A perplexing paradox.
- High-functioning adults represent a unique sub-group of adults with ADHD who face their own unique challenges.
- ADHD can co-exist with high intelligence but still make many life endeavors, including work, more difficult to navigate.
- Successful adults with ADHD cite energy, cognitive dynamism, courage, and resilience as potential benefits of ADHD.
Although by no means dealing with anything approximating the sociocultural hardships, difficulties, and biases members of historically marginalized communities face, high-functioning adults with ADHD do represent members of a unique group whose challenges are not typically discussed.
Graduate or medical students and established professionals may exhibit core deficits of ADHD masked by high intelligence1, leaving them to muddle through different levels of education, forge an occupational identity, and seemingly achieve a level of stability.
Their reward: to continue to face struggles in the workplace with time management, disorganization, and other common difficulties while trying to keep up with the day-to-day demands of their jobs, often drawing the necessary extra time, effort, and energy from their personal and relationship lives, sometimes at a significant cost to these domains.
Problems Faced by High-Functioning Adults with ADHD
Among high-functioning adults with ADHD, impairments, such as punctuated or lengthy academic paths, underperformance, underemployment, job loss, and other setbacks are in their own way demoralizing.
This can have a ripple effects for employment, work performance and satisfaction, advancement, and financial status, not to mention mental and emotional well-being and sense of self. In turn, these matters affect personal lives and options. We are not defined by our jobs, but this domain of life is not trivial.
The Paradox of ADHD: Sometimes Doing Well and Sometimes Not
ADHD presents a conundrum about which many people still argue. Its characteristic self-regulatory or executive dysfunctions fall along a spectrum of normative human capacities.
ADHD presents a quantitative difference in the development and consistent execution of self-regulation skills, a difference of degree of difficulties and effects, not a qualitative difference of the kind of difficulties faced by people of all sorts.
For the majority of individuals with ADHD, it is a persistent issue, although there are settings and circumstances in which someone with ADHD can perform very well, if not exceptionally.
This fact makes slipups and setbacks all the more maddening for the person with ADHD, particularly trying to explain them when they seem inconsistent with their strengths.
Successful Adults with ADHD Share Their Stories
A qualitative study of “successful” adults with ADHD went right to the source, interviewing six high-functioning individuals about their experiences of making symptoms work for them—or at least, working around them2.
The main themes of the personal benefits of ADHD for these adults with ADHD are:
- Cognitive dynamism – Spontaneous mental activity, flashes of ideas, and, at times, deep hyper focus, were viewed as fueling creative, divergent outlooks and wide-ranging curiosities to explore.
- Courage – Managing the demands of living with ADHD, including confronting various fears and uncertainties associated with the diagnosis, was viewed as engendering the value of personal differences and nonconformity. There were also themes of adventurousness as well as facing head-on the role of being an outsider.
- Energy – As a group, adults with ADHD described a great deal of spirit and capacity for action from a surplus of both physical and mental energies. This energy also accounted for the advantages of passion and will.
- Humanity – Self-acceptance and social intelligence in relationships were noted, working hand-in-hand with humour and emotional awareness, all of which likely contributed to reports of chiefly positive outlooks.
- Resilience -Successful adults with ADHD interviewed in this study found ways to persist in endeavours in the face of adversities, adapting their approaches to face challenges and meet demands.
- Transcendence – This strength was succinctly characterized as the appreciation of beauty and excellence, which often connects with feelings of awe and wonder.
Admittedly, this was a small sample of a select group of adults with ADHD. Nonetheless, this sort of research is valuable in terms of a deep dive into their lived experience.
When all is said and done, effective treatments for ADHD intervene at the level of lived experiences of clients, targeting difficulties and barriers to well-being, often by also highlighting and accentuating the use of strengths, sometimes uncovering and fostering some new or unsung ones along the way.
1 Rommelse, N., van der Kruijs, M., Damhuis, J., Hoek, I., Smeets, S., Antshel, K. M., Hoogeveen, L., & Faraone, S. V. (2016). An evidenced-based perspective on the validity of attention-deficit/hyperactivity disorder in the context of high intelligence. Neuroscience and Biobehavioral Reviews, 71, 21–47. https://doi.org/10.1016/j.neubiorev.2016.08.032
2 Sedgwick, J. A., Merwood, A., & Asherson, P. (2019). The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD. ADHD Attention Deficit Hyperactivity Disorder, 11, 241-253. https://doi.org/10.1007/s12402-018-0277-6
Article By – J. Russell Ramsay, Ph.D., is a professor of clinical psychology and co-founder/co-director of the Adult ADHD Treatment & Research Program at the University of Pennsylvania’s Perelman School of Medicine.