When you hear the terms ADHD or ADD, you likely think about problems with attention, impulsivity, and hyperactive behavior. These are some of the hallmark symptoms of attention-deficit hyperactivity disorder (ADHD), formerly known as attention-deficit disorder (ADD). But they aren’t the only symptoms of this common neurodevelopmental disorder. In fact, there are many lesser-known symptoms of ADD/ADHD that are often overlooked. When you hear the terms ADHD or ADD, you likely think about problems with attention, impulsivity, and hyperactive behavior. But there are many lesser-known symptoms of ADD/ADHD that are often overlooked.

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ADD/ADHD BASICS

Many healthcare providers use the guidelines in the American Psychiatric Association’s Diagnostic and Statistical Manual, 5th edition (DSM-5), to help diagnose ADD/ADHD. However, the manual’s diagnostic criteria mostly describe the symptoms of ADD in children. As a result, ADHD symptoms in older kids and adult ADHD symptoms are not as well known. Additionally, a number of common ADD symptoms in both children and adults—typically ones that are also found in other mental health conditions—are not criteria for diagnosis. Consequently, although ADD/ADHD is a growing national health crisis, it continues to be highly misunderstood and incorrectly treated. Less than 20% of adults with ADD/ADHD receive an appropriate diagnosis and treatment, according to research. There’s a lot more to be learned about the disorder. For example, the brain SPECT imaging work at Amen Clinics clearly shows that ADD/ADHD is not just one thing. In fact, there are 7 types of ADD that can have a variety of symptoms and root causes. Below are 7 common but often overlooked symptoms of ADHD.

7 OVERLOOKED SYMPTOMS OF ADD/ADHD

1. Hyperfocus

Pop quiz! Ask yourself, what are symptoms of ADHD? When you answered this question, hyperfocus is probably not what came to mind. Yet, it is a common symptom of ADHD, research has found. However, it is not a symptom used for official diagnosis. With hyperfocus, instead of having trouble paying attention, an ADD/ADHD brain can have difficulty shifting attention. An individual with ADD/ADHD may become hyperfocused by intensely zeroing in on a compelling project or activity. This can occur for hours at a time and frequently to the exclusion of everything else. It is the antithesis of distractibility and is seen in both children and adults. Why does this happen? Key aspects of the brain’s reward system are often underactive in people with ADD/ADHD. Experts believe that certain activities engage the brain’s reward system to such a degree, an individual with ADD/ADHD has trouble disengaging with that interest or activity. This is a hallmark symptom of what the physicians at Amen Clinics call Type 3: Overfocused ADD.

2. Sleep Issues

The Sleep Foundation reports that anywhere from 25% to 50% of people with ADHD experience sleep issues. One 2020 longitudinal study found that ADD/ADHD symptoms and sleep issues have common neural correlates, including structural changes of certain areas of the brain. Since symptoms of sleep issues can look a lot like ADD/ADHD, and poor sleep makes ADD/ADHD symptoms worse, either disorder can get overlooked or misdiagnosed. Children with ADD/ADHD commonly experience nightmares. Starting around puberty, however, people with ADD/ADHD become more apt to have shorter sleep times, including trouble falling asleep and staying asleep.

3. Mood swings

It’s very common for people with ADD/ADHD to experience mood swings, research has found. Moods, emotions, energy levels, and concentration in ADD/ADHD individuals fluctuate a lot, sometimes many times in a day. A population study involving more than 5000 children found mood swings in 38 % of kids with ADD/ADHD. An individual with ADD/ADHD may switch from excited one moment, to sad, anxious, and angry the next. It may stem from fluctuations in attention, going from inattention to hyperfocus or feeling emotions intensely and having trouble containing them. Individuals with ADD/ADHD can also get frustrated and angry easily, oftentimes due to the condition.

4. Low Self-Esteem

Compared to neurotypical peers, research consistently indicates people with ADD/ADHD have lower self-esteem. There are many factors that may contribute to this. One study shows ADD/ADHD individuals have been discriminated against, criticized, and even bullied because the general population has little understanding or acceptance of neurodiversity and individuality. When ADD/ADHD goes untreated or undiagnosed, self-esteem is particularly hurt. The individual receives criticism for their behavior, which may be perceived as a personal failing rather than a consequence of a brain that works differently. This can go on for a lifetime and damage self-worth. While an adult diagnosis of ADD/ADHD can be a huge relief, getting an ADD/ADHD diagnosis as a child in itself can harm self-esteem. Young kids don’t want to be different and often misinterpret their condition to mean there’s something wrong with them.

5. Hypersensitivity

Research shows that individuals with ADD/ADHD do not process sensory information like neurotypical people do. As a result, they can be hypersensitive to physical (sound, sight, touch, or smell) and/or emotional stimuli with a tendency to be easily overwhelmed by too much information. For example, if someone with a neurotypical brain is wearing a sweater with an itchy tag, they may feel the tag at the back of their neck, but they will eventually stop sensing it is there. Instead, their attention goes to more important things. However, an ADD/ADHD brain has trouble filtering out unimportant sensorial information. It will continue to notice the tag. All sorts of other information will keep coming in, piling up until the system is overwhelmed. Common sensory triggers for ADD/ADHD individuals may include any of the following:

• Touch that is too light, firm, or sudden
• Textures like hair rubbing up against skin, restrictive clothing, tags, or coarse fabric like wool
• Smells such as strong odors from artificial fragrances, perfumes, detergent, shampoo, and food
• Sights such as bright or flashing lights
• Sounds such as multiple simultaneous conversations, loud music, grating noises, or fireworks
• Tastes such as particular spices, bold flavors, and even food temperatures

Additionally, ADD/ADHD individuals are sensitive to being around too many people, being exposed to strong feelings (their own or other’s). When an individual with ADD/ADHD experiences sensory overload, they may overreact to a situation by lashing out or underreact by shutting down. Overload may also increase anxiety, levels, panic attacks, irritability, trouble focusing, and restlessness.

6. Intrusive Thoughts

At one time or another, most of us will experience intrusive thoughts—sudden, unwanted, often negative and/or bizarre thoughts or images that can sometimes be disturbing, violent, or sexual. When they are frequent, they are often associated with mental health conditions such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), or stress. However, it turns out intrusive thoughts are also a symptom of ADD/ADHD. One study  compared college students diagnosed with ADD/ADHD with neurotypical college students on measurements of intrusive thoughts. Participants with ADD/ADHD scored significantly higher. Intrusive thoughts are most often associated with inattentive ADD/ADHD and distractibility. It is believed that differences in brain function and neurotransmitter levels (serotonin, dopamine, norepinephrine) in people with ADD/ADHD may play a role in the development of intrusive thoughts.

7. Rejection Sensitivity

Rejection sensitivity is a form of emotional dysregulation linked to ADD/ADHD. Experts suspect it happens due to differences in brain structure of individuals with the condition. Their brains have trouble regulating rejection-related emotions and behaviors, which makes them painfully more intense. Indeed, rejection sensitivity symptoms include experiencing severe, almost unbearable emotional (and sometimes physical) pain when an ADD/ADHD individual receives real or perceived rejection (withdrawal of love, approval, acceptance, or respect), teasing, or criticism (even when it’s constructive). It can also be prompted by self-criticism following a real or perceived personal failure. The response is usually greatly out of proportion to the situation that triggered it. It can be followed by a noticeable mood shift. In some people, the pain is expressed as rage at the rejecting person or situation. But the moods return to normal fairly quickly.

KNOW THE SYMPTOMS

If you recognize any of these symptoms in yourself or a loved one, be sure to reach out to a qualified mental health professional for an evaluation. ADD/ADHD and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.