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What is ADHD?
ADHD, or Attention Deficit Hyperactivity Disorder, is a recognised neurodevelopmental condition that affects the way the brain regulates attention, motivation, and behaviour. It is not a sign of laziness or lack of effort.
Instead, ADHD reflects genuine differences in brain structure and chemistry, particularly in areas linked to attention, reward, and self-regulation.
Although commonly associated with childhood, ADHD isA lifelong condition. It can present differently across individuals and age groups, which is why some people only recognise it in adulthood. Understanding what ADHD actually is and what it is not is the first step toward making sense of your experiences.
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The Three Types of ADHD
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Diagnostic systems (eg DSM-V or ICD-10) classify ADHD into three main types based on the most noticeable symptoms. These categories can be useful patterns for understanding how ADHD can present differently one person to another. Many people experience traits from more than one type, and symptoms often shift over time, especially as children grow into adulthood.
Inattentive Type
Inattentive ADHD can bethe most easily overlooked presentation. Instead of being disruptive or obviously restless, people with this type tend to struggle with concentration, memory, and organisation.
Everyday challenges might include losing track of conversations, forgetting appointments, misplacing essential items like keys or bank cards, or finding it hard to finish tasks that feel boring or repetitive. Many describe themselves as “scatterbrained” or “always in their head.”
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This type can be particularly difficult to spot in school-aged children who are well-behaved but appear dreamy or disengaged. Because it lacks the outward signs of hyperactivity, inattentive ADHD is frequently mislabelled as laziness, lack of effort, or even anxiety.
In adulthood, it often shows up as missed deadlines, unfinished projects, and a constant feeling of being disorganised despite good intentions.
Hyperactive-Impulsive Type
This is the type most people imagine when they think of ADHD. In childhood, it often shows up as difficulty sitting still, blurting out answers, or being “always on the go.” In adults, hyperactivity may look less like running around and more like an internal restlessness.
For example, some adults may feel a constant need to move, fidget during meetings, or find it hard to unwind at the end of the day.
Impulsivity is also a key feature. Adults with this type may make snap decisions, interrupt others without meaning to, or speak before thinking.
For some, this can lead to challenges with finances, relationships, or work. It can also bring spontaneity, high energy, and the ability to take risks that others shy away from.
Combined Type
The combined type is the most common presentation in both children and adults. As the name suggests, it includes traits from both inattentive and hyperactive-impulsive types. A person might lose track of time and forget appointments, while also feeling restless, fidgety, or prone to impulsive decisions.
It is also important to note that ADHD is not static.
The balance of traits often changes with age and environment. Someone who was outwardly hyperactive as a child may find that their energy turns inward in adulthood, showing up more as racing thoughts or mental fatigue than physical restlessness.
Conversely, someone whose difficulties were mainly inattentive may develop more noticeable impulsivity under stress or in unstructured environments.
How ADHD is Understood Today
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Research into ADHD has developed significantly over the past few decades. We now know that it is linked to differences in how the brain processes dopamine and other neurotransmitters, which play a role in reward, motivation, and executive functioning. These biological differences are why ADHD is consistent across cultures and why it runs in families. references?
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ADHD is not caused by poor parenting, lack of discipline, or “too much screen time.” While lifestyle factors can make symptoms better or worse, they do not cause ADHD. Recognising it as a neurodevelopmental condition helps reduce stigma and allows people to seek appropriate support.
Why ADHD is Often Missed
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ADHD is one of the most under-recognised neurodevelopmental conditions in adults. While more children are being identified today than in the past, many people still slip through the net until much later in life. This happens for several reasons, ranging from stereotypes and social expectations to the way individuals adapt and mask their struggles.
It is positive that more people are having their ADHD diagnosed. Whilst it is causing many people to question whether they may have ADHD, this does not necessarily mean that there is an over-diagnosis of the condition. If you have a high quality, comprehensive assessment from someone suitably qualified to assess and rule out alternative explanations, you can be confident in the outcome.
Stereotypes and Misunderstanding
For decades, ADHD has been associated with one very specific picture: a young boy who cannot sit still, talks too much in class, and struggles with behaviour. This image has dominated public and even professional understanding of the condition. As a result, anyone who does not fit that stereotype, for example someone who is quiet, academically capable, or appears outwardly organised, is often overlooked.
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In reality, ADHD does not always present as obvious hyperactivity. Many people experience symptoms like mental restlessness, forgetfulness, disorganisation, and difficulty sustaining focus. Because these challenges are less visible, they are often dismissed as personality quirks, laziness, or stress rather than recognised as signs of ADHD.
It is does not mean that someone with ADHD is problematic or engages in criminal activity, which is another stereotype. Whilst ADHD can indeed be linked with impulsive and reckless acts, this is not always the case, and may show up in other ways such as interrupting, compulsive spending, and quick decision making which is later regretted.
The Role of Masking
Masking is another major reason that ADHD goes undetected. Masking means consciously or unconsciously covering up difficulties in order to meet expectations or avoid negative judgement. From a young age, many people with ADHD develop coping mechanisms to blend in, such as working twice as hard, relying on strict routines, or mimicking the strategies of others.
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While masking can help people “get by,” it also hides the true extent of their struggles. Teachers may see a child who is performing adequately without realising the exhaustion and anxiety behind the scenes. Colleagues may view an adult as competent without noticing that they spend twice as long preparing or that they collapse from burnout after work. Over time, masking often leads to fatigue, stress, and even mental health difficulties, yet it continues to keep ADHD hidden.
Why Women and Non-Binary People Are Often Overlooked
ADHD research and diagnostic criteria were historically based on boys, which means the different ways it shows up in women and non-binary individuals were not recognised for many years. Women are more likely to internalise their struggles rather than act out, and they are often socialised to be quiet, compliant, and high-achieving. As a result, they may present with symptoms such as perfectionism, chronic anxiety, or emotional sensitivity instead of the disruptive behaviour more commonly associated with ADHD.
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Many women and non-binary people are therefore misdiagnosed with anxiety, depression, borderline personality disorder, or other conditions that may be wrong or may only explain part of their experience. This contributes to delays in diagnosis and can leave people feeling misunderstood and unsupported for years.
Confusion with Other Conditions
ADHD symptoms overlap with several other conditions, which can complicate diagnosis. Adults may be told they are simply experiencing stress, burnout, or even a demanding lifestyle. Difficulties with focus, memory, and organisation may be attributed to anxiety or depression rather than considered as potential signs of ADHD.
While co-occurring conditions are common, focusing only on surface-level symptoms often means the underlying ADHD is missed. This can lead to treatments that only partially help, leaving individuals frustrated and wondering why they continue to struggle.
Seek professional
help today
If you recognise yourself in these descriptions, seeking a professional assessment can provide clarity and open the door to support.
At PATH North West, I provide:
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Specialist ADHD assessments for adults (16+)
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Face-to-face appointments in Manchester or online UK-wide/internationally
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Combined ADHD and autism assessments if needed
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Comprehensive reports and personalised recommendations
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Optional post-diagnosis therapy and support, subject to availability
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Recognition by major insurers, including BUPA, AXA Health, Aviva, and Vitality Health
Please note, I am not a right to choose provider and you would need to check with your GP/local NHS trust as to whether any prescribers would accept a private ADHD assessment
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You do not need a referral, and appointments are confidential, thorough, and guided by NICE standards. If you would like to know more or arrange an assessment, please email pathnorthwest@protonmail.com.
Protective Factors that Hide ADHD
Some people with ADHD are able to manage reasonably well during childhood or early adulthood because their environment offers strong support or structure. For example, a child with attentive parents, rigid school timetables, and plenty of supervision may appear to cope, even though they are expending significant energy to do so. Similarly, adults in highly stimulating jobs may thrive when work keeps them engaged and fast-paced, only to find their difficulties resurface when life becomes more routine or demanding.
These protective factors can delay recognition of ADHD for years. It is often only when external support is removed, such as leaving home, starting a career, or balancing work and family life, that the difficulties become unmanageable and the true picture of ADHD emerges.
The Impact of Being Missed
Living with undiagnosed ADHD can be exhausting. Many adults spend years feeling as though they are underachieving or not reaching their potential despite working hard. They may blame themselves for being disorganised, forgetful, or inconsistent, when in reality these are symptoms of an undiagnosed condition.
This often leads to low self-esteem, shame, or a belief that they are failing in areas where others seem to cope with ease.
Recognition and diagnosis can therefore be life-changing. It provides clarity, reduces self-blame, and helps people access the support they need to manage their lives more effectively.
The Wider Impact of ADHD
ADHD can touch many aspects of life, from work and relationships to self-esteem and mental health. Challenges with organisation, deadlines, or forgetfulness can lead to frustration at work. Impulsivity may affect finances or relationships. Emotional intensity can cause conflict or leave someone feeling drained.
However, it’s important to note that ADHD also brings unique qualities, including creativity, resilience, and problem-solving under pressure. Understanding ADHD means recognising both the challenges and the potential strengths it can bring.
Benefits to working with PATH North West
HCPC-Registered Clinical Psychologist:
You’ll be assessed by a qualified professional with 18+ years of specialist experience in working with neurodiverse adults, including in the NHS.
Private ADHD and Autism Assessments:
No long NHS wait times. We offer timely, confidential and comprehensive assessments tailored to adults.
In-Person or Online:
Insurance registered Health Provider:
Face-to-face sessions available in Chorlton, Manchester (Mondays), or online appointments available (Fridays).
​Psychology services that are registered with Aviva, AXA Health, BUPA, and Vitality Health.
Specialist in ADHD & Autism:
Extensive experience working with adults with Autism and ADHD, including late-diagnosis individuals, females and LGBTQ+ clients.
Evidence-Based Therapy Available:
I am experienced in EMDR (Eye Movement Desensitisation and Reprocessing) and Acceptance and Commitment Therapy (ACT), which may be available post-diagnosis