Over the past year, many people have found it difficult to focus, pay attention and get tasks done. They notice, too, that they are more irritable and restless.
Certainly, our psychology clinic has received a large increase in referrals to evaluate previously asymptomatic people who are now wondering if they might have attention deficit hyperactivity disorder (ADHD).
Before self-diagnosing or consulting your doctor, consider these other common causes of ADHD symptoms.
Symptoms of ADHD are non-specific
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.
What is ADHD?
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.
How common are ADHD symptoms in adults?
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.
Couldn't it be undiagnosed ADHD?
While it is possible that a diagnosis of ADHD was missed or overlooked in childhood, research shows this is rare. For the past 12 years our centre has run an ADHD screening clinic, evaluating young adults who think they may have ADHD.
Overall, we’ve only diagnosed about five percent 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.
Okay, so what do I do about these symptoms?
Regardless of the cause, there are a number of things you can do to reduce or eliminate ADHD symptoms.
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.
If all these things fail to make a difference, it might then be time to consult an expert. Remember, however, that medication won’t make you want to do your work or chores, and won’t help you become more organized or more attentive during endless Zoom meetings.
Allyson G. Harrison is Associate Professor of Psychology and Clinical Directo at the Regional Assessment & Resource Centre at Queen's University, Ontario.