Adhd's Impact On University Students: Challenges And Strategies

Attention-deficit hyperactivity disorder (ADHD) can present a unique set of challenges for university students. Research suggests that students with ADHD are more likely to drop out of university due to the overwhelming challenges that a new learning environment can present.

The transition to university often involves leaving an existing social structure and joining a new one, learning a new schedule, remembering new academic materials, and figuring out how to live independently for the first time. These changes can be especially difficult for people with ADHD, who often struggle with executive functioning challenges. Executive functioning skills are essential for organisation, planning, and time management – all of which are vital for success in a learning environment, particularly university.

Students with ADHD often face difficulties with time management, organisation, and prioritisation. They may struggle with being on time, preparing and planning for the future, and completing tasks. They may also experience social issues, negative thoughts, and poor self-esteem.

However, there are several strategies that can help students with ADHD stay on track. These include setting alarms, working with their urge to procrastinate, studying smarter, scheduling study time, and implementing strategies to stick to their plans.

Poor academic performance and achievement

The main reason for this is that people with ADHD often struggle with executive functioning challenges. Executive functioning skills are essential for being able to effectively organise yourself, plan things, and manage your time. These are essential facets of being successful in a learning environment, particularly university, where you are in charge of the majority of your own schedule and have a high level of self-autonomy. If you have ADHD, you might find it challenging to manage your time, organise your tasks, or prioritise your workload.

It is not uncommon for students with ADHD to be late, miss deadlines, or forget about things. It is not that they are lazy or don't want to do their work, it is because their executive functioning skills are not neurotypical, and therefore they naturally struggle more with these aspects of life and learning.

Students with ADHD may also have rejection sensitive dysphoria (RSD). This is when criticism draws a strong emotional response, meaning students with ADHD who get feedback on their assignments may take it to heart and feel more put down by it, even if it is constructive criticism. This can make it hard to take feedback on board. RSD can also affect social rejection.

Students with combined ADHD or hyperactivity ADHD may find it hard to concentrate in a university setting. University lecture theatres can be large and full of hundreds of other students, many of whom might be eating, chattering, using laptops, or be on their phones. There are a lot of stimuli and distractions within university lecture halls and large seminar rooms, and this can make it hard for someone with ADHD to concentrate.

Students with ADHD may try to follow along with the lecture, but the environment they are in may not be conducive to how they learn best, meaning they struggle to keep up or might miss parts of the lecture because they are distracted.

Troubles with time management

University students with ADHD often have irregular lifestyles due to poor time management. They may struggle with being on time, preparing and planning for the future, and prioritising tasks. This can be particularly challenging when moving to university, as students are often living independently for the first time and have increased responsibility for managing their own schedule.

To improve time management skills, university students with ADHD can try the following strategies:

• Set multiple alarms to allow time for distractions and to ensure they don't oversleep.
• Remove all distractions for a set period of time to focus on the task at hand.
• Work on tasks in small bouts, taking regular breaks.
• Set up reminders on their phone for deadlines and other important events.
• Think about the consequences of being late or not doing something when deciding which tasks to prioritise.
• Record lectures in case they get distracted and forget to take notes.
• Take advantage of peer tutors or focus groups for extra support and instruction.
• Contact the college's disability service office to discuss any special accommodations they may need, such as extended test-taking time or a private exam room.

Difficulty regulating and managing emotions

Social Issues and Poor Self-Esteem

Students with ADHD often struggle with social issues and experience negative thoughts, leading to low self-esteem. They may find it challenging to build and maintain friendships and other relationships. The transition to university can be particularly difficult, as they navigate a new social environment and try to establish meaningful connections.

Extreme Reactions and Emotional Outbursts

University students with ADHD may exhibit extreme reactions in their interpersonal relationships, such as sudden emotional outbursts, including episodes of excitement, screaming, or anger. They might also tend to suppress their negative emotions or practice avoidance, which can further complicate their social interactions and lead to relationship difficulties.

Continuous Worry and Anxiety

These students often find themselves trapped in repeated cycles of negative thoughts and worries. They may obsess over past events, ruminating on regrets and failures. This can lead to increased anxiety and self-doubt, affecting their overall well-being and academic performance.

Impact on Academic Performance

The emotional challenges faced by university students with ADHD can also impact their academic performance. They may struggle with feelings of dissatisfaction towards their grades and have difficulty starting and completing tasks. Procrastination and poor time management can further contribute to their academic challenges.

Strategies for Improvement

To improve their emotional regulation and management, university students with ADHD can benefit from various strategies:

• Developing healthy routines: Establishing a consistent daily routine, including regular sleep and eating patterns, can help reduce feelings of overwhelm and improve emotional regulation.
• Time management techniques: Using planners, calendars, and reminders can help students stay organised and manage their time effectively, reducing feelings of anxiety and improving emotional well-being.
• Seeking professional help: Therapy, such as cognitive-behavioural therapy (CBT), can be beneficial in changing negative thought patterns and improving emotional regulation.
• Medication: Taking prescribed medication as directed can help manage ADHD symptoms and improve overall emotional well-being.
• Social support: Connecting with other students with ADHD or joining support groups can provide a sense of community and help students feel less isolated.

Substance and alcohol use

Research has shown that college students with ADHD are more likely to use alcohol and drugs at higher rates than their peers. This is likely due to the increased academic and social demands, reduced parental support, and elevated risk for anxiety and mood disorders that college students with ADHD experience. These students may also be more prone to binge drinking and are more likely to engage in behaviours associated with problematic drinking. For example, students with ADHD who were treated with stimulant medication were more likely to report drinking-induced blackouts, losing friends or romantic partners because of drinking, and even hospitalisation due to drinking.

The misuse and diversion of ADHD medications are also common problems on college campuses. The prevalence of stimulant medication diversion by students with ADHD was found to be 26% in the previous 6 months, 35% in the previous 12 months, and 62% during their lifetime. In addition to diverting their medication, college students with ADHD frequently deviate from taking their medication as prescribed by taking it more frequently and/or at higher doses, using it in conjunction with drugs and/or alcohol, or intentionally misusing it to get high.

Given the significant risk of stimulant medication misuse and diversion, clinicians should consider establishing contracts that require students to use their medications appropriately and clearly explain the potential medical and legal consequences of misuse and diversion.

Medication treatment

The issue of medication adherence is further complicated by the fact that many students with ADHD transition from living at home to living on their own during their college years. This means that they must learn to manage their medications independently, which can be challenging. Here are some strategies that can help college students with ADHD manage their medications effectively:

• Develop a medication routine: In college, students need to target their medication to be effective when they need it. This may involve taking medication all day, every day, or only during class time. Working with a healthcare provider to develop a comprehensive medication plan is essential.
• Anticipate refill needs: College students must monitor their medication supply and plan to get refills on time. They can work with their family physician or use student health services at college. It's important to discuss the logistics of both options in advance.
• Take medication as prescribed: It's crucial to take the prescribed dosage, as this is the amount determined to be the most effective for the individual's brain chemistry. Taking more medication will not enhance its effectiveness. If the medication is no longer working, it's important to consult a doctor.
• Watch for shifting side effects: Side effects of ADHD medication can be impacted by lifestyle changes, such as the transition to college. Meeting with a doctor to understand potential side effects and what to do if new ones occur is essential. Encouraging students to monitor their feelings and take notes can help make informed decisions.
• Don't share medication: Sharing medication is illegal and can be dangerous. Stimulants may be harmful to people who are not diagnosed with ADHD. College students should keep their medication safely locked away and never share it with others.
• Limit alcohol consumption: Stimulant medications can amplify the effects of alcohol, leading to faster inebriation. It is generally recommended to drink less when taking stimulant medications. Consulting a doctor to determine the best strategy for alcohol consumption is important.
• Monitor medication effectiveness: It is the responsibility of the college student to monitor the drug's effectiveness and side effects and to refill the prescription as needed. Discussing any concerns with a healthcare provider is crucial.
• Find a local healthcare provider: Regular monitoring of medications by a local healthcare provider or university health services is essential to ensure the dosage remains optimal for the individual.
• Find a local pharmacy: Determining where to order and pick up medication is crucial, especially if the student is far from home. Setting reminders to refill prescriptions on time is also important.

Frequently asked questions