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Karla Ryder remembers a time when she struggled at work.
“My attention to detail was suffering. My managers would say I hadn’t done stuff,” says the social-care worker. “I had to meet with HR.”
Ryder had been diagnosed with attention deficit hyperactivity disorder (ADHD) as a teenager.
From the age of 19, she was prescribed Ritalin, a stimulant used to treat ADHD. But as an adult, the ADHD would still find ways to affect her working day.
ADHD is characterised as a behavioural disorder by the HSE. Symptoms include a short attention span, restlessness, forgetfulness and difficulty in being organised and getting tasks completed.
The exact cause of ADHD has not been pinpointed, according to the HSE, the NHS and the Centres for Disease Control in the US. But genetics is a likely factor, the three say.
There’s no data on how many people in Ireland are living with ADHD but adults living with it can struggle with most areas of life that require organisation – including work.
There have until recently been few resources to support adults with ADHD. But these days there’s a support group meeting in Dublin, and the HSE is looking at rolling out a clinical programme.
Karla Ryder, sitting with her husband Conor Farrell on Saturday, is eating lunch after a busy day.
She was hesitant about whether to tell her employers about her condition, which she says is “stigmatised”.
“The manager I had wasn’t an approachable person,” she says. Ryder says she had to disclose her condition eventually: “I had to take responsibility for myself before I got fired.”
Ryder, who had availed of ADHD Ireland’s services as a teenager, says that she looked around and realised there were few supports around as an adult.
Two years ago, she set up an evening support group for adults with ADHD, meeting every two weeks at the ADHD Ireland building in Carmichael House, Dublin 7.
As a student, Ryder says, she excelled in English. Her teachers would note in her reports she was distracted, that her handwriting was messy.
Ryder says she would be watching the teacher explain a maths lesson, and find it difficult to follow the lesson as a “fuzzy feeling” would come over her.
“I’d go into a daydream, into my own world without a sense of what to do or where to go. Without direction, you know?” she says.
Males are generally diagnosed with ADHD more than females, as females exhibit less of the “hyperactive” and impulsive behaviours and are more prone to being distracted, according to studies.
Electrician Bernard Groves, who attends the twice-monthly support group at ADHD Ireland, said he “struggled really badly” school.
“It was [problems with] concentration and being able to obey commands, trying to sit still,” he says over the phone on Tuesday.
In fifth year, Groves’ school counsellor suggested he had ADHD. “With the way the system worked, it took me about a year to get an appointment [with a psychiatrist].”
Impact on Work
Ian Callaghan, who was diagnosed with ADHD three years ago, works in banking. His problem, he says, was always procrastination in work.
Callaghan began working as a teacher after he graduated from college, a job he said he struggled in.
“I couldn’t organise myself. All the material I had gotten in. As in, I couldn’t actually teach. I couldn’t hold it in my brain,” he says.
“You had to do lesson plans, you had to prepare it, you had to teach it. I couldn’t do that,” he says. Eventually, he left.
Groves says as well as working as an electrician and being married with four kids, he manages a kids’ Gaelic football team.
He says of the balance: “Trying to juggle it all, I find it really hard.”
The job requires being on call, from 11pm to 6am. But, he says, he always wanted to be an electrician and this helps: “I can cope with it very well. Because I have a good interest in it, I seem to focus.”
Ryder, who leads the support group, says the people she meets work in all types of industries, including creative types and entrepreneurs who struggle with managing their work-life balance.
“They’re struggling behind closed doors in dealing with procrastination,” she says. “They’re running around, maybe they’re neglecting other aspects of their life just to get the job done.”
Peter Connolly, an occupational therapist and founder of website Lifestyle Awareness, works with adults with ADHD as well as other issues such as anxiety and burnout.
He says ADHD can slip by people’s radar, unknowingly seeping into their work life.
“They mightn’t realise what their problems are,” he says. “The school system maybe missed it. Then they’ve grown up and maybe they’ve been underperforming or lost some jobs.”
“This could result in people being called lazy, which is completely unfair,” he says. “A workplace can look at an issue through a particular lens, a rigid one-size-fits-all approach.”
For people with ADHD, a lack of structure and accountability for their work can leave them struggling, Connolly says.
“Having that persistence, being a self-starter, that part of their brain doesn’t work the same way as somebody else’s,” he says.
But, Connolly says, workplaces can make reasonable accommodations for people that cost next to nothing.
Assistive technology like noise-cancelling headphones can shut out distractions, he says. Being able to move around can help, too.
He says that visualising information and writing stuff down “helps with people’s executive function and memory”.
“Everyone’s a little bit different. There’s not a simple solution for everyone.”
Callaghan, the banker, says that after a short stint on Ritalin and Strattera he is now managing his condition without medication.
He swears by the book Atomic Habits by James Clear for creating a daily routine of small habits that build confidence and give him energy.
“I’ll put an audiobook and listen to it while I cycle to work. I deleted the Twitter and Facebook apps from my phone,” he says.
Ryder, the social-care worker, says with the assistance of her employer, she sought out a life coach who helped her implement small changes to her day.
“Sometimes I need to go into the office on my own to get stuff done,” says Ryder. That can involve working on the weekends when there are fewer distractions, she says.
Services in Dublin
Services for adults are few and far between, according to Ken Kilbride, the CEO of ADHD Ireland.
ADHD Ireland has a list of 13 clinicians, counsellors and occupational therapists on their website.
Most people will opt to see a psychiatrist for their treatment plan (which includes medication), says Kilbride.
“We have four psychiatrists on our list; two have stopped taking on new clients because their lists are so long,” he says.
Groves, the electrician, says that he disengaged from services as a teen, and the HSE is unable to access his file from back then – so now he is being assessed for ADHD again.
Trying to get an appointment was a “disaster”, he says. “I went to four different psychiatrists before I found the one I see now.”
An assessment on the private system requiring multiple sessions can cost from €750 to €1,000, Kilbride says. People can pay upfront in some places, or are charged per session.
The HSE, with the College of Psychiatrists of Ireland, is developing a clinical programme for adults with ADHD.
According to the HSE website, the programme will develop a model of care for the delivery of services.
Kilbride says that as part of the programme, “demonstration clinics” will be open in community-health organisations in Dublin, Limerick and Sligo.
“Once they can show how they work and if they work well, then they’ll open in other centres,” he says.
The HSE did not respond to a query in time for publication on when the demonstration clinics would be opened and what they would look like.