ADD People are smart

The vast majority of people with A.D.D are smart. They are also almost universally underachieved to the level of their intellect. Because they haven’t done well in school or frequently have had career failure and disappointments, which may negatively impact their self-esteem and render them feeling unsuccessful, still that does not make them any less intelligent. And many ADD people are very smart, so smart in fact that the early grades of school offer little or no challenge to their performance capacity. Either they can pay “enough attention to get it” or, as ADD people always end up doing, they develop successful (initially, at least) in-the-moment compensatory strategies to enable them to succeed. They cut corners, they wait till the night before and than “perform under pressure”, they find smart friends who take good notes in class, and sometimes they cheat. They adapt as they need to and do so as a functional adaptation (a “survival strategy” if you will).
For some, the strategy falls apart early, in elementary school (or even prior). Others sail through high school and undergraduate college and university (admittedly a smaller cohort). The largest single factor is often when the level of the intellect and the effectiveness of the compensations reach the breaking point related to the degree of difficulty and complexity of the tasks required. In other words, the functional capacity is no longer able to meet the demands and challenges of one’s life. It is not that one has “developed” ADD in your 20’s or 30’s; it is that your ability to adequately cope is no longer effective (“fraying at the seams” is the term I often use to describe it).
— Mayer Hoffer M.D., F.R.C.P.(C.), B.Sc.(Med.), Dip. Ch. Psych., Diplomate of the American Board of Psychiatry and Neurology Psychiatrist specializing in the diagnosis and treatment of ADHD across the life cycle

A Doctors ADHD Education - At Best, Two Lectures!

The training of a medical student is typically 4 years in duration. The first year is spent digesting a huge amount of basic material – anatomy, physiology, pathology etc. The second year continues the process of basic science with an exciting introduction to some patient contact. The third and fourth years are largely hospital and clinic-based as the imparting of clinical knowledge proceeds. Final examinations are completed at the end of the fourth year followed by a hospital-based internship of 1-2 years leading to one becoming a GP (general practitioner) or FD (family doctor). Time spent in a psychiatric rotation generally amounts to 1 or 2 months in total. During that time, Attention Deficit Disorder will have amounted to one lecture, maybe. (Ironically, most GP’s and FD’s who may have found psychiatry “boring and irrelevant” while in school will be the first ones to tell you that mental health issues represent 1/3 to 1/2 of their daily work load and most wish they were better trained to deal with it.)
Following completion of the process of becoming a doctor, either after a few years of practicing or immediately after completion of the internship, a graduate physician who wishes to become a psychiatrist can apply and, if accepted, enter a residency program of 3-4 years duration to study psychiatry. In the current manner, a training psychiatrist studies general adult psychiatry and, if he or she so desires, can “specialize” in child and adolescent psychiatry. Again, in the process of becoming a general adult psychiatrist, the sum total of teaching about A.D.D is one lecture (or, at best two) with some clinical discussion depending on what cases are seen.
That’s the good news. Leave aside that what is taught is frequently outdated and misleading crap. But right from the inception, Attention Deficit Disorder is improperly positioned.
— Mayer Hoffer M.D., F.R.C.P.(C.), B.Sc.(Med.), Dip. Ch. Psych., Diplomate of the American Board of Psychiatry and Neurology Psychiatrist specializing in the diagnosis and treatment of ADHD across the life cycle

Most of my adult psychiatric colleagues will not diagnose or treat ADHD

The majority of ADHD patients will never be diagnosed nor treated. Most of my adult psychiatric colleagues still will not diagnose ADD and will not treat ADD. Sounds a bit crazy, doesn’t it?Unfortunately, lots of doctors feel a great deal of pressure to appear like they know everything about everything. In particular, my psychiatric colleagues can get very nervous, prickly, and combative when they are confronted by their patients asking them questions about Attention Deficit Disorder. Most of them don’t know too much about the area and are nervous about their lack of knowledge and familiarity. And in psychiatry, it is fairly easy for a clinician to divert any discussion away from A.D.D. – the “ bullshit baffles brains ” approach. I am forever dumbstuck by the number of times new patients in assessment tell me how many times they have approached doctors and specialists about their own concerns that they may have ADD only to be told that “it’s not important” or “it doesn’t exist” or “we’ll look at that after I treat your depression/ anxiety/ personality disorder” or “there are much deeper issues to look at.
— Mayer Hoffer M.D., F.R.C.P.(C.), B.Sc.(Med.), Dip. Ch. Psych., Diplomate of the American Board of Psychiatry and Neurology Psychiatrist specializing in the diagnosis and treatment of ADHD across the life cycle