Let’s stop assuming that because we can’t see the impact of ADHD on a child that their symptoms are mild and much simpler to navigate.
The assumption that kids with ADHD are doing fine because it all looks OK, is a very dangerous one to make:
They may be achieving well in school, but we don’t know what they’ve missed that’s keeping them from achieving their potential.
They may be learning well, but it’s at the cost of their mental wellbeing because they are secretly struggling to keep it all together.
Or maybe a treatment plan that included medication was what they needed to achieve at their best but we felt that their lost items, social struggles or inconsistent school results weren’t serious enough to warrant that kind of support.
“The fact is, we don’t really know the internal impact of ADHD on our children and they might not really understand it either, especially if their presentations aren’t as visible.”
The fact is, we don’t really know the internal impact of ADHD on our children and they might not really understand it either, especially if their presentations aren’t as visible.
If we’re basing our decisions for treatment and support solely on what we see, we’ll be missing all that we don’t and this decision will impact their ability to thrive.
Each child with ADHD is different. Their life situation, environment, learning ability, talents and any co-occurring conditions will impact how their ADHD manifests too. I can’t tell what your child, or even my own goes through in his ADHD brain every day, but I can share a little about growing up with mine.
Growing up with ADHD – A Glimpse Inside my Childhood Brain
When I was a kid, I never realised that my brain went non-stop.
There was always something on my mind and I assumed everyone else’s brain was the same. I was always day-dreaming of myself in places or with people a lot more interesting than where I was at that moment. But when I got in trouble, was worried, frustrated or even excited about something, it was all I could think about. It would go through my head on repeat, either by setting often unrealistic expectations for how something should be or ruminating for hours on a mistake I had made.
“I would impulsively try to solve a problem or find a way to make myself feel better and this showed up in a lot of addictive behaviours.”
Often, I would impulsively try to solve a problem or find a way to make myself feel better and this showed up in a lot of addictive behaviours. These may have made me feel good at the time but ended with me feeling even worse later on.
Everything was either amazing or awful and there was no in between.
Eventually I learned to think about myself in these terms too. I either did everything wrong or everything was perfect and the feedback from those around me determined my self-assessment. Anything done in between those extremes heightened my feelings of not being good enough and as I grew older this led to my anxiety.
My brain went so fast and showed things so vividly, I often forgot where I was, how much time had passed or what was said to me moments before.
My brain could get so loud, that people would call my name while next to me numerous times and I couldn’t hear them. Sometimes I would think I was answering but I would eventually clue in that I was responding in my head! Meanwhile, I wouldn’t even notice that the person would be frustrated waiting for me. I wouldn’t be able to tell you how long they had waited for me in the first place.
My lack of focus and attention often meant that I missed key pieces of information too. This led to me having to ask to get something repeated or risk doing the tasks and getting something wrong.
Looking back, I often annoyed the people around me with forgetting information, not appearing like I was listening, or misunderstanding directions and social cues, but I never understood exactly what it was I did. I never remembered what I said or the sequence of events that would eventually lead to me not meeting someone’s expectations.
My brain latched onto these situations, constantly debating them, reminding me of all the people who grew tired of me or I had let down, the tasks I’d messed up, and the meltdowns I’d had. These stories became how I defined myself. If these things kept occuring and I couldn’t stop them from happening, then I felt that I was the problem.
I never realised how much my brain worked to avoid the pain that came with feeling bored.
I never knew that my brain kept moving to keep itself stimulated even if that meant zoning out on things that were important to me. This made learning more of a struggle than it should have been, only I never realised it. I just assumed everyone else was better at it than me, I needed to try harder and I just wasn’t as smart as I thought I was.
As I got older, to keep from falling asleep in classes or being distracted, I began writing everything the teacher said. If my brain wasn’t on non-stop, I would be exhausted. I could never predict the timing of either.
“I just couldn’t understand why I wasn’t able to do (tasks) consistently. How could I get bored with things I loved as quickly as with things I didn’t?”
I also couldn’t predict when I would hyperfocus into school or personal interests either, this inconsistency was hard to explain to others and even harder for me to understand myself. For example, I loved to read and could read for hours – sometimes – but reading could also be a chore and there were times I couldn’t force myself to do it.
I also loved to write and as a kid I thought I was good at it. I just couldn’t understand why I wasn’t able to do this consistently. How could I get bored with things I loved as quickly as with things I didn’t? This would happen in a lot of different areas of my life: with people, healthy habits or career choices and I always struggled to make sense of this. This made me begin to doubt myself, unable to trust that I could accomplish things I wanted to do in my life.
My inattentive ADHD came with what must have looked like ‘selective memory’ to those around me. I could remember some things I was interested in, and this sometimes helped for school, but I struggled with things like multistep directions, important dates or retaining information for school exams.
I could remember to do some things that I wanted to do for myself, but I often forgot tasks I had to do for others. Chores I’d done growing up over and over again, had to be explained to me a few times before I got them right.
My consistency in how I completed tasks was all over the place too. Everyone expected me to remember certain day to day things, but when I forgot I never connected how much this impacted people around me. Every time someone was upset with me, it felt new to me. I never knew that this would make me appear selfish and when people said this to me, I couldn’t understand why they would think that. I never planned on not paying attention or not remembering. It was a mistake. I just didn’t realise that I was making these kinds of mistakes more often than people around me. To compensate for this, I began to second guess myself.
“I put pressure on myself to not make mistakes like forgetting or missing details. I became a perfectionist in hopes of avoiding feeling like I had let people down and tried to please them.”
Issues with Emotions
Inattentive ADHD, for me as a kid, also meant that I struggled with regulating my emotions. I felt them so intensely. Joy felt momentous and I never wanted it to end, while things that were painful, worrying or difficult would leave me feeling crippled inside.
When I was younger, I would often have meltdowns when I experienced disappointment from others. But as I got older and learned that this wasn’t acceptable, I would turn that pain inwards.
The intensity of these feelings carried so much weight. My brain would be lost in thoughts of ruminations, dreams of what could be or simply thinking of how I could change things. But the frustrating thing about my thoughts were that they rarely made me take action to change anything.
“Inattentive ADHD, for me as a kid, also meant that I struggled with regulating my emotions. I felt them so intensely. Joy felt momentous and I never wanted it to end, while things that were painful, worrying or difficult would leave me feeling crippled inside.”
I could feel horrible about an argument with a friend, desperately want to do something to fix it, but I couldn’t find the confidence, clarity or motivation to do anything about it.
I couldn’t explain or predict when I would meltdown. I couldn’t control them when they happened and each time they did, I felt a little more helpless inside. When I got into my teens I started battling with my confidence and tried to cope with the symptoms of my anxiety with a lot of unhealthy coping mechanisms that almost had me dropout of high school. I had no idea what made things so much harder, what I could do to change or why I couldn’t make myself just act differently. I suppose on the outside, they may have looked like defiance, disrespect or lacking self discipline. On the inside my feelings of anxiety, low self esteem and lack of confidence just seemed intensified.
Adulthood: Diagnosis and Treatment
As an adult, I can’t remember when so many thoughts of inadequacy, anxiety and self doubt became just a normal part of my life. I can’t remember a time where I never thought the way I did or acted the way I did either.
“It is harder to repair a broken adult than to give the right treatment to a child. So, knowing that there are additional needs, let’s start thinking about what we can do to help our ADHD children now.”
I wasn’t diagnosed until I was 40 years old and it will take me years to unravel the stories I’ve told myself and come to terms with all that I’ve lost in possible academic and athletic achievements, broken relationships and a stagnant career.
It is harder to repair a broken adult than to give the right treatment to a child. So, knowing that there are additional needs, let’s start thinking about what we can do to help our ADHD children now. Even though their needs may not be visible in the present moment, it doesn’t mean they won’t benefit from the right support if it’s put in place.
It does seem strange to ask for treatment or begin supporting a condition that looks invisible for so many of us, but don’t underestimate how little things can make a big difference.
A holistic approach in meeting the needs of our ADHD children will always be best:
Setting up a caring environment of routine and clear expectations is important, while developing an understanding of the way our children’s ADHD presents at home and school is crucial.
Keeping our children knowledgeable about their ADHD as they get older is important too. If they don’t learn about it from us, how will they know who to go to and when as things get more challenging?
Since we are aware of the delayed development of executive functions, there are many ways we can start addressing this now. Social, emotional, physical and mental well being can also be supported knowing that our ADHD children often struggle with emotional dysregulation and this impacts many areas of their lives.
As our ADHD children turn to teens, it’s imperative to remember that there is asynchronous development and learning ways to help balance their need for independence and support at the same time is imperative.
The use of medication is always a personal one, however, as much as it can’t be the only treatment used with your child, excluding it without considering how it could positively impact your child isn’t always ideal either.
Many of the struggles I dealt with growing up stemmed from my inability to harness my focus or ability to pause, and a lot of unhelpful coping mechanisms came from trying to manage this on my own.
“…if we hold off on adding medication until we think our ADHD children need it, by the time we notice that they’re struggling, I can tell you that it’s often too late.”
One thing I know for sure is if we hold off on adding medication until we think our ADHD children need it, by the time we notice that they’re struggling, I can tell you that it’s often too late. The truth is they’ve most likely been struggling for a while by that point and the option of using medication may become a battle, especially if it’s never been discussed in the past.
As the demands of school, home and social lives increase, the mental weight of it eventually becomes too much, especially if left to manage on their own and we need to remember that.
This was a glimpse inside my childhood brain, but it won’t be exactly like another child’s ADHD brain.
Treatment needs will look different to everyone:
Treatment can’t become an option only if there are academic or social problems.
It can’t be an option when it’s simply about conforming to the demands of others either.
Instead treatment needs to help our ADHD children learn about who they are as neurodivergent people and what works best for them.
It needs to help them grow into the best versions of themselves, with the ability to create a life that works for their strengths, talents and challenges in mind.
“When we withhold options of treatment and support, we limit our ADHD children’s ability to reach their potential.”
We must remember that ADHD is an invisible, chronic condition and all we see is the very tip of the iceberg. There is so much more happening just below the surface and we need to make sure our treatment plans address the symptoms we can’t see just as urgently as the one we can.
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