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ADHD Iceberg: Exploring The Visible and The Invisible

ADHD is more than just a restless kid, and there's a lot that goes into it - both seen and unseen. While some factors of ADHD are perceptible and plain, other components tend to be hidden.

By gaining a thorough understanding of the visible and invisible components of ADHD, we can support individuals struggling with this neurodevelopmental disorder.

Nonetheless, there are numerous ADHD symptoms and signs, even after ADHD is diagnosed, that remain hidden and unseen. Such signs remain hidden under the primary symptoms, the reason why it is called the ADHD iceberg.

What Is ADHD?

ADHD stands for Attention Deficit Hyperactivity Disorder. A neurodevelopmental disorder that affects not only adults but children too. People struggling with ADHD may face difficulties in performing normal activities and in various aspects including school or work performance, daily routines, and interactions with people.

The prominent causes of ADHD are not fully understood but a combination of environmental, neurological, and genetic factors are the reason behind developing ADHD. A person suffering from ADHD may have affected brain regions and neurotransmitters which are responsible for executive functioning, attention regulation, and impulse control.

The ADHD Iceberg Argument

There are certain signs and symptoms of ADHD which are less obvious and remain unnoticed even by the individual suffering from this disease. ADHD includes symptoms such as hyperactivity and impulsivity but these symptoms only reflect a small proportion of the overall condition and the rest remains hidden.

This argument focuses attention on certain symptoms which are not apparent to the people and even to the person affected by ADHD and the complete picture of the person suffering from ADHD cannot be seen from obvious symptoms.

Visible Symptoms Of ADHD

The tip of the iceberg reflects the visible symptoms of ADHD. If left untreated, these symptoms become obvious in childhood and continue to adulthood.

Some visible symptoms of ADHD include, but aren’t limited to:


Also known as "Predominantly Hyperactive-Impulsive". It is characterized by inappropriate physical movements, fidgeting, and restlessness. A person suffering may experience difficulty remaining seated or staying still and may seem to be in continuous motion.

This also affects the rate of speech of the person which includes interruption in conversations, speaking out loud, and answering questions before they are completed. Studying or reading can be a challenging task for such individuals.


It is a behavior that includes acting without worrying about the consequences which may lead to swift decisions and behaviors that are inappropriate to the circumstances. People suffering from ADHD may find it difficult to control their impulsivity and which will result in difficulty performing normal functioning.

Impulsivity can be the main reason behind disturbing relationships and social interactions as it affects emotionally. Impulsivity makes the waiting period a difficult task as people become impatient and stubborn.


Another aspect of ADHD is forgetfulness in which a person will become forgetful or absent-minded which will lead to missing essential information, staying organized, and completing tasks. As ADHD affects different regions of the brain it may alter the system which controls the memory and it is completely unintentional.

People may often misplace important items which include keys, wallets, or school materials which increases frustration and disruption.

Invisible Symptoms Of ADHD

Beneath the iceberg of visible symptoms lies the extreme and complicated base that defines ADHD. To develop effective arbitrations and support these underlying aspects are crucial and must not be disregarded.

Some invisible symptoms of ADHD include:

image of ADHD Iceberg
ADHD Iceberg

Neurological Factors

ADHD involves a disturbance in brain functions and structure which results in affected persons' behavior, cognition, and behavior. Neurological disorders play a consequential role in ADHD and these neurological causes of ADHD are not fully understood but research has highlighted certain factors that contribute to the disorder such as Dopamine dysfunction.

Dopamine is responsible for attention and motivation. Individuals suffering from ADHD may have low levels of dopamine resulting in difficulty in maintaining attention and staying focused on a particular task. Other factors also include neurotransmitter imbalance, cortical and subcortical differences, etc.


Genetics plays a significant role in developing ADHD. Genetics is considered to be highly congenital, meaning it tends to run in families. Individuals with a family history of ADHD are at higher risk of developing ADHD in comparison to individuals with no family history of ADHD.

Twins who share 100% of their genetic information are more likely to develop ADHD as compared to nonidentical twins who share 50% of their genetic information. Genes such as the Dopamine transporter gene (DAT1) and the dopamine receptor gene (DRD4), which are responsible for the regulation of Dopamine and Brain development, have a high association with this condition.

Impaired Sense of Time

Evidence shows that people who have ADHD develop time blindness, the inability to accurately measure time. They struggle with management issues and can easily lose track of time because of simple distractions. Consequently, they are unable to concentrate and may have trouble planning things in advance. Additionally, having trouble concentrating can result in a variety of problems, such as failing to live up to expectations or demands at work or home. People with ADHD are frequently mischaracterized as being lazy and may be called failures in their personal lives.

Serious Learning Problems

Learning involves using the executive functions of the brain, which include the capacity for concentration, attention, engagement with a task, and working memory. However, ADHD has an impact on these processes and makes learning very challenging. A person with ADHD also processes information differently than someone without it. Studies have revealed that the frontal lobe is significantly underdeveloped in a number of ADHD cases. Communication, concentration, and memory problems are common in people with ADHD.

It is also linked to problems with reasoning and comprehension. Evidence suggests that kids with ADHD may struggle to write, read, organize their belongings, express their emotions verbally, and perform logical analysis. They also become cognitively impaired as a result of constant inattention. It becomes nearly impossible to sit for long periods of time and pay attention without fantasizing about things.

Coexisting Conditions

More than two-thirds of people with ADHD are found to have at least one other coexisting condition. 40% of ADHD patients have oppositional defiant disorder (ODD). This demonstrates a pattern of arguing, losing temper, becoming angry, resentful, and purposefully irritating. Another study showed that 38% of ADHD patients have a co-occurring mood disorder. These mood disorders include depression, mania, and bipolar disorder.

Anxiety disorders are present in 30% of children and almost 53% of adults with ADHD. They are overly concerned with a variety of issues, including school and work, and may feel agitated, stressed out, tired, and tense. Anxiety also makes it difficult for them to sleep well.

Misconceptions Regarding ADHD

While the modern world is becoming more and more accepting and inclusive of ADHD, and the symptoms that come with it, there are a lot of misconceptions that revolve around it too.

That's why it's all the more important, for us essentially, to clear these misconceptions to support individuals suffering from ADHD. Here are a few to educate you, and give you a broader perspective:

  • ADHD is not a real disorder: Some people believe ADHD to be a sign of poor behavior or lack of discipline. However, ADHD is a neurodevelopmental disorder and needs significant medical attention and counseling.

  • ADHD only affects boys: Though ADHD is more frequent in boys as compared to girls, it's increasingly prevalent in girls as well. This is also the reason why it's so misdiagnosed.

  • Everyone has a little bit of ADHD: While it's normal to experience occasional inattention or restlessness, having ADHD is a distinct and persistent pattern of symptoms that significantly impairs daily functioning.

  • ADHD is overdiagnosed: While there may be instances of misdiagnosis, ADHD is a complex condition that requires careful assessment by consulting health care professionals. Proper diagnosis is crucial to provide appropriate support and interventions.

  • ADHD is just an excuse for not trying hard enough: ADHD-related difficulties are real and not a matter of laziness or lack of effort. Recovering from ADHD requires hard work and consistency and must not be neglected.

Key Takeaways

The analogy of the ADHD iceberg illustrates that while hyperactivity, impulsivity, and forgetfulness are apparent signs, there are deeper and more complex aspects that remain unseen. Understanding the visible and invisible components of ADHD is crucial in supporting individuals who face the challenges posed by this disorder.

The visible symptoms, represented by the tip of the iceberg, include hyperactivity, impulsive behavior, and forgetfulness. These symptoms are more apparent, especially in childhood, and can significantly impact a person's daily life, academic or work performance, and social interactions.

Beneath the surface lie the invisible symptoms, driven by neurological and genetic factors. Dopamine dysfunction, neurotransmitter imbalances, and genetic influences play a significant role in the development of ADHD.

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