Unpacking ADHD: Part 1 - Beyond the Buzzwords

Illustration depicting an ADHD brain intertwined with a heart, symbolizing the unique emotional and cognitive characteristics associated with ADHD.

To get a diagnosis, these challenges usually need to show up before age 12, stick around for at least six months, and genuinely get in the way of everyday life—whether at home, school, or work (National Center for Biotechnology Information, 2020). Think of it like this: the "rulebook" for how brains typically develop sets certain expectations, and with ADHD, the brain's development takes a different path, leading to symptoms that don't quite match those expectations (National Center for Biotechnology Information, 2020). The official guide, the DSM-5, even breaks it down into three main types: primarily inattentive, primarily hyperactive/impulsive, or a combination of both (National Center for Biotechnology Information, 2020). The ripple effects of ADHD can be huge, impacting friendships, school or job success, and even increasing the likelihood of other mental health challenges (National Center for Biotechnology Information, 2020; Cortese & Castellanos, 2019).

How Our Understanding of ADHD Has Evolved

Our understanding of ADHD has come a long way. It's not just about hyperactive kids anymore! While it's been recognized for a long time, the way we diagnose it has become much more refined, especially with the DSM-5's detailed subtypes, which helps us appreciate its many faces (National Center for Biotechnology Information, 2020). Historically, people often thought of ADHD as something only kids had, marked by obvious bouncing-off-the-walls energy. But recent years have shown a big shift: more adults are getting diagnosed, especially from 2020 to 2023, following a prior downward trend (American Psychiatric Association, 2025). This shift is partly attributed to increased awareness and a reduction in the stigma associated with the condition (American Psychiatric Association, 2025). This broader view means we're moving past the simple idea of childhood hyperactivity to understand that ADHD can look different in adults—sometimes it's more about an internal restlessness or a quiet struggle with focus (American Psychiatric Association, 2025). This maturation in understanding profoundly influences how ADHD is perceived in society, transitioning from a narrow, often judgmental, perception to a more comprehensive and accepting one, although considerable stigma regrettably continues to persist (Visser et al., 2024).

At its heart, ADHD is understood as a dysfunction of executive functioning, primarily involving activity within the brain's frontal lobe (National Center for Biotechnology Information, 2020). These executive functions are like the brain's CEO, responsible for crucial tasks beyond just paying attention. They help us make decisions, plan ahead, solve problems, stop ourselves from acting on every impulse, and even manage our emotions (National Center for Biotechnology Information, 2020; Kolar & Cortese, 2019). The reasons behind ADHD are complex, a mix of our genes and the environment we grow up in (National Center for Biotechnology Information, 2020; Cortese & Castellanos, 2019; Kolar & Cortese, 2019).

Stay tuned for Part 2, where we'll dive deeper into how ADHD uniquely impacts brain development.

References

American Psychiatric Association. (2025, February 10). ADHD in adults: New research highlights trends and challenges. https://www.psychiatry.org/news-room/apa-blogs/adhd-in-adults-new-research-highlights

Cortese, S., & Castellanos, F. X. (2019). The neurobiology of ADHD: Still an enigma? Frontiers in Human Neuroscience, 13. https://doi.org/10.3389/fnhum.2019.00042

Cortese, S., Solmi, M., & Fusar-Poli, P. (2021). Neuroimaging of attention-deficit/hyperactivity disorder: A narrative review of recent findings. Current Opinion in Psychiatry, 34(2), 108–114. https://doi.org/10.1097/YCO.0000000000000674

Dutta, C. N., Christov-Moore, L., Ombao, H., & Douglas, P. K. (2022). Neuroprotection in late life attention-deficit/hyperactivity disorder: A review of pharmacotherapy and phenotype across the lifespan. Frontiers in Human Neuroscience, 16. https://doi.org/10.3389/fnhum.2022.938501

Kolar, A., & Cortese, S. (2019). The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): What every clinician should know. Current Psychiatry Reports, 21(10), 96. https://doi.org/10.1007/s11920-019-1088-7

National Center for Biotechnology Information. (2020). Attention-Deficit Hyperactivity Disorder. In StatPearls. StatPearls Publishing.

Neuroimaging and ADHD: fMRI, PET, DTI findings, and methodological limitations. (2013). Journal of Attention Disorders, 17(6), 455–469. https://pubmed.ncbi.nlm.nih.gov/23682662/

Visser, J., van der Meer, S., van der Heijden, P. T., & de Jong, J. T. (2024). Unmet needs and priorities for stigma reduction in ADHD: A qualitative study with young adults, parents, teachers, and mental health care professionals. BMC Psychiatry, 24(1), 847. https://doi.org/10.1186/s12888-024-05459-y

Wang, S. Y. A., Manza, P., Tomasi, D., Volkow, N. D., Wang, G. J., & Zhang, Y. (2023). Shared and distinct neurobehavioral phenotypes of child obesity and ADHD. Translational Psychiatry, 13(1), 74. https://doi.org/10.1038/s41398-023-02359-x

Wu, F., Zhang, W., Ji, W., Zhang, Y., Jiang, F., Li, G., Hu, Y., Wei, X., Wang, H., Wang, S. Y. A., Manza, P., Tomasi, D., Volkow, N. D., Gao, X., Wang, G. J., & Zhang, Y. (2024). Stimulant medications in children with ADHD normalize the structure of brain regions associated with attention and reward. Neuropsychopharmacology.