People often think of Attention Deficit Hyperactivity Disorder (ADHD) as affecting how people think and behave, like being easily distracted or inability to sit still and focus. Being classed as a ‘learning difference’ or ‘neurodiversity’ means that people can assume it is about the brain and therefore primarily impacts the brain – but what about other parts of the body?  Here, we explore four examples of how ADHD can also impact someone’s body and reflect on these in relation to school and workplace accommodations.

These examples are taken from personal experience and may not reflect everyone’s experience of how ADHD affects their body as every person is different. The author has opted to write anonymously due to previous experiences of stigma in the workplace in relation to their ADHD.

1. Random bruises – from accidentally knocking into door handles to more regularly having minor accidents, ADHD can impact how people move about in the world and the risks they take. It is not uncommon for me to find that I have bruises of ‘unknown origin’ as I can’t remember what caused them, and they can take a while to heal. Working in familiar places tends to help as I have learned how to manoeuvre my body in those spaces and can take care of regular trip or bump hazards.
2. Sore muscles and joints – as either super active and needing to move a lot or being stuck in an awkward position for hours as I’ve not recognised the passage of time, my muscles and joints are rarely in the ‘ergonomic’ position we’re supposed to adopt in the workplace. Daily stretching helps, but years of physical therapy and investigations have resulted in me learning that my body is more likely to be regularly sore and tight, my joints need extra support, and I need external prompts to remind me to check on my posture. Being able to move during the workday can also be very helpful.
3. Headaches – sensory overload and/or forgetting to eat and drink enough throughout the day (both of which are linked to my ADHD) means that I am liable to get headaches. Working in spaces with lights, sounds and temperatures I cannot control, or needing to engage socially with lots of people, can be triggers. The headaches can be intense enough to be distracting and stop me from working effectively. As someone who might otherwise struggle to focus and get things done, this added layer is not only painful but also incredibly frustrating.
4. Fatigue – there are times when the cumulative toll of trying to ‘manage my ADHD’ (or ‘mask’ as some call it), or even just do ‘normal things’, is all too overwhelming and I burn out. The exhaustion is like no other that I’ve experienced and can be so intense in its presentation that doctors seek to rule out other possible causes, including testing for thyroid conditions and cancer. For me, it tends to build up as an experience of being more fatigued than usual, and needing more breaks and rest, although what feels ‘restful’ may actually be physical activity and seem counterintuitive. In the workplace, trying to prevent this kind of fatigue is not always easy to manage when one is not completely in control of one’s diary or workload.

Why it matters in the context of accommodations

School and workplace accommodations are changes made to the environment or job to enable a person to perform the task – they are vital for providing equal opportunities. This can include assistive technologies, changes in schedules, and additional support with certain types of tasks. This approach to accommodations recognises the social model of disability, which focuses on removing barriers for people and recognises that such barriers can be disabling. 

When it comes to ADHD, the application of such adaptations can sometimes overly emphasise enabling the person to be ‘more effective’ – for example by targeting concentration and time management. The person with ADHD may be left to implement these on their own or to continuously have to advocate for them in the workplace (i.e. request more frequent movement breaks in long team meetings). Peers/administrators/colleagues may not appreciate the importance of also addressing environmental and social factors, especially if a person’s productivity appears to be ‘good’ or on par with others.

These examples show why it can be useful to think about ADHD more broadly when considering school and workplace accommodations, and to consider the wider wellbeing impact of accommodations. This can include considering how accommodations can support someone to reduce the physical impact they experience, such as ensuring someone is not unnecessarily suffering from headaches or becoming exhausted. This shift of focus can mean that ‘effectiveness’ is not the only goal of accommodations. It also recognises that ADHD does not only impact a person’s thinking and behaviour but also how the combination of environment and ADHD can be felt within the body.

A longer version of this article was previously published on OU News.