Does Everyone Have ADHD?

So you've just come out to a friend as having ADHD. They nod sympathetically and say "oh yeah I procrastinate and get distracted too". The moment lands flat and you hear crickets chirping. (My ADHD Cricket app going off in your handbag).

You feel kind of dismissed and maybe a bit defensive but struggle to find the words to explain why it's not the same thing. And also the question sits in the back of your mind "but do I really have ADHD or am I just a failure?" The irony here is that self doubt is a classic part of the standard ADHD traits.^{8 9 10}

There's Shades of Grey

The ADHD traits are about extremely poor short term memory, difficulty focussing, difficulty getting started with things, impulsive behaviour, impulsive emotions, impulsive speaking and impulsive humour. Everybody has these issues to some degree. That is not contested.^{1 2} But for some people it is at a level which severely impacts their lives. For example did you know that someone with ADHD has a life expectancy of around 10 years less than someone without?¹²

Brain scans and MRI imaging etc. is expensive and time consuming so usually ADHD diagnosis is made using a set of questionnaires. They try to figure out whether the ADHD symptoms are affecting a minimum number of areas of your life, causing serious impacts and were present before the age of 12.³

The Scale of It

ADHD is caused by the part of your brain that takes control over your prime impulses and makes adult decisions doesn't work properly. (The scientific explanation is something to do with not having enough neurotransmitters or receptors or some such). And the impacts can be ridiculously debilitating. We can't just decide to control them. Telling us to just relax and concentrate is like putting booze in front of an alcoholic and telling them to just simply learn to drink in moderation.

To give an example from my own life, do any of you remember the endowment mortgage mis-selling scandal in the late 1990s? I had a form to complete and send off which would have allowed me to claim £16,000.00 in compensation. That form was on my desk for three years. I looked at it every day. But there was a statute of limitations. If you didn't claim by a certain date you couldn't claim. And I sat and looked at that form as the date came and went. I am not rich. Rather the reverse. It took me years of scrimping to pay off that amount. Some people may say just pull your socks up and prioritise. If I could have, don't you think I would have done so? I know of many similar stories. A friend of mine failed to submit his tax returns for five consecutive years and then the Inland Revenue inspectors turned up at his door to arrest him.

These sort of things happen every day to people with ADHD. It can be crippling. If we could force ourselves to focus and do what we need to. We would. Period! (As the Americans say).

The Real Impacts

The symptoms people have heard of are fidgeting, being easily distracted, forgetful, talking over people. Research has mapped at least 150 distinct categories of symptoms.⁴ These relate to memory, attention, emotional regulation, sleep, time perception, household management, money, relationships, social life, physical health, self identity and many others.

The one that I find personally most annoying of all is called 'Activation Freeze'. It is where we have a problem just getting started with things. This even applies to things I enjoy, like watching a TV programme or reading a novel. Can you imagine the cumulative effect of not being able to engage with things you enjoy doing?

There are other common problems for sufferers. Objects become invisible if they are not in their usual place hence we are always losing our keys or phones.

The impulsivity is not just about kids being restless and running around the playground like mad eegits. It is about impulsive spending, impulsive eating, and all kinds of other destructive impulsive behaviours.

I personally have a destructive tendency to speak very impulsively and make inappropriate jokes at the wrong time. I can't tell you how many times this has got me into trouble at work. And it can be incredibly difficult to resist. (I imagine that this is something like what people with Tourette's syndrome experience, only without the tics). Sometimes I know my joke is inappropriate and out of place but resisting the urge to say it anyway is overwhelming. And it's not just about speaking impulsively; it is often about acting out as well.

And there is the emotional impulsiveness as well. Our emotional reactions can be extreme and unexpected and can run unchecked, although people around us may not see physical manifestations of this.

There's a fancy term 'Rejection Sensitive Dysphoria' or RSD. We get intensely emotional over a perceived rejection. Maybe non-ADHD people get this too but again it's about the level of impact. Analysis of hundreds of cases by experts shows that it is severe in people with ADHD.¹¹

And there is a thing that has been called 'emotional time travel' where we re-live past mistakes as if they are happening now. I suffer badly from this one. Sometimes I suddenly out of the blue remember something embarrassing I did 50 years ago and I almost physically cringe and yelp.

Some days are worse than others and it's sometimes almost like being a different person.

The breadth of the challenge list is itself part of the answer to "do I really have it." ADHD isn't one symptom that everyone gets sometimes. It's a consistent pattern across almost every area of daily life, day after day, year after year.

The Brain Evidence

ADHD is not a personality type, a style or a failure of effort. There is measurable brain-level evidence. Albeit difficult to measure and quantify. A 2007 study at the US National Institute of Mental Health scanned the brains of 223 children with ADHD repeatedly over time and found that the part of the brain responsible for focus, planning and impulse control reached peak development roughly three years later in the ADHD group than in children without the condition. In the ADHD group, half of the brain's outer layer had reached peak thickness by age 10.5. In children without ADHD, this happened by age 7.5.⁵

Brain imaging cannot currently reliably diagnose ADHD in an individual. They only show up clearly across large groups, not individual scans.⁵ So it is not useful as a diagnostic tool.

Studies using twins have consistently estimated that around 74% of the variation in who has ADHD and who doesn't comes down to genetics. Nature not nurture.^{6 7}

So Why Does It Feel Like Everyone Has It?

People who come out with the reaction I mentioned at the top of this article are trying to be supportive and empathetic and wanting to connect. Even reassuring. The traits really are universal. Distraction, forgetfulness, the urge to put things off are all part of the human experience. What is different is the dial setting.

The neurotypical response accidentally flattens a real distinction.

For a book I'm working on I started compiling a spreadsheet of examples of the typical problems faced by people with ADHD in the workplace. Just for illustration here are some that I find particularly interesting.

If You're Asking The Question

To be certain you need to go and see your doctor. Medications can help a LOT of people and can transform your life. (Sadly I can't take them because I have a history of heart problems).

If you're curious there are a lot of free on-line ADHD diagnosis questionnaires that can give you an instant answer.

WHO Adult ADHD Self-Report Scale (ASRS v1.1) via Mental Health America: https://screening.mhanational.org/screening-tools/adhd/

Psychology Today's ADHD Test (based on the same validated instruments): https://www.psychologytoday.com/us/tests/health/adhdattention-deficit-disorder-test

Important framing: Neither of these gives you a diagnosis. They're screeners. A high score means the question is worth taking to a doctor. A low score doesn't necessarily mean the question goes away.

A Note On What This Post Isn't Saying

It isn't saying ADHD is the only explanation for the challenges listed here.

Anxiety, depression, sleep problems and thyroid issues can all produce symptoms that look similar to ADHD. So these might need a different type of treatment.

And it is not an exact science. Some people will carry a significant load of ADHD traits without meeting the full diagnostic threshold. That experience is real and hard even without a formal diagnosis.

The Bottom Line

Everyone has the symptoms that ADHD sufferers experience. It's just about the level of impact. If you're curious, go to your doctor because there are treatments available. And once you know you have it, even if you don't take the medications you will be better able to figure out what to do to reduce the impact.

As always, if I state something as a fact I like to give scientific backup. The supporting links are below if you want to read further!