We've shared some of our frequently asked questions.
ADHD, or Attention Deficit Hyperactive Disorder is a medical condition affecting brain development. This results in delayed neurobehavioral development (as compared with normal age range milestones). It is often expressed in children through the inability to sit still, or maintain attention and self control. While generally diagnosed during childhood but can persist into adulthood.What is Adult ADHD?
There is a general misconception that AHDH is a childhood disorder which one can outgrow by adulthood, often when it is treated with medication and behavioural therapies in childhood.
However, recent studies find that at least 2/3 of children with ADHD will become adults with ADHD. Of the 1/3 that appear to have outgrown it, literature suggests that these adults have simply integrated their coping skills sufficiently.
This means that ADHD as a diagnosis is not age bound, and that the only differentiation may be in its expression. However, if you are diagnosed with Adult ADHD the studies are clear that you were born with it. In the majority of late diagnoses it is often seen that the disorder was overlooked (especially in the case of Inattentive presentation) in childhood, or in its presentation hadn’t yet met the requirements for a Disorder (see later). The loss of structure (school/parentals) later in life, however, would trigger the impairment. Lack of awareness of the impact on adults would often mean that adults would only be diagnosed after a significant life event brought about due to the impairment.
Given the increased likelihood of Substance Use Disorder (Addiction) amongst undiagnosed ADHD adults, it is often only in rehab that a diagnosis is made. At least 40% of persons entering rehab may have undiagnosed ADHD – a staggering statistic if you consider that ADHD only accounts for 2-5% of the general population.
Wikipedia suggests a disorder is:
“…a functional abnormality or disturbance. Medical disorders can be categorized into mental disorders, physical disorders, genetic disorders, emotional and behavioral disorders, and functional disorders. The term disorder is often considered more value-neutral and less … In mental health, the term mental disorder is used as a way of acknowledging the complex interaction of biological, social, and psychological factors in psychiatric conditions…” [https://en.wikipedia.org/wiki/Disease#Disorder]
Or effectively, when the inability to manage the complex interactions have a significant impairment on your life outcomes, then it is seen as a disorder.
A mental health professional who would consider an exhaustive life case history, in part relying on third party- and self-reporting in order to assess the extent of impairment.
However, a renowned psychiatrist specializing in ADHD, Dr Russell Barkley, suggests that few professionals devote enough time to make this assessment. He does not believe an hour is sufficient to interrogate an individual’s history, and at a minimum believes that an initial consult should be around 4 hours.
Secondly most mental health professionals are akin to general practitioners, and unless they specialize in ADHD diagnoses, will not necessarily be alert for impaired executive functioning and its impact on the patient’s life choices.
Certain Mental Health Disorders (including ADHD) are covered by the majority of countries legal disability protections which prevents discrimination in the wokplace.
The South Africa Disability Act defines a disability as:
o There must be an impairment
o The impairment must be long-term or recurring
o The impairment must be substantially limiting
Under the Act, a diagnosis of ADHD ensures that you have protection under the law to be employed, and where necessary, reasonable accommodations are made.
However, the challenge with all mental health disorders is in their being “invisible” disorders. A brain doesn’t have a wheelchair to make. Through lack of awareness and misinformed perceptions, companies often require a higher order of proof of a mental health disorder – if they even recognize it at all.
In order to meet these criteria a verified diagnosis supported by a Psychiatrist would be needed. On its own that may not sound onerous, however, if you refer back to the section on disorder diagnosis you will understand that this is not always as straight forward as it seems.
This does not suggest that one seek out professionals who will custom diagnose, but that one’s ensure that in order to enjoy the protection of the Act a professional who is current and specializes in ADHD is sought.
Within the current South African work environment there is little attention placed on accommodations for mental health disorders which often means that many sufferers “suffer in silence”.
Over time this then leads to possible comorbid conditions (depression, SUD, etc) and/or loss of career prospects.
In the US it also results in the higher likelihood of job terminations – where in SA the labour laws are not supportive of summary terminations (however, this does create the potential for an increase in comorbid conditions impacting the workplace).
The most obvious answer should be yes – if you’ve managed to jump through the hoops thrown at you then you owe it to yourself to ensure your company provides adequate accommodations.
But the most obvious answer is somehow not so obvious.
If you’ve worked with a psychiatrist who is prepared to support your status, you still have to take into consideration the lack of awareness in the workplace.
The common retorts of “Everyone is a little ADHD” or “ADHD is a myth, you’re lazy” means that people are disinclined to declare their ADHD status. In the ADHD community the question is often asked “Should I declare my ADHD at the workplace” and the response is overwhelmingly “No, unless you are sure that they will be supportive or understanding”.
So, in principle, because you can’t see your disability, and other people don’t believe it is a disability, then you should rather suffer in silence.
If anyone does not see the ridiculousness in that statement then I can suggest a few other disorders to consider.
I believe that the only way to increase awareness is to be prepared to stand by your rights and demand the protection of the Disability Act. If you are aware of specific areas where accommodations will support your career development then make an informed decision and use the resources at your disposal. It may mean that you would need to be instrumental in raising awareness with your HR department and immediate management.
But ultimately that choice remains your own.
If you choose to declare your status and just need SUPPORT to address accommodation needs with HR/Line Management.
If you choose not to declare your status, we can WORK TOGETHER to develop the coping strategies and skills that best suit YOU to manage your work life.
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If you want to raise AWARENESS of the impact of ADHD in the workplace you can invite me to present to HR/Disability Committee, or general Disability/Wellness Drives.