of jobs during short
periods of time, or be stuck in the same position for years with no promotion chances, due
to their attention difficulties. It is also common for them to make mistakes and miss
deadlines at work, limiting their performance, even if the job is appropriate for their
educational level.

Adults with ADHD may show the following symptoms in their workplace: they can make
mistakes when filling out forms in administrative jobs or have difficulties with details. For
example, if they programme, they often make code errors. They may not read instructions
carefully, and rather work quickly and sloppily, or dwell too long on details, making a
simple task take much longer.

In addition, when they have to do monotonous tasks, such as filling out spreadsheets,
forms, or entering data, they tend to be easily distracted or have a hard time starting this
type of task. They often put off difficult tasks, because they know how challenging they
can be for them. Moreover, to finish tasks on time, they may need to have explicit
deadlines, since they usually tend to carry out several tasks at the same time without
finishing any of them.

Regarding their planification skills: they may have difficulties organizing their time and
tasks and using agendas. They start tasks in a disorganized way, without prioritizing the
important ones or breaking large tasks into smaller tasks to make them more manageable.
Additionally, they may also have a hard time estimating work time, so a task they may
think will take a day to be completed, can end up taking a week to finish. As a result, they
often get busy with work they intend to get done on time and end up with a lot of
backlog.

Forgetting is also typical of adults with ADHD: they can lose important work papers or
files. For example, a teacher can lose his students’ homework because he forgot it
somewhere. They may also forget appointments, meetings, or may schedule two
meetings for the same day because they forgot the first one, or to check their schedule.
For this reason, they may also show strict strategies to avoid forgetting, like carefully
checking their house or workplace before leaving, etc.

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About hyperactivity, it is common for these symptoms to appear at work: people with
ADHD have difficulty doing jobs that involve sitting for a long time. They tend to play with
pens, bite their nails, or go around their workplace doing different tasks, as if they never
get tired. It should be noted that many of these behaviors may be less severe in adulthood
than they were in childhood, but this can lead to stress and discomfort.

Finally, in academic settings, like college, adults with ADHD may show some of the
symptoms they experienced during childhood, but to a lesser extent: difficulty
concentrating in class, being easily distracted by thoughts, memories, or external stimuli,
forgetting homework, having trouble concentrating while studying, experiencing
boredom, and career changes. This hinders their chances of obtaining higher education
and training.

Social difficulties
Adults with ADHD not only have difficulty at work, they also have trouble interacting with
peers. Some may change partners easily because they get tired of them quickly, while
others may have problems starting new relationships due to self-esteem problems or a
negative self-image. They may also be impulsive when starting a relationship or when they
have problems with their partner.

Those with families may have marital and parenting problems due to attentional deficits,
as well as difficulties managing finances due to impulsive purchases, lack of money
organization, etc.

When interacting with other people, adults with ADHD may have trouble concentrating on
a conversation, seem absent, and the person speaking to them may need to repeat a
question or phrase it more than once. Furthermore, they might change the conversation
topic because a thought or memory crossed their minds, or because some external
distractor caught their attention. Additionally, after having a conversation, they may
forget some details. This is all related to the difficulties of paying attention to a
conversation. Though unintended, this behavior can be perceived as a lack of interest,
making the counterpart (friends, partner, family member, etc.) misinterpret these
oversights and reproach them for forgetting something important. This greatly harms their
social relationships.

In relation to hyperactivity problems, people with ADHD, with hyperactivity symptoms,

may have a tendency to intervene in other people’s conversations, or talk excessively,

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interrupting other people. They may respond impulsively, without self-editing what is
about to be said, even being hurtful.

Other hyperactivity symptoms include an inability to control impulses, which can lead to
disrespecting social boundaries or interrupting their friends and family. Because of this,
they may be described as “nosy”.

In summary, these social difficulties can undermine the self-esteem of people with ADHD.
They may exhibit symptoms of sadness, worry, fear of failure, and overreactions to
negative criticism about their attention or hyperactivity deficits.

Hobbies and leisure time difficulties

Adults with ADHD may have many hobbies and constantly search for new ones, which, at
first glance, might seem that they do not have difficulties in this area. However, they often
fail to relax during these activities or enjoy them.

Because they have trouble concentrating, they abandon hobbies when they become
difficult to maintain or when they notice that they have a hard time concentrating, such as
reading, playing games (crossword puzzles, board games), or watching movies. In addition,
they can easily get bored with their interests and tend to change them: one week they are
interested in art and painting and the next week they want to play several sports at the
same time.

Moreover, and mainly related to hyperactivity, they may impulsively choose new hobbies
or may want to do several at once, due to their inability to sit still. They tend to have a lot
of energy and get busy with activities to help them relax, especially sports.

References
American Psychiatric Association. (2014). Guía de consulta de los criterios diagnósticos del
DSM-5 (Spanish Edition of the Desk Reference to the Diagnostic Criteria From DSM-5).
American Psychiatric Pub.

Fejerman, N. & Grañana, N. (2017). Neuropsicología infantil. Paidós.

Marshall, P.; Hoelzle, J. & Nikolas, M. (2021). Diagnosing Attention-Deficit/Hyperactivity

Disorder (ADHD) in young adults: A qualitative review of the utility of assessment

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measures and recommendations for improving the diagnostic process. The Clinical
Neuropsychologist, 35(1), 165-198.

PJC, J.; Ramos-Quiroga, J. A.; Chalita, P. J.; Vidal, R.; Bosch, R.; Palomar, G. & Prats, L.
(2012). Diagnóstico y tratamiento del trastorno por déficit de atención/hiperactividad en
adultos. Revista Neurología, 54 (Supl. 1), S105-15.

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