Navigating the reality of ADHD
Highlighting systemic barriers to diagnosis and treatment
At the age of 16, Daniel Gonzalez received a diagnosis of attention deficit hyperactivity disorder (ADHD), a process made easier thanks to his mother’s discovery that he could still see a pediatrician before turning 18.
Now, at age 22, he’s deeply grateful for that timing, knowing how challenging it can be to secure a diagnosis as an adult. He says that, while everyone’s experience is different, he always sensed something was off for him.
“If my mom never got me the diagnosis, I’d be in a way worse place than I’d be right now, but I also feel like [it] would have probably taken until I was, like, 30 to do that kind of thing because it’s a nightmare, especially how the healthcare system is right now,” Gonzalez says. “I could not imagine myself bothering to go through all of that.”
While ADHD is increasingly being recognized, Canada currently lacks formal data on the prevalence of ADHD in adults. Research from IQVIA, a Canadian health data firm, indicates a rise in ADHD medication prescriptions—15 per cent more people sought treatment from 2021 to 2022 alone. Their research also shows that Quebec leads the country in psychostimulant prescriptions.
James-Olivier Jarry, 21, looks back on his childhood and acknowledges that his ADHD diagnosis explains a lot—especially when it comes to the hurdles he faced in the classroom. Back then, it wasn’t so much about feeling different; it was about learning to navigate a mind that was always distracted.
“You’ve got to work two times harder to get the job done,” Jarry says.
He explains that his parents had their suspicions early on, but remarks that even a decade ago, ADHD was less understood, and few people were tested for it.
The evolving understanding of ADHD reflects broader changes in medical recognition. The National Institute for Health and Care Excellence only officially acknowledged ADHD in adults 16 years ago. In 1994, ADHD was divided into three subtypes: inattentive, hyperactive/impulsive and combined. In 2013, instead of strict subtypes, ADHD was recognized as something that can change over time in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
Gonzalez recalls that information on ADHD diagnoses wasn’t easily accessible, and his mother only learned about it “through a friend of a friend.” He adds, “Schools could definitely be more integrated with helping undiagnosed kids. I had to struggle my entire high school life being completely undiagnosed.”
His experience highlights a significant gap in support for students with ADHD, an issue that healthcare professionals echo. In 2019, several doctors in Quebec signed an open letter to other medical practitioners, teachers, parents and the government addressing the rise in ADHD medication prescriptions, urging the public to consider the issue beyond the higher rates alone. Prescriptions don’t necessarily equate to diagnoses and it’s unclear how many people receiving ADHD medications are formally diagnosed.
A 2024 survey commissioned by the Ohio State University Wexner Medical Center found that 25 per cent of adults in the U.S. believe they have undiagnosed ADHD. However, navigating the diagnosis process is challenging. In Canada, public services are often short-staffed, leading to longer wait times for assessments. Meanwhile, private evaluations can cost $2,000 on average. This financial barrier can prevent many individuals from obtaining the necessary support.
Gonzalez also reflects on the ongoing challenges he faces, even with a formal ADHD diagnosis.
“I made this analogy a couple days ago, but it’s like if a deaf person had to call somebody to get deaf accommodations,” he says. “These systems are designed by people who are neurotypical, so it just seems 10 times more difficult.”
To change his medication, Gonzalez says he needs to navigate a lengthy process, often waiting weeks to reach his doctor after realizing his current prescription isn’t working. He says that this process can be especially frustrating since these medications are meant to be taken daily.
“They’re not psychiatrists; they can only prescribe. So as someone with ADHD, you have to push against your own disability to figure out what might work best for you,” Gonzalez adds.
In academic settings, obtaining accommodations for ADHD can be particularly challenging. Individuals must first provide proof of their diagnosis. Once this is achieved, Gonzalez highlights that he had to independently seek out the resources available to him.
Concordia University provides workshops for students with learning disabilities, giving them access to resources offered by the Access Centre for Students with Disabilities.
Registered students with proof of their diagnoses can attend workshops that help them manage their time during studies and exams, develop note-taking strategies in class and learn how to control their anxiety and focus better.
However, these resources can come with limitations. Gonzalez notes that while he was accommodated based on the support he received in previous school settings, such resources lack transparency on what they offer.
“It’s kind of like a blind game of chess because you have to poke and see, ‘What’s the most accommodation I can get?’” he says.
Some teachers take the initiative to address these challenges themselves. Hisako Noguchi, a professor in the Concordia linguistics department, says that the university provides expert-led workshops for students and faculty.
“I believe I have a better understanding of the challenges students are facing,” Noguchi says, explaining that she applies certain techniques she learned to adapt her teaching methods.
For instance, she incorporates different colours and uses a standard serif font to enhance readability. She also selects images to illustrate concepts, recognizing that visual elements can aid understanding.
However, Gonzalez points out that ADHD is still widely misunderstood, with the term itself feeling like “a blanket statement,” that doesn’t fully capture the diverse ways it affects people.
“It’s not hyperactivity, it’s dysfunction. It’s getting overwhelmed easily, it’s getting really frustrated very quickly and very easily,” he says. “Emotional dysregulation is a very common thing for people with ADHD.”
Clinical psychologist Dr. Thomas E. Brown explains in his educational videos on the Understood YouTube channel that ADHD is not simply a behavioural issue. Brown explains that the disorder involves the brain’s executive functions, which manage focus and self-regulation. In people with ADHD, the default mode network—the brain’s active network when the mind is at rest—often becomes overactive, interfering when concentration is needed.
To counteract that, stimulants are the most commonly prescribed medications for treating ADHD, typically taken daily. However, non-stimulant options are available for those with adverse effects, though the choice depends heavily on individual health needs.
Gonzalez says treatment has been transformative for him, and he urges others to seek help if they suspect they might have ADHD.
“I seriously did not realize how much ADHD was hindering me in my own functionality,” Gonzalez says. “You might not realize how much it affects you; I can’t understate how huge it is.”
This article originally appeared in Volume 45, Issue 5, published November 5, 2024.
