Sitting in high school classes was “always a struggle” for a young Joshua Claytor. He filled his papers with “doodles.” Certain math concepts eluded his understanding.?

Despite these early signs, it took the Vine Grove man decades to learn he had attention deficit hyperactivity disorder — ADHD.?

When he got diagnosed last year at 42 years old, things about his life started to make sense.?

He then realized that “quirky” things about his character were actually all part of his ADHD. Fixating on a hobby for a few months, then never touching it again. Taking rejections hyper personally. Getting ready for work one moment, and realizing the next that too much time had passed and he was already late.?

All these symptoms, from time blindness to rejection sensitive dysphoria (RSD) are common but often-ignored parts of ADHD, therapists who treat it said.?

What is ADHD? Where does it come from?

The Centers for Disease Control and Prevention says ADHD is among the most common neurodevelopmental disorders and usually pops up during childhood.?

Johns Hopkins says ADHD symptoms are “almost always apparent by the age of 7,” with elementary school helping to reveal inattentiveness.?

Often characterized by forgetfulness, daydreaming and carelessness, among other symptoms, the disorder affects millions around the country.?

Time blindness, too, is common in the ADHD brain, experts said, often making people who have it late to events.?

“It’s really hard to manage time to have an accurate sense of time, to have a good kind of internal guess of how long something is going to take or how long it’s been that you’ve been working at something,” Brenda Arellano, who specializes in treating ADHD, said. “That’s a really difficult thing for a person with ADHD to keep track of.”?

Therapy can help with becoming more aware of time and other symptoms. ?Still,?ADHD’s causes are unknown, though the CDC says scientists want to find out if things like brain injury, low birthweight and exposure to alcohol or tobacco in utero can lead to it.?

Like many other mental health conditions, people often misunderstand and stigmatize ADHD.

For example, there’s this idea that ADHD is “caused by bad parenting,” said Louisville-based Arellano, who works at Well Kentucky.?

But it’s just not that simple.?

“Certainly, environment plays a factor,” she said. “But it’s not something that’s going to be caused by bad parenting or eating too much sugar or watching too much TV or anything like that. Certainly those things might not help with your ADHD, but it’s not like that’s the reason why you have it.”?

Different kinds of ADHD?

A person with ADHD may be predominantly inattentive, predominantly hyperactive/impulsive – or have both presentations, Arellano said.?

ADHD on television usually looks hyperactive or impulsive, Arellano said. “We often see it as … a little boy that’s just bouncing off the walls. Super, super energetic. Can’t sit still for a second. … And it certainly can be that way, but it also can be much more than that.”?

People with hyperactive ADHD can struggle with impulse control, regulating frustration and balancing long and short term goals, Arellano said. They may end up with more broken bones and traffic tickets than other people, or appear to talk more than average.?

Inattentive folks may get distracted easily and struggle with time management. These challenges have “big impacts” on school and meeting deadlines at work.?

Males are more likely to be hyperactive/impulsive or both, while females are more likely to be inattentive, Arellano said, though anyone can have any presentation.?

Males also are more likely to get diagnosed, she said. That’s potentially because it’s easier for teachers and parents to spot disruption than daydreaming as an issue.?

But there is a misconception that people with ADHD are lacking the ability to pay attention. That’s just not true, according to licensed clinical social worker Sarita E. Trawick.?

“The people that have ADHD often can actually hyper focus on something that they’re interested in,” said Trawick, who sees clients in Kentucky?and Oregon.

Pairing an activity or area of interest with the boring or difficult task can help, she said. ?

Calling ADHD “dopamine deficit” may be more accurate, she said. That’s because “Boredom is like death to someone who has ADHD.”?

Dopamine serves as a “reward center,” according to the Cleveland Clinic, and is also called the “feel good hormone.” People with ADHD may not have enough dopamine — or too much.??

Is ADHD ‘curable’??

Talk therapy and medications like Adderall can help manage ADHD symptoms.?

And while it’s not clear if it’s curable, people can learn to manage symptoms with these treatments.?

Some people do appear to “grow out” of ADHD?as they get older, according to Arellano, who primarily works with youth.?

But the “jury’s out” still on why that happens — and it’s not true for everyone. ADHD may also appear to fade with age for those who look for careers that play to their strengths and not their weaknesses.?

“If you’re somebody who has a really hard time staying in their seat, it doesn’t make sense that you’re going to grow up and get an office job where you have to sit in a chair still for eight hours,” Arellano said. “You might do something that has a little bit more interaction or where you can move.”

In that case, she explained, it’s not that ADHD went away. The person is simply playing to their strengths.?

The condition “is manageable,” Arellano said. “We can learn to work with the way that a person’s brain is wired and we can seek out situations and environments and supports that … (don’t) hold the person back from showing their intelligence and their other talents.”?

Stigma of seeing self as flawed??

ADHD, to Claytor, often felt like a “punchline,” a “joke,” especially in high school.??

“We didn’t really talk about ADHD being a real mental illness,” he said. That made it difficult to recognize and address symptoms.?

Even now, he struggles when he reflects on past events and realizes how much his ADHD-related rejection sensitivity disorder (RSD) has affected his life. It even forced him to give up dating, he said.?

For years he took rejection as a personal attack on his value, making him lash out at perceived attackers.?

“To look and see that you didn’t have to defend yourself, that you overreacted, that you hurt people that you cared about. It’s hard to confront,” Claytor said. “It’s hard to face … because it’s embarrassing.”

You must “relive that hurt and having to learn to not only hope for forgiveness from the person that you’ve hurt, but also to forgive yourself,” he said.?

RSD can happen to people with ADHD because, Arellano said, the brain may hyper-focus on one thing — something a person said or did — and may overanalyze it. The person with ADHD may even blame themselves for the real or perceived rejection.?

“It can be really hard to move on from that,” she explained. “Folks with ADHD have a hard time with regulating emotions, so their feelings can be more intense and it can be hard to work through and cope with those feelings.”?

Because ADHD can hinder a person’s ability to focus or cause them to hyper focus, it can be difficult to separate symptoms from the individual who has them — both for that person and those around them, Arellano explained.

“You’re seeing yourself as, like, ‘I’m stupid’ or ‘I’m a bad student’ or ‘I don’t like school’ or ‘I’m a bad friend,’” she said. “All of those thoughts that really have more to do with your ADHD than with you are going to make it really difficult for you to show up as your full, true, authentic self.”?

That negative messaging and feedback can start at a young age, Trawick said.?

“Think about how, on a daily basis even, hour to hour, how much feedback you might get about yourself not being like everyone else,” she said. “If you carry that over time, you’re constantly waiting for you to get in trouble or waiting for you to do the wrong thing and then be rejected.”??

Think of the child who’s kicked out of class, out of school. Who’s told they can’t come over to a friend’s house anymore because they’re too hyper.?

That’s a “lot of rejection” for kids with ADHD to endure, Trawick said.?

It impacts how they interact with the world.?

“How do you … demonstrate that you’re a good friend if you forget appointments, … you forget things, you forget to show up. You can’t pay attention. You forget what they told you because memory is an issue,” Trawick explained. But: “what, often, people forget is that: That’s the friend that if you call them, they’ll be right over. They’ll drop everything to do something for you.”??

Changing the narrative?

Arellano teaches her clients to change how they speak about their ADHD and separate it from their sense of self, which she said is a key part of therapy.?

For example, her clients learn to say: “I’m a smart kid. I know what I’m doing. I’m very knowledgeable. I’m actually a pretty good student. And I have ADHD and I procrastinate sometimes and that really bites me in the butt.”?

Or: “I’m a very considerate person, and my ADHD sometimes wants me to interrupt people, and that’s something I’m working on.”?

The way movies and television sometime depict the disorder makes it easy to generalize and stigmatize the disorder too.?

There is this image, Arellano said, that people with ADHD are “dumb” or “airheaded.”?

But: “The research that’s out there that looks at folks with ADHD and their intelligence shows that they’re either average or even above average intelligence,” she said. “So this potential idea that might be floating out there that folks with ADHD are dumb or lazy or unmotivated is just simply not true and not supported by the research.”?

‘There’s definitely hope’

Claytor uses a technique called “body doubling” to help cope with his ADHD symptoms. He has an “ADHD buddy” who stays on the phone with him so they can complete things together like cleaning or dishes.?

Sometimes just having someone around, even virtually, helps him focus.?

He knows he can’t go back in time to high school and get a do-over knowing that he has ADHD.?

He’s in therapy and strives to make his life better now and in the future.?

He wishes he could tell his younger self: “Hey, it’s going to get better and there are tools that you can use” to make sure of it.?

That, and: “There’s definitely hope.”?