ADHD is more complex than hyperactivity - here are six unexpected indicators you might overlook
Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition shrouded in misconceptions.
It doesn't always involve patients bouncing off the walls, unable to maintain a gentle conversation, or struggling to concentrate on daily tasks.
In fact, its symptoms are so far-ranging that many people go half their lives without receiving an official diagnosis.
With this in mind, a band of healthcare professionals are attempting to raise awareness of the lesser-known, possibly unexpected ADHD indicators.
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Amongst them is consultant psychiatrist Dr James Kustow, who believes the misunderstanding that the condition is all about hyperactivity and over-impulsiveness can actually be harmful.
He told The Telegraph this week: "I find it helpful to think of ADHD as a broader, multi-system brain and body dysregulation. "People don’t come in and say, 'I am hyperactive' or 'I am impulsive'.
"They come in with the consequences, the way those symptoms play out in their lives."
1) Taking risks in relationships:
Whether it be in-between the sheets or moving in together, Kustow says a common sign of ADHD often emerges in relationships, and takes the shape of taking controversial risks after becoming bored quickly.
"This won’t be the case for everyone, but there can be a ‘chasing what’s shinier around the corner’ mentality, which can strain romantic relationships," he explained, adding that this pattern forms part of broader, novelty-seeking behaviours. It's all about dopamine.
"If the reward system baseline is low, that can lead people to unconsciously seek out ways to boost dopamine, and can lead to addictions of all forms," the medic continued. "You’re not just talking about risky sexual encounters, but also substances and other addictions such as gambling, pornography, screens, social media, food and work."
2) Flexibility, clumsiness and exhaustion:
It might sound strange, but many studies have evidenced that physical flexibility is a common trait amongst people with ADHD. The issue is, however, that this flexibility can cause unforeseen injury and sprain.
Their loose limbs might also make them appear clumsy or accident-prone. According to Kustow, there's a link between ADHD, injury and fatigue.
He explained: "We know that around half of people with ADHD are hyper-mobile, and what that means is that your connective tissue – the tissue that holds the body together - is lax and more floppy.
"That can lead to altered proprioception, the sense of where your body is in space."
3) Disordered eating:
Though eating disorders usually fall under a different mental health umbrella entirely, Kustow says there can be a crossover between dangerous food habits and ADHD. Again, he believes it's due to perceptions of reward and regulation within the brain.
"If someone is not organised about meal preparation, they end up hungry and reaching for addictive ultra-processed foods," the psychiatrist continued.
"Many people with ADHD will finish everything on their plate regardless of whether their system needs it or not.
"This is partly impulse control, partly emotional eating and dopamine craving, but it’s also about a dysregulated sense of satiety – not being able to sense when they are full and no longer hungry."
4) Being TOO organised:
Yep, you read that. According to Kustow, the perception that ADHD-sufferers don't know their left from their right, lose everything they own, forget things and can't stay on top of their schedule is grossly incorrect.
He emphasised that, in some people, the disorder can present itself as over-organisation, hyper-focus and an addiction to work.
"The core symptom here is rejection sensitive dysphoria (RSD)," Kustow continued. "It’s not an official diagnostic term, but we see it often in clinics. People with ADHD are more sensitive to rejection from other people, so this can lead to people-pleasing or perfectionism.
"They need that stimulus of the anxiety and fear to stay organised, but without it, their life is in chaos."
5) Insomnia and vivid dreams:
Even after a person with ADHD climbs into bed at night, their overstimulated imaginations might stop them from being able to drift off to sleep. Alternatively, they're more likely to suffer from vivid dreams and even nightmares.
On top of this, Kustow added that studies show a correlation between ADHD and sleep apnoea.
Offering an explanation, he continued: "The circadian rhythm is biologically and physiologically dysregulated. It’s as if someone has taken a normal sleep time and wake time and shifted it about an hour to the right… so people with ADHD as a group get tired later and take longer to fall asleep."
With regards to sleep apnoea, which can prove dangerous, Kustow added: "Hypermobility affects the tissues around your upper airway, causing it to briefly shut down.
"That leads to a period of apnoea – not breathing – followed by a gasp. Some studies show that up to a third of people with ADHD have sleep apnoea."
6) Over-sensitivity:
Not emotionally, but to stimulants like light, sound, touch and smells.
Feeling overwhelmed by the likes of intense lighting, loud noises, busy crowds and extreme smells - also known as a sensory issue - is a symptom usually linked to autism, but Kustow says it can also present itself in ADHD cases.
This, he believes, could be the result of weaker 'breaking' systems in the brain, which make it harder for ADHD patients to regulate how they respond to the environment around them.
"It’s about patterns, not individual symptoms," Kustow noted. "The more of these that are present, the more it increases the likelihood, so then you go and do a thorough assessment."
Topics: Mental Health, Health, Real Life, Advice
Rhianna Benson