ADHD diagnosis in adults: Q&A with “Understood Explains” host, Dr. Roberto Olivardia
Many people aren’t diagnosed with ADHD until adulthood. But knowing how to start the diagnosis process can be overwhelming, confusing, and time-consuming — especially if you have to sift through a lot of misinformation on the internet.
That’s why the Understood Podcast Network is bringing back its limited series podcast, Understood Explains, for a second season: “ADHD Diagnosis in Adults.” This season, we explore the ins and outs of diagnosing adults with ADHD.
In each episode, host Dr. Roberto Olivardia shares his expertise on adult ADHD diagnosis, both from his clinical background and from lived experience. He’s a clinical psychologist and a Harvard lecturer who was diagnosed with ADHD as an adult.
Read on to learn about Understood Explains Season 2. And for actionable tips on getting an ADHD diagnosis as an adult, listen to Season 2 of Understood Explains on Understood.org or wherever you get your podcasts.
In this new season of Understood Explains, you talk to us about ADHD diagnosis in adults. Why is this such an important topic now?
Dr. Olivardia: ADHD is a condition that is significantly misunderstood. It has a reputation of being overdiagnosed, when studies and my clinical experience demonstrate the opposite. This is especially true for adults with ADHD, who are often underdiagnosed and therefore untreated. And untreated ADHD can cause or contribute to lots of problems at work and at home.
Given the topic of this season of Understood Explains, are there any special things you do to help make the information as digestible as possible for listeners who might be struggling with attention?
Dr. Olivardia: It’s super important to me, as someone with ADHD, to know our audience. Each episode is between 10 and 15 minutes. There are clear section headings and also audio cues to help people know when one section is ending and the next section is beginning. I sprinkle in some personal anecdotes, along with humor here and there. The key is to keep people engaged.
That’s why we broke the season down into eight very short, very focused, informational episodes — plus one bonus episode where several people, myself included, share our diagnosis stories. And we’re releasing all the episodes at once so people don’t have to wait to find the information they need. You can choose to listen all the way through or to jump to an episode that’s especially relevant to you. Like maybe the one about online ADHD testing. Or what to do if you have a diagnosis but don’t think it’s accurate.
What are some of the most surprising differences in how ADHD looks in adults versus how it looks in kids? In what ways have you seen this, whether as a psychologist treating your patients, as an adult who yourself has ADHD, or as a father raising two teenagers with ADHD?
Dr. Olivardia: It’s important to note that ADHD can show up in different ways for different people. Some challenges may increase as kids get older. For example, some kids with ADHD do relatively OK in school, where they often have a lot of supervision and organizational supports. But the wheels fall off in adulthood when there’s less supervision and a much greater need for organization and time-management skills.
Adults with ADHD tend to find themselves in more situations where impulse control issues can snowball. We also see ADHD’s impact on health play out more in adulthood, where addictive behaviors can be a big issue for a lot of folks with ADHD.
You were diagnosed with ADHD at 35. Can you tell us about your diagnosis path and what ultimately led you to get tested?
Dr. Olivardia: When I was young, the only kids diagnosed with ADHD were kids with conduct disorders. Many of them were seen as “troubled” — failing classes or engaging in criminal behavior. Many of them had severe learning disabilities, which back then resulted in having to repeat a grade (or two or three).
Although I had many symptoms of ADHD, I did well in school grade-wise, and I had good social skills. No one knew how exhausting it was for me to get through a typical school day, though, or how I always waited until the last minute to start big projects. I hated school so much that the idea of college seemed like torture.
College turned out to be far more engaging and enjoyable for me than high school, but my ADHD showed itself in other ways. Like the time I was awake for over 72 hours — without any caffeine — so I could finish writing a thesis that I’d procrastinated on. And with more choices came a clearer awareness that I could easily get addicted to anything I found rewarding.
It wasn’t until my mid-20s that the classic book, Driven to Distraction, was written, and people started talking about ADHD in adults. The more I looked into ADHD, the more I saw myself reflected in whatever I was reading, whether it was first-person accounts or studies looking at sleep issues and ADHD, procrastination, you name it…. Strangely, for me, realizing I had ADHD wasn’t this big epiphany as much as a feeling of comfortable familiarity. Like putting on a pair of gloves that fits perfectly. I knew years before I got an official diagnosis that I had ADHD. But I thought it was important to make it official for myself, my family, and my patients.
Did anything change for you after your diagnosis? And looking back, is there anything you wish you’d known sooner?
Dr. Olivardia: For me, nothing changed after the official diagnosis. The change for me came a few years earlier when I realized I had ADHD. It’s been a continued evolution of knowledge and connecting dots to various life experiences. I get excited when I read new studies about ADHD. Today, we know far more about ADHD than we knew even 20 years ago, let alone when I was a kid.
If I’d known then what I know now, life would have been easier. The thing I think about most is my high school experience. Understanding my ADHD back then would have helped tremendously. My strategies for getting through school could have been more precise. I would have definitely benefited from some academic accommodations, especially around tests like the SATs. I would also have benefited from being screened for learning issues, like dyslexia, dysgraphia, and dyscalculia.
These are some of the many reasons why I’m so glad to be part of the Understood team that’s creating all these great free resources to help people start thriving with learning and thinking differences. The podcast has been really fun to work on too.
The season covers everything from online ADHD testing to what you need to know about medication and non-medication treatments for ADHD. Do you have a favorite episode?
Dr. Olivardia: Each episode is packed with important information. But I have two favorites: Episode 1: Should I get tested for ADHD? And Episode 7: How do I emotionally prepare for an ADHD diagnosis?
Episode 1 lays out the most important elements of the symptoms of ADHD and clears up some misunderstandings people usually have about the condition. But also, I see it as gentle encouragement for people to see the value of getting tested for ADHD and how it can open them up to opportunities.
Episode 7 deals with the psychological responses to finding out you have ADHD, which is so important to cover. Sadness, anger, relief — there isn’t a universal experience. And I want people to know that and feel validated in whatever their emotional response is to getting diagnosed. More importantly, I want people to use that emotional response as a guide to now get the support and treatment they need.
What do you hope listeners take away from the podcast?
Dr. Olivardia: Honestly, everything! The Understood team and I worked diligently to cut out any filler and make sure the content cuts right to the chase of what listeners need. Let’s face it, as someone with ADHD, I don’t always have the patience to listen to an hour-long podcast when I’m just looking for a specific answer to a specific question. Our short, streamlined episodes give listeners key takeaways they can put into action. With the right information, you can make better choices for yourself and your loved ones. That’s what this is all about.
For more information, visit https://www.understood.org/podcasts/understood-explains-season-2. If you have comments, email us at [email protected]. We’d love to hear from you!