How we can support young people and adults with ADHD

What exactly is ADHD?

ADHD is Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder that affects people's behaviour. People with ADHD can seem restless, overactive, may have trouble concentrating and may act on impulse (such as doing things without thinking through the consequences).

What are common challenges young people with ADHD experience?

It depends on their age. Some young people get behind in their schoolwork and they may start to get in trouble a lot. Initially, they’re seen as fun, because they’re the life and soul of the party, and young people think they’re very funny.

Some young people will almost encourage them to do naughty things, because they'll then go and do it impulsively. As they start to get a little bit older, they start to get noticed by everybody because they’re supposed to be mature now. So, why are they acting in an immature way?

Now the kids who often found them funny, start to find them annoying instead. Then, there’s this gap between what they’re capable of and what they’re actually reaching.

Attainment versus achievement starts to widen and they start to be left behind academically, especially  because people with ADHD often have other conditions too, such as dyslexia, autism or anxiety.

When you get into the teenage years, or a bit older, is when you sometimes find a degree of inertia, which means inactivity or the tendency to do nothing. With a lot of the over-activity squished inside, you’re left with this young person who procrastinates and is disorganised.

Again, they’re being nagged by everybody. They ask ‘Why can’t you just do this?’, but they actually can’t. They start to feel more of a failure. Their self-esteem drops. Often, but not always, you get the onset of problems, such as anxiety and depression, in these mid to late teens.

How does ADHD affect you personally?

I have mainly the hyperactive type. I was quite a bright little girl. I could read by the age of three, but I just wanted to be doing something all the time. I was brought up abroad in the jungle, so I have a very odd upbringing. I was pretty much ignored and left to my own devices, but I just wanted to learn.

All the way through school, I wasn’t the kind of child that couldn’t pay attention. I was just the type of child that wanted to be given more and more and more to do. At home, I was number three of four. My older siblings were very good, and so I think I stuck out as being the naughty one of the family.

I don’t mind having ADHD, as it suits me. I’ve chosen a career that needs me to be always on the go and doing plenty. I have a daughter with ADHD, who’s 20, and he has the combined type. My son, who’s 16, and he has a combined type, too. They definitely get it from me.

Is ADHD hereditary?

Yes, certainly. What we know most about ADHD, in terms of where you get it from, is that it’s strongly genetic. But there are other causes too.                                                

Does ADHD present different in males and females?

We know that there are around four times more males than females who've been diagnosed with ADHD. There are probably more girls in the inattentive ‘potato type’ that I talked about, which tends to get under diagnosed.

I can’t tell you how many teenage girls I’ve had come in saying, ‘I never knew I had a problem. But now I realise I’ve had a major problem. Everybody’s taken no notice and just told me to buck up’.

What are the common misconceptions surrounding ADHD?

Firstly, that it’s made up and it doesn’t exist. It absolutely does! We have vast amounts of research to support it.

Secondly, that it’s a relatively new diagnosis from only the last 20 or 30 years. We’ve actually known about it since 1770.

Thirdly, that medication is dangerous and addictive. It’s absolutely not. We’ve been using the same medication since before the 1960s, in some cases. Certainly, Ritalin, which lots of people have heard about, has been used since the 1960s. They’re quite old medications that we make very well.

Other misconceptions are that these young people are just badly behaved. These young people can sometimes put in 300% effort, just to get to the same level of concentration as other young people who don’t have ADHD. They can’t sustain that.

Are there any treatments that can help people living with ADHD?

It depends on how severely affected they are. The National Institute of Clinical Excellence guidelines says young people with ‘severe’ ADHD should have medication. 

Now, I don’t much like that word ‘severe’. I think it’s quite scary to parents and carers. It’s not descriptive. I tend to talk about ‘impairing' or held back, in terms of doing their best.

It’s being impaired academically, not doing as well at school. Socially, starting to muck up friendships. And emotionally, people are having to be on their case and nagging them all the time. If young people reach a level of impairment, then medication is the first choice. There are broadly three different types of medication.

The stimulants that have been around for decades are the first choice. They work the best. And also, we know them the best, which is a very reassuring, when you have medication that has been used for decades. It’s important to note that medication should come with supportive therapy.

Now, below the age of teenagers, they probably don’t need that. They just need to know that they’re not the only one. It helps them to know that their doctor has it. Trust makes a great kind of friendship.

It also helps them to know that there are lots of other young people with it, too. There's young people who're just the same as them, so they don’t need to feel that they’re on their own.

But, once you get into the teenage years, that’s when more psychological coaching and support can be really helpful. Trying to find helpful and supportive people for these young people can be really difficult.

I do as much as I can in clinic. It’s not just about changing doses, it’s all about making more of a connection with that young person to help them.

Do you have any advice for our adult Scout volunteers living with ADHD? How can they use it to their advantage?

If you’re the inattentive adult, then you’re always going to miss the smell of the roses around you. So, actively being treated can be really helpful. If you’re the hyperactive or mixed type of ADHD, like I am, then use your energy. The young people love it!

I’m a real young person magnet, I think because they say, ‘Oh, you’re fun. You’re engaging and you show that you like us.’ I love to have a lot of fun with them in clinic. You can use those attributes, which I think of as the positive side of having ADHD, in your volunteering.

I think the reason I’m a popular paediatrician with young people is because they feel I understand them. They usually leave with a smile on their face because we have a good laugh.

Have you got any tips for the Scout volunteers looking after young people with ADHD? How they can help them?

I think that a very major one is not to blame them for things they can’t help. A lot of common complaints will be, ‘They’re childish’ or, ‘They’re a bit loud and they need to stop bouncing around’.

But often, these young people will be off medication by the time they get to their Scouts meeting in the evening. That's because if you take the medication too late during the day, it can affect sleep.

Understanding that the impulsive and hyperactive part of their brain is years behind the rest of their brain and behind other young people who don’t have ADHD is important. This immaturity, this impulsive activity, the bouncing around is typical.

I sometimes ask parents or carers if they feel like their young person acts like a young person much younger than what they are, and the parents or carers will often agree. That’s because these parts of their brain are behind.

They can’t help behaving like four-year-old, if they’re eight. The medication doesn’t mature their brain, but it kind of patches that problem until the brain has a chance to mature itself.

As Scouts, we believe it’s important for us to try to understand each other’s neurodiversity. We offer more information and practical tips for supporting yourself or someone else with ADHD.