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What is High Functioning ADHD?

Written by Sarah Norman

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  • adhd

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Mar 13, 2024, 11 min read

Is it possible to be successful and have ADHD? With so much written online about this condition, our goal is to provide the most informative and accurate information on all types of ADHD, and what you need to know to access treatment. 

Here, we are exploring whether or not ‘high functioning ADHD’ exists, what this means, what the common symptoms are, if it is possible to have ADHD and be a high achiever, and how to define success if you have ADHD. We will also look at how to receive a diagnosis later in life, and what coping strategies and support systems are in place to help. 

Introduction to high functioning ADHD

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about ADHD, we can help. 

What is ADHD?

ADHD stands for attention-deficit/hyperactivity disorder, and it is a type of neurodivergence that means a person’s brain is hard-wired in a different way to neurotypical individuals. In adults, some of the symptoms of this condition can include things like having trouble focusing, exhibiting impulsive behaviours, and struggling to pay attention. 

These symptoms can make daily life more of a challenge, as they impact things like learning, studying, working, organising, managing time, getting tasks done, and more. Some of the signs of ADHD to watch out for in others might include things like:

  • Making seemingly careless mistakes on a regular basis 
  • Struggling to maintain attention during long tasks, and missing details
  • Struggling to organise tasks and activities, and to manage time
  • Regularly losing important things such as keys or phones
  • Being forgetful with important things like paying bills or appointments
  • Struggling to wait patiently, for example, waiting in a line 
  • Exhibiting restless behaviours, such as having difficulty sitting still, or fidgeting 
  • Excessively talking, interrupting others, or answering too early
  • Becoming easily distracted by unrelated things and external stimuli

"ADHD is about a lack of stimulation from the brain so individuals find they need to be in situations that stimulate them. If you are in a multi-faceted job where you can shift from one task to another you will thrive as ADHD thrives on challenges."
- Dr Khurram Sadiq, Consultant Psychiatrist

What is high functioning ADHD, and is it an official diagnosis?

You may have heard the term ‘high functioning ADHD’ or a variation of this in the past, but it is important to make clear that this is not an official diagnosis. A person can be diagnosed with ADHD, but not with high functioning ADHD. However, the idea of a person with ADHD being able to function at a high level and be successful in certain areas of life is not uncommon. This typically happens when someone has ADHD but has discovered coping mechanisms that work extremely well for the deficits they experience with the condition. 

"High Functioning ADHD is about matching the skillset with the work or activity you are doing. If there is a mismatch in this and you are in a non-stimulating, monotonous environment, more ADHD symptoms will subsequently become noticeable. There is less ability to multi-task and do multiple things at different times.  However, you may flourish in an engaging environment which demands multi-tasking."
- Dr Khurram Sadiq, Consultant Psychiatrist

A person with high functioning ADHD may still exhibit the same ADHD symptoms as other people – and in some cases severe ADHD symptoms – but may have a set of mental systems and physical procedures they have used over the years to allow them to achieve the tasks they want to and adhere to all of their responsibilities without failure. 

While ADHD is known to impact how an individual may function each day, high functioning ADHD may either mean:

1. The person’s symptoms are not as severe

2. They are able to manage life responsibilities and goals in a way that works for them

3. They struggle in certain areas of life while excelling in others

It may seem as though high functioning ADHD is not a problem, since the person experiencing the symptoms has managed to stay ahead of them and implement coping mechanisms to help. However, just because someone appears to be doing well on the surface, does not mean they are not feeling an immense amount of internal pressure. This is well illustrated through the concept of the ADHD Iceberg, which you can read more about here. Internal pressure like this can build up over time and cause a number of issues, including stress symptoms, physical ailments and ADHD burnout

What is high functioning ADHD?

One 2018 study looked into the research on high functioning individuals with ADHD in comparison to other people with ADHD, and described the idea in the following way: 

An individual who fully meets the criteria for ADHD, but still is able to function relatively well, is described as having high-functioning (HF)-ADHD, with some ADHD expressions being severe and others located more towards the mild end of the diagnostic spectrum. Both may still be relatively impairing compared to an individual’s potential, although to the outside observer the less impaired individual may not appear to be struggling.” 

This is often considered to be ADHD Masking, which is sometimes also referred to as ‘impression management’ or ‘camouflaging’. This coping mechanism helps to manage how other people around an individual with ADHD see them. It enables them to present themselves in a way that looks as if they do not have any ADHD symptoms. You can learn more about ADHD Masking in our guide: What Is ADHD Masking, And How To Spot It

Can you have ADHD and be a high achiever?

In short, yes. ADHD has had its fair share of stigma over the years suggesting its traits and symptoms are often perceived as “impoliteness, character weakness, immaturity, emotional dysfunctionality, and unreliability”, according to a 2020 study on public perceptions of adult ADHD. In reality, many people can live with the condition and still achieve great success across all areas of life, including in academia, careers, and creative endeavours. Other areas of life can be successfully managed by a person with ADHD, such as parenthood, relationships, household chores, and more. 

Intelligence is thought to be a possible factor in why some individuals manage to utilise coping strategies better than others. Research done in 2017 found adults with a particularly high IQ may have the ability to better compensate for their ADHD-related deficits, and display enough executive functioning to help them efficiently problem-solve their way through the ADHD symptoms causing them distress. However, a high IQ does not negate the symptoms entirely. As mentioned in a 2022 article in PsychologyToday.com, “ADHD can co-exist with high intelligence but still make many life endeavours, including work, more difficult to navigate.”

High functioning ADHD could also be a result of some people viewing their ADHD symptoms as benefits rather than shortcomings. For example, studies have identified some self-reported positive aspects of living with ADHD, such as creativity, and high levels of energy, drive, determination and perseverance.

A 2018 study found further attributes of ADHD that can be viewed as beneficial in those with the condition, such as divergent thinking, an adventure-seeking mindset, self-acceptance, nonconformity, sublimation, and hyperfocus, which can cause an intense state of focus when carrying out fun or interesting tasks.

One study mentions the commonality of overachievers with this type of high functioning ADHD existing in the areas of entrepreneurship, technology, research and development, politics and sport, among others. 

The plethora of evidence suggesting ADHD does not define success means those who have a diagnosis of the condition should not see it as a hindrance, or something that will get in the way of their life goals and career successes. While it can certainly be challenging, an understanding of your own ADHD-related deficits, and support from loved ones and/or an ADHD specialist can lead to better management of the condition, and as a result, more achievement and success. 

The success one can experience when living with ADHD should not be seen as limited – a previous study looking at professionally successful adults living with ADHD found it is much more important to work on how your ADHD symptoms are compensated for in order to achieve victories in the areas you would like to.

What are some of the common symptoms of high functioning ADHD?

The symptoms of high functioning ADHD in adults are no different to regular ADHD, however they may manifest in slightly different ways, or appear to be more of a problem in certain settings. For example, those with high functioning ADHD may find their symptoms are more noticeable in a work setting, such as:

  • Missing or running late for meetings 
  • Missing transport regularly, such as flights or trains 
  • Succumbing to procrastination regularly 
  • Becoming easily distracted during times when they are expected to learn or work 
  • Leaving important tasks unfinished 

Other symptoms people with high functioning ADHD may notice at work include things like productivity issues. For example, one study involving a manufacturing company found ADHD to be associated with a 4-5% reduction in work performance, thought to be due to poor time management, procrastination and distractibility. Further studies have found that receiving poor performance evaluations can be an issue for those with ADHD, and 55-69% of subjects with ADHD reported having problems getting work done efficiently and working to their full potential. 

People with high functioning ADHD may also suffer from some of the aforementioned ADHD symptoms, like struggling to organise tasks or calendars, or regularly losing important items, but have figured out the best ways to manage their own symptoms and continue to get things done despite their existence. 

High achievers can still have ADHD

It is important to remember ADHD often presents differently in women than in men. For example, women may display fewer features of hyperactivity and more of inattentiveness, and in those with high functioning ADHD their specific symptoms may reflect this gender difference. 

In children, symptoms of high functioning ADHD could include issues that appear very similar to regular ADHD, such as having an inability to stay in their seat, excessive fidgeting, a lot of talking, excessive running or climbing, having difficulty waiting their turn, interrupting people often, becoming easily distracted, and more.

What are the downsides to high functioning ADHD?

Keep in mind that using strategies like setting alarms to ensure you don’t miss anything and taking excessive notes may seem helpful in the moment, but even these handy tactics for staying organised can become exhausting when used for a long time without addressing the underlying cause of the issues. 

Also, if a person with ADHD utilises many coping strategies to appear as if they have everything under control, medical professionals and ADHD specialists could find it more difficult to identify, diagnose and treat the problem. 

How can I get a diagnosis of ADHD as an adult?

You cannot receive a diagnosis of high functioning ADHD – even if you believe this describes your experience – because this is not an officially recognised diagnosis. You can, however, receive a diagnosis of ADHD if you meet the DSM-5 diagnostic criteria, which for adults includes showing a persistent pattern of five or more symptoms of either inattention, or hyperactivity and impulsivity (or both) that interferes with functioning.

According to the Centres for Disease Control and Prevention, the criteria for inattention includes issues like: 

  • Regularly failing to pay close attention to details, or making careless mistakes in schoolwork, at work, or in other activities
  • Regularly struggling to hold attention on tasks or activities
  • Regularly failing to follow through on instructions and failing to finish work or chores
  • Regularly struggling to organise tasks and activities
  • Regularly losing things that are necessary to complete a task or activity, such as tools, wallets or paperwork

The criteria for hyperactivity and impulsivity includes issues like: 

  • Regularly fidgeting with things or tapping hands or feet
  • Regularly feeling restless 
  • Regularly being hyperactive, as if driven by a motor 
  • Regularly talking excessively 
  • Regularly interrupting others and struggling to wait 

Further diagnostic criteria must be met in order to receive a diagnosis, but undergoing an ADHD assessment is often the best way to learn what symptoms need to be present for a genuine diagnosis to be made, and to see if you fit this criteria. 

Getting support for high functioning ADHD

Many high functioning adults can still receive an ADHD diagnosis later in life, and in fact around 3% of adults aged 50 or older say they experience significant ADHD symptoms and are often diagnosed later in adulthood. This is thought to be because they have experienced high functioning in early life due to a supportive environment.

What coping mechanisms can I use?

Certain coping strategies can really help people with ADHD who struggle to manage their symptoms in everyday life. These might include things like:

  • Prioritising organisation to make tasks and activities as efficient as possible 
  • Getting rid of clutter to reduce external distractions
  • Creating routines with tools like checklists that can help better manage daily life
  • Using resources such as planners and reminder tools to manage time and avoid missing important things 
  • Breaking goals down into smaller tasks to make them easier to accomplish 
  • Using technology to help, such as automated services and time management programs 
  • Managing physical health in order to maximise mental capacity, by getting enough sleep, eating a healthy diet, getting regular exercise, and more

Remember, while coping strategies for managing ADHD can be helpful, the idea is to make life easier without becoming more stressed and overwhelmed internally. If you feel your coping mechanisms are adding to your mental load, you should seek support from an ADHD specialist or speak to your GP. 

What support and treatments are available?

We believe all advice and support for those with ADHD (including those who self-identify as having high functioning ADHD) will be most effective when personalised to the individual in order to address their needs and specific symptoms. You can speak to your GP about getting treatment for ADHD, or reach out to a private specialist – many people choose to do this in order to avoid the potentially long NHS waiting lists. 

ADHD treatment typically involves a combination of medication (you will find a guide to ADHD medication in the UK here) and/or a type of therapy that has been specifically recommended for your needs. This could be psychoeducation, behavioural therapy, cognitive behavioural therapy (CBT), or something else.

For those who struggle with daily tasks at work or in another area of life that is causing particular distress, occupational therapy could be beneficial. ‘Occupation’ typically refers to anything to do with a person’s employment, job or profession, however in this case occupational therapy is a type of therapy designed to help people function well in their daily life, whether for their job, a hobby, or just to manage life more effectively and efficiently. 

Treatment options for high functioning ADHD

You can learn more about how this could help you in our article: Occupational Therapy For ADHD: Can It Help?

You can also find out more about the support available for those with ADHD, and what is involved in a private ADHD assessment here. At Augmentive, we believe advice and support for those with ADHD should always be bespoke and tailored to the individual to help with their specific symptoms.

That’s why, whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from a private ADHD assessment or review, to broader options like helping you to find a psychiatrist for support on your journey.

If you have a question about mental health, like what the signs and symptoms of combined ADHD are, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.

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