A perplexing paradox.

What Is 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.

ADHD do represent members of a unique group

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.

ADHD presents a quantitative difference
Vector of a child subconscious mind of an adult man concept

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:

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.