The ADHD Iceberg

A diagnosis of ADHD for many parents and carers can be a real 'eureka' moment or 'aha!' experience. For years, you might have noticed that your child has been struggling in ways, that were difficult to understand. Your child has been struggling at school and at home, in sustaining attention, staying still and being organised. However, there are other times, when they seem to focus really well on tasks they enjoy like computer games which can seem bewildering.


Parents and young people may identify that there are delays in emotional maturity, behaviour or learning and this leads to them seeking an assessment to explore whether ADHD could be an explanation.


There are many misconceptions regarding ADHD and what it means for young people and their families. Imagine an iceberg, most of it lies underneath the surface of the water and be invisible.


Symptoms of ADHD can be described like an iceberg – where the core symptoms of inattention, hyperactivity and/or impulsivity may be present, depending on the profile but there are other numerous hidden challenges including learning issues, impaired self-esteem, emotional hyperarousal and being highly sensitive, which lie under the surface of the water.


A comprehensive assessment process considers the whole child or young person and the difficulties that they are presenting with. Dr Amber Sadiq, one of the psychiatrists and an ADHD specialist describes the assessment as helping people to join the dots and understand how their brains work. By doing so, strategies can be developed to help improve functioning.


The CAMHS team at Eleos Clinic see young people who have experienced intense emotional symptoms or anxiety which has developed around the fear of making mistakes. Sometimes young people have had other diagnoses like Dyslexia or Developmental Coordination Disorder and there is an established and known overlap between other neurodevelopmental conditions and ADHD.


The key to a successful ADHD assessment is to help the patient and family recognise the strengths and difficulties, and to shed more light on why there has been a struggle in managing learning, friendships, or other aspects of daily life.


The diagnosis can often be a relief to young people who can experience emotional difficulties related to their ADHD, this can include shame and not feeling good enough because they may have internalised messages around being ‘different’ or not being like their peers. When young people recognise that there is an explanation for their symptoms and that there is help available, it can be life changing. They do not need to struggle in silence any longer.