Mental Health Check-In: Adult ADHD

by Holley Rouse, CAWG Candidate Representative

I have always known my brain worked differently than most people’s. I did well managing my quirks throughout childhood and in college due to coping skills — some healthy and some not as healthy — and what I now know was masking. Masking is presenting yourself in a way that seems like you aren’t dealing with attention deficit hyperactivity disorder (ADHD) behaviors in order to fit in. It’s often unintentional. Several people in my family used similar skills to navigate life, so it didn’t seem unusual to any of us.

But the pandemic changed everything. The daily structure I had was gone and many of my coping mechanisms were no longer possibilities or were drastically different. I slowly felt myself turning into someone I didn’t recognize. The anxiety I had struggled with for years got worse. Even simple tasks seemed impossible, yet I wasn’t depressed. I was either hyper-focused or constantly self-monitoring to bring my focus back to the task at hand. It was mentally exhausting. As you can imagine, studying was incredibly difficult unless I was hyper-focused, which caused me to forget to eat, drink and use the restroom, which is not healthy nor sustainable long-term.

Thankfully, I started seeing an amazing therapist in January 2021 who happened to have ADHD. She immediately asked me when I had been diagnosed with ADHD and was shocked to find out that I hadn’t been! After about a year of working with her, it was time to get an official diagnosis and medication to continue making progress.

The diagnostic process itself wasn’t difficult; however, the wait was excruciating. Altogether, the time from calling to schedule testing to seeing a psychiatrist for medication was eight months. The initial screening involved a lot of paperwork and a telehealth interview followed by in-person testing. I hated the actual testing. It was tedious and boring, and I could not sit still. It was worth it with ADHD and anxiety. I knew about the latter from prior therapy experiences, but it was validating to see it on paper.

I feel very fortunate to have access to medical professionals who listened to me, but that is not the case for many people. The diagnostic criteria for ADHD are based on symptoms prevalent in people assigned male at birth, particularly in childhood. People assigned female at birth often are undiagnosed as children, struggle greatly and seek help only after a major event (like a pandemic or childbirth). Many of us are just now getting diagnosed and realizing that lifelong struggles are in fact ADHD symptoms. The other issue with obtaining an ADHD diagnosis is that the symptoms have to be negatively affecting your life most of the time. Therefore, if your coping skills and masking are decent, you may not realize you have ADHD and that there are treatments that can improve your quality of life.

Adult ADHD symptoms include:

  • Executive functioning challenges (prioritization of tasks, planning and execution).
  • Problems focusing or directing attention.
  • Chronic stress and overwhelm.
  • Excessive activity or restlessness when seated.
  • Anxiety.
  • Problems remembering information.
  • Poor working memory (like losing your coffee or rereading the same page over and over again).
  • Procrastination, lack of motivation or an inability to initiate tasks.
  • Boredom.
  • Hyper-focus.
  • Negative self-image due to other symptoms.
  • Impulsivity (can lead to overspending).
  • Making careless mistakes or not giving close attention to details.
  • Fatigue, especially after long periods of hyper-focus.
  • Racing thoughts, often intrusive.
  • Depression or apathy.
  • Learning disabilities (commonly dyslexia and dyscalculia).
  • Indecision that you cannot move past.
  • Disorganization (especially with bills).
  • Non-linear thinking and fantastic creativity.

Symptoms vary based on type of ADHD, but they can also change based on age, stress levels and hormonal swings, which is particularly challenging for people with uteruses. It’s also important to note that every person with ADHD is not a monolith. Knowing one person with ADHD means you know one person with ADHD. Someone else with ADHD may have completely different symptoms and coping skills.

If someone is intelligent, they may be very adept at masking ADHD symptoms but may seem to never fully live up to their potential. ADHD can also lead to substance-abuse, eating disorders and other mental health disorders like anxiety in the ADHD brain’s search for stimuli. Dr. Hallowell and Dr. Ratey, leading experts on the disorder and authors of ADHD 2.0, refer to people with ADHD as having “a race car for a brain, but with bicycle brakes.” The race car is constantly looking for gas as it’s speeding down the road, even if it just filled up and needs to stop to get directions. After starting medication, my anxiety is almost completely gone. Turns out my brain was using anxiety as a source of stimulation! My psychiatrist indicated that is the case for many people with ADHD, which is why she starts people on ADHD meds before antianxiety meds or antidepressants. Often, once the ADHD is treated, the co-occurring mental health disorder “disappears.”

ADHD isn’t all negative though! There are advantages to having a neurodiverse brain. These include an insatiable appetite to learn, endless creativity, non-linear thinking, ability to stay calm in an emergency, empathy and many others. Finding your strengths and capitalizing on them is incredibly important for people with ADHD. Two of the reasons I am drawn to the actuarial field are its emphasis on education and constant evolving of the industry, both of which appeal to my unique brain.

Medication, therapy, regular exercise, other ADHD-focused lifestyle changes and accommodations can help manage symptoms. However, half of the battle is knowing that there isn’t anything wrong with you! You aren’t lazy, stupid or inadequate. Getting diagnosed with ADHD has helped me harness my strengths and find creative solutions for my challenges. For example, I keep snacks in a lazy susan on my kitchen table to grab when I leave the house because seeing them helps me remember I will need one later.

It is important to note that ADHD is considered a disability under the ADA. This gives people with diagnosed ADHD access to testing and work accommodations to better accommodate their neurodiverse brains. The CAS Exam Registration page has a Helpful Information section with details on “Special Arrangements for Candidates with a Disability” for more information.