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What is ADHD? - Differences from ADD, Myths and Facts

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"I can't focus," "I keep getting distracted," "I procrastinate" - everyone experiences these. However, ADHD (Attention-Deficit/Hyperactivity Disorder) is not just a concentration problem, but a neurodevelopmental disorder where the brain operates differently. It's not laziness or lack of willpower.

Related articles: Causes of Poor Concentration | How to Improve Focus Without Medication

Definition​

ADHD is a neurodevelopmental disorder characterized by difficulties in attention regulation, impulse control, and behavior management. The prefrontal cortex and dopamine system operate differently from neurotypical individuals.

Core Characteristics

  • Difficulty maintaining attention
  • Difficulty controlling impulses
  • Hyperactivity or restlessness
  • Difficulty executing plans
  • Distorted time perception

Differences Between ADD and ADHD​

History of Terminology​

Past (1980s)

  • ADD (Attention Deficit Disorder)
  • ADHD (Attention Deficit Hyperactivity Disorder)
  • Classified as separate diagnoses

Present (Since 1994)

  • ADD is no longer officially used
  • All unified under ADHD
  • Instead, divided into 3 subtypes

Three Types of ADHD​

1. Predominantly Inattentive Presentation

This is what used to be called "ADD"
- Often appears spaced out
- Mind wanders during conversations
- Frequently loses things
- Difficulty following instructions
- Appears quiet and well-behaved, leading to late detection

Common in Women and Adults

  • No "hyperactivity," not recognized as ADHD
  • Misunderstood as "lazy," "daydreamer," "scattered"
  • Main reason for delayed diagnosis

2. Predominantly Hyperactive-Impulsive Presentation

- Difficulty sitting still
- Constantly moving
- Talks excessively
- Difficulty waiting turn
- Impulsive decisions

Common in Children

  • Noticeable, detected early
  • Misunderstood as "disruptive child," "troublemaker"

3. Combined Presentation

- Both inattention + hyperactivity
- Most common type
- Diverse symptoms

Common Myths and Facts​

Myth 1: "ADHD is a childhood disease"​

Fact

  • About 3 million adults with ADHD (Korea)
  • 60-70% symptoms persist into adulthood
  • Many diagnosed as adults after not being detected in childhood

Adult ADHD Symptoms

  • Missing work deadlines
  • Financial management difficulties
  • Relationship conflicts
  • Emotional regulation difficulties
  • Frequently forgetting appointments

Myth 2: "It's just laziness and weak willpower"​

Fact

  • Brain imaging studies show differences
  • Reduced prefrontal cortex activity
  • Dopamine neurotransmitter deficiency
  • Cannot be solved by "effort" alone

Neuroscientific Evidence

  • MRI: Prefrontal cortex 5-10% smaller
  • PET: Different dopamine transporter density
  • Heritability: 70-80% (very high)

Myth 3: "If there's no hyperactivity, it's not ADHD"​

Fact

  • Predominantly inattentive presentation has no hyperactivity
  • Internal hyperactivity (mind is noisy)
  • Not externally visible, difficult to detect

Hidden Symptoms

  • Constant stream of thoughts
  • Internal restlessness
  • Mental fatigue
  • Appears as a "quiet person" externally

Myth 4: "Medication causes addiction"​

Fact

  • Low addiction risk when taken as prescribed
  • Without treatment, higher risk of substance abuse
  • ADHD medications "normalize" the brain
  • Medication is one treatment option

Related: ADHD Medication Guide

Myth 5: "Sometimes they focus well, so it's fake"​

Fact

  • ADHD is not "no ability to focus" but "inability to regulate focus"
  • "Hyperfocus" phenomenon: excessive focus on interesting tasks
  • Large difference in focus between important tasks vs. enjoyable tasks

What is Hyperfocus?

  • So absorbed in favorite activities that time flies
  • Gaming, hobbies, interesting projects, etc.
  • The problem is inability to focus "when needed"

ADHD Self-Assessment Checklist​

If 6 or more symptoms persist for over 6 months, professional consultation recommended

Inattention Symptoms

  • Often overlooks details and makes careless mistakes
  • Difficulty sustaining attention in tasks
  • Seems not to listen during conversations
  • Fails to follow through on instructions
  • Difficulty organizing tasks and activities
  • Avoids tasks requiring sustained mental effort
  • Frequently loses things
  • Easily distracted by external stimuli
  • Often forgetful in daily activities

Hyperactivity-Impulsivity Symptoms

  • Fidgets with hands or feet or squirms in seat
  • Leaves seat in situations where remaining seated is expected
  • Runs or climbs excessively in inappropriate situations
  • Difficulty engaging quietly in leisure activities
  • Acts as if "driven by a motor"
  • Talks excessively
  • Blurts out answers before questions completed
  • Difficulty waiting turn
  • Interrupts or intrudes on others

Note: This is not a formal diagnosis

  • Professional (psychiatrist) diagnosis required
  • Must meet DSM-5 diagnostic criteria
  • Need to differentiate from other conditions (depression, anxiety)

Why Are ADHD Diagnoses Increasing Recently?​

1. Improved Awareness​

Past

  • Dismissed as "troublemaker," "lazy child"
  • Especially women and inattentive type not detected
  • Reluctance to visit psychiatrist

Present

  • ADHD awareness increased
  • More online information
  • Reduced mental health stigma

2. Digital Environment Changes​

Era of Overstimulation

  • Short-form content (TikTok, Reels, Shorts)
  • Forced multitasking
  • Instant gratification culture
  • Shortened attention span

Result

  • Experiencing "digital ADHD" symptoms
  • Need to distinguish from real ADHD
  • Temporary symptoms from environmental changes vs. persistent disorder

3. Work Environment Changes​

Modern Workplace

  • Increased multitasking demands
  • Constant emails/messages
  • Increased knowledge work requiring focus
  • ADHD symptoms become more noticeable

Past

  • Physical labor, repetitive tasks
  • Could manage with ADHD
  • Symptoms less problematic

4. Overdiagnosis Controversy​

Concerns

  • Misdiagnosing temporary concentration problems as ADHD
  • Seeking medication prescriptions "to study better"
  • Pathologizing normal scatter-mindedness

Truth

  • Some overdiagnosis exists
  • But many groups still underdiagnosed (women, adults)
  • Accurate differential diagnosis by professionals important

ADHD Diagnosis Process​

Step 1: Self-Recognition​

Triggers

  • Impairment in daily life
  • Repeated mistakes and frustration
  • Others' criticism
  • Online self-tests

Step 2: Professional Consultation​

Visiting Psychiatry

  • Detailed interview (1-2 hours)
  • Checking childhood symptoms (before age 12)
  • Symptoms in multiple settings (school, work, home)
  • Differential diagnosis from other conditions

Information Needed

  • School records from childhood
  • Family observations
  • Current symptom diary
  • Checking co-occurring conditions

Step 3: Psychological Testing​

Comprehensive Psychological Assessment

  • Attention test (Continuous Performance Test)
  • Intelligence test (IQ)
  • Executive function test
  • Emotional state assessment

Time Required

  • 2-4 hours
  • Cost 100-300 USD (varies by clinic)
  • Insurance may cover

Step 4: Diagnosis and Treatment Plan​

Applying DSM-5 Diagnostic Criteria

  • 6 or more symptoms
  • Started before age 12
  • Persists for 6+ months
  • Present in 2+ settings (school + home)
  • Impairs social/academic functioning

Treatment Options

  • Medication
  • Cognitive behavioral therapy
  • Coaching/counseling
  • Lifestyle improvements
  • Combined treatment

Related: ADHD-Friendly Lifestyle Habits

ADHD and Co-occurring Conditions​

70-80% have other co-occurring conditions

Common Co-occurring Conditions

  • Anxiety disorders (50%)
  • Depression (30-50%)
  • Learning disabilities (30-50%)
  • Conduct disorder (40-60%, children)
  • Substance use disorders (adults)
  • Sleep disorders (50-70%)

Why Do They Co-occur?

  • Shared dopamine system abnormalities
  • Secondary problems from ADHD (frustration → depression)
  • Shared genetic factors
  • Complicates treatment (medication adjustment needed)

Why Treatment is Necessary​

Risks of Untreated ADHD​

Children/Adolescents

  • Lower academic achievement
  • Peer relationship difficulties
  • Low self-esteem
  • Increased school dropout risk

Adults

  • Job retention difficulties
  • Financial management failures
  • Relationship breakdowns
  • 4x higher traffic accident risk
  • Increased substance abuse risk
  • Increased likelihood of legal involvement

Benefits of Treatment​

Medication Treatment Efficacy

  • 70-80% experience symptom improvement
  • Enhanced academic/work performance
  • Improved relationships
  • Restored self-esteem
  • Reduced accident risk

Long-term Benefits

  • Improved educational attainment
  • Increased employment stability
  • Increased relationship satisfaction
  • Improved quality of life
  • Prevention of secondary conditions

When to See a Doctor?​

When to Seek Help​

Consultation Recommended If:

  • Repeated impairment in daily life
  • Unable to perform to ability in school/work
  • Continuous relationship problems
  • Always missing deadlines
  • Frequently losing things
  • Time management difficulties
  • Repeated regret from impulsive decisions
  • Often hear "Why do you do that?"

Severity Check

  • Persists for 6+ months
  • Present in multiple situations
  • Clear functional impairment
  • Doesn't improve despite efforts

When Not Necessary​

Normal Range

  • Only occasional concentration problems
  • Only in specific situations (e.g., exam periods)
  • Recovers with adequate sleep/rest
  • No impairment in daily life
  • Performs well on desired tasks

Temporary Causes

  • Sleep deprivation
  • Extreme stress
  • Depression/anxiety symptoms
  • Nutritional deficiency
  • Medication/alcohol effects

Related: Causes of Poor Concentration

Living with ADHD​

ADHD is treatable and manageable

Recognizing Positive Aspects​

ADHD Strengths

  • Creativity
  • Crisis management ability
  • Passion and energy
  • Unique perspective
  • Utilizing hyperfocus

Related: ADHD and Creativity

Realistic Expectations​

Cure vs. Management

  • ADHD is not "cured"
  • But can be effectively managed
  • Living normally while controlling symptoms
  • Developing personal strategies

Lifelong Management

  • Continuous treatment
  • Regular evaluation
  • Maintaining lifestyle habits
  • Stress management
  • Building support systems

Advice for Family and Friends​

Understanding​

Remember

  • It's not intentional
  • It's a brain difference
  • They are trying
  • They feel frustrated too
  • Need support, not blame

How to Help​

Effective Support

  • Clear communication
  • Provide visual reminders
  • Create routines together
  • Acknowledge small achievements
  • Be tolerant of mistakes
  • Encourage professional treatment

Things Not to Say

  • "You're not trying hard enough"
  • "You're just lazy"
  • "Why can't you do it?"
  • "Everyone else can do it"
  • "Your willpower is weak"

Conclusion​

ADHD is not a matter of willpower or effort, but a neurodevelopmental disorder where the brain operates differently. With early detection and appropriate treatment, one can live a completely normal life.

Key Points

  1. ADD is outdated terminology - Now all unified under ADHD, divided into 3 types
  2. Not laziness - Neurodevelopmental disorder proven by neuroscience
  3. Adults too - 60-70% symptoms persist into adulthood
  4. Professional diagnosis required - Self-diagnosis is for reference only, accurate differential diagnosis needed
  5. High treatment efficacy - 70-80% respond to medication, improved quality of life

Don't Misunderstand

  • "Sometimes focuses well, so it's fake" - Hyperfocus is an ADHD symptom
  • "Childhood disease" - Adult ADHD is very common
  • "Medication causes addiction" - Normal prescriptions are safe
  • "Overcome with willpower" - It's a brain issue, needs treatment

What to Do

  • Consult professional if symptoms persist
  • Get accurate diagnosis
  • Consider medication/non-medication treatment
  • Improve lifestyle habits
  • Find strategies that work for you

Remember

  • ADHD has strengths, not just weaknesses
  • Many successful people have ADHD
  • Early treatment is important
  • Can live normally with management
  • You're not alone, support is available

"ADHD is not your entire identity. Your brain just operates differently. With proper understanding, treatment, and your own strategies, you can live a successful life."

If you feel your concentration is poor, first identify the cause. It could be ADHD or something else. An accurate professional diagnosis is the first step.