When most people think about ADHD, they think about someone who has trouble paying attention.
Someone who is easily distracted, loses focus during conversations or has difficulty sitting still.
Those can certainly be part of ADHD. But in adults, ADHD is often more complicated than simply having a short attention span.
One of the most frustrating parts can be the inconsistency.
An adult may concentrate intensely on something interesting, sometimes for hours, yet struggle to begin a routine task that needs to get done.
An email that should take five minutes sits unanswered for days. A bill gets forgotten. A small project keeps getting postponed until suddenly it becomes urgent.
This can be very confusing.
“Why can I do difficult things but struggle with simple ones?”
“Why do I keep procrastinating when I know it makes my life harder?”
Much of this can involve executive functioning, the mental processes that help people organize, prioritize, manage time, remember what needs to be done and shift between tasks.
ADHD can also affect attention in ways that seem contradictory. Someone may struggle to stay focused during a meeting but become completely absorbed in something they find interesting.
The problem isn’t always an inability to pay attention. Often, it’s difficulty regulating attention.
From the outside, that inconsistency can look like a lack of effort. It usually isn’t that simple.
For some adults, these patterns were present much earlier in life but became more noticeable as responsibilities increased.
School provides schedules, deadlines and external structure. Adult life increasingly requires people to create that structure themselves while managing work, finances, relationships and family.
Strategies that once worked well enough may no longer be enough.
Of course, being distracted, forgetful or prone to procrastination doesn’t necessarily mean someone has ADHD. Poor sleep, anxiety, depression, chronic stress, medical conditions and other factors can cause similar difficulties.
That is one reason understanding the whole person matters.
Adult ADHD is about much more than being distracted. For many people, the deeper struggle is consistently directing attention and organizing daily life.
Understanding that difference can make sense of struggles that may have been confusing or misunderstood for years.
Peter P. Zafirides, MD
Central Ohio Behavioral Medicine
