ADHD is like having a really s****y personal assistant,’ declares Jonathan*. The 23-year-old is one of the many receiving a diagnosis of the chronic condition during the pandemic. The unique circumstances of isolation and restriction coupled with hyper dependency on gadgets and devices has lent itself favourable for clearer manifestations of the disorder, it seems. As countries like Canada report an increase in diagnosis (not incidence) of ADHD in the past two years, Chennai seems to fit the patterns too.
While the diagnosis didn’t exactly come as a surprise for Jonathan, it has certainly put his doubts to rest, offering a good measure of relief. “When I was younger, I joked about how I might have ADHD. But, it was during the start of the pandemic I got on Reddit; there’s a subreddit called ADHD and I was going through the posts. All of it sounded so similar. That’s when I met a therapist and found out. Then, it all made sense,” he recounts.
Avatars aplenty
Jonathan later found that his symptoms and manifestations had been close to typical expressions of the condition. Like many people with ADHD, he — a pretty bright student — too started doing poorly in school after class 6. Procrastination had crept into his everyday life. All of this made sense in hindsight post diagnosis, he notes. Monotony was cripplingly painful; something made worse by the pandemic. The lack of adequate stimuli when confined inside the house, especially during the time he was down with Covid, had him drained of energy. Working from home is still a struggle, given his inherent difficulty with scheduling and managing time.
Abhirami’s* story is slightly different. Her impulsiveness found expression in how she handled money. Trouble with organising her schedule made it greatly difficult to hold down a job. Productivity only came late at night, in the absence of noise and even bright lights. She found herself coping, rather instinctively, by organising the world around her — from kitchen cabinets to closet corner, cleaning brought relief. Besides, while Jonathan found resonance with the ADHD experience of most others, Abhirami realised how different it was for her the first she compared symptom stories with a fellow potential.
“A friend’s friend got his diagnosis at the age of 28 years. I had a conversation with him just to see how he went about it. The more he talked about it, the more I realised how completely different it is for me. Later, I discovered that ADHD in adult women is different from how it is with adult men, from symptoms to diagnosis. So it is easier to brush it off in women because people tend to think it is lethargy and laziness,” she elaborates. While manifestations in men tend to veer towards impulsiveness and hyperactivity, women tend to struggle more with attention deficiency.
Even years of medical training had not prepared Lekha*, a 28-year-old doctor who got her diagnosis in June 2021, for real-life manifestations of the disorder. “It is something that we studied about in med school but what is described in the textbooks as classic ADHD talks only about a very narrow spectrum of what the disease is. There is very little awareness of adult ADHD and how it presents in women. It is extremely difficult to access that knowledge unless there is an ADHD community or educators talking about this. That is how I figured I might have the condition,” she explains. It was the resources she found online, especially on Twitter, that eventually had her seeking a diagnosis with a psychiatrist at NIMHANS (National Institute of Mental Health and Neurosciences).
The right help
Beyond all these shortcomings, reaching the right kind of help is still several levels of difficulty away. “The therapist I was going to suggested I get a planner and start writing things down; that’s the worst advice. This is why I would like a therapist who specialises in ADHD. It is quite common in countries like the US but it is very difficult to find them here,” points out Jonathan.
Friends of Abhirami who were pursuing PhD in Psychology or had recently started working as counsellors admitted that they were only trained to recognise ADHD in children. “There’s a difference between a psychologist and psychiatrist. Then, there are people who parade around as mental health professionals but do not have the life experience to diagnose someone or give therapy. A few classmates I know who finished HR Psychology (Masters) and started working as counselling psychologists or school/organisational counsellors. Knowing how much we learnt during the course, I know they can’t handle the heavy stuff any person might seek help for, especially a child. So, It is important to find the right kind of help,” she cautions. It always helps to talk to your psychologist/psychiatrist about their credentials and background before diving deep into the process.
A life, altered
Despite all this, therapy and treatment may not be an option for everyone, given how expensive it is. And peer support and online resources come in handy to carry you through your coping mechanisms, they suggest. Jonathan swears by the ADHD subreddit. He and Abhirami have found relief in a Twitter comic strip account on ADHD. Abhirami, who struggles with hot temper and irritability, goes the kindness route — takes a few seconds to respond or react — to get over the bump. Lekha realised that she had instinctively relied on body doubling — doing a task in the presence of another person — all her life.
Sandhya Shivakumar, counselling psychologist, has more pointers. “It is about self management, behavioural changes and becoming more self aware. There is a tendency to simply pick up the phone, look at it and put it back; especially in the middle of an activity. So, mindfulness is something that will really help. Sometimes, it also helps to make behavioural changes; that is what we work with but in a more guided fashion. Having fixed time for certain things in a day, where you don’t do anything else but that task, can help. Look to complete tasks in a realistic fashion.
When task completion happens, there are new synapses formed; you can actually modify your neural wiring. So, this behavioural change can reflect as a neurobiological change as well,” she elaborates. To save yourself from the pressure of completing tasks, you can stick to the two minute rule; in most cases, that is enough time to bring in task engagement, she advises. There is a lot of science to not using the phone before sleeping and it can prove very beneficial for people with ADHD, she adds.
While Sandhya agrees that there has been an increase in diagnosis over the past two years, she shares that mental health professionals would not be quick to offer the label for multiple reasons. “As mental health problems have to be looked at in a context and not just by the criteria. So, we need to look at the level of impairment in their functionality. Only then you offer the diagnosis,” she points out. Besides, with adults having a lot more factors influencing mental health, their symptoms of inattention and distractibility could fit the bill for ADHD just as much as it does other conditions. In that case, they might receive a working/differential diagnosis; one that can be improved upon based on further evidence, she elaborates.
The pandemic itself may have had a role in pushing those in the vulnerable area into ADHD but they might not have a significant clinical diagnosis. Adults who have had over exposure to gadgets and are experiencing these symptoms, they can modify your lifestyle and contain the symptoms and go without an ADHD diagnosis. “If you have no history (of mental illness), hardly any behavioural problems in childhood and it’s only been a reactive outcome of the pandemic, this is probably the reason why professionals don’t want to say you have ADHD. It is also a kind of labelling that stays with the person forever, which is unnecessary,” she assures.