Study finds positive self-reported aspects of the ADHD experience among young women, especially related to hyperactivity and hyperfocus

– Three young Nor­we­gian women. Source: Young and Promis­ing show (SBS)

As is true for chil­dren and ado­les­cents, many adults expe­ri­ence sub­stan­tial chal­lenges relat­ed to hav­ing ADHD. These chal­lenges often include rela­tion­ship prob­lems, edu­ca­tion­al and work chal­lenges, dif­fi­cul­ty adher­ing to long-term plans and goals, and time and mon­ey man­age­ment difficulties.

Giv­en these well-doc­u­ment­ed dif­fi­cul­ties, it is not sur­pris­ing that ADHD treat­ment with adults has large­ly adopt­ed a deficit mod­el that empha­sizes reduc­ing the symp­toms and impair­ments asso­ci­at­ed with the condition.

While these are impor­tant treat­ment goals, and the focus of much treat­ment research, lit­tle atten­tion has been giv­en to pos­i­tive aspects of ADHD that some may expe­ri­ence. Attend­ing to this is impor­tant, as it could reduce stig­ma, pro­vide ideas about a strength-based approached to treat­ment, and per­haps con­tribute to reduc­ing the demor­al­iza­tion that some adults with ADHD experience.

A study pub­lished recent­ly in BMJ Open, titled Sil­ver lin­ings of ADHD: a the­mat­ic analy­sis of adults’ pos­i­tive expe­ri­ences with liv­ing with ADHD, pro­vides inter­est­ing new infor­ma­tion on the pos­i­tive fea­tures of ADHD that some adults report.

Par­tic­i­pants were 50 adults in Norway–nearly 90% were women; media age = 34 years–with self-report­ed ADHD who were par­tic­i­pat­ing in a study of a new online, self-direct­ed treat­ment for ADHD in adults (study sum­ma­ry here).

Dur­ing the study, par­tic­i­pants were asked to describe what they expe­ri­enced as “pos­i­tive aspects of hav­ing ADHD” and four the­mat­ic cat­e­gories emerged from their responses.

1) Recognizing the dual impact of some ADHD characteristics:

Many par­tic­i­pants stat­ed that core ADHD char­ac­ter­is­tics like hyper­ac­tiv­i­ty and impul­siv­i­ty could be expe­ri­enced as pos­i­tive fea­tures. Below are some rel­e­vant quotes:

“I am active. I am often able to do a lot in a short peri­od of time and then I get to expe­di­ence more.”

“If it is some­thing I real­ly like, I have bet­ter endurance than oth­ers. I can work on some­thing I enjoy for­ev­er with­out stopping.”

“I am spontaneous/impulsive. I can eas­i­ly just ‘jump into it’ and that has giv­en me a lot of great experiences.”

Hyper­fo­cus­ing was also com­mon­ly men­tioned as an ADHD advan­tage, albeit with some impor­tant caveats.

“I think my ADHD has helped me through­out the exam peri­od. If it had not been for a kind of hyper­fo­cus, it would not have worked. But then again, I might not have post­poned the read­ing for as long as I did if I did­n’t have ADHD.”

“The only pos­i­tive is hyper­fo­cus on tasks that are real­ly excit­ing, but for ADHD to be con­sid­ered pos­i­tive in this set­ting, the task has to be some­thing use­ful, such as school or work.”

It is note­wor­thy that only a sin­gle par­tic­i­pant not­ed any pos­i­tive aspect of their inat­ten­tive symptoms.

2) Unconventional thinking:

Uncon­ven­tion­al think­ing and behav­ior were also com­mon­ly not­ed as pos­i­tive aspects of ADHD. These includ­ed being cre­ative, hav­ing nov­el ideas, see­ing things from a dif­fer­ent per­spec­tive than oth­ers, and being good at find­ing solu­tions. Par­tic­i­pants also empha­sized, how­ev­er, that the social con­text and expec­ta­tions of oth­ers could be an obsta­cle for uti­liz­ing these strengths. Quotes relat­ed to this theme are shown below.

“I am cre­ative and solu­tion-ori­ent­ed and very pas­sion­ate about the things that I am inter­est­ed in.”

“I enjoy try­ing new things, and if I do not get it right the first time, I will exam­ine the pos­si­bil­i­ty of try­ing a sim­pler method.”

“I am pret­ty for­ward, and I am not afraid to take up space when I need a bit of atten­tion. I know a lot of peo­ple and that is prob­a­bly because I am not scared to say hi to new people.”

3) ADHD & the pursuit of new experiences:

Par­tic­i­pants felt that hav­ing ADHD con­tributed to their being adven­tur­ous and seek­ing out nov­el expe­ri­ences; this con­tributed to feel­ings of being coura­geous. Here are some rel­e­vant quotes:

“I seek new envi­ron­ments where I can learn new things”

“I enjoy try­ing new things, and if I do not get it right the first time, I will exam­ine the pos­si­bil­i­ty of try­ing a sim­pler method.”

“I have expe­ri­enced things that only would have hap­pened by tak­ing a risk ”

4) Building resilience and personal growth:

Espe­cial­ly pow­er­ful was the sense that although hav­ing ADHD was chal­leng­ing, efforts to cope with these chal­lenges also con­tributed to their resilience and per­son­al growth. This theme is clear­ly expressed in the quotes below.

“Being diag­nosed with ADHD made me learn a lot about myself. Things I per­haps have been annoyed about, I can now accept and think that it is not ‘my fault’ in a way.”

“I am bet­ter at han­dling resis­tance or chal­lenges now, because I have learned to han­dle such chal­lenges, it is part of life to have ups and downs.”

“I dis­cov­ered that I have ADHD in adult­hood, so I lived most of my life in the belief that I am like every­one else. I have had high expec­ta­tions to myself, com­pared myself to oth­ers, and achieved a lot (…) So when I found out about my chal­lenges, it all became like a piece of cake. I could with good rea­sons low­er the expec­ta­tions to myself and final­ly rest with a clear conscience.”

One par­tic­i­pant who worked as a teacher felt that “I notice that I can meet chil­dren with ADHD with more under­stand­ing, so they feel safe with me quick­ly, and I know I can help them in chal­leng­ing sit­u­a­tions, or pre­pare them a bit extra, so that they are able to get through their school day.”

Summary and implications:

This inter­est­ing qual­i­ta­tive study explor­ing adults’ expe­ri­ence of the pos­i­tive aspects of hav­ing ADHD offers an impor­tant per­spec­tive on the dis­or­der. While clear­ly acknowl­edg­ing that ADHD cre­at­ed chal­lenges for them, their per­cep­tion that ADHD also made pos­i­tive con­tri­bu­tions to their lives is an impor­tant coun­ter­weight to focus­ing sole­ly on deficits.

One impli­ca­tion of these find­ings is that the assess­ment and treat­ment of ADHD in adults should include an explo­ration of any strengths and resources that indi­vid­u­als feel ADHD has con­tributed to. This is con­sis­tent with the view that the most effec­tive psy­chother­a­py will include a focus on clients’ strengths and resilience in addi­tion to ame­lio­rat­ing symp­toms and deficits.

As the authors note, “by putting an empha­sis on the full range of expe­ri­ences relat­ed to ADHD, both good and bad, one might be able to offer treat­ment inter­ven­tions more in line with the needs of adults with ADHD, which may be favor­able for treat­ment engage­ment and clin­i­cal out­comes. For instance, ther­a­pist could help adults with ADHD to iden­ti­fy strengths, which may be ben­e­fi­cial for self-esteem and self-efficacy.”

With­in cog­ni­tive-behav­ioral ther­a­py, one could also use pos­i­tive expe­ri­ences with ADHD to reframe neg­a­tive auto­mat­ic thoughts or mal­adap­tive cog­ni­tions. These spec­u­la­tions should indeed pro­vide inter­est­ing top­ics for fur­ther stud­ies. A focus on pos­i­tive sides to ADHD with­in research may also have soci­etal impli­ca­tions by chang­ing social per­cep­tion around ADHD and by this reduc­ing stig­ma relat­ed to the diagnosis.

There are sev­er­al issues with this study to rec­og­nize. First, the sam­ple is rel­a­tive­ly small, pre­dom­i­nant­ly female, and Nor­we­gian. Thus, the extent to which these find­ings would gen­er­al­ize to men with ADHD and adults from the US and oth­er coun­tries is not certain.

In addi­tion, by fram­ing the prompt to have par­tic­i­pants to describe what they expe­ri­enced as “pos­i­tive aspects of hav­ing ADHD’, some par­tic­i­pants may have gen­er­at­ed pos­i­tive fea­tures to com­ply with the ques­tion, and not nec­es­sar­i­ly because they actu­al­ly expe­ri­enced pos­i­tive aspects of ADHD. Ask­ing “Are there any aspects of hav­ing ADHD that you have expe­ri­enced as pos­i­tive” could have reduced the demand char­ac­ter­is­tic of the question.

Final­ly, it should be not­ed that par­tic­i­pants per­cep­tions are not nec­es­sar­i­ly objec­tive­ly true and pos­i­tive con­se­quences they described from hav­ing ADHD con­ceiv­ably could have lit­tle direct­ly con­nec­tion to the dis­or­der. Even so, how­ev­er, one could argue that what peo­ple per­ceive to be the case about their lives is what mat­ters most.

While these are all impor­tant issues to con­sid­er in sub­se­quent research. attend­ing to what some adults expe­ri­ence as pos­i­tive aspects of ADHD is an impor­tant issue to pur­sue. As the authors note, explor­ing the full range of expe­ri­ences asso­ci­at­ed with ADHD in adults may more ful­ly cap­ture what their life is like and may enhance adults’ engage­ment in treatment.

This per­spec­tive may also con­tribute to incor­po­rat­ing the recog­ni­tion of strengths and resilience into treat­ment, rather than a more exclu­sive focus on symp­toms, impair­ments, and deficits.

– Dr. David Rabin­er is a child clin­i­cal psy­chol­o­gist and Direc­tor of Under­grad­u­ate Stud­ies in the Depart­ment of Psy­chol­o­gy and Neu­ro­science at Duke Uni­ver­si­ty. He pub­lish­es the Atten­tion Research Update, an online newslet­ter that helps par­ents, pro­fes­sion­als, and edu­ca­tors keep up with the lat­est research on ADHD.

The Study in Context:

• Sur­vey of 2500 fam­i­lies finds what ADHD treat­ments seem to work/ not work as applied in the real world
• What are cog­ni­tive abil­i­ties and how to boost them?