ADHD at college – where are we now?

What is the first thought that comes to mind when you hear “college”? In movies, college is often portrayed as a one long party with infrequent visits to the library and lots of football. The reality, in most cases, is that college life is far more stressful. The academic pressure, increased perception of competition, building new social groups and finding your place is hard enough, not to mention when ADHD is added to the mix. We speak to Dr. Antshel, Professor and Director of Clinical Training Psychology at Syracuse University, to learn more about how ADHD affects college students.

Firstly, are college students under too much pressure?

I have a biased opinion (I work for a college), so you need to consider that. I would take a step back and suggest that this idea of pressure starts even back in elementary, middle and high schools. I don’t think this is a college-specific problem. In general (within US culture), there is an increased emphasis on performance and outcomes, which is associated with increased anxiety and depression that we are seeing in today’s youth.

Colleges undoubtedly are part of that problem, but my experience is that these students arrive on campus already feeling the pressure to perform. In my opinion, there is not much change in pressure from high school compared with going to college. I think it might be a small change in the sense that everybody at college has the same capacity or ability level whereas in high school you are working with peers with a wider range of abilities.

What are the unique challenges that college students with ADHD face?

There are a variety of things that are specific to ADHD that make college ‘the perfect storm’. The first is that college students, for the most part, are away from home for the first time. They have their independence which contrasts with the level of support they had back in high school. We know that one of the defining characteristics of ADHD are difficulties exerting functional independence and I think this environment can therefore create difficulties.

Furthermore, we must not forget that college is not just about academic development but also students’ social development. We know that people with ADHD can face challenges with social development, and this is important to be aware of as an educator or for anyone responsible for identifying and supporting students with ADHD at college. There are also concerns about the misuse of stimulant medications which is, unfortunately, increasing in prevalence. There have been cases where college students with ADHD who have a prescription for stimulants are approached by peers for their medication. That, combined with some of the social difficulties that they may have, increases the likelihood that they may distribute their medication to their peers.

ADHD also appears to have a stigma at college – why do you think that is?

There are several reasons for that in my view. Stigma is an attitude which can lead to prejudice and discrimination. College is primarily defined by academic and social development – both of which can be challenging for college students with ADHD. When their peers (without impairment) see them having these difficulties, I feel there is a tendency to try and label them as ‘ADHD’. The label isn’t so much the problem, although many students are concerned about being labeled. It is the behaviors themselves that are creating the stigma – I’m referring to the stereotypical behaviors like turning up late for class and the embarrassment associated with that or being unable to recall the answers for an assignment. I think that’s one explanation.

Another explanation is that ADHD is often viewed in a skeptical way by college professors. For example, those with ADHD are entitled to testing accommodations, and are allocated extra time on tests. I am certainly aware of college professors who think this is an unfair advantage. They have the opinion that because these students have made it to college, they must be bright enough to do well and therefore they should not be given these extra allowances. I have had to emphasize that ADHD is not about intelligence – those with ADHD are certainly intelligent enough to do well in college. Unfortunately, I think that some college administrators, professors and instructors, through their skepticism of ADHD, may in fact be contributing to that stigma.

What can be done to reduce stigma at and beyond college?

As a field, we have not done a great job yet. 10-15 years ago, there was a movement in psychology that believed that if we emphasized the biological nature of these conditions, that it would reduce the stigma. Despite this biological evidence, the stigma is still there. Simply knowing that a condition has biological underpinnings does not remove the prejudice or the stereotypes. My interpretation is that the stigma is attributed to how much control people perceive that others have over the actions.

The best approach is to increase contact between people with and without ADHD, to grow the understanding that ADHD as a condition is not entirely within a person’s control. People learn that those with ADHD are not choosing to act like this. Take the example of some classic ADHD symptoms such as forgetfulness. Working on an assignment with someone with ADHD who may forget key facts and figures – that is not something anyone can fake. This builds a level of understanding for the impairments they are facing.

Recommended read: Learn how college students can get support for ADHD. Dr. Antshel gives his thoughts on facilitating success with ADHD at college.