Graduate programs are faced with complicated challenges as they try to figure out how to support neurodiverse students. The number of students with Attention Deficit Hyperactivity Disorder (ADHD) diagnoses has been growing steadily since doctors began issuing diagnoses in the 1990s. At that time, however, there were no expectations of accommodations, whereas today students with documented diagnoses are legally entitled to support. But the condition is still commonly misunderstood. Many faculty see a need—and an opportunity—to be more effective mentors to students with ADHD.
It is not uncommon for students with ADHD to be highly successful until they encounter the particular combination of stress, complexity, and many poorly defined tasks that comprise graduate students’ workloads. For us, this has raised a pressing question: What do programs and faculty need to know about ADHD and their students with ADHD to facilitate these students’ success?
One of us was moved to learn more about ADHD when she realized that several of her advisees had received ADHD diagnoses in graduate school; the other also has students with ADHD and was diagnosed with ADHD while in graduate school herself. Together, we began to wonder what we and our colleagues would benefit from knowing in order to support students with ADHD effectively. Like good anthropologists, we turned to our students and asked for their insights. They immediately cautioned us that ADHD looks different in different people and that students can have very different experiences of it.
The first thing students want advisors and departments to know is what ADHD is and what it isn’t. Both the name—Attention Deficit Hyperactivity Disorder—and popular understandings of the condition can be highly misleading. While hyperactivity may be common among adolescent boys, it is not necessarily so for girls or adults. Likewise, ADHD does not indicate a lack of attention per se. Instead, it marks a brain that finds it especially challenging to regulate attention. You feel like there is tons of stimulation all the time. This level of stimulation becomes the norm, and it is hard to impose hierarchies and organization. This is the draining distraction that people with ADHD always have to manage. Living with ADHD is often living in a condition of having far too many obligations and tugs on one’s attention and a weakened ability to intuitively prioritize. Our students with ADHD are torn more than most between their coursework, their teaching obligations, their email obligations, their research obligations, their dirty laundry obligations, and their obligations to their teary friend. Their brains want to go all in on every activity—or not to engage at all. And all of these obligations feel equally pressing in the moment.
To have succeeded at a level that brought them to graduate school, students with previously undiagnosed ADHD are likely to have depended on one or both of two strategies. Do-or-die deadlines can help focus one’s attention tremendously. People with ADHD may do phenomenal work with deadlines looming. But the stress that this generates can easily backfire, further exhausting already strained executive function and making it even harder to impose cognitive discipline. At the same time, many students with ADHD have learned to summon a kind of hyper-attention to focus intently for long stretches of time. Dancing from task to task is challenging for many because it takes time to call up the mental reserves to tackle a new activity. Thus, while they may be adept multitaskers when the cognitive or emotional demand of the activity isn’t too high (for example, answering a straightforward email), making progress on complex problems may mean working with unbroken attention on a single task—a luxury that many of our students’ schedules do not easily allow. Yet some have admitted to us that they don’t function as well when they have too few different tasks to juggle, another example that no time management strategy works for everyone.
There are benefits to having a brain that doesn’t naturally follow pre-established pathways. You can be more open to new ideas and may have an increased capacity for making unexpected connections. For this reason, our students with ADHD are often exceptionally intellectually creative. These same qualities of mind can also become a source of struggle that spills over into students’ writing, however. Otherwise high-performing students might submit work that seems unexpectedly disorganized or even incoherent. Paragraphs may be a mishmash of ideas; sentences may go on and on. This is particularly likely to be the case in high-stakes, timed settings like exams when stress may make it even harder for students to impose order on their thoughts. In other cases, students may labor to prioritize their insights or know when to limit their inquiry. They may know that there is something inherently interesting in what they are uncovering, but not have a handy sense of knowing what is most important—which discoveries should be emphasized and which should be treated as the supporting cast. This is not necessarily a sign of ADHD, of course. Learning how to organize ideas is one of the more difficult skills one acquires in graduate school. But ADHD can make this especially challenging. As mentors, we appreciate knowing that organization may be a special challenge for these students and that they may benefit from additional time or conversation.
An important point that emerged from our conversations with students is that there is no single solution for all students, all of the time. While some students may benefit from deadlines and accountability, others may do best with space and time. And what works one month doesn’t necessarily work the next month, even for the same person. Many students told us that once a routine (or idea) becomes too familiar, they will seek out novelty to stay engaged. One student explained, “While ADHD is legally recognized as a learning disability, I think this characterization of the condition tends to subsume or misconstrue the reality that people with ADHD are learning new things constantly. What may look like distraction to someone else is actually a necessary aspect of structuring the everyday for someone with ADHD.”
One thing that advisors may find startling to hear is many students with ADHD find certain forms of structure to be damagingly painful. In some moments, structure may be a relief; a strict deadline can clarify what should be prioritized. But when structure was defined as more deadlines, deliverables, or frequent meetings, it could easily be felt as an added burden, increasing students’ levels of stress. And stress always seemed to make ADHD worse.
Does this mean that our students would like their workloads restructured? Not necessarily. They understand that to be successful academics, they have to learn how to manage the many pulls of this life. While some embraced the relief in the moment that accommodations offered, others expressed concern about being treated differently than others. The range of students’ feelings toward their neurodiversities means that advisors cannot assume that students will always be their own best advocates. But by educating ourselves about ADHD and talking about it with our students we can build a foundation for effective support. When students feel safe discussing their particular challenges—and recognized for their unique abilities—they are more likely to enter into the conversations that can help advisors identify and meet their needs.
Our students also had one last caution—they told us stories about how difficult it was to get diagnosed as adults, and how costly. Mentors may not always understand the barriers to formal diagnosis, which can require multiple days of testing and cost as much or more than many students’ rent, but which is not covered by university health insurance in many institutions. We have heard of students who were told to be more effective patient advocates. This may be something that they would love to do, but cannot without a certification that remains out of reach. We need to remember that the part of the university system that is supposed to support students with disabilities only becomes accessible with authorizing paperwork. That is, structural inequalities shape how people address their ADHD and what formal remedies are available to them. This might, in fact, be useful to keep in mind for all our students, not just the ones who know they have ADHD.
As our discussions with students made clear, there is no standard set of guidelines for being a good mentor in these circumstances. Lots of frank conversations will have to take place, if the student wants them, for advisors to appreciate how this diagnosis helps students make sense of their daily experiences and how best to work with them. Such conversations may be tough to initiate. For students who fear negative judgment, the conversations may well feel scary as well as offering relief. A departmental culture that understands and values neurodiversity will help to make it easier. And students who are seen and supported by their advisors will find it easier to succeed.