Cat Jones didn’t realize she had attention-deficit, hyperactivity disorder (ADHD) until around 2012 while working at an insurance company, where she says her production levels for processing claims were “unacceptably low.” Her doctor suggested she try Adderall, one of the most common medications prescribed to treat ADHD. “Once I tried it, it just kind of changed everything,” Jones, 30, of Lawrence, Kansas, told MarketWatch. During a subsequent job at a small grassroots nonprofit, where Jones oversaw financial matters, donor outreach and several other responsibilities, things took a turn for the worse. “This position required me to do so many tasks at once that the Adderall actually seemed to become a hindrance; I had other work, though, that required the kind of focus I needed Adderall for,” Jones said. “My work, medication, and overall health became so hard to juggle that I knew I had to step down before I made a major mistake that would hurt the company,” she said. Jones, now working a temp job in finance, spends her evenings working to create a new nonprofit organization for LGBT youth in her community. “I’m definitely channeling my energy into it, which I think is helping with the ADHD,” she said. “I didn’t start it with the idea of, ‘Hey, this is going to help me cope’ — but it ended up being helpful.”
Jones is among the 4.4% of U.S. adults who have ADHD, which drew renewed attention last month thanks to journalist Yashar Ali’s viral Twitter
thread combating misconceptions and trivializations of the neurodevelopmental disorder. ADHD, which is marked by inattention and/or hyperactivity–impulsivity, is often comorbid with mood and anxiety disorders. “Because many people think those with ADHD all have similar symptoms and challenges, we don’t often get the empathy and support we need,” tweeted Ali, who says he was diagnosed at age 13. “ADHD is something we live with every day, hour, minute. It can ravage our lives and you may not even be aware of it.” Symptoms begin during childhood — the prevalence of kids diagnosed with ADHD rose from 7.8% in 2003 to 11% in 2011 — and can persist into adulthood. While boys exhibit a higher prevalence, girls may present different symptoms and remain underdiagnosed.
To be sure, a years-long debate has raged over whether children are being over-prescribed ADHD drugs. And the number of calls to poison-control centers in the U.S. regarding intentional or unintentional ADHD medication exposure among people aged 19 and under increased overall by more than 60% between 2000 and 2014, according to a 2018 study in the peer-reviewed journal Pediatrics. Russell Barkley, a clinical professor of psychiatry at the Virginia Commonwealth University Medical Center, calls ADHD a disorder of “executive functions” like working memory and self-motivation. Many people with ADHD also struggle with time management, emotional self-regulation and self-restraint, he said. “People think it’s just an attention disorder, and it’s a lot worse than that,” Barkley told MarketWatch. “It’s not taken as seriously as it should be, because I think the name implies a rather trivial impairment when there’s much, much more going on.” Young people with ADHD are more likely to get laid off Consider, for example, 2013 research that found young adults diagnosed with ADHD are much less likely to enroll in a four-year institution after high school, and 11 times more likely to be unemployed and not in school. The group with ADHD was also more likely to have ever been fired, more likely to have ever been laid off, and more likely to have ever quit a job due to dislike relative to a comparison group. “They’re more likely to have a much more checkered work history with more frequent job changes,” Barkley said. “When you’re just starting out in your career, it’s not too bad.” However, it can affect your promotional opportunities, he said. Meanwhile, “childhood ADHD reduces adult employment by approximately 10 percentage points, reduces earnings by 33% and increases social assistance receipt by 15 percentage points,” according to a separate 2013 National Bureau of Economic Research working paper. Jalpa Doshi, the lead author of a 2012 study analyzing the economic impact of ADHD and a professor of medicine at the University of Pennsylvania’s Perelman School of Medicine, suggested to MarketWatch that “early identification and early management and support systems for ADHD would be key.”
Those could perhaps help “avoid the consequences later on in terms of either being unemployed,” she said, “or being employed but having lower wages, or being less productive at work either through absenteeism or presenteeism.” Adults with ADHD also report more difficulty with personal-finance issues like managing and saving money, missing loan payments, impulse buying, having utilities terminated over nonpayment, and having a poor credit rating, according to Barkley. But, as Ali pointed out in his Twitter thread, people’s experiences with ADHD aren’t homogeneous — nor are their strategies for managing it or even their general attitude toward the disorder. ADHD coach Erik Anderson, a longtime disability advocate from St. Louis, Mo., who has both ADHD and cerebral palsy, struggles with his working memory, being on time and “rumination and negative stories,” he told MarketWatch. “The human brain tends toward negativity anyway, but with ADD-ers, that’s kind of amplified,” he said. “So we tend to tell ourselves bad stories, and catastrophize, and minimize our accomplishments.”
Anderson, a 56-year-old project leader with the Attention Deficit Disorder Association’s workplace committee who was informally diagnosed around 2002, is now considering getting a diagnosis as he grows more open to the idea of taking medication. But he currently benefits from using a reliable calendar system, setting alarms, allowing for transition time between activities and wearing an Apple Watch
that dispenses haptic-feedback reminders. He uses an array of small things that cumulatively help keep him centered, he said. “It’s having multiple systems, redundant systems, and reminders in a language that works for me,” he said. He also points to the power of a quiet “fidget” — like a deck of cards to shuffle — to keep his fingers busy and his attention focused on a meeting or presentation.
“The struggle is invisible very often, but the struggle is real — when people see me walk across the room, they can tell I have a physical disability. They never see my ADHD,” he added. “So they don’t see all of the work I need to do to make sure that I am my best me.” Chicago-based public-relations professional Katy Hoeper, 24, got her diagnosis during her sophomore year of college. If she doesn’t take her medication — currently 15 milligrams of Adderall XR — she finds it difficult to keep her train of thought for extended periods of time. “My mind feels like it’s moving much faster than my mouth is moving, so I have to be very conscious of what I’m saying and whether or not it’s matching with what I’m thinking,” she told MarketWatch. “I feel like my mind is so constantly thinking of things and jumping from topic to topic to topic.”
Hoeper, who says she is “extremely open” with others about her ADHD, sighed while recalling some people’s reactions in college to her taking medication (at the time, Vyvanse). “I feel like people would attribute things that I’ve achieved to taking medicine — and not even in a cruel way, just like, ‘Ah, man, you’re so lucky; I wish I had some Adderall for my final next week,’” she said. “When I take my medicine, sometimes I really do feel like it does enhance my work — but at the same time, I feel like it’s almost leveling out the playing field.”
Many people with ADHD tend to do well in fields like the performing arts, photography or videography, athletics, emergency medicine, law enforcement and the military, according to Barkley. It can help if a job involves movement, allows for teamwork rather than solo work, and provides a regular change of scenery, he added. Adderall does, however, come with side effects, including tremors, palpitations and anxiety. Michael Liner, the 33-year-old founder of a disability-law practice in Cleveland, says he deliberately pursued a career in which he could connect with clients, break up work into hour-long chunks and not be stuck behind a desk most of the day. “I struggle to focus for long periods of time. I’m constantly jumping from different activities to different activities,” he said. “But I’ve basically been able to build my business around those realities.”
And Hoeper loves her PR job because, she says, every single day is totally different. “I think I chose the route that I did because the day-to-day is always different and it’s not boring,” she said. “That comes from probably either my ADHD, or just in general my personality — I don’t really know how to decouple the two.”
Barkley, who attributes his twin brother’s fatal car accident to ADHD and its effect on his driving habits, warns against framing ADHD as a “gift.” But Anderson, who is familiar with Barkley’s thinking, says he prefers a more positive mind set. “It is every bit as serious as Barkley says, but I don’t subscribe to quite how dark his slant seems to be,” he said. “I find ADHD eminently fascinating and incredible in its possibility.” “I’m not always so on board with the idea of taking medicine to address some ‘problem’ that I have, because this is the way that my brain is wired,” Hoeper added. “I feel like there are positives for me having ADHD. I think that I can make connections between pretty obscure topics, or I can throw something back to a book that I’ve read. I feel like I can make connections in my mind a lot faster and more creatively than maybe people who don’t have ADHD.” Some research does link ADHD to creativity. One 2018 study, for example, suggested that “ADHD may be advantageous for certain types of creative thinking; speciﬁcally, divergent, unconstrained creative cognition.” If you think you have undiagnosed ADHD, or you haven’t disclosed your ADHD at work, here’s what to do: Own your disorder. Accept it, acknowledge it and come to terms with it, Barkley said. “If you don’t do that, then you won’t treat it,” he said. “You won’t engage in the routine daily management of your condition to prevent all of these secondary harms that are preventable.” Get evaluated by a professional, he said, and educate yourself through sites like CHADD.org and ADD.org. Be smart about disclosing at work. “Some employers are very disability-accommodating and will work with you and provide reasonable accommodations; others will begin to document your deficiencies and use those as grievances to fire you,” Barkley said. “You really need to be careful about disclosing ADHD until you have a sense of, ‘How does this workplace accommodate and welcome neuro-diverse people?’” Try to first orchestrate some accommodations yourself, the national ADHD advocacy organization CHADD recommends — setting up electronic reminders for appointments, for example, or working later or earlier to dodge distractions. The group also advises phrasing requests to a boss in a positive way (“I work best when I…”) instead of directly mentioning the ADHD. Figure out if you’re eligible for reasonable accommodations under the Americans with Disabilities Act. (Not everyone with ADHD needs workplace accommodations, but if you do, a diagnosis won’t automatically qualify you.) The ADA says a person has a disability “if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment.” Focus on your strengths. “I am the creative mind in the office … and the people that I surround myself with are the people who make sure that the calendars run effectively and make sure that my desk is organized,” Liner said. “Don’t focus on your weaknesses. Instead, embrace your strengths and surround yourself with people who complement you.”
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