The most well-known characteristics Attention Deficit Hyperactivity Disorder (ADHD) are inattention, hyperactivity and impulsivity. These symptoms fail to accurately reflect the nature of the disorder. In this article we explain how to recognize three defining characteristics of ADHD: low tolerance for interpersonal rejection, emotional hypersensitivity, and hyperfocus.
The DSM-V, the bible of diagnosis in mental health, contains a list of 18 diagnostic criteria for ADHD. Although an effort has been made to discriminate some symptoms in adults, the problem is that these criteria are still based on studies and research carried out with children. As a consequence, we are faced with the reality that ADHD traits in adolescents, adults and the elderly are not as well known. This has led to misdiagnoses and failed treatments for many people, and explains why ADHD is automatically associated with hyperactivity and poor concentration.
We believe that this overview requires an update that addresses 3 crucial characteristics that explain all aspects of ADHD and more precisely define its nature:
- Interest-based motivation.
- Emotional hypersensitivity.
- Low tolerance to interpersonal rejection.
1) Motivation based on interest.
What does it mean to have interest-based motivation?
Despite its name, ADHD does not cause an attention deficit. In reality, what it causes is inconsistent attention that can only be activated in specific circumstances.
People with ADHD often recognize situations in which they manage to "plug in" or enter a "streak" or period of deep concentration and connection with the task they are doing. When we talk about this we are describing a state of "hyperfocus": an intense concentration on a particular task during which the individual feels that he can achieve everything he sets out to do. In fact, so much concentration can be achieved that one loses track of how much time has passed.
This state of hyperfocus arises from a momentary appearance of interest, novelty, urgency or “last minute” deadline.
The nervous system, and therefore the motivation, of a person with ADHD is set in motion by interest and not by a priority order of the tasks to be performed.
Which are the recommendations to work better with an interest-centered motivation?
- Medication to level neuronal factors.
- Develop new techniques to awaken motivation when necessary.
For one thing, the drug component of treatment helps prevent people with ADHD from being distracted when they are focused. And on the other, the person who suffers from the disorder must learn to create their own personal system to arouse interest from how and when one works best, creating the optimal entry conditions, instead of waiting for motivation to appear randomly. Recall that most existing planning and organization systems are designed for neurotypical brains that use priority and time to generate motivation.
This job is very personal and can change over time. It can include strategies such as including a third party, that is, asking someone else to sit down and keep you company while you do your job; or "inject interest" by transforming an otherwise boring task using imagination. For example, an anatomy student who is bored with studying might imagine that he is learning how to save the life of someone he cares about.
2) Emotional hypersensitivity.
What is it?
Most expect people with ADHD to have visible hyperactivity. This only occurs in 25% of children and 5% of adults. The rest experience an internal feeling of unease. When people with ADHD are asked to describe this feeling, they often say,
“I am always in tension, I never relax"
"I cannot just sit and watch television with my family"
"I cannot turn off my brain and body to go to sleep at night"
People with ADHD have thoughts and emotions that are much more intense than those of average. Its high moments are higher and the lows are lower. This means that they come to experience feelings of happiness or anguish more intensely than their peers.
Research results show that children with ADHD can develop low self-esteem because they find they have difficulty committing to and finishing what they started. In adulthood this can turn into shame, a pervasive emotion that results in ongoing negative self-talk.
How to recognize emotional hypersensitivity?
Many people with ADHD are initially misdiagnosed with a mood disorder. Research shows that, on average, an adult will go through 2.3 professionals and have tried 6.6 antidepressants before being diagnosed with ADHD.
Here you can continue reading about the diagnosis and treatment of ADHD.
The types of questions that are important to ask are: When you are upset or sad, does it last a long time or do you tend to calm down easily? Do you feel that sometimes it is difficult for you to stop thinking about a certain topic or idea and perhaps several hours or days go by where it is difficult to distract yourself from it?
What can I do to control my emotional hypersensitivity?
To counteract feelings of shame and low self-esteem, people with ADHD are often encouraged to seek support from other individuals. These can be a father, a mother, an older brother, a teacher or a friend. Anyone, who can reaffirm a positive outlook on the person and allow them to get out of their internal negativity and discover how to improve their quality of life.
3) Low tolerance to interpersonal rejection
What is it?
It is an intense vulnerability of the perception of being rejected, judged, or mocked by people who are important in the life of the one who suffers it.
People with ADHD have a hard time describing this primitive low tolerance reaction and often even hide it from others. Those who experience it often do not want to talk about it because of the shame they feel for not having control, or because they do not want others to know about this intense vulnerability.
How to recognize low tolerance for interpersonal rejection?
The question that can help to identify this low tolerance for interpersonal rejection is: “In your life in general, have you felt much more sensitive than the people around you to rejection, teasing, criticism or your own perception of having failed?"
When a person internalizes the emotional response to this low tolerance, it can be seen as a development of a mood disorder. When the emotional response is externalized, it appears as an outburst of anger. Half of the people who receive anger management help previously had unrecognized ADHD.
How is low tolerance for interpersonal rejection regulated?
98/99% of adolescents and adults with ADHD acknowledge experiencing RSD. For 30%, RSD is the most damaging aspect of their ADHD, in part because it does not respond to therapy.
Alpha-agonist medications, such as guanfacine and clonidine, can help treat it. Only one in three people experience relief from either drug, but 60% experience solid benefits when they try both.
When treated successfully, people with RSD admit to feeling "at peace" or having an "emotional armor." They see that the same things that previously hurt them now disappear without leaving injuries. They also report that instead of handling three or four thoughts at a time, they now have only one.
This article is a translation and update of the text written by psychiatrist William Dodson, MD, in English.
Approximately 10 million adults have ADHD. ADHD appears in most cultures in about 2.5% of adults.
Getting a diagnosis can help you understand your challenges and be better prepared for the future. take an evaluation and clear your doubts.
