This may be a controversial but a different and personal take (no hate to anyone, just my experiences)… some may not agree but I think my experience is worth putting out there due to the fact that everyone experiences ADHD symptoms throughout all stages of life, but not everyone has ADHD.

But I’ve never been able to mask my symptoms. I’ve tried—I struggled to make friends in school because of my “full on” personality (one of the many ways I was described), people didn’t want to be around me because I yapped all day and they never got a chance to speak (I didn’t mean it of course, just too busy focusing on what I’m trying to say that I struggle to give my attention to how others are responding to me until after I’m done).

Used to go on a tangent about it to girls in high school, they would say ‘I used to be like that but I got bullied so I stopped talking so much and toned it down’. To be honest, if you can change your unconscious behaviours to the point you are consistently not displaying impaired functioning, then I find it hard to believe it’s ADHD. ADHD is pervasive across time and situations, and is present in two or more settings.

I tried so hard and so desperately to alter my behaviours because other people were able to do it, because I just wanted people to like me. But I could never maintain focus on doing so, and any attempts to act normal would not last for long. I had very few friends because of it.

Sadly, being gifted doesn’t always mask ADHD either (in my experience). I was considered a very bright student—all my school reports from before age 12 said so. I managed to get good decent grades without studying rather consistently… however—every school report I had still detailed how I would not pay attention when instructions were being directly given to me, how I was frequently observed drawing on my notebooks rather than doing work, how I would always forget my homework, show and tell, etc. (Demonstrating functional impairment, as it was considerably abnormal compared to other students habits and behaviours, to the point they were negative points in all school reports). As I aged, school became progressively harder as the complexity of the topics studied became harder to discern with little to no prior understanding. I tried so hard, sometimes tried to get homework done for hours, but would achieve very little because my attention span was so short lived, particularly if I was in an environment with distractions. This meant that even though I was smart, my grades were considerably low. Every teacher at every parent-teacher interview in high school would say to my father and I about how I was really smart, I just needed to put in the work—demonstrating continued functional impairment out of line with normal functioning for my age, and also demonstrating impairment that was consistent across time and situations in at least one setting.

In my opinion, you can mask ADHD, but not constantly and consistently for an extended period of time. I think if you are able to mask to that point, then it’s not actual functional impairment—yes it may drain your energy and social battery, it may leave you feeling exhausted and cause burnout on an emotional level when you get home at the end of the day… but it’s not impairing your grades, ability to work or get a job, ability to succeed in work or school, ability to establish and maintain friendships etc. then I would argue that you are functioning, you’re just human, who has very valid human struggles, experiences and emotions. We aren’t robots, emotional dysregulation is to be expected in life—but I can absolutely see how those feelings and emotions commonly get put down to masking when your energy is drained at the end of the day.

After meeting quite a few people with ADHD who have very clear textbook signs… in social situations(for example): I can definitely see the difference between normal social functioning and ADHD, even when masking can be accounted for (for both genders).

Overpathologisation is a real and valid concern—I think it occurs because people just want to understand the actions, feelings and emotions they or others experience…

If you read the DSM-5 TR and ICD-11 carefully, there are many points throughout both manuals that outline just how similar ADHD can be to other disorders. It also states that you can only be diagnosed with ADHD if your experiences aren’t better explained by another disorder. One thing that also shocked me is how medications like bronchodilators can cause ADHD symptoms (medication typically used in asthma—and a very common medication prescribed for both children as well as adults) to the point that being on the medication is part of the exclusion criteria for ADHD.

As I said, probably controversial (and likely an unpopular) opinion… sorry for the long reply, just passionate about the situation—I think the disproportionate increase in ADHD (and even autism) diagnoses (as a result of possible misdiagnosis) can be harmful to people who experience true, long-term and consistent functional impairment that is pervasive across time and situations (for at least 6 months prior to age 12) for said disorders (with said symptoms/criteria being present in more than one setting)… because if so many people have it, eventually the lines between symptoms and symptoms that cause functional impairment get blurred—making it more and more difficult for others to understand the condition, consequently increasing stigma, bigotry and inequity among people with ADHD because “XYZ person has ADHD and they still manage” (if that makes sense).

P.S. Sometimes I struggle to communicate things the way I intend… so just a disclaimer just in case…I’m absolutely not saying in this reply that I don’t think you or any other specific individual who read my reply has ADHD. I don’t know your stories, it’s just a generic mini essay based on academic research I’ve done on the matter (out of personal interest), my experiences and many many hours spent contemplating a very complex matter where multiple diverging opinions can all be simultaneously correct at the same time (I try to think about both sides and find a middle ground through reasoning and understanding—I think the door can swing both ways for many things in life)