Nobody thought to assess me for ADHD as a child. As an adult, I’ve come to realize I have almost textbook ADHD, thanks in part to a really great article in the Atlantic. For many academically high-achieving women, ADHD becomes indistinguishable from anxiety. I spent a decade treating anxiety that never quite went away, but when I found a sympathetic psychiatrist and started treating it as ADHD, I suddenly felt better.

In retrospect, the symptoms seem obvious. I startle easily, because when I am working on something I find interesting, I am entirely gone to the world. I forget things if I don’t keep meticulous notes. I interrupt people and forget what I’m saying midsentence. If you give me a worksheet, I probably won’t complete the back or anything that is shown in a box; I won’t read the boxes on menus, either. Every notebook I have has pages of repetitive doodles I use to pay attention.

The number of academics I know with diagnosed or suspected ADHD is high, but as a graduate student, that wasn’t even on my radar. Now, as a faculty member, I regularly make accommodations for undergraduate students, but graduate study is less structured and typical supports don’t always apply. Extra time on exams, for example, is useless in a program that has no exams. I’m writing here less as a person who has ADHD and went to graduate school (although I am one), and more as a person who advises graduate students and happens to have experience with ADHD. So, with that preamble, I want to explain here a few things about ADHD and how they can play out in the context of graduate school.

Rejection sensitive dysphoria is the worst

Rejection sensitive dysphoria is an ADHD symptom that shapes how people experience interactions with and feedback from other people:

Rejection sensitive dysphoria is an extreme emotional sensitivity and emotional pain triggered by the perception — not necessarily the reality — that a person has been rejected, teased, or criticized by important people in their life. Rejection sensitive dysphoria (RSD) may also be triggered by a sense of failure, or falling short — failing to meet either their own high standards or others’ expectations.

William Dodson, “How ADHD Ignites Rejection Sensitive Dysphoria” [link]

Basically, everything goes from 0 to 11 with no warning. For some people, this type of emotional extremism is constant, and for others it can be an occasional symptom

Graduate school can be an RSD nightmare. A graduate student with ADHD might experience gentle feedback meant to encourage mild revisions as a devastating personal failure, a suggestion that they cannot complete graduate school, or worse.

Clear communication can help, as can allowing students time to reflect. So, for example, you might schedule a meeting to discuss a student paper in two parts rather than one: One brief meeting to give feedback, and another brief meeting to discuss the revision plan. This gives the student time to process the feedback privately so they can give their full attention to a plan for revising. Alternately, you might give the feedback in writing a day or two before a planned meeting to discuss.

In either case, make a clear, unequivocal statement about what has been done well and what potential the project has. Encouragement and reiteration never hurt anyone. Additionally, be clear about what your expectations are for revision in terms of what must be done and how long you’d estimate it will take. “You need to define your terms,” for example might mean “You need to spend 30 minutes adding a couple sentences on page 1 and page 4” or it might mean “You need to massively restructure this whole thing.” Many students don’t intuitively know the difference, and students with ADHD are very likely to assume the worst.

Time is definitely fake

Most people have time blindness at least occasionally, but people with ADHD tend to experience it more. I show up for meetings either very early (like, weirdly early) or slightly late. And, like many people with ADHD, I’m extremely deadline oriented. The eleventh hour is in many ways the only hour, because nothing feels pressing until it’s extremely pressing.

Artificial, self-imposed deadlines often do not work for people with ADHD. Real deadlines usually work, but sometimes only because the person with ADHD has learned how to leverage shame to get things done — this works, but it’s really bad for people’s wellbeing.

The adviser’s role isn’t to walk a graduate student through every part of a process that is highly individualized. However, advisers can help by setting real, incremental deadlines for projects and finding ways to be firm but flexible with these. For example, if a student misses a deadline, you should check in with them but avoid scolding them. State the problem clearly: “I’m checking in since you missed the deadline we discussed for your draft of chapter 2.” But, remember to reiterate the real scope of the problem and withhold judgment: “This is probably going to put you a little behind on your goal, so let’s come up with a new timeline that can work.”

Students with ADHD generally shame themselves more than enough for a lifetime, and as mentors and teachers, we need to remember that our job isn’t to make people feel bad about themselves as people.

Structure helps

To expand on the point about time and deadlines: Many people with ADHD greatly benefit from structure but struggle with breaking tasks into component parts and roadmapping them. This piece about task initiation is aimed at parents of children with ADHD, but much of it holds for adults. Starting things is hard. Seeing them through to the end is hard. Figuring out which parts are salient and important to pay attention to right now when you struggle to regulate attention is almost impossible.

Spending a few minutes mapping out a project with your graduate students can save them a lot of suffering and is a great practice to model. With some supervision and in-person feedback, most students can probably manage most of this themselves, but the types of high achieving students who tend to wind up in grad school have likely snuck by without having to learn to do this on their own. (Sort of like how they maybe got to college without learning how to study.)

As a professor, my desk is covered in notes and so are the two pinboards I use for task management — which are right behind my monitor so I can see them at a glance. As a grad student, I didn’t have a static workspace or a clear model for how to task manage meaningfully. Help your student experiment with and find a way to road map so they can do the larger scale projects graduate school expects of them.

This is the same type of pedagogical process we use in designing course projects; those same scaffolding practices can help graduate students reach their full potential. Many students can figure this out on their own, but the odds of a student with ADHD being able to without some kind of torturous process are low.

Grad school should be difficult, not impossible

If you’re reading this thinking students with these types of needs can’t cut it as academics, you’re wrong. These are reasonable acommodations that students with ADHD might need in a graduate setting. Modifications and supports like these can help students–the same students your admissions folks deemed capable of completing graduate study–flourish rather than flounder.

I’m loathe to fall into “ADHD is really a superpower,” but for all the difficulties and challenges ADHD can present, people with ADHD tend to excel at certain kinds of work. The same big picture thinking that makes roadmapping difficult can mean someone excels at system-level problem solving and making unexpected connections. A tendency towards hyperfocus can drag someone down a rabbit hole, but for many researchers, rabbit holes are the path to inspiration. Unusual approaches and thought processes can be the basis of increased creativity.

The point of this article is not to say students with ADHD can’t excel in graduate school: they absolutely can. My point, rather, is that we need to be thoughtful about scaffolding and acommodations so that we are ensuring all students have the opportunity to excel. What I am offering here is a partial guide and starting point for figuring out how to do that.