ADHD in the Workplace: What You Should Know–and What Can Help

BY Lesley Alderman, LCSW | May 15, 2024

Pete came to our weekly psychotherapy session frustrated with work. He had just returned to his office, post pandemic, and found the new, open plan noisy and overwhelming. Pete, which is not his real name, has attention-deficit/hyperactivity disorder (ADHD) and is easily distractible and sensitive to noise. He had trouble concentrating, was irritated by the constant chatter of colleagues, and, as a result, was feeling less productive.

“Could you talk to your manager about getting some accommodations?” I asked.

“No way!” he said. “That would be a career killer.”

Pete’s wariness is not uncommon. A few of my psychotherapy patients with ADHD have confided in their managers, but most feel it’s unwise to do so. They fear they will be stigmatized and sidelined.

Edward Hallowell, M.D., agrees with their concern. The founder of the Hallowell ADHD Centers and one of the leading authorities on the disorder, explained to From Day One: “We’re not there yet. Most corporate professionals think of ADHD as some kind of mental illness.”

Given that ADHD is not well-understood in the workplace, how can employees speak up about their needs in a way that feels safe? And how can managers and HR leaders better understand how to respond to those needs–whether employees want to name their ADHD, or not? A well-accommodated employee is, after all, a happier and more productive one. “It’s in everyone’s best interest to remove obstacles to someone’s performance,” said Hallowell. Here’s what experts recommend:

Know What It Is

ADHD is a neuro-developmental disorder characterized by symptoms of restlessness, impulsivity and difficulty sustaining attention to boring tasks. It tends to run in families and is often inherited from a parent. There are three types: inattentive (dreamy and distractible), hyperactive-impulsive (restless and talkative), and a combination of the two. Most adults with ADHD have the inattentive type. Though it was long considered to be a childhood disorder affecting mostly boys, research has shown that it persists into adulthood—about 30% to 70% of children with ADHD continue to have symptoms later in life.

Ned Hallowell, M.D., a pre-eminent expert on ADHD (Photo courtesy of the Hallowell ADHD Centers)

An undiagnosed adult may think of themselves as spacey, messy, or undisciplined—and they often suffer from low self-esteem. A recent study found that only 10% to 25% of adults with ADHD receive an accurate diagnosis and adequate treatment. “They are often inaccurately diagnosed with anxiety or depression, which are really just the fallout of untreated ADHD,” said Ari Tuckman, a psychologist in West Chester, Penn., who specializes in the treatment of ADHD. As Hallowell puts it: “It’s like driving on square wheels.” In dealing with tasks, you will make progress, but it may take longer.

And That the Diagnosis Is On the Rise

While children are still the most likely group to be identified with the disorder, the number of adult diagnoses has been rising for decades. The pandemic accelerated the trend: the overall incidence in adults (30 to 49 years old) nearly doubled from 2020 to 2022, fueled mainly by an increase in diagnoses among women, according to Epic Research, a medical-record software company. While it’s not clear exactly why women are being diagnosed more often, experts theorize that it may be due to increasing smartphone and technology use, which can amplify distractibility and stress, as well as a greater awareness that ADHD can be also be a women’s issue. As more adults are diagnosed, they—like Pete—often face workplaces that are not ADHD-literate.

How It Affects Work Performance–But Not Always in a Bad Way

People with the disorder may have difficulty with organization, time management and procrastination—all of which can make it hard to meet deadlines and work within teams. They find tedious tasks, such as scheduling and filling out expense reports, unusually challenging and have a different sense of time than others. “People with ADHD have more difficulty seeing time and feeling the future,” notes Tuckman,

More than half (56%) of adults with ADHD said they believe the disorder “strongly impacts their ability to succeed at work,” according to a 2008 survey by McNeil Pediatrics. A more recent survey by Akili, a therapeutic-technology company, interviewed 500 adults with ADHD and found that employees with ADHD felt the disorder had a negative impact on their career.     

And yet, people with ADHD often display qualities that work in their favor, notes Hallowell, who himself has ADHD. He sees the condition as a trait, not a disorder, that has positive benefits like creativity, humor, and spontaneity. “There’s more to it than most people realize,” he said. “ADHD is terrible term. We have an abundance of attention. Our challenge is where to put our focus.” People with ADHD can spend hours on topics that interest them and see details that others might miss, a trait sometimes called hyperfocus. Many successful people have talked openly about their ADHD, including Michael Phelps, Simone Biles, James Carville, astronaut Scott Kelly and JetBlue founder David Neeleman.

How to Get Diagnosed

If you persistently miss deadlines, are chronically late, and feel like staying organized is a big effort, first ask a trusted friend or colleague if they find you more scattered than others. Then, make an appointment to see a psychologist or psychiatrist who specializes in treating the condition. There is no one standardized test—instead a professional will take a thorough history and may ask family members and friends to complete questionnaires about your behavior. You may be asked questions like, How often do you misplace items, feel bored and restless, or lose track of what needs to be done? If you meet the criteria, your doctor may talk to you about medication, therapy or coaching and, if needed, provide a diagnosis so you can receive accommodations at school or at work.

Understand What Helps

Most people diagnosed with ADHD rely on medication to control their symptoms. Typical medications include stimulants such as Ritalin and Adderall, which increase the levels of the neurotransmitters dopamine and norepinephrine in the brain. There are also non-stimulant drugs such as Strattera. Stimulant medications that treat ADHD are the “most effective of medications in psychiatry,” said Tuckman, and help tame distractibility and impulsivity. 

About two thirds of people with ADHD diagnoses are prescribed stimulant medications, and that percentage has remained fairly consistent since 2013, according to Epic Research. Some people can help manage their symptoms by exercising regularly, getting proper sleep, and implementing strict organization and reminder systems. Or they hire very competent assistants.

Once you are diagnosed and have figured out the best treatment, it’s like “getting fitted for the right eyeglasses,” said Dr. Hallowell. “Things come into sharper focus.”

How to Make the Workplace More ADHD-Friendly

Small modifications can go a long way to helping people with ADHD perform better on the job. Tuckman suggests considering adjustments in the three domains described below. As an employee, you can make tweaks on your own or ask your manager for help. As for managers, if you have a worker who is struggling with organization and meeting deadlines, you could take the lead at putting these practices into place.

Make distractions softer. Quiet spaces, headphones, and working on off-hours (say, early or late), can help mitigate the clatter of a bustling office. Often working from home is a good solution.

Make important information stand out from the chatter. Putting assignments in writing, recording meetings, and highlighting deadlines can help workers whose focus is not great to stay on task.

Bring the future closer to the present. Those who struggle with adhering to deadlines will benefit when big projects are broken into smaller chunks, and check-ins are on the calendar with frequent reminders of when tasks are due.

So, Should You Tell Your Boss?

If you have ADHD, you may be covered under the Americans with Disability Act (ADA). However, you might not want to play that card unless you absolutely must, says Belynda Gauthier, a retired HR director and past president of Children and Adults with ADHD (CHADD). “The first time I did a presentation on ADHD in the workplace, I launched into detail about how the employee should approach his supervisor or manager and suggested that he might want to go directly to HR first. An audience participant interrupted to tell me that her HR office actually is the problem for her. Oops! I took this to heart, did some serious thinking, and revamped my presentation. I no longer recommend revealing one’s diagnosis until and unless it’s necessary.” Indeed, 92% of surveyed adults with ADHD believe that their colleagues hold misconceptions, the most common of which is “people with ADHD just need to try harder.” 

A better strategy might be to simply approach your manager with a positive attitude and a few solutions. “Be sure to tell them what you are good at,” advised Hallowell.

Gauthier suggests something like: “I am really enjoying processing these widgets, and I think I’m doing a good job. I believe I could do an even better job if I could move to that cubicle that’s farther from the copy machine. So many co-workers use it all day and everyone stops to say hello.” Avoid the use of the word “but” to qualify your suggestions and don’t be whiney, she says.      

Accommodations can help, but sometimes the best solution is finding the right job in the right environment with the right supports. “When I finally figured out I had it, it was a relief,” David Neeleman said in a recent interview with Forbes. “I was just really careful to surround myself with people that could complement my ADHD. I have people around me that help implement a lot of the ideas I have.” When you can turn your intense focus on something that truly fascinates you, ADHD can be a bonus rather a deficit.

Lesley Alderman, LCSW, is a psychotherapist and journalist based in Brooklyn, NY. In her therapy practice, she works with individuals and couples. She writes about mental health topics for the Washington Post and has been an editor at Money and Real Simple magazines and a health columnist for the New York Times.

(Featured photo by Valentin Russanov/iStock by Getty Images)

 


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According to a 2024 analysis by the U.S. Chamber of Commerce, “even if every unemployed person with experience in the financial activities or professional and business service sectors were employed,” the report reads, “only 42% and 44% of the existing job vacancies in these industries would be filled, respectively.”In 2022, the Association of International Certified Professional Accountants (AICPA) and Chartered Institute of Management Accountants (CIMA) launched the first federally registered apprenticeship for finance and accounting professionals, and in its first year signed up 17 employers from 15 industries, including healthcare, industrial gas, banking, and manufacturing. One hundred apprentices have registered with the program in its first year.When AICPA and CIMA set out to create apprenticeships, the aim was to address the worker shortage in the accounting and finance field with early career talent. “When we started talking to employers who would want to hire people from these programs, we found that they were more interested in reskilling workers,” said Joanne Fiore, AICPA’s VP of pipeline and apprenticeships. Rather than recruit new talent, employers wanted to use apprenticeships  to retain their current workforce and train them as strategically minded contributors. The purpose of the Registered Apprenticeship for Finance Business Partners is to develop management accountants for the finance function of the future–not just number-crunchers, but “key players in strategic decision-making and broader business transformation,” said Fiore.Even if this program is able to shrink the skills gap, the labor shortage is likely to persist. There just aren’t enough young people entering the field to balance out their retiring elders. One problem: the profession has a reputation for being, well, dull.To fill the talent pipeline, and help rebrand the profession, AICPA and CIMA have piloted a youth apprenticeship program in Maryland high schools, aiming to drum up excitement and interest in the field among young people.Customizing the Programs Organizations, employers, and educators have found ways to tailor apprenticeship programs to their needs. They’re not just for recruiting, they can be deployed for talent development as well. “With the digital transformation of our economy, tens of millions of jobs now require workers to use tools to build things–only the tools are digital and workers no longer need to wear hardhats,” said Craig, author of Apprentice Nation.Often, those skills are software related. Where hospitals and healthcare providers use Epic, marketers use HubSpot, and HR uses Workday. “Companies are increasingly demanding that applicants for these jobs already have these platform skills–skills which are much harder to learn in a classroom than on-the-job via an apprenticeship,” Craig said.“Apprenticeship brings an organic culture of learning into any workplace and helps business perform better,” writes Jean Eddy in Crisis-Proofing Today’s Learners: Reimagining Career Education to Prepare Kids for Tomorrow’s World. “An apprenticeship program breathes new life into workplaces and lets employers quickly tap into a culture of learning that so many now are desperate to build.”Scaling Earn-and-Learn to Quell the Labor ShortageApprenticeships are difficult to start, and they’re difficult to scale. Few employers have the infrastructure to both employ and train unskilled workers at the same time, and most require the help of intermediaries like the AICPA and CIMA, which provide the instruction and the infrastructure.While it may be a while before apprenticeships alone make a dent in the labor shortage, analysis of the success of existing programs is promising. Not only are retention rates high–Aon, for instance, retains 80% of its apprentices–the Department of Labor estimates that employers get a 44.3% return on investment for apprenticeship programs.“While traditional apprenticeships emphasized hands-on skill acquisition under a mentor, modern apprenticeships often integrate technology-based learning, including virtual simulations and online coursework, to complement on-site training,” said Katie Breault, SVP of growth and impact at YUPRO Placement, a recruiting firm focused on skills-based hiring. Finance and tech roles are particularly suited to apprenticeships, she told From Day One. “Industries undergoing digital transformation, for example, greatly benefit from such programs. They offer real-time learning opportunities, crucial for staying relevant in dynamic fields.”The problem with apprenticeships as a solution to the labor shortage is that we just don’t have enough of them yet, said Craig. Plus, in his estimation, they’re under-funded and under-marketed on both the demand and supply side. “Many young people and their parents think of apprenticeships as a ‘second tier’ option–if they think of them at all,” he laments in Apprentice Nation. White collar employers may be thinking much the same. Yet as investment continues and apprentices pop up in surprising places, like the finance department, enthusiasm may spread. “It certainly fits the accounting profession,” Fiore said. “And if it fits the accounting profession, my sense is that it will fit many professions.”Emily McCrary-Ruiz-Esparza is a freelance journalist and From Day One contributing editor who writes about work, the job market, and women’s experiences in the workplace. Her work has appeared in the BBC, The Washington Post, Quartz, Fast Company, and Digiday’s Worklife.(Featured photo by Amorn Suriyan/iStock by Getty Images)

Emily McCrary-Ruiz-Esparza | February 14, 2024