Lack of Motivation or ADHD?

Have you or someone you know ever heard the following phrases:

“You aren’t living up to your potential.”

“You can be so spacey.”

“Why aren’t you more organized?  Your desk is a mess!”

“Just try harder.  If you weren’t so lazy/irresponsible, you might be able to get things done.”

“You lost your (keys/glasses/phone/other personal item) again?”

Many bright and talented individuals have been criticized for being lazy, unmotivated, and irresponsible because they procrastinate, frequently lose things or don’t complete work tasks or chores.  Though there could be many reasons for the lack of follow through, disorganization and forgetfulness, one explanation is it could possibly be Attention Deficit Hyperactivity Disorder.

Both children and adults can manifest this disorder in different ways, and people be the predominantly inattentive type, the predominantly hyperactive type, or a combination of both hyperactive and inattentive.  The inattentive type is usually the most difficult to detect, as it is can be subtle and is largely internal struggle.

According to the most recent diagnostic manual used by clinicians (DSM V), there must be a persistent pattern of inattention and/or hyperactivity/impulsivity that interferes with functioning or development, and the person must demonstrate at least six symptoms for at least a period of six months to a degree that is inconsistent with her developmental level which negatively influences her social and occupational life.  These symptoms must be present prior to the age of twelve.

Unfortunately, ADHD seems to be largely misunderstood by the public.  People cannot have a “dusting” of ADHD—one either has it or does not have it.  Though sometimes people joke that “I’m so ADHD,” it is a neurological disorder that usually affects multiple aspects of a person’s daily life.  One of the many brain areas affected by ADHD is the prefrontal cortex, where our inhibition and decision making occurs.  This area of the brain does not function as well for people with ADHD, hence why they usually have problems with impulsivity (e.g., interrupting others or shouting out in class) and making careless mistakes.

A genetic link has been found with ADHD, so usually people inherit it from a parent or grandparent.  Untreated ADHD can cause a multitude of problems, including academic or vocational struggles, low self-esteem, substance abuse, social isolation, marital failures, accidents and depression. Though these are not formal symptoms in the DSM-V, people with ADHD usually have enormous difficulty waking up in the morning and getting to places on time, which subsequently can result in a variety of problems, such as chronic tardiness to work or class, or missing important things such as job interviews. Moreover, if a person is not formerly diagnosed and treated, family members and friends may simply think the person is choosing to be this way, that if they tried hard enough they could act differently.  This naturally leads to frustration and strife for both parties, and even more isolation for the person suffering from ADHD.

I usually see adults with ADHD, and most often times they come to my office without a formal ADHD diagnosis.  Throughout their lives, they have had to strain and struggle, and have often internalized the blame and frustration expressed to them by others, and believe they are lazy, stupid, disorganized or irresponsible.  It’s a shame to see individuals at this place in their lives, when catching ADHD earlier could have helped them obtain the treatment and accommodations they needed (I should also say, it is common for people with ADHD to also have some kind of learning disability).  ADHD is often over or underdiagnosed by practitioners because other conditions can have similar symptoms.

Accommodations can help students with ADHD get things like additional time for assignments and tests, or special seating arrangements so distractions are minimized.  Adults can obtain accommodations at their workplace under the Americans with Disabilities Act.

If you suspect that you or a loved one has ADHD, the first plan of action would be to obtain a formal evaluation by a psychologist who can properly test for this disorder.  Remember, it’s a neurological disorder so there is an appropriate battery of neuropsychological tests that can evaluate for ADHD.  If a formal diagnosis is assigned, the next step would be to meet with a psychologist who specializes in ADHD—this can be very helpful in terms of obtaining skills to organize, slow down and remember things.  A medication evaluation by a psychiatrist is also usually recommended.

Overall, if you suspect that ADHD may be impacting your life, please get help, because help is out there.  To learn more about adult ADHD, I would like to recommend the book “You mean I’m not Lazy, Stupid or Crazy? A Self Help Book for Adults with Attention Deficit Disorder” by Kate Kelly and Peggy Ramundo.