When I received a late diagnosis of combined type ADHD, so many of the challenges I faced in my job as a lecturer suddenly made sense.
Neurodiversity refers to the natural differences in neurological functioning that are a normal and valuable aspect of human diversity. It is an umbrella term for autism, attention deficit hyperactivity disorder (ADHD), dyscalculia, dyslexia, and dyspraxia, and sometimes includes conditions such as dysgraphia, mysophobia, slow processing, stammering, and Tourette’s syndrome. Neurodivergence is often categorised separately from mental health conditions, like anxiety or depression, because it doesn’t appear suddenly in adulthood or after a pivotal experience.
Regarding the workplace, neurodiversity is a protected characteristic under the Equality Act (2010), and neurodiverse employees are entitled to reasonable adjustments under UK law.
What actually is ADHD?
ADHD is caused by a deficiency in the production of dopamine (motivation/task completion), norepinephrine (attention), and serotonin (soothing/calming). These deficits present in two main symptoms: executive dysfunction and emotional dysregulation. Both can significantly impact a person’s work, making it challenging to focus on tasks, organise work or time effectively and regulate emotions appropriately. Individuals with ADHD feel that it prevents them from performing to their perceived potential at work (Fuermaier et al., 2021).
The emotional dysregulation of employees with ADHD manifest in different ways in the workplace, one of which is the amount of energy neurodiverse people expend on “masking” (acting in a neurotypical way) – which Beth Sennett outlined in her recent piece for Wonkhe.
ADHD can appear somewhat dualistic, with many of its key symptoms becoming strengths in the right environment – and key strengths becoming weaknesses in the wrong environment. Equally, certain aspects of academia can both help or hinder a person with ADHD
Executive dysfunction and hacking the ADHD brain
Executive dysfunction is characterised by a lack of motivation to complete tasks. This is caused by lower-than-typical levels of dopamine – the neurotransmitter that links the “knowing” and “doing” parts of the brain. On the surface, this appears to others as a lack of motivation – of even laziness. But what is going on inside the brain is that the “knowing” part of the brain wants to do a task but it is unable to communicate this with the “doing” part of the brain.
People with ADHD become good at hacking their brains to produce the dopamine they need to complete tasks. However, these are not always the healthiest methods and are one reason we see higher levels of burnout in individuals with ADHD. For example, one hack is using the threat system to motivate. External threats like punishment for missing deadlines, or internal threats like self-shaming are used as motivation to complete tasks. Before my diagnosis, this was the way I would motivate myself to complete tasks, which ultimately led to me becoming temporarily blind in one eye due to a condition called Central Serous Retinopathy.
A healthier method is starting a task with something creative, which can help produce enough dopamine to initiate the entire task. Creativity and problem-solving are two key attributes of individuals with ADHD, meaning we can easily find novel and creative solutions to problems that neurotypicals often find harder to solve. Higher education is a great sector for us because it can offer creative freedom on multiple, varying, and interesting projects.
Another is through buddying up or body doubling. This is when an individual with ADHD who needs to complete a low dopamine generating, or frustrating, task is physically placed next to a colleague working on a similar task. This allows them to ask questions about anything they may have missed or misunderstood with the immediacy they crave and will gently hold them to account without micromanaging. It also gives their brain the dopamine reward associated with belonging to a team or group. However, it is important that the co-worker is also relatively focused and does not distract the person with ADHD with small chitchat or other distractions.
Another way that managers can help people with ADHD produce a more consistent flow of dopamine hits to keep motivated is to help them break large tasks need breaking down into smaller tasks with shorter deadlines.
A double-edged deadline sword
That being said, deadlines can cause problems if they are not set right. Extended deadlines for large tasks will mean someone with ADHD will not start the task as it does not offer any immediate reward or threat. This does not mean that they are ignoring the task. Their “knowing” is aware of the task and deadline, but it cannot motivate the “doing” part of the brain. This paralysis can actually be very distressing. In this instance, a deadline is a hindrance.
The way to use deadlines to enable staff with ADHD is to create shorter deadlines that break down larger tasks into smaller tasks – a technique often referred to as “chunking”. Smaller tasks offer a more immediate dopamine reward when completed and therefore help to motivate, and can sometimes lead to a person with ADHD finishing a task much quicker than their neurotypical counterparts could.
This is because if an individual with ADHD feels as though they are good at something and are gaining regular dopamine hits when completing a task they find stimulating, they can become “hyperfocused.” This is a state characterised by intense and focused attention on a task to the exclusion of everything else. When hyperfocused, an individual with ADHD can complete a large amount of work in a short period.
That being said, it is very difficult to control when hyperfocus occurs, so it cannot be relied upon when scheduling work. It can also mean that the individual neglects their basic needs – such as eating, personal care, or downtime – in favour of completing the task. Because hyperfocus comes with feelings of freedom from the usual constraints of ADHD, an interruption can cause extreme frustration. Combined with the emotional dysregulation some people with ADHD experience, a disruption can also lead to an emotional outburst which managers dealing with such conduct need to be aware is an element of the disability.
Do not disturb…
When considering the physical work environment for employees with ADHD, it becomes crucial to balance social and quiet spaces. People with ADHD can experience sensory overload, so allowing them to use noise-cancelling headphones, turn off notifications, and implementing “do not disturb” signs that are respected is vital. Sensory overload can also come from physical sensations such as needing to go to the toilet. Allowing someone with ADHD the freedom to leave meetings to use the toilet means they can come back and focus on the content of the meeting or discussion – rather than being overwhelmed by physical sensations.
It’s also essential to recognise that interruptions can come from people but also from inefficient systems that hinder productivity. Waiting for information that is readily accessible or having to navigate through complicated IT systems can disrupt a hyperfocus state that has taken the person a while to get into. Equally, allowing them to have snacks, coffee, and water at their desk means they can care for themselves without breaking their flow.
Try to balance these quiet spaces with dynamic spaces, so people with ADHD can take a break to engage in “dopamine hunting” in a bustling environment if needed.
Valued team members
Being asked and valued to utilise our skills is another way a workplace can enable and motivate individuals with ADHD, as often having ADHD is associated with something called Rejection Sensitive Dysphoria, a heightened sensitivity to rejection, criticism, and failure. This again works both ways, and genuine positive feedback, reassurance, and valuing an employee with ADHD are highly effective ways of motivating them. It also makes ADHDers interesting and varied projects as this provides the validation they crave.
Many of the adjustments and ideas discussed will be beneficial for both neurotypical and neurodivergent individuals and if neurotypical, you may have found yourself reading some of these tips and thinking that they would help you focus, too. However, it is important to note that while neurotypical people can exhibit neurodivergent traits, neurodivergence is a permanent neurological condition where these traits are experienced consistently and can be debilitating. Statements like “everyone is a little ADHD” or “everyone is on the spectrum” are untrue and minimise the experiences of neurodivergent people.
Equally, ADHD is a complex and varied condition that impacts individuals in multiple ways, and some of these solutions may not work for all people with ADHD.
Talking directly to colleagues and direct reports with ADHD about what adjustment could be made – as well as allowing for periods of trial and error – is ultimately the best form of support. Once people with ADHD have the right co-created, flexible support, and optimum environment, their superpowers will become apparent.
Great article Matt, you taught me a lot about chunking with our Senior Fellowship journey…💪 we so often focus on the student support but sometimes neglect enabling staff to show their super powers!
Congratulations Matt on your article, very insightful and more is needed in this space, particularly for those colleagues who are diagnosed with ADHD later in life. The approaches we should be taking with our students can be effectively mirrored with our staff within complex and diverse organisations such as Higher Education. More research and exploration of RSD is also needed as workplaces become more diverse in the future.
My youngest is being assessed for ADHD.
The difference in how the condition presents in girls is very interesting too.
Your article was very informative, so thanks for posting.
The underdiagnoses of women and girls with ADHD is nothing short of a scandal in my opinion. This is why I tried to focus on the internal challenges that ADHD can cause, rather than the external manifestations, which like you highlight, can look different in women and girls. I wish you all the best luck with the assessment, and I am pleased that you found the article informative. Please do feel free to keep in touch: matt.coldrey@hartpury.ac.uk
The language around the functional neuroanatomy of executive function (and dysfunction) in this article is misplaced I fear. For example, the widespread consensus broadly since the invention of functional MRI has been that the brain’s activity is largely the result of network phenomena rather than distinct ‘parts’ of the brain. What does the ‘doing’ part of the brain correspond to here?
Secondly, all of the genetic and clinical evidence suggests a very substantial overlap for a great many people diagnosed with ADHD and the majority of people who are not – much of the very significant heritability of ADHD lies in common genetic variation (eg. https://www.nature.com/articles/s41588-018-0269-7#Sec10). Humanity is a neurological spectrum. There is no definitive pathophysiological dividing line between people who are ‘neurodivergent’ and people who are not ‘neurodivergent’.
To be clear, I absolutely am not arguing that ADHD does not exist, and clearly for some individuals who suffer from severe clinical ADHD its impact is profound. Indeed, genetically, where there is evidence of overlap with depression and schizophrenia.
What I am arguing is that the reason that many people display the kinds of behavioural traits that we call ADHD and the reason that they are common, is that they were very significantly advantageous for at least some of our human evolutionary history.
As the article argues, in the correct context of a supportive workplace, people who have been diagnosed with ADHD can make a fantastic contribution and are often uniquely placed to do so. In that very meaningful sense, it’s label as a ‘disorder’ is one of the many troubling problems with its definition.
Thank you for you comment Thomas; it is valuable to have your professional perspectives shared. I do agree that referring to parts of the brain is a outdated, but I borrowed the analogy from Dr. Russell A. Barkley, as I thought it succinctly explains executive dysfunction to a lay audience. As a sociologist at heart, I also appreciate your points regarding neurodivergence, and I think you highlight the complexity with how impairments interact with societal structures to disable people.
Thanks for the reply Matt, and apologies for the delay in mine (*insert complaints about exam marking workload at this time of year here*), and for my strident tone – I think a touch of end-of-term-itis colours my writing style(!). My apologies for coming across a bit strong – it wasn’t my intention.
I do think Russell Barkley’s explanations have generally been shown to have at best a mixed evidence base though, and I tend to be very skeptical about positions sketched with little evidence base by someone who has such a significant financial stake in the promotion of those position (he has made a lot of money out of selling ‘self-help’ style books to anxious parents, and has taken significant consultancy money from numerous pharmaceutical companies). The justification for the monamine neurotransmitter (dopamine, serotonin etc) deficit hypothesis traditionally has been that drugs (stimulants) that are known to interfere with dopamine transport have been used to treat ADHD – a circular argument (there are many in the history of psychiatry alas!).
There have been genetic variants associated with ADHD that are part of the physiology of dopamine and serotonin processing (though evidence is contradictory and mixed), but given the profound role of dopaminergic and serotinergic modulation in a large proportion of conscious functions (and in very subtle and poorly understood ways across a great many regions of the cerebral cortex), there is little evidence for a ‘deficit’ of dopamine, noradrenalin, or serotonin in the pathophysiology of ADHD.
In this respect the ‘deficit’ model is reminiscent of the serotonin deficit model for depression which rests on a similarly thin evidence base (https://www.nature.com/articles/s41380-022-01661-0) and received a lot of media fanfare last summer (eg https://www.bbc.co.uk/news/health-62286093). The charity Mind put it best I think: “the evidence for this is very weak, and if changes to brain chemistry occur, we don’t know whether these are the result… …or its cause.” (https://www.mind.org.uk/information-support/types-of-mental-health-problems/depression/causes/). I suspect this applies to ADHD just as it does to depression.
I totally agree with you, and with the thrust of the article, about the complexity of the interaction of people with societal structures, though I am not well versed in the evidence base for that of course.
Wow, this blog is a must-read for universities and colleges! It provides excellent guidance on supporting staff with ADHD and creating an inclusive environment. Kudos to the author for shedding light on this important topic and offering helpful strategies!