Symptoms of attention deficit hyperactivity disorder (ADHD) involve much more than struggling to sit still or feeling as if you’re bouncing off the walls.
While those are indeed common symptoms of ADHD, people with the condition — which affects an estimated 8.4 percent of children and 2.5 percent of adults, according to the American Psychiatric Association (APA) — can also have difficulty focusing, controlling impulses, staying organized, and completing tasks.
Sadly, however, the internet is rife with harmful myths and stereotypes making it seem as if people with ADHD are lazy, aren’t smart, simply need to try harder in school, or are the product of bad parenting.
In reality, “ADHD is 100-percent manageable, and children who have ADHD, who learn to manage their symptoms, can easily grow to be extremely happy and successful adults,” says Shanna Pearson, the founder and president of Expert ADHD Coaching, who herself has ADHD.
So, what are the common myths about ADHD — and what is the truth about this very misunderstood mental health disorder?
Myth 1: Only Young Boys Get ADHD
Fact: Children and adults can have ADHD regardless of gender. However, they’re not diagnosed at the same rates, says Teresa Thompson, a licensed clinical social worker in private practice in Brooklyn, New York.
According to the Centers for Disease Control and Prevention (CDC), 11.7 percent of American boys have been diagnosed with ADHD, compared with 5.7 percent of American girls.
What might account for the difference? Externalizing behaviors (such as talking excessively, constant fidgeting, or interrupting others) are commonly associated with boys as opposed to internalizing behaviors (such as daydreaming or leaving tasks unfinished) which are more common in girls with ADHD, Thompson explains.
“Schools, communities, and even the medical system are more likely to catch potential ADHD behaviors that ‘stand out’ like being disruptive in class, hyper-energized, and reckless,” she adds.
“Girls with ADHD tend to be less physically hyperactive, yet they’re inwardly mentally and emotionally hyperactive — for example, living lifetimes of exciting possibilities in their minds within a single hour, which is less visibly noticeable thereby attracting less attention from teachers than with boys,” Pearson says.
The result? “Girls with ADHD tend to slip through the cracks more often, and their symptoms sometimes get confused with anxiety or depression,” Pearson says.
There’s also some debate in the medical community about whether ADHD might be overdiagnosed in boys and underdiagnosed in girls. One small study published in February 2018 in Applied Neuropsychology: Child suggested that gender stereotypes play a role in the overdiagnosis of ADHD in boys.
Myth 2: Children With ADHD Are Always Hyperactive
Fact: There are actually three kinds of ADHD that, based on your symptoms, you may be diagnosed with, according to the CDC:
- Predominately hyperactive-impulsive presentation
- Predominately inattentive presentation
- Combined presentation
“Children with hyperactive symptoms fit into the stereotypical image many people have of ADHD — bouncing off the walls, not listening to directions, acting impulsively,” says Thompson.
Hyperactive-impulsive symptoms include:
- Constant restlessness, movement, or fidgeting
- Excessive talking
- Frequently interrupting others
- Quickly becoming angry, impatient, or frustrated
- Often unable to play or take part in leisure activities quietly
“In contrast, children with mostly inattentive symptoms may be forgetful, easily distracted, and have poor attention to detail,” says Thompson.
Inattentive symptoms include:
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
- Difficulty staying focused, following instructions, or keeping track of important dates or tasks
- Often does not seem to listen when spoken to directly
- Is easily distracted
- Lacks organization or persistence
- Frequently loses things
Myth 3: ADHD Is Caused by Poor Parenting
Fact: “There is no strong evidence to support the idea that ADHD is caused by any certain form of parenting,” says Thompson. While experts don’t yet fully understand the causes of ADHD, genetics appear to play a significant role, she adds.
Pearson agrees. “People who have ADHD are born with ADHD and will have ADHD regardless of who is raising them,” she says. “ADHD is genetic, and genes are the largest factor causing a person to have ADHD.”
In addition to heredity, experts at the American Academy of Pediatrics say all of the following are potential contributors to developing ADHD:
- Brain function and anatomy
- Exposure to substances such as alcohol or nicotine in the womb
- Significant injuries to the head
- Premature birth
- In rare cases, toxins in the environment like lead
Myth 4: ADHD Is a Learning Disability
Fact: ADHD is a neurodevelopmental disorder, not a learning disability, according to the CDC. This is a common misconception, says Thompson, because ADHD can make learning in the average school or college setting challenging.
For example, grade school students struggling with ADHD might be reprimanded for fidgeting, daydreaming, or talking out of turn, while college-age students with ADHD might find it hard to finish assignments that they find tedious or to stay organized enough to keep up with coursework.
Myth 5: Sugar Causes ADHD
Fact: Sugar and highly processed foods do not cause ADHD. It is possible that sugar can affect ADHD symptoms, but scientific evidence so far has been mixed.
For instance, a small study published in BMC Pediatrics in January 2022 indicated that high sugar intake was more common among kids with ADHD than those without ADHD. On the other hand, a study published in the Journal of Affective Disorders in January 2019 suggested that sucrose (aka table sugar) — often found in sweetened beverages and packaged foods — was not linked to ADHD.
Although experts don’t know for sure how sugar influences ADHD, they do recommend limiting sugar consumption in general for several reasons.
“Too much sugar causes our brains to crash regardless of whether or not you have ADHD,” Pearson explains. “For people with ADHD, in particular, sugar highs and crash cycles are detrimental to symptom management.”
Too much sugar is also associated with physical health risks, including an increased risk of cardiovascular disease, according to a scientific statement from the American Heart Association (AHA), published in August 2016 in Circulation.
The AHA recommends limiting daily sugar intake to:
- 38 grams (9.5 teaspoons) a day for men
- 25 grams (6.25 teaspoons) a day for women, as well as children above age 2
Myth 6: Caffeine Revs Up Hyperactivity in Adults
Fact: While caffeine may make an already over-energized or impulsive person with ADHD feel even more amped up, some adults with ADHD — particularly those who don’t take medication — believe caffeine helps them focus, says Thompson.
In fact, one study of U.S. Army soldiers with ADHD, which was published in November 2020 in the Journal of Clinical Medicine, showed that caffeine consumption may reduce ADHD symptoms and improve concentration.
Myth 7: No One Really Needs Medication for ADHD
Fact: The opposite is true: Many people with ADHD find medication helpful in managing their symptoms, Thompson says.
There are two types of ADHD medications:
- Stimulants, which are the most commonly prescribed medications for ADHD
- Nonstimulants, which are sometimes used alongside or instead of stimulants
Different medications are prescribed for different symptoms. For instance, stimulants like methylphenidate (Concerta) and lisdexamfetamine (Vyvanse) may improve focus, and nonstimulants like clonidine (Catapres) may improve impulse control and concentration, Thompson says.
Finding the right medication for a particular person — or the right combination of medications — can be a trial-and-error process. Often, the prescribing doctor may need to adjust the dose of medication more than once to find the right fit, Pearson explains. And if one medication doesn’t work, it’s quite possible that another one will.
“It’s also important to note that ADHD medication does help people stay focused, but it doesn’t help with what to focus on,” Pearson says. “This is why, in addition to medication, people also need ADHD management skills.” Many people with ADHD attend behavior therapy or psychotherapy to learn these skills.
Myth 8: All Kids With ADHD Get the Treatment They Need
Fact: ADHD is more commonly diagnosed and treated in some children than others — and gender, race, and socioeconomic stereotypes and biases may be to blame, Thompson says.
One study published in March 2021 in JAMA Network Open, which included data for more than 238,000 children, showed that Asian, Black, and Hispanic children were significantly less likely to be diagnosed with ADHD compared with white children. Furthermore, white children were more likely to receive treatment for ADHD than Asian, Black, or Hispanic children.
At the same time, some experts believe that Black and brown children are more likely to be misdiagnosed with ADHD.
“Troublingly, there are also unresolved questions around the possible overdiagnosis of ADHD in Black and brown children (especially Black boys) and children from working class and poor households,” Thompson says. “Subtle attitudes of racism or classism may make children of these backgrounds more likely to be labeled as ‘unruly’ and ultimately receive an ADHD diagnosis that doesn’t really fit.”