The ADHD Iceberg: Meme or Reality?

Many people think that having ADHD means only having a few widespread symptoms, like fidgeting and trouble focusing.

However, there are many less apparent signs that even those diagnosed don’t know about. These signs are often invisible, “hidden” under the main symptoms, so they call it the ADHD iceberg.

In this post, we’ll dive under the surface and uncover what’s there.

[Definition]What Is ADHD Iceberg

According to recent research, about 3.5% of the US population lives with ADHD¹, and the number rises to 5%² if we’re talking globally. It doesn’t sound like much, but it means that you definitely know someone with ADHD. And if you don’t, it might be you.^,

Despite the “popularity” of the disorder, most people who don’t have it and some of those who do think it lines up to just two symptoms: attention deficit and hyperactivity. Otherwise, why would they call it like that?

The iceberg analogy perfectly explains the actual situation. There are the most frequent and visible symptoms on the tip, but many other things are below the surface.

Understanding the whole picture is vital to

a) knowing what’s happening to you,

b) knowing how to help yourself, and

c) improving communication with fellow ADHDers and your loved ones.

So let’s kick off the diving journey and see what the ADHD iceberg hides.

[Visible Symptoms]The Tip Of The Iceberg: The Symptoms You See

As we already said, two main symptoms are chilling on the tip of the ADHD iceberg: inattention and hyperactivity.³ Each of them can be broken down into several more sub-symptoms. A person with ADHD might have all or just several; there is no perfect standard.

Inattention symptoms

Trouble paying attention.

Students with ADHD often have problems at school, as they struggle with focusing on the subject.

Avoiding tasks that need longer focus.

A person with ADHD might put off a task until the last moment before the deadline just because they know doing the task will require a lot of effort.

You are getting distracted in the middle of the task.

If you have ever tried to fold the laundry with ADHD, you know you’ll manage to clean the whole apartment on your way from one drawer to another.

Poor time management.

People with ADHD often have trouble with the concept of time⁴, making them either be late or come much earlier than needed.

Losing things.

While everyone can lose their keys occasionally, it happens much more often if you have ADHD.

Hyperactivity symptoms

Fidgeting.

Not everyone who shakes their leg while seated has ADHD, but pretty much everyone with ADHD will do this or some other kind of squirming.

Feeling restless.

People with ADHD often feel like they must be constantly on the go. Simply sitting or lying down doing nothing might be an issue for them.

Communication problems.

Talking to those with ADHD might sometimes be challenging. ADHDers tend to speak fast and loud, interrupt others, and answer questions before they have even been completed. People who don’t know about the diagnosis might think you are rude, but it’s just the disorder talking.

[Hidden Symptoms]Below the Surface: The Symptoms You Don’t See

The rest of the ADHD iceberg lies in dark waters, leaving many symptoms invisible to others. It makes it harder to diagnose the disorder, especially in adults. If you’re a young boy constantly running and screaming, you can be diagnosed and treated. If you’re an adult woman with low self-esteem and mood swings, they’ll probably just say that’s who you are.

So, what’s hidden at the bottom of the iceberg?

Decision paralysis.

People with ADHD might freeze when they need to make a decision, especially if they need to make it fast or if a lot of information is involved.

Executive dysfunction.

The executive functions ADHD-free people take for granted might be low or non-existent in people with the diagnosis, making planning, organizing, or anticipating consequences very hard.

Hypersensitivity.

People with ADHD might be over-sensitive, either emotionally or physically. If you have ADHD, you might be too sensitive to irritating criticism and turtlenecks.

Emotional dysregulation.

Okay, emotions are complicated if you have ADHD. People with the disorder have lots of emotions but struggle with regulating⁵ and expressing them healthily. In most cases, it will involve crying, screaming, and other unpleasantness, making the heads turn.

Sleeping problems.

If you have ADHD, there is a high chance you also have trouble sleeping⁶. It doesn’t necessarily mean insomnia; you can binge-watch The Crown on Netflix until 5 a.m. without realizing it.

Lack of flexibility.

While ADHD is mainly associated with a lack of focus, ADHDers can be very focused on one plan or idea, so it might be hard to see other options or change plans.

Lack of motivation.

The ADHD brain works differently from other brains, especially when it comes to dopamine release⁷, so people with ADHD often have problems with motivation. When you don’t have motivation AND struggle with discipline and time management, actually finishing tasks and achieving goals, deserve a medal.

Low self-esteem.

While low self-esteem is not exactly a symptom of ADHD, it’s something people with ADHD often suffer from. Living with the disorder usually involves lots of shame and distress. Making efforts and still not being able to live up to expectations might lead to low self-esteem and depression.

Co-existing conditions.

Speaking of depression, people who have ADHD are in the group at risk for other conditions⁸, including anxiety, bipolar disorder, and learning disabilities.

Every disorder is unique, just like every person is unique. Your set of symptoms might differ from the one above, or you might have some of these issues without having ADHD. Talking to a professional (not a Tik Tok influencer) and getting the proper diagnosis based on your unique symptoms is vital to a more fulfilling, pleasant life, even if now it seems unreachable.

[Strategies]Saving the Titanic

The best news is that your Titanic doesn’t necessarily need to hit the iceberg. While ADHD can’t be cured completely, there are ways to manage the symptoms and take them under control instead of letting them control you.

While every case is unique and requires consultation with a professional, there are general recommendations for living with ADHD:

Try therapy. Cognitive Behavioral Therapy can help you manage the symptoms, deal with anxiety and self-esteem issues, and level up your organizational skills.

Consider medication. While starting medication can be scary at the beginning, it can also be beneficial for people with ADHD. First-line treatment options⁹ for ADHD include stimulants (methylphenidate, amphetamines) and non-stimulants (atomoxetine, guanfacine, clonidine).

Control your diet. However irritating it can be, your mom was probably right to make you eat that broccoli. A healthy diet has been reported¹⁰to positively influence ADHD symptoms, while high-fat and high-sugar foods can sometimes worsen the situation. Let’s be honest. A burger won’t kill you, but maintaining a healthy lifestyle and taking supplements¹¹ can help.

Be a part of the community. When the symptoms kick in, there is a considerable temptation to lock yourself in the room and not talk to anyone again — what’s the point if they won’t understand you? But some understand, and talking to them through apps like NUMO ADHD can help you feel less lonely if that’s what you’re feeling.

And remember….

[Positive ADHD iceberg]It’s Your Power, Not Your Flaw

While ADHD can bring many problems and discomfort, it makes you — you. The ADHD iceberg might hide many negative issues, but it also hides a bunch of superpowers¹².

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1. Energy.

The H in ADHD is there for a reason. While hyperactivity is often looked upon as a negative side of the disorder, and it can cause problems in some situations, there are also situations where those energy outbursts can work in your favor. Hikes, marathons, all kinds of sports — there is a whole world of things you can do better than others, so why not be proud of it?

2. Hyper-focus.

On the other side of “I can’t focus on my job presentation for a single second,” there is also an “I’ll be concentrating on this hobby I like for 10 hours straight and will only stop because I’m hungry. Or maybe I won’t.” Hyperfocus can become a severe drive for your career or other vital parts of your life as long as you do something you love.

3. Self-awareness.

Just like with the “negative” parts of the ADHD iceberg, some things are not exactly a symptom of ADHD but are rather logical consequences of having the disorder. Therapy is often a part of the treatment. Hence, those with ADHD tend to understand their emotions and detect their triggers faster and more effectively than a regular neurotypical person who doesn’t do therapy.

4. Creativity.

Living with ADHD pushes you to approach things differently, which can be an excellent drive for creativity and ingenious thinking. ADHD brains work differently, it’s a fact, but don’t they always tell you that you need to “think out of the box” to succeed? Well, you are out of the box from the moment you were born.

5. Risk-taking.

People with ADHD generally have higher risk tolerance, which can make their life a bit more dangerous at some point. But it also makes you braver and more spontaneous, which is a perfect recipe for an adventure — whether an impromptu road trip or a startup.

6. Resilience.

What doesn’t kill us makes us a bit more depressed and robust. ADHDers must navigate a neurotypical world, combat stigma, always advocate for themselves, and stand up whenever they fall. Most kids with ADHD are perceived¹³ as resilient, and most likely, it’s a trait that stays with you for life.

7. Sense of humor.

There is no study on this, as you can’t measure the humor, but let’s be honest — people with ADHD are awesome at jokes. Are those jokes often self-deprecating and sarcastic? Yeah, probably. Does it make them less funny? I don’t think so. It’s hard to walk this life without being able to laugh at all its difficulties, and ADHDers have mastered this skill perfectly.

[Wrapping It Up]Wrapping It Up

The waters under the ADHD iceberg are dark and full of terrors but also treasures (and cute starfishes). People with ADHD might suffer from communication issues, executive dysfunction, or lack of motivation, but they are also brave, funny, and super-creative. So don’t be afraid to dive — the better you understand yourself and the iceberg, the more chances that Titanic of yours has to kick the brakes on time and the more pleasant and fulfilling your life can be.

Science sources

₁_{Attention-Deficit/Hyperactivity Disorder: Restricted Phenotypes Prevalence, Comorbidity, and Polygenic Risk Sensitivity in the ABCD Baseline Cohort}

₂_{The Worldwide Prevalence of ADHD: A Systematic Review and Metaregression Analysis}

₃_{Attention Deficit Hyperactivity Disorder}

₄_{Timing deficits in attention-deficit/hyperactivity disorder (ADHD): Evidence from neurocognitive and neuroimaging studies}

₅_{Emotion dysregulation in attention deficit hyperactivity disorder}

₆_{Associations of sleep disturbance with ADHD: implications for treatment}

₇_{Evaluating Dopamine Reward Pathway in ADHD}

₈_{Adult ADHD and comorbid disorders: clinical implications of a dimensional approach}

₉_{Evidence-based pharmacological treatment options for ADHD in children and adolescents}

₁₀_{Eating Patterns and Dietary Interventions in ADHD: A Narrative Review}

₁₁_{The Effect of Vitamin D Supplementation on Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials}

₁₂_{The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD}

₁₃_{Are There Resilient Children with ADHD?}

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ADHD Iceberg: Navigating The Hidden Depths