are you restless or is it adult adhd?

just as fever is a medical symptom, problems with attention, focus and concentration — alone or in combination with irritability and restlessness — are symptoms  common to a wide variety of disorders . self-reporting of adhd symptoms on questionnaires has up to  78 per cent false positive rate  for adhd diagnosis.  symptoms alone are not enough to diagnose this disorder .

even recall of childhood behaviours is not an accurate way to make this diagnosis. comprehensive long-term followup studies show that many adults whose records show they did not meet criteria for adhd in childhood  nevertheless inaccurately recall childhood behaviours similar to adhd when questioned as adults .

adhd is a neurodevelopmental disorder that affects about  9.4 per cent of school-aged children  and about  4.4 per cent of adults in north america .

diagnostic criteria  include more than just having symptoms. to be diagnosed with adhd as a teen or young adult requires all of the following:

• a number of these symptoms must have been present and impairing in two or more major life areas (such as home and school) prior to age 12;
• the symptoms must have been chronic; and
• the symptoms cannot be due to other conditions that can mimic adhd, such as depression, anxiety, stress, sleep problems, drugs/alcohol abuse, perfectionism, thyroid problems, trauma or personality disorder.

the first five of those “adhd mimics” are conditions  that have increased  due to the pandemic and lockdown rules. past traumas or certain personality traits have also made coping with lockdown  much more stressful .

even before the pandemic, symptoms of adhd in the general population were  very common . studies of post-secondary students with and without adhd show that a  high number of non-disabled students experience these non-specific symptoms on a daily basis .

life during the pandemic has been very stressful  for many people. research from our lab shows that  the more anxious, depressed or stressed you are, the more symptoms of adhd you’ll experience , even if you have never previously been suspected of having adhd. we know that  cabin fever  has many symptoms similar to adhd, and  social isolation  also has many negative effects on brain functioning.

overall,  we’ve only diagnosed about five per cent of these people with adhd . this finding is consistent with other studies  showing that most of the time, later-onset symptoms of adhd are due to something else .

1. get into a groove . people function best when they have a consistent routine; covid-19 and working from home have eliminated a lot of the structure we used to enjoy. focusing when your children are home, the dog barks or your partner is on a loud meeting in the next room is extremely difficult.

try to find a quiet location to do your work, put up a sign that alerts others when you need to focus, and prioritize doing your  most difficult work in the time of day that is best for you . if that is late at night or first thing in the morning, then adjust your expectations for the rest of the day.

2. say goodnight to sleep problems . poor sleep quality and sleep disturbance result in  significant problems with attention, focus and memory . additionally, waking up and going to bed at inconsistent times can cause significant problems, similar  to being constantly jet lagged .

to improve sleep quality,  practise what is called good sleep hygiene , such as keeping a regular sleep schedule, having a bedtime routine and maintaining a comfortable, quiet sleeping area. and,  get your phone out of your bedroom  because it’s disrupting your sleep!

3. read all about it . strategies that work for those with adhd work for anyone having these symptoms. many excellent  books describe  ways to improve focus and  get more done . there are  also great websites  that describe proven ways to improve your attention.

4. cut down on use of electronic devices . with covid-19 lockdown and working from home, most people are spending more time online, but  electronic devices are highly addictive  and  extremely distracting . in fact, a review of the research shows that overuse of  electronic devices leads to brain overload, increases distraction and lowers overall performance . studies have also shown a strong link between  mental health symptoms and excessive use of electronic devices .

one of the biggest challenges we hear about from the post-secondary students we see at our centre is limiting the use of electronics. there are some great apps that  limit the amount of time you’re online, and websites that offer strategies  to help you take control of your smartphone use.

5. worry list/worry time . pandemic stress has many people worrying constantly, so much so that their mind is always distracted and they can never focus. further, their brains have become accustomed to hijacking thinking any time a worry surfaces, so you need some  cognitive behavioural techniques  to manage the worrying and encapsulate it to happen only at certain times of day.

you want to  retrain your brain  to understand that worry is allowed only at certain times. a worry list works like a meeting agenda, making sure you address all the worries, but only at a defined “worry” time.

6. exercise . sitting in a chair all day staring at your computer screen is not doing wonders for either your cognitive or physical health.  we know that exercise helps people cope better with stress and anxiety , but it also  helps your brain work better .

even going outside for a 20-30 minute walk each day  helps your mood and improves attention and focus . at the very least, make sure you stand up and move around for at least five minutes every hour.