Let’s Talk About ADHD.

ADHD is so much more than everyone thinks — let’s talk about what I mean by that.

source: behance.net

I’d like to begin with this note: I originally had the idea for this article a YEAR ago, and the draft with the headline and some miscellaneous paragraphs has sat here since. It’s ironic. My name is Hannah, I’m 23, and I have ADHD.

When people hear ADHD or ADD, they typically envision a hyperactive or distracted child who has the attention span of a goldfish, and not more beyond that. While many of my report cards in grade school boasted that I was “a pleasure to have in class, but a distraction to myself and others”, that is a very narrow way to view ADHD and ADD. Like many disorders, it’s multi-faceted and more complex than just fidgeting in your seat or getting off topic like what people have wrote it off as for decades. As I’ve gotten older and found it harder to do daily tasks and basic things, I really started to wonder what was wrong with me. I thought it was just another dimension of my depression, but then when I discussed the things I struggled with other friends of mine that I knew had depression, we didn’t always match up. I felt so strange, I had myself convinced for a long time there was something wrong with me outside of the things that I already knew that I had.

So that’s why I’m writing this article. I want people like me experiencing similar feelings to know that they aren’t alone in this, and that there’s also nothing wrong with them. ADHD and ADD and a lot of learning disabilities need to be destigmatized and we need to educate people more on them.
Before I get started, I feel it really important to note that I am not a medical professional, nor an expert on learning disabilities, I am just someone who has done their research to be as educated as possible as I write this, as I try to discuss something that I deal with on a daily basis. If you find yourself resonating with what I’m writing here, please speak to your primary physician or a mental health specialist for more clarity on the subject and to see about getting tested for it, and try to avoid self diagnosis. With that being said, I want to discuss some of the symptoms and components of ADHD that don’t see the light of day as often and are not discussed as frequently as they should be.

Rejection Sensitive Dysphoria (RSD)

I have felt the crushing blow that RSD can make you feel like you’re having. I’ve found myself over-analyzing texts trying to “read between the lines” when there wasn’t any additional message there, I have been known to not handle constructive criticism the best if it’s delivered in a very brusque manner, I consider myself hypersensitive because of how much I read into people’s emotions and body language.

Rejection Sensitive Dysphoria, also referred to as RSD for short, is an intense emotional reaction to the perception that you have disappointed those around you, and because of that can leave a person feeling as if the people in their life have withdrawn love and respect for you.¹ A lot of things can trigger the feeling of RSD; constructive criticism given to you by your boss, a small miscommunication between your romantic partner, or maybe even feeling like you’ve failed your own personal goals. More often than not, no actual rejection has happened, but it FEELS like it has and it hurts a lot. People who struggle with RSD are described as being “overly sensitive”, whether it’s a label they’ve been given by someone else or themselves. RSD has a way of making you pay attention to someone’s body language, or their tone, even how they might write a text or email to you. The slightest shift in communication can trigger this feeling. This condition runs parallel with symptoms of Bipolar Disorder, Borderline Personality Disorder, or Autism, and can sometimes be misdiagnosed as such.

People that have RSD appreciate positive reinforcement and reassurance from friends, family and romantic partners when these emotional panes strike, they may be able to handle criticism well if it’s delivered in the form of a “compliment sandwich”, which sandwiches a piece of criticism between two or more articles of praise and can help soften the blow of that critique and reduce the chance of hypersensitivity flares. Treatment for RSD can be as simple as seeing a therapist/specialist for Cognitive Behavioral Therapy (CBT) to help develop healthy coping mechanisms when experiencing the stress and heightened state of emotions that RSD can bring on.²

Auditory Processing Disorder (APD)

Sounds can be difficult sometimes, if someone is talking too quickly I likely won’t get all of what they’re saying, but if someone is talking too slowly I won’t be able to follow them either. I watch almost everything with subtitles on because the idea of reading what I’m watching somehow helps me comprehend what I’m watching better. I am the person who constantly makes my friends repeat themselves, and I am constantly inadvertently paying more attention to the conversation happening somewhere else in the room with strangers than the one happening with me in it. I struggle with a lot of auditory processing, and a lot more people do than you think.

Auditory Processing Disorder (APD) is a condition that makes it difficult to process words and sounds or anything that the ear hears. While APD and ADHD are two different conditions, someone with ADHD may also experience symptoms of APD, and vice versa. Someone may also be misdiagnosed with ADHD when they are just struggling with APD specifically. Someone who struggles with APD may:

• Seem tuned out of a situation if they aren’t sure what people around them are saying.
• Have a hard time following conversations fully.
• Ask people to repeat themselves due to just not understanding what was just said.
• Struggle with verbal instruction or spoken directions and quickly forget what was just told to them.
• Stumble on words a lot and confuse one word for another.
• Get easily distracted by background noise, and have a hard time filtering it out.³

If someone you know tend to unintentionally eavesdrop on someone else’s conversation, say “what?” or “huh?” a lot in response to something said, may bode better with instructions that are written down due to forgetfulness and the inability to retain what was spoken to them, and tend to be more introverted as a result of their difficulty following social situations, they may struggle with APD. But how can you help someone with APD? There are a few things you can do to accommodate those that have APD, such as using visual aids whenever possible, try your best to emphasize key words even if you have to “over-iterate” what you’re saying, speak as clearly as possible and slower, and most importantly, don’t get mad at someone with APD if they ask you to repeat yourself several times or to slow down during storytelling or instructions. Patience and understanding is one of the biggest ways you can help those with APD.

Executive Dysfunction

I am someone who, despite good intentions, gets disorganized very easily, and my version of organized is a neurotypical’s version of clutter and chaos. I have horrible memory for things that were JUST told to me, I am an impulse spender for the rush of instant gratification and serotonin it provides, and I lose my steam pretty quickly; mustering the motivation to crack down on the hyperfixation-of-the-month goes as quickly as it came to me. Executive dysfunction strikes me down CONSTANTLY. The biggest part of my dysfunction is what has been coined as “ADHD paralysis”, which is recognizing all the things that you want to do and accomplish, but you physically or mentally cannot bring yourself to complete them, and your thoughts just race. There have been several moments that I’ve been laying in bed, brain “hurting” and my thoughts buzzing like a hive of bees because there were so many things I wanted to accomplish in that moment instead of just slothing around in bed, but I could NOT drag myself out of it.

Executive Dysfunction is a term for the cognitive, behavioral, and emotional difficulties someone with ADHD and various learning disabilities may face.⁴ Individuals with Executive Dysfunction may struggle with:

• Time management skills/time blindness.
• Staying organized; struggle with object permanence.
• Emotional dysregulation and trouble controlling emotions.
• Impulse control, example: impulsive spending, spur-of-the-moment plans, changing personal appearances on a whim.
• Memory and retaining spoken words.
• Motivation to accomplish goals and tasks/ADHD Paralysis.
• Planning and problem solving, sticking to schedules and pre-designated plans.

There are numerous ways that you can help someone that struggles with executive function. Someone that has a hard time finishing tasks or struggle with time blindness may benefit greatly from taking things step-by-step as opposed to “the big picture” as well as carving out designated chunks of time for how long something should take them (example: folding laundry-20 minutes). Someone who struggles with meeting deadlines and remembering dates may appreciate written schedules. Someone who has difficulty remembering verbal instruction just given to them may do better with written instruction instead. This one of the biggest components of ADHD and most learning disabilities because of how wide the span of executive function is. This won’t be diagnosed on its own, but there are several types of assessments you can take to see how well your executive function perform, like Barkley Deficits in Executive Functioning Scale (BDEFS) which helps screen where the executive functions appear to be most “weak”, whether it be with organization or emotional control.

Interoception & Self Regulation

Have you ever realized you’ve gone the entire day without eating something because you didn’t “notice” you were hungry? Or stay up super late because you didn’t “feel” tired? Yeah, me too. Interoception is all about sensory and being able to listen to your body, and sometimes neurodivergent people struggle with that. I know that I do.

Interoception is a term that basically means understanding what your body does and being able to feel when your body may need something.⁵ Receptors in your body send a message to your brain to tell you what it needs! So someone that has sensory processing issues may struggle to feel when their body is hungry, when they get too cold, or give their body enough sleep when they feel rested enough because their body doesn’t give them strong enough signals. People that have issues with interoception struggle with self-regulating, like staying hydrated or eating enough food. In addition to ADHD and other learning disabilities, interoception issues and self-regulating are also a comorbidity for eating disorders.⁶

The best ways to help anyone that struggles with interoception is to practice mindfulness exercises like meditation or anything that makes someone feel a little more connected to their body. In addition to this, keeping a schedule of when the affected person should eat and drink water will help ensure they’re getting enough nutrients and hydration throughout their day. They can also set a timer each night as an indicator that they should sleep soon to ensure they get enough rest.

Delayed Sleep Phase Syndrome (DSPS)

My sleep schedule has a track record of… not being great. I think it started to go downhill in high school, when I first discovered you could just pull all-nighters to get your work done instead of doing it in the chatter and noise of day time. I would show up to school the next day toting an iced coffee and my best effort to keep my eyes open during my first period AP English class, but my efforts were not always successful. When I graduated high school and took a gap year, my sleep schedule became practically nocturnal, and when I went to college, sleep was a scarce resource to me. There were never enough hours in the day for me. I kept pushing back, or delaying the time I would go to bed, and it got to a point where even if I didn’t have school the following day, I would get tired around 1AM and wake up at 5AM as if I was waking up to get ready for school.

Delayed Sleep Phase Syndrome, or DSPS is the condition where someone’s sleep schedule is “delayed” by a few or more hours, resulting in them going to sleep later and also either waking up later in the day the following day, or not feeling rested enough to be fully present in the day ahead.⁷ Your body will start to get in the habit of giving you the indication it’s tired later on in the evening as opposed to when it should naturally, and as a result, your body won’t produce the alerting signals to wake up at an appropriate time. While DSPS isn’t strictly indicative of ADHD and may be the product of another underlying conditions, there have been several studies done on how the two may be linked to one another within the last few years. People with ADHD are often restless and hyperactive which can result in that same restless feeling when trying to fall asleep for the evening. People with ADHD might also start to have issues with DSPS if they feel as if they can only get work done in complete isolation and quiet that the nighttime brings them, unaware that it may cause more issues than it solves.

The best way to combat DSPS would be over-the-counter sleep aids, such as melatonin, light therapy to recalibrate your body’s circadian rhythm⁸, or chronotherapy which is DELIBERATELY adjusting your sleep schedule little by little at a time to get it to the desired bed time.

Maladaptive Daydreaming

For those that don’t have ADHD, snapping out of daydreams is usually an easy thing to do. They’ll be quick moments someone lets their mind wander, and don’t get nearly as complex as maladaptive ones tend to. As someone who has been described as frequently having their head in the clouds, it is so easy to get lost in your own mind. You start to build elaborate worlds and scenarios about your future in your brain, you really start to visualize it and the people that exist in it, realistic or not, I’ve caught myself in those daydreams for several minutes, or sometimes even a half hour.

Maladaptive daydreaming is a condition that causes vivid daydreams to distract from real life events and what is happening in the real world around the daydreamer.⁹ Different things can trigger a maladaptive daydream, like something that popped up as a topic in conversation, or certain sensory stimuli like touch or smell for example. Common symptoms of a maladaptive daydreamer include:

• Having very vivid daydreams that have detailed plot and “characters”, strong themes, etc…
• Struggling to complete daily tasks.
• Having difficulty falling asleep at night.
• Making repetitive body movements (see BFRB’s below), as well as talking to one’s self.
• Being in a daydream state for several minutes to several hours.¹⁰

While there isn’t a formal method used to diagnose maladaptive daydreaming itself, there is a scale that assesses whether or not someone is maladaptive daydreaming, and to what extent. The scale measures the content of the daydreams, the ability or lack thereof of the daydreamer to be able control what they’re experiencing, how much stress the daydream can cause, and how much daydreaming and the detach from the real world interferes with the daydreamer’s real world and its events. Treatment for maladaptive daydreaming can look like Cognitive Behavioral Therapy like we mentioned earlier, as well as discussing coping strategies with a mental health specialist. In a few trials, the medication, Fluvoxamine used to treat symptoms of OCD has provided aid to this condition, but there isn’t enough research currently to support use of this drug for this application.

Body Focused Repetitive Behaviors (BFRBs)

I have a horrible habit of picking at my face constantly, as well as struggling with letting hair grow on my body and my face, so I constantly shave and pluck hairs from my body. I’ve dealt with the gnawing feeling that I constantly have to pick and prod at myself until my mind stops sending me signals to do so. It’s like a pleasure-pain almost; I know that the result of me picking at every blemish on my skin will likely hurt, and sometimes result in acne scarring or unsightly scabs, but I do it anyways because in that MOMENT it satisfies a part of my brain. I’ve fallen victim to the vice grip that BFRBs can have on people in a negative way.

Body Focused Repetitive Behaviors, or BFRBs for short, are behaviors that focus on self grooming, are a response to anxiety or triggers, or are used for sensory stimulation.¹¹ There are many kinds of BFRBs, like pulling at one’s hair (trichotillomania), picking at your skin (dermatillomania), biting your nails (onychophagia), and even biting your cheek or lip or cracking your joints excessively. These behaviors are almost always subconscious, and more often than not someone may start excessive self grooming behaviors and not realize it. People will bite their nails until they bleed, some people will pull at their hair until they have patches of hair missing from their head. BFRBs are very common, and a lot of people with ADD or ADHD may experience them due to the inability to have impulse control, as well as the level of dopamine released when self-grooming in BFRB fashion.

The best treatment for BFRBs are behavioral therapy, specifically treatment that has someone replace the bad grooming habit with a good habit. This is called Habit Reversal Training (HRT) and works to identify what specific stimuli trigger the BFRBs, as well as logs history of the BFRB to look for any patterns. In addition to this kind of treatment, “fidget toys” have been more popular than ever for both individuals that struggle with BFRBs themselves, as well as individuals that struggle with multiple symptoms of ADHD.

Stimming

Stimming is honestly the topic I was most looking forward to discussing in this article. As someone who stims regularly, either due to my brain not being “awake enough” and needing stimuli to keep it attentive, or as a response to anxiety or sensory overload, it’s like you have all of this movement that you HAVE to release and focus into a part of your body or into an action you’re doing, and doing it feels better. As I have written this article, I have been bouncing my leg in my chair because I can’t focus just by staying still for long periods of time, and when I went through school I was a chronic pen clicker or ruler flicker. I was the “doodle-in-the-margin-of-all-my-pages” girl because I just couldn’t help it. If I have a bad sensory experience I know what GOOD sensory stimuli will help me.

Stimming, or self-stimulating behaviors, are typically seen as repetitive movements or sounds. Stimming is a behavior attributed most commonly to autism, ADHD, anxiety, and other neurological conditions.¹² Stimming is similar to BFRBs, but are not exclusive to self-grooming habits. Yes, someone who is stimming may bite their fingernails or crack their knuckles, but they might bounce their leg, tap their finger on a desk or cabinet, whistle or hum, tap their pen, or pace back and forth. There are also more noticeable or pronounced stims like repetitive blinking, bouncing up and down or doing repeated physical exercise, rearranging objects, rocking back and forth, rubbing and touching “sensory safe” items (items that will not overstimulate an individual who is already stimming), flapping hands and wrists, snapping, and clapping. For the most part, stimming is a safe and normal thing for neurodivergent individuals to do as a way to regulate themselves, as long as their stim is not harmful to themselves or others around them. There are a couple reasons that people stim; stimming happens when an individual needs to stimulate themselves or help reduce sensory overload, cope with unfamiliar environments or surroundings, express their emotions when words don’t come as easily to them, or use it as a tool for reducing anxiety.

Because stimming and stims aren’t usually a bad thing, there isn’t specific treatment for them, unless it’s a harmful stim like some of the more self-destructive BFRBs which can be treated with behavioral therapy. More often than not, letting someone perform their stim without judgement and ridicule, or helping them stim if they ask for it is the most helpful thing that you can do and that they can do for themselves.

Echoalia

Echoalia needed to have a place in this article, despite it not being on the same scale as these other conditions I’ve talked about. While it is like stimming, I wanted to give it its own section. I find that, more often than not, I am like when a parakeet learns a new word and it’s all that bird can say for a week or two. Whether it be something stupid from the depths of meme culture online that just feels entertaining to repeat, or if it’s a random word that jumps to mind, like the word “escutcheon” that was wrapped around my brain for a month straight. Sometimes just the act of repeating a singular word or lyrics incessantly is the only way I can commit something to memory too.

Echolalia is simply put, a term for repeating heard words, phrases and sounds, whether it be immediately after hearing them, or delayed like a day or a week after hearing the phrase.¹³ Sometimes in excess. Echolalia is a strong component of autism because of how people with autism learn language compared to someone without autism, and the repetition of certain things can act as stimming to them as well. Echolalia is a symptom of autism, ADHD, Tourette’s, and other common neurological disorders. For the most part, echolalia is harmless, and is just the constant urge to repeat various sounds heard over time, certain songs or phrases might be inappropriate or considered disruptive, but echolalia itself isn’t a bad thing. As I mentioned, being able to itch the verbal or vocal “scratch” is soothing and can be a form of stimming for someone. In cases of ADHD/ADD, there is more control when someone is experiencing echolalia to not say the current buzzword or phrase, but someone with Tourette’s has “tics” where they may blurt out random words or whistle or yell things that they may have just heard or heard earlier that day and it’s impossible for them to control those urges.¹⁴

There isn’t really any specific treatment for echolalia and it’s best to let your neurodivergent loved ones “do their thing”, so-to-speak. More often than not, if they’re repeating the same line in a song or the same movie quote, or even just a single word, it’s probably really satisfying to them to utter, or maybe if they keep repeating the joke they just get a lot of joy out of saying it. As long as what they’re repeating doesn’t hurt you, themselves or anyone around them, there is really no reason to worry.

Hyperfixation & Hyperfocus

This is the biggest part of ADHD that I resonate with and I know a lot of other people will too! It’s such an all-encompassing term to discuss, because it could be as simple as listening to the same few songs for a couple weeks straight or fixating on specific food items for a while and not really wanting to eat anything outside of what those items are. The part that sticks with me is picking up new hobbies and interests in a flash, and having all this new energy and motivation, those hyperfixation periods. At one point, I was really into the IDEA of car modding, I had a brief stint with embroidery and knitting, I took a heavy interest in studying law for a while, or maybe we could talk about the time I wanted to start making my own plus size clothes or an app like Tinder but for finding friends. These are just a FEW examples. I’ve changed my trajectory for the future about a million times in college because there was always TOO MANY things I wanted to do. I go through periods where I hyperfixate on an idea or concept, could be a breakfast sandwich from a local place that’s the only thing I’m craving, or it could be the thing that I want to buy that I can’t stop thinking about until I do, like the shoes I told myself would go with every outfit and waited eagerly to go on sale, bought, stared at, and then never wore, or the video game I was really into playing for a while, and then dropped like a sack of potatoes.

Hyperfocus is essentially the ability to focus in on a new project or learning new information, or just anything that interests you for a prolonged period of time.¹⁵ These hyperfixation phases can last days, weeks, sometimes even MONTHS. It could be someone sinking hours of time into a video game, or someone suddenly deciding to learn a new instrument, it’s all about the release of “good brain chemicals” when diving into something new and exciting that keeps the neurodivergent going back to hyperfixations and those hyperfocus periods of time. People with ADHD or that experience periods of hyperfocus chase that “thrill” of picking up a new habit or hobby or interest, it’s a way of stimulating our brain and “waking up” for the day.¹⁶ But as quickly as these fixation periods come, they go the same way, and the “spell” is broken before the next one begins. Someone that hyperfixates may struggle with impulse control and might end up procrastinating on important tasks if the object of their focus came first, and it’s hard to pull one’s self away from them. Many neurodivergent folk outside of just those with ADHD experience hyperfocus and hyperfixations and it’s probably one of the most common signs of neurodiversity.

While these hyperfocus moments and hyperfixations aren’t inherently bad, they can take over very quickly. Sometimes they can be productive, sometimes not. There isn’t specific treatment that someone should seek out if they experience them, and it’s honestly a big component of the ADHD and neurodivergent gothic. If the hyperfixation your friend or loved one has adopted is relatively harmless, support them! Listen to them tell you what they’ve learned and express their special interest to you, that is the best way to support someone going through it. When a neurodivergent individual has the strength to get started on something new, always offer encouragement.

Now that we’ve discussed some crucial terms, let’s take a look at statistics. Remember at the beginning of my article where I mentioned wanting to break the stigma that ADHD was just “one thing”? The statistics I’m about to present you are a good example of how, in the past, ADHD has gone underdiagnosed or completely misdiagnosed, especially in women and members of the BIPOC community. You’ll find my sources for these statistics at the bottom in the page with their corresponding footnotes, as well as footnotes on any other topic I’ve discussed in this article.

ADHD in Children

• “Boys are more likely to be diagnosed with ADHD than girls (12.9% compared to 5.6%).”
• “The estimated number of children ever diagnosed with ADHD, according to a national 2016 parent survey,1 is 6.1 million (9.4%).”
• “Many children with ADHD also have other disorders. According to a national 2016 parent survey,1 6 in 10 children with ADHD had at least one other mental, emotional, or behavioral disorder. About 5 in 10 children with ADHD had a behavior or conduct problem.” About 3 in 10 children with ADHD had anxiety.”
• “Other conditions affecting children with ADHD: depression, autism spectrum disorder, and Tourette syndrome.” ¹⁷

ADHD in Adults

• “Adult attention deficit hyperactivity disorder (ADHD or ADD) is a neurological disorder that affects an estimated 4.4 percent of U.S. adults, and is more commonly diagnosed in men (5.4%) than in women (3.2%).”
• “Prevalence estimates for adult ADHD in the U.S. vary. One 2019 study estimates an adult ADHD prevalence of 0.96 percent — doubling from 0.43 percent a decade prior.”
• “ADHD was historically considered a childhood condition, but it is now recognized as a lifelong condition that persists well into adulthood. Persistence rates, however, vary, ranging from 6% to 30% and perhaps even higher.” ¹⁸

ADHD in Women

• “Gender differences have been reported in the prevalence rates of ADHD, with the published literature indicating that the prevalence of ADHD in boys is 2- to 9-fold higher than in girls in clinical samples and 2- to 3-fold higher in epidemiologic samples. These findings are consistent with the 3- to 16-fold higher prevalence of ADHD in boys than in girls across European countries as well.”
• “Multiple factors may contribute to the lack of ADHD diagnosis in girls during childhood, including differences in predominant symptoms (internalizing rather than externalizing) and subtype (inattentive rather than hyperactive); the presence of comorbid psychiatric disorders, including depression and anxiety, which are linked to internalizing ADHD symptoms; the presence of comorbid obsessive-compulsive disorder, often accompanied by perfectionistic behaviors, that might mitigate symptoms and delay diagnosis; the need for referral by others (parents and teachers) for treatment and the fact that referrals are made more often for boys than for girls; and the tendency for relational (covert) aggression to be more prominent than overt aggression in girls and for physical aggression in girls with ADHD to be less prominent than in boys with ADHD.” ¹⁹

ADHD in the BIPOC Community

• “Battling ADHD stigma in the BIPOC community is nothing new, but evidence shows that people of color — black and Latino in particular — are much less likely to be diagnosed with ADHD, even though they show symptoms at the same rate as white people.” ²⁰
• “Minority children were less likely than white children to receive an ADHD diagnosis. With time-invariant and -varying confounding factors statistically controlled the odds of ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were 69% (95% confidence interval [CI]: 60%–76%), 50% (95% CI: 34%–62%), and 46% (95% CI: 26%–61%) lower, respectively, than for whites.”
• “School officials are more likely to assign African-American children to special education classes (which is the only educational resource employed to address many black children with ADHD), although many of the symptoms they display may be resolved with proper treatment that would allow them to remain in their regular classes. Between 1980 and 1990, black children were placed in special education at more than twice the rate of whites.” ²¹
• “African-American parents (57%) are more likely to believe that their children’s race or ethnicity and fears of being “labeled” remain one of the important factors preventing acceptance of the diagnosis and treatment of children with ADHD.” ²²

Despite DECADES of struggle, we are making progress in the medical community, and we are seeing formal diagnoses of ADHD on the rise, more than what we’ve seen in 20 years alone.²³ More people are using their platforms to tell their stories and raise awareness, and more people are putting in the time and work to do hefty research and trials in a once very neglected part of the medical field.

My aim with this article has been to inform anyone that comes across it, more people like… Well, me. I felt so strange and different from people for so long and never understood why. As I’ve gotten older, I understand more and more about myself and why I am the way that I am, and it has helped me so much. I’m grateful for it. So if I can use my humble platform to raise awareness, then I will! You aren’t alone, you aren’t broken, and there are other people that are just like you and I. Thank you for reading.

[1] Higuera, V. (2019, October 29). What Is Rejection Sensitive Dysphoria? Healthline. https://www.healthline.com/health/mental-health/rejection-sensitive-dysphoria

[2] Dodson, W., & Saline, S. P. (2021, March 19). How ADHD Ignites Rejection Sensitive Dysphoria. ADDitude. https://www.additudemag.com/rejection-sensitive-dysphoria-and-adhd/

[3] Pera, G. (2019, March 25). Sounds Like Auditory Processing Disorder. ADDitude. https://www.additudemag.com/central-auditory-processing-disorder/

[4] Rodden, J., & Saline, S. P. (2021, April 8). What Is Executive Dysfunction? ADDitude. https://www.additudemag.com/what-is-executive-function-disorder/#:%7E:text=Executive%20dysfunction%20is%20a%20term,%2C%20organization%2C%20and%20time%20management.

[5] Morin, A. (2021, April 19). Interoception and sensory processing issues: What you need to know. Understood.Org. https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/sensory-processing-issues/interoception-and-sensory-processing-issues-what-you-need-to-know

[6] Khalsa, S. S. (n.d.). Interoception in Eating Disorders: A Clinical Primer. Psychiatric Times. Retrieved April 28, 2021, from https://www.psychiatrictimes.com/view/interoception-eating-disorders-clinical-primer

[7] Delayed Sleep Phase Syndrome (DSPS). (2017, September 12). Stanford Health Care. https://stanfordhealthcare.org/medical-conditions/sleep/delayed-sleep-phase-syndrome.html

[8] Patrick, R. R. (n.d.). Attention Deficit Hyperactivity Disorder and Delayed Sleep Phase Syndrome May Be Linked. AASTWeb. Retrieved April 30, 2021, from https://www.aastweb.org/blog/attention-deficit-hyperactivity-disorder-and-delayed-sleep-phase-syndrome-may-be-linked

[9] Kandola, A. (2021, April 21). What to know about maladaptive daydreaming. Medical News Today. https://www.medicalnewstoday.com/articles/319400#what-is-it

[10] Cirino, E. (2018, December 13). Maladaptive Daydreaming. Healthline. https://www.healthline.com/health/mental-health/maladaptive-daydreaming#symptoms

[11] Olivardia, R., & Panel, A. A. M. R. (2021, March 22). Hair Pulling! Skin Picking! Nail Biting! Oh, My! ADDitude. https://www.additudemag.com/body-focused-repetitive-behaviors-adhd-anxiety/

[12] Pietrangelo, A. (2019, June 28). Stimming: Causes and Management. Healthline. https://www.healthline.com/health/autism/stimming

[13] Stubblefield, H. (2019, September 19). Echolalia. Healthline. https://www.healthline.com/health/echolalia#types

[14] Medical Diagnosis. (2020, January 24). Tourette Association of America. https://tourette.org/about-tourette/overview/diagnosis/medical-diagnosis/

[15] Flippin, R., & Panel, A. A. M. R. (2021, March 2). Hyperfocus: The ADHD Phenomenon of Intense Fixation. ADDitude. https://www.additudemag.com/understanding-adhd-hyperfocus/

[16] TotallyADD, O. F. G. R.-. (2021, February 17). Hyperfixation and ADHD. TotallyADD. https://totallyadd.com/hyperfixation-and-adhd/#:%7E:text=What%20Is%20Hyperfixation%3F,%2C’%20or%20’completely%20engaged.

[17] Data and Statistics About ADHD | CDC. (n.d.). Centers for Disease Control and Prevention. Retrieved May 4, 2021, from https://www.cdc.gov/ncbddd/adhd/data.html

[18] ADDitude Editors, & Saline, S. P. (2021, March 22). ADHD Statistics: New ADD Facts and Research. ADDitude. https://www.additudemag.com/statistics-of-adhd/

[19] A Review of Attention-Deficit/Hyperactivity Disorder in Women and Girls: Uncovering This Hidden Diagnosis. (n.d.). NCBI. Retrieved May 4, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195638/#:%7E:text=The%20prevalence%20of%20ADHD%20in%20adulthood%20appears%20to%20be%20more,men%20when%20diagnosed%20with%20ADHD.

[20] Frye, D. (2021, April 27). Children Left Behind. ADDitude. https://www.additudemag.com/race-and-adhd-how-people-of-color-get-left-behind/#:%7E:text=Battling%20ADHD%20stigma%20in%20the,same%20rate%20as%20white%20people.

[21] Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade. (n.d.). NCBI. Retrieved May 4, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691530/

[22] Bailey, R. K. (2013, June 27). The Impact of Attention Deficit/Hyperactivity Disorder in African-Americans; Current Challenges Associated with Diagnosis and Treatment. IntechOpen. https://www.intechopen.com/books/attention-deficit-hyperactivity-disorder-in-children-and-adolescents/the-impact-of-attention-deficit-hyperactivity-disorder-in-african-americans-current-challenges-assoc

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