Four surprising signs of adult ADHD: what's behind them, and what to do next in the UK

A new Washington Post piece lists four less obvious signs of ADHD in adults. Here is a UK take on each, an honest look at the evidence, and what to do if you recognise yourself.

This week a Washington Post piece by Richard Sima looked at four less obvious signs of ADHD in adults: emotions that swing quickly, difficulty with planning and follow-through, a different sense of time, and hyperfocus. It's a good read, and it matches what many of our readers ask about. So here is a UK take on the same four, with an honest look at what's known about each and what to do if you recognise yourself.

How to read a list like this

The Post is careful to say that none of these signs is diagnostic on its own, and we'd say the same. Inattention, restlessness and impulsivity are normal human experiences. As the Post notes, a diagnosis needs several symptoms causing significant impairment in daily life, with some present in childhood, and a clinician has to tell ADHD apart from things like depression, anxiety and autism. A list of signs is a reason to ask a question, not an answer.

1. Big feelings that shift fast

The Post describes emotional dysregulation as very common in ADHD but not part of the formal US diagnostic criteria, which fits our understanding of the main diagnostic manuals. People describe moods that flare and fade quickly, and a strong reaction to criticism. A 2014 review in the American Journal of Psychiatry (Shaw and colleagues) noted that many people with ADHD have difficulty regulating emotion, and also that there is no agreement yet on how to define it clinically.

That uncertainty matters. Emotional ups and downs can also come from anxiety, depression or other conditions, so if this is your main difficulty, describe it in detail at assessment: how fast it changes, how intense it is, and what sets it off.

2. Trouble planning, switching and following through

Executive function covers planning, prioritising, switching between tasks, making decisions and holding things in mind. The Post reports an expert estimate that executive difficulties occur in around half of people with ADHD. In daily life this tends to look like knowing what you need to do and still being unable to start, or losing the thread halfway. Many of the practical fixes work by moving structure outside your head, which we cover in our coping strategies guide.

3. A different sense of time

The Post describes some adults finding time dragging when they're bored and vanishing when they're absorbed. It also cautions that the popular term "time blindness" overstates things. That is what we found when we looked at the evidence: timing differences are real in some studies, but the research on adults is thin and mixed. Our piece on what the research actually shows on time blindness goes through it.

4. Hyperfocus

Hyperfocus is intense, sustained absorption in one thing, to the point of shutting out everything else. The Post reports a 2019 study in which adults with more ADHD symptoms reported more frequent hyperfocus. It is often called a superpower, and it can be useful. It can also be costly if it pushes out meals, sleep or other people.

On its own it isn't a reliable marker. Plenty of people lose themselves in things they love. The more telling question for a clinician is whether you can steer your attention when you need to, not whether you can ever concentrate.

What to do if you recognise yourself

• ✓Write down specific examples. Clinicians want concrete detail: what happens, how often, how long it has been going on, and what it costs you at work, at home and in relationships.
• ✓Think about childhood. Some symptoms should have been present when you were young. School reports and the memories of family members can help.
• ✓Try a screener, knowing its limits. Ours is a starting point, not a diagnosis. Take the free 3-minute screener.
• ✓Choose your route. There's the NHS, including Right to Choose, and private assessment. Our guide to getting an adult diagnosis in the UK compares them, and what to expect from a private assessment explains what happens in the appointment.
• ✓Use what's open to you now. Here is what support you can get without a diagnosis.

We've also written about other signs of ADHD in adults that are often missed and five signs your struggles might be ADHD, not laziness. Our directory lists accredited private ADHD clinics across the UK.