Attention-deficit hyperactivity disorder (ADHD) and addiction are common comorbidities. Meaning that people with ADHD are more likely to turn to substances to cope, and people in recovery often discover that they have ADHD once sober. However, ADHD is often underdiagnosed, especially in women. This can make having ADHD in addiction recovery especially challenging.
I was misdiagnosed for 8 years of my recovery. Professionals said my problems included depression, anxiety, and — believe it or not — not working hard enough on my recovery! It was only after I decided to take control of my recovery that I started to find answers to a life-long condition impacting my quality of life.
What is ADHD?
According to the American Psychiatric Association, attention deficit/hyperactivity disorder is one of the most common mental health disorders affecting people from children into adulthood.
As the name suggests, ADHD affects your ability to focus, your capacity to stay still, your attention span, and your impulsive behaviors.
But it’s important to remember that symptoms vary from person to person. In fact, there are actually three different types of ADHD, which I’ll outline below.
It is estimated that 8.4 percent of children and 2.5 percent of adults have ADHD. However, those figures are almost certainly inaccurate. People with ADHD are often misdiagnosed, especially among women and people with substance use disorders.
What Are the Different Types of ADHD?
There are three different types of ADHD. To be clinically diagnosed, children must meet six of the symptoms and adults must meet five or more.
Type 1: Inattentive ADHD
Symptoms include:
- Struggling to pay close attention to details or making careless mistakes
- Difficulty staying focused on tasks or activities
- Inability to listen during conversations
- Starting tasks and quickly losing focus
- Disorganization and struggling to organize tasks and environments
- Avoiding or disliking tasks requiring sustained attention
- Often losing possessions
- Forgetting to complete daily tasks like chores or errands
Type 2: Hyperactive/Impulsive ADHD
Symptoms include:
- Fidgeting
- Difficulty staying seated
- Running or climbing when inappropriate
- Always being ‘on the go’
- Children have difficulty playing quietly
- Talkativeness
- Interrupting conversations or blurting out answers
- Difficulty waiting in line
- Intruding on others
Type 3: Combined ADHD
This is a combination of both inattentive and hyperactive types and symptoms.
Typically, we associate the thought of loud children running around when we think of ADHD. However, ADHD symptoms in adults is something we often overlook.
In adults, ADHD symptoms present differently compared to children. It mostly shows up when experiencing difficulties on the job and in relationships. Adults with ADHD might be disorganized at work, miss deadlines, forget tasks, or fail to return missed calls and emails. Relationally, an adult with ADHD may struggle to regulate their emotions, be prone to emotional outbursts, fail to pay attention to what their partner says, or appear checked out. They can also struggle to pay bills on time, forget about social commitments, or avoid texting/calling someone back.
ADHD in Addiction Recovery
ADHD co-occurs with substance use disorder for a number of competing reasons. As I alluded to earlier, people with ADHD often turn to drugs and alcohol to cope.
Research shows that 40 percent of children with ADHD used alcohol, compared to 22 percent of children without an ADHD diagnosis. Among adults, research shows that 21 percent of males and 13 percent of females* use substances to make up for the deficiency in dopamine (a feel-good brain chemical). And data shows about 25 percent of the people in addiction recovery have been diagnosed with ADHD.
Genetics also plays a major role. Parents with ADHD are 4 times more likely to have a child with ADHD. Similarly, a parent with substance use disorder can also increase the likelihood of a child going on to struggle with addiction.
* A note about women and ADHD: Women are often misdiagnosed because of how their ADHD presents. Many women don’t exhibit the same symptoms as men or children with ADHD, and their coping strategies often mask the typical signs of ADHD.
In my case, I am highly organized and responsive. But I’m always on the go and constantly overwhelmed. I take on too many jobs, and while I have a high work output, concentrating takes all of my energy. So I have nothing in the tank at the end of the workday. My ADHD was only diagnosed several years into my recovery and after a series of misdiagnoses.
How ADHD Affected My Recovery
I was 8 years sober when I was diagnosed with ADHD. I’d spent years watching as my friends in recovery thrived. They seemed to have boundless energy — going to work all day, working out, going to meetings, and socializing in the evenings. Yet here I was, depressed, exhausted every single day, using food to cope, and having virtually no social life.
My days started with drinking tons of coffee to energize myself, but I still struggled to pay attention and stay on task. Work became increasingly difficult. I’d have breakdowns in the office — to the point where I had to walk out — because of the unbearable noise, stimulation, and volume of work.
My friends in recovery said I should work harder at my aftercare program. My doctor told me I was depressed and had anxiety. And I genuinely believed these points of view for years. It was only when I began seeing a psychiatrist for my unrelenting depression that things finally started to change.
During my first visit with a psychiatrist, she spent a long time taking a detailed history. I answered more questions in that one session than I answered in all the doctor visits I had throughout my life combined.
No one had ever asked about my childhood and home life, how I did in school, the reasons why I drank and took drugs, how I interacted in relationships, the emotions I felt, my energy levels, and my ability to concentrate. Instead, I was simply labeled a “difficult child” and, later in life, an alcoholic.
I think this is the sad reality for a lot of people in recovery.
What I Learned About ADHD
My psychiatrist diagnosed me with hyperactive/impulsive ADHD. She thought it was a miracle that I was still in recovery, given everything I was dealing with.
According to my psychiatrist, my brain was in overdrive. Compared to other people, I had to focus intensely for much longer periods to complete a task. It took me longer to learn, train, and interact. (It’s no wonder that working all day and going to meetings at night was too much for me!)
She also said my brain lacked sufficient dopamine. And that diagnosis perfectly explained my feelings of depression and why I reached for certain foods, social media, and casual relationships as coping strategies — they all release dopamine! It also explained why I used alcohol and stimulants as a child, as they too release dopamine.
What I actually needed, she explained, was medication to increase my brain’s dopamine to a normal level.
Making these discoveries and advocating for my mental health made such a huge impact on my outlook — and my recovery. I felt like everything finally made sense. There was finally an explanation for why I wasn’t thriving and felt depressed or exhausted all the time.
How Proper Treatment For ADHD Helped My Recovery
My psychiatrist gave me a new lease on life by prescribing Adderall, a medication to treat my ADHD.
I’m not exaggerating when I say that Adderall changed my life. The world went from black and white to color. The increase in dopamine helped me to focus, as well as sustain my energy. I even had enough left in the tank to socialize and be present in my relationships.
I always thought I was an introvert who couldn’t deal with the draining nature of people. Now I see that people are overwhelming to me because of my ADHD. But now that I have more dopamine in my brain, I have a greater desire to see the people I love instead of avoiding them.
I know Adderall doesn’t work for everyone — and that’s okay. For some people in recovery, it can feel triggering, especially if you took stimulants in active addiction. I’d be lying if I said I don’t get reminders of what that was like on this medication. But I’m also someone who likes to challenge dominant points of view in recovery.
Making Decisions That Support My Recovery
My philosophy is that we’re all different, requiring different interventions to meet our individual needs. I also believe in the right to self-determine and that we have control over our recovery process. I’m capable of making decisions that are best for me, and I believe other people in recovery have this right, too.
I believe the risk of abusing my ADHD medication is low. I don’t buy into the stigmatizing view that people with substance use disorders are always motivated to take drugs. There’s zero motivation to avoid or escape a life that I’ve worked so hard to rebuild. And, as a precaution, I have been completely open with my mental health provider about being in recovery. I take my medication as prescribed and schedule bi-weekly appointments to regularly check-in.
I finally know what it’s like to thrive in recovery… and it feels wonderful.
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