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What Is High-Functioning ADHD in Adults

Written by:
Saya Des Marais
MSW

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Highlights

  • “High-functioning ADHD” is not a formally recognized medical term. Official diagnostic guidelines don’t specify the level of functioning.
  • People with high-functioning ADHD are successful in different areas of life but it doesn’t mean they don’t face struggles brought on by this disorder.
  • There is a debate about using the term “high-functioning ADHD” because it can cause challenges in getting a diagnosis, promote biases related to both “high-functioning” and “low-functioning” people with ADHD, and encourage masking to fit societal expectations.

Many people believe that adults with attention deficit hyperactivity disorder (ADHD) struggle to hold jobs or achieve success, but that’s a myth. The reality is much more nuanced, and many people with ADHD are incredibly successful in their careers and in life. But while they may thrive in certain settings, those labeled as “high-functioning” often navigate unique ADHD-related challenges that go unnoticed. This outdated term can create misconceptions about their experiences and lead to misunderstandings about the support they need.

In this article, we’ll dive into the complexities of high-functioning adult ADHD, debunk common myths, and highlight the importance of acknowledging the diverse experiences of those living with this condition.

See a medical provider online for a detailed ADHD assessment. Learn if you have ADHD according to official, evidence-based diagnostic criteria.

What Is High-Functioning ADHD?

“High-functioning ADHD” isn’t a formally recognized medical diagnosis. If you’re diagnosed with ADHD, then you have ADHD—the diagnostic criteria [1*] don’t specify the level of functioning you have. When people refer to “high-functioning” ADHD, they are typically using a casual term to describe someone with ADHD who has (or appears to have) a higher level of adaptive skills.

Adaptive skills are the everyday skills for daily functioning that are needed to meet the demands of your life and environment. For example, for someone with “high-performing ADHD,” these skills could include:

  • Being able to keep up with basic tasks like hygiene, finances, and household chores
  • Having satisfying relationships in their lives
  • Having a successful and enjoyable career

On the outside looking in, it may appear that people with “high-functioning ADHD” aren’t held back by their symptoms at all. But if you have ADHD, then only you know how this condition affects you. 

Many people who are labeled as “high-functioning” are objectively successful, and there’s no doubt that people with ADHD can be high achievers. But, internally, these individuals continue to face the same symptoms. Just because you’re “high-functioning” and successful doesn’t mean you don’t deserve support for ADHD.

"Oftentimes, high-achieving individuals with ADHD are very hesitant to seek care because they have attained some level of success. Sometimes there is a struggle internally, while outwardly their life appears to be going very well. However, sometimes the scattered thinking, distractibility and forgetfulness are more apparent in close relationships. These symptoms can lead to additional mental health consequences such as anxiety, depression and insomnia just to name a few."
Dr. Michael Chichak
Medical provider at MEDvidi

Is “High-Functioning” an Outdated Term?

Some advocates have pushed to banish functioning labels when talking about autism and other forms of neurodivergence, like ADHD. Dividing neurodevelopmental disorders into “high” and “low” functioning can be dehumanizing, and may not reflect the vast range of both strengths and struggles that people with these conditions face.

Some of the reasons that the neurodivergent community has advocated for retiring the term “high-functioning” when it comes to autism or ADHD include:

  • It’s not medically accurate. When you’re diagnosed with ADHD (or autism), you’re not given a medical label for your functioning level. There’s no consensus on what, exactly, makes one person higher-functioning than another. This lack of precision means that labels can misrepresent individual capabilities and challenges, and create an illusion of uniformity among people who, in actuality, have diverse experiences.
  • It’s dismissive of people’s struggles. People who are labeled as “high-functioning” may be dismissed when talking about how ADHD has affected their lives. Just because they appear to manage certain responsibilities or tasks well doesn’t mean they aren’t facing significant internal battles. Their struggles may be overlooked and lead to a lack of understanding and support from others.

  • It assumes challenges. On the flip side, the label “low-functioning” can be assumptive. We may assume that “low-functioning” people aren’t able to function in certain areas of life—for example, that they can’t work in a traditional job. But these assumptions are often wildly inaccurate because each individual is so unique. In reality, some people labeled as low-functioning may excel in areas that aren’t typically recognized or valued by society, such as creative or technical skills.

  • It can delay diagnosis. People who are labeled as “high-functioning” may not get taken seriously when they express concerns about having ADHD. For example, healthcare providers might dismiss their concerns simply because they have a job or appear to be functioning adequately in daily life. This skepticism can prevent them from receiving a proper diagnosis and the support they need.

  • It encourages masking to fit neurotypical standards. At the end of the day, how “high” or “low” functioning you are labeled as being depends entirely on how well you’ve been able to function within neurotypical standards. This pressure to conform can lead to masking behaviors, where neurodivergent people feel the need to hide their true selves to blend in. Over time, this can result in burnout and emotional distress, and can even result in other mental health conditions like depression or anxiety.

Symptoms of High-Functioning ADHD

People with high-functioning ADHD still face the same symptoms as anyone else with ADHD. Your exact symptoms may differ based on the subtype of ADHD you have (predominantly inattentive, hyperactive-impulsive, or combined), but generally include:

  • Trouble staying focused on tasks or activities
  • Making careless mistakes in schoolwork or projects
  • Difficulty organizing tasks and responsibilities
  • Avoiding tasks that require a lot of mental effort
  • Frequently misplacing things you need
  • Getting easily distracted by noises or other things happening around you
  • Forgetting daily routines or obligations
  • Fidgeting or tapping your hands or feet when you are supposed to sit still
  • Finding it hard to stay seated in situations where it’s expected
  • Feeling restless or wanting to move around when you need to be calm
  • Struggling to do activities quietly
  • Talking a lot or feeling like you can’t stop chatting
  • Answering questions before they are fully asked
  • Having a hard time waiting your turn
  • Interrupting others during conversations or activities
"Many of these symptoms can appear to be signs of a driven, successful person. People on the outside will often excuse these behaviors as just being due to how much the individual has on their plate. However, internally, the struggle brought on by ADHD can be much more significant."
Dr. Michael Chichak
Medical provider at MEDvidi

Start with a free online ADHD test to evaluate the probability of having this condition.

On top of these formally recognized symptoms, some other signs of high-functioning ADHD include:

  • Putting in extra effort just to perform at the same level as your peers.
  • Feeling burned out by the constant pressure to succeed.
  • Developing compensation strategies to mask symptoms, such as creating elaborate organizational systems or excessively planning.
  • Feeling an overwhelming sense of frustration or inadequacy when you struggle to meet expectations despite working hard.
  • Constantly second-guessing your abilities and fearing that others might see through your facade of competence.
  • Struggling to enjoy leisure time because you feel compelled to be productive (which may lead to a cycle of guilt and stress).
  • Feeling isolated or misunderstood because others might not recognize the effort you need to put in.
Have you found familiar symptoms and experiences in the lists above? It may be helpful to consult a medical provider for an ADHD assessment.

Causes

The causes of “high-functioning” ADHD, as well as any other form of this condition, are still being studied. So far, scientists have found that it can be caused by a combination of risk factors, including:

  • Genetics
  • Brain differences
  • Early childhood trauma
  • Prenatal exposure to certain chemicals

How well you’re able to function with ADHD within neurotypical environments can have many different causes.

IQ

Some research suggests that IQ may play a role. People with ADHD can be incredibly intelligent. In one study [2*] , people with ADHD who have higher IQs performed better on executive functioning tests than people with ADHD with lower IQs. But another study [3*] found that people with ADHD and high IQ still face significantly worse executive functioning problems than their high-IQ peers without ADHD.

Compensating Behaviors

The author of one paper [4*] writes that people with high-functioning ADHD may be more skilled at compensating for some of the difficulties that the disorder brings. For example, you might have studied extra-long hours at school or have implemented rigid self-organization techniques. These coping strategies can be helpful, but for some people, they can lead to masking—or hiding your true self in order to fit in.

Strengths and Support

In some cases, people who are “high-functioning” may have simply learned how to use the unique strengths that come along with ADHD to their advantage. For example, they may have found a career in which they’re able to hyperfocus on their interests, come up with new ideas, and be dynamic leaders. Importantly, this typically involves being in environments where your true self is allowed to shine, and where the people around you understand your strengths and struggles.

Treatment

Lastly, many people with ADHD are high-functioning due to effective treatment. ADHD treatment, particularly medications, has been found to be very helpful in reducing the negative effects that ADHD can have on your life. With the right treatment, be it medication management, psychotherapy, support groups, or lifestyle changes, you can overcome the challenges that ADHD symptoms may present and succeed in any area you choose.

Go through an assessment and get a personalized treatment plan for ADHD online.

Negative Impacts of High-Functioning ADHD on Daily Life

If you live with high-functioning ADHD, then people may assume that you don’t face the same struggles as those who are labeled as “low-functioning.” But, in reality, you likely continue to face the same symptoms and can even experience unique struggles because of the “high-functioning” label.

  • You can’t get a diagnosis. The “high-functioning” label might lead medical practitioners to not take your concerns seriously, which could make it difficult for you to receive an appropriate ADHD diagnosis, even if you face significant challenges.
  • You are not taken seriously. When you voice your struggles, others might dismiss your experiences and assume you can handle responsibilities without issues.
  • You are not given accommodations. Without recognition of your unique challenges, you might miss out on essential accommodations that could help you thrive in various settings, such as work or school.
  • Others assume you’re “lazy” or “stupid.” People might mistakenly label you as lazy or unintelligent and overlook that your difficulties stem from ADHD, not a lack of effort or capability.
  • You are always masking. You could feel compelled to hide your symptoms to fit societal expectations (or “mask”), which might exhaust you and lead to emotional fatigue over time. Masking can also lead to increased stress and mental health problems.
  • You blame yourself for your symptoms. The pressure to perform at a certain level might cause you to internalize your struggles and feel self-blame instead of understanding that ADHD is a legitimate condition that impacts your life.

When to Seek Professional Support

If you live with ADHD but have been labeled as “high-functioning,” you deserve support just as much as anyone else. Outdated labels can’t adequately describe the breadth of your experience, and just because you’re successful on the outside doesn’t mean that life with ADHD isn’t challenging for you in unique ways.

If you think that ADHD could explain the symptoms and experiences you’ve been having, then see a healthcare provider right away. Getting the right treatment and support can go a long way in limiting the negative effect that ADHD has on your life and helping you to function better in daily tasks.

At MEDvidi, you can see a healthcare provider as soon as today. Providers at MEDvidi understand the nuances of life with ADHD and are here to listen to your unique experiences and create a personalized plan for ADHD treatment online.

Sources

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4 sources
  1. CDC. Diagnosing ADHD. Attention-Deficit / Hyperactivity Disorder (ADHD). Published May 15, 2024.
    Source link
  2. Milioni, A. L. V., Chaim, T. M., Cavallet, M., de Oliveira, N. M., Annes, M., dos Santos, B., Louzã, M., da Silva, M. A., Miguel, C. S., Serpa, M. H., Zanetti, M. V., Busatto, G., & Cunha, P. J. (2017). High IQ May “Mask” the Diagnosis of ADHD by Compensating for Deficits in Executive Functions in Treatment-Naïve Adults With ADHD. Journal of Attention Disorders, 21(6), 455-464.
    Source link
  3. Antshel KM, Faraone SV, Maglione K, et al. Executive functioning in high-IQ adults with ADHD. Psychological Medicine. 2010;40(11):1909-1918. doi:10.1017/S0033291709992273
    Source link
  4. Lesch K. “Shine bright like a diamond!”: is research on high‐functioning ADHD at last entering the mainstream?. Journal of Child Psychology and Psychiatry. 2018;59(3):191-192.
    Source link
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Written by:
Saya Des Marais
MSW
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This article contains scientific references. The numbers
in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.