Maybe It Isn’t Dementia

Adult ADHD is the master of disguises.

Photo by Ava Sol on Unsplash

Attention Deficit Hyperactivity Disorder (ADHD) is the stealth disorder. It can masquerade as depression, as anxiety, or as memory loss. It’s devilishly difficult to diagnose. Taking treatments for one of the conditions it mimics can make it worse.

Although we usually hear about ADHD as a problem in children, it occurs frequently in adults as well. Adults don’t tend to be hyperactive, but they do display other familiar ADHD behaviors – inability to organize thoughts, hyper focus on what interests them, zero focus on anything that doesn’t, and difficulties with time management.

What’s important about ADHD is the fact that many adults don’t realize they have it. Because the symptoms look like other disorders, it often goes undetected for years.

“Unrecognized ADHD permeates so many chronic problems for individuals, for families, and for society,” says Gina Pera, a noted health educator and the author of Is It You, Me, or Adult ADD?

Unexplainable Behavior

Pera began delving into Adult ADHD when she couldn’t understand why her romantic interest (and now  husband), a research scientist, behaved in unexplainable ways – such as asking her out on a date and showing up with no money, missing his freeway exit repeatedly, or having two car accidents within a month. What she discovered was a disorder in adults that had received little attention from physicians and mental health professionals.

At risk of oversimplifying our complex brain chemistry, ADHD stems from an anomaly in how the brain releases dopamine, a chemical associated with rewards. In a person with ADHD, dopamine transmission is erratic – sometimes too slow, sometimes too fast, sometimes not at all. The result is individuals who may ignore calls to do tasks that don’t stimulate them, who forgets what other adults consider “basic,” or who cannot organize their work, their time, or their thoughts.

A common symptom is what Pera calls “time blindness.” For a person with ADHD, she says, “there are only two times – ‘now’ and ‘not now.’ ‘Now’ is what interests you at the moment, and it is the only thing that exists.” Everything else – promises, commitments, chores – is ‘not now’ and disappears over the horizon, out of mind.

Forgetting to take out the garbage, or being so lost in a book that you don’t hear others around you, are not necessarily causes for alarm. “There’s no trait associated with ADHD that doesn’t occur in the general population,” Pera says. “We all procrastinate sometimes. We all want to do the fun thing before the hard thing sometimes. We all forget sometimes. We all have trouble organizing our thoughts sometimes.” A person with ADHD experiences several of these traits “at the significantly higher end of the spectrum.”

Misdiagnosis Is a Danger

The greatest danger of ADHD is how easily it can be misdiagnosed as something else. If Sally retires from work and doesn’t have the stimulation it provided, her doldrums or restlessness could be mistaken for depression or anxiety. Forgetfulness might be judged an early sign of dementia. A wrong diagnosis, and a wrong treatment plan, could actually worsen ADHD symptoms, Pera says. That’s why it’s important to choose doctors and therapists who are knowledgeable about ADHD and can recognize it.

If you’d like to evaluate yourself or someone you love for ADHD, the  National Institute of Mental Health website has an excellent tool. You will also find a variety of well-researched information at Gina Pera’s website, ADHDRollerCoaster.

And for even more depth, be sure to tune in to the newest edition of TheEndGame podcast, where Gina Pera discusses what is known and yet unknown about this syndrome. Plus, hear a delightful essay on mothers and daughters, read by author Susie Kaufman.

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