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Lacy Almeida, MSN, PMHNP-BC

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Lacy Almeida, MSN, PMHNP-BC

Psychiatric Nurse Practitioner at Lavender

It usually starts at 1 a.m.

You’re not asleep. You’re on your phone, watching a stranger list the “signs you secretly have ADHD”: you can’t start boring tasks, lose your keys daily, hyperfocus for six hours on something that doesn’t matter, interrupt people before they finish their sentence.

Your stomach drops a little.

That’s me. That’s all me.

If a video or a checklist has made you wonder about ADHD, you’re certainly not the only one. Adult Attention Deficit Hyperactivity Disorder, or ADHD, is real. It’s also easy to confuse with other conditions or experiences. Social media can help you notice patterns, but it can’t tell you what is causing them.

So what is ADHD really, how does it present, and what can you do if you recognize some of the signs in yourself?

What is ADHD?

ADHD is a neurodevelopmental condition marked by ongoing inattention and/or hyperactivity and impulsivity that interferes with everyday functioning.¹ In daily life, it can affect your ability to direct attention, manage impulses, start or switch tasks, follow through, and regulate emotions.

Despite the name, ADHD is not simply a lack of attention. Many adults with ADHD can focus intensely when something is urgent, interesting, or rewarding, then struggle to focus on a routine task. That difficulty regulating attention is part of what makes ADHD so frustrating: you know you can focus, but not always on demand. This intense absorption is often called hyperfocus, which adults with ADHD report experiencing more often than others.²

ADHD can also affect emotional regulation. Some adults feel intense frustration or irritability, or struggle to calm down once upset. While not a core diagnostic criterion, emotional dysregulation is commonly reported by adults with ADHD and can be genuinely impairing.³

ADHD doesn’t look the same for everyone

Within ADHD, there are three recognized presentations: predominantly inattentive, predominantly hyperactive/impulsive, and combined.¹

Inattentive ADHD can look like nodding through a meeting and realizing you missed the main decision, paying a bill only after the late notice arrives, losing track of conversations, misplacing items, or needing an urgent deadline to spur you into action. This is the most common presentation.²

Hyperactive/impulsive ADHD, on the other hand, looks more like restlessness, interrupting others more than intended, or making decisions impulsively.¹ Combined presentation includes symptoms from both.

These symptoms are worth paying attention to when they are persistent, show up in more than one area of life, and create real impairment, rather than occasional distraction.

High-functioning people can have ADHD, too

This is the part that keeps many adults from seeking help. You can have a degree. You can have a successful career. You can be the person everyone else sees as organized and dependable. And you can still have ADHD.

Instead of measuring life or career success, it is important to ask: “How much effort does it take to keep everything together?”

Maybe you are excellent at your job, but regularly stay up late finishing work you could not make yourself start earlier. Maybe you never miss an appointment because you keep three calendars and numerous phone alarms. None of this proves an ADHD diagnosis, but it explains why a good evaluation looks beyond grades, job titles, and outward achievement. As clinicians, we look at how long these patterns have been present, where they show up, and what they cost you.

Women are especially easy to miss. They more often have inattentive symptoms and co-occuring anxiety or depression that can mask or delay diagnosis.²

ADHD has lookalikes (and sometimes they overlap)

Difficulty concentrating is not unique to ADHD. Anxiety, depression, poor sleep, chronic stress, and thyroid disease can all disrupt attention. Impulsivity and restlessness can also overlap with symptoms of bipolar disorder, borderline personality disorder, and anxiety disorders.⁴

Sometimes, more than one thing is happening. Many adults with ADHD also have mood disorders, substance use disorder, or other co-occurring conditions.⁴

That is another reason thorough evaluation matters; the goal is not just to identify the problem, but to understand what’s driving it so that your treatment fits.

What if it is ADHD? Next steps

If something you stumbled upon online made you wonder about ADHD, treat that as something to get curious about, rather than something to self-diagnose or ignore. The first step is to reach out to a licensed clinician for an assessment.

Before your appointment, you can write down examples from daily life:

  • When do you struggle to start, finish, or switch tasks?
  • Where do your symptoms show up most?
  • Did you notice these patterns in childhood or adolescence?
  • What else might be affecting attention, including sleep, anxiety, depression, stress, or substance use?

ADHD is treatable with medication, therapy, or both. You can also explore behavioral strategies or accommodations to support your functioning.

The goal is not to become perfectly optimized, but to make daily life easier to manage: fewer missed deadlines, fewer evenings lost to avoidance, and more trust in your own ability to follow through. Whenever you’re ready, our experienced Psychiatric Nurse Practitioners are here to listen and help you explore what’s going on. Get started here.

Lacy Almeida

About the Author Lacy Almeida, MSN, PMHNP-BC, is a board-certified psychiatric nurse practitioner with 13 years of nursing experience. She provides care across New Jersey, specializing in ADHD, anxiety, depression, and insomnia. Her holistic, patient-centered approach combines evidence-based psychiatric care with lifestyle strategies, mindfulness, and education to support each client’s individual needs and goals.


References

  1. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
  2.  Cortese, S., Bellgrove, M. A., Brikell, I., et al. (2025). Attention-deficit/hyperactivity disorder (ADHD) in adults: Evidence base, uncertainties and controversies. World Psychiatry, 24(2).
  3. Beheshti, A., Chavanon, M.-L., & Christiansen, H. (2020). Emotion dysregulation in adults with attention deficit hyperactivity disorder: A meta-analysis. BMC Psychiatry, 20(1), 120. https://doi.org/10.1186/s12888-020-2442-7
  4. Blanco, C., & Surman, C. B. H. (2024). Diagnosing and treating ADHD in adults: Balancing individual benefits and population risks. JAMA Psychiatry, 81(12), 1189–1190.

All content and information on this website are for informational purposes only. None of the material is intended to be a substitute for professional medical advice, diagnosis, or treatment. This information does not create any client-provider relationship. Please consult with your mental health care provider before making any health care decisions or for guidance about a specific medical condition.

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