The Oxford English Dictionary describes a ‘crux’ as ‘a particular point of difficulty’.1 

 An ‘ADHD Crux’ can also be described as the tipping point: the stage, juncture or instance when a realisation that ADHD may be responsible for difficulties and challenges experienced on a daily basis occurs.

Research and understanding into the aetiology of ADHD has resulted in an upsurge of adults realising that ADHD could be responsible for the difficulties they may be experiencing.

ADHD is highly prevalent in the prison population. Although it may seem an extreme example of an ADHD Crux it is, unfortunately, very common:

‘A meta-analysis of 42 studies indicated that 25.5% of the prison population met the criteria for ADHD. These data suggest that compared with the general population, the prevalence of ADHD is 5-fold higher in youth prison populations (30.1%) and 10-fold higher in adult prison populations (26.2%) (Young S, 2015).’ 2

Yet, despite these figures, there is no system in place, upon incarceration, to screen offenders for ADHD. A diagnosis followed by treatment and support could be the juncture in their lives that facilitates long-lasting change.

An aspect of ADHD that is not discussed as widely is the overly trusting nature that can accompany it. This could, possibly, be linked to Rejection Sensitivity Dysphoria (RSD). It has been described as extreme sensitivity and pain triggered by the perception – real or imagined – of being (Dodson W, 2016).3

A person with ADHD who is triggered, easily, by RSD may offer their time, energy and finances, becoming a ‘people pleaser’ to ensure acceptance. Therefore, taking advantage of a person with ADHD can be a common occurrence.

Tony (42) recalls his personal experience of this:

“My step-father wasn’t very loving or attentive. He preferred that we were seen and not heard. The fact that he didn’t want anything to do with me made me want to please him more. When I was 20-years-old he bought a house in my name. I signed the paperwork, I suppose, out of a need to be loved and accepted.  

“He rented out the property but was always missing mortgage payments. I would make up the payments to avoid disruption to my credit score. Years later he re-mortgaged the house and I, stupidly, signed the paperwork. He spent all the money (£70,000), left me with the debt and I had to declare bankruptcy. It was one of the lowest and darkest points in my life.

“It was during counselling that ADHD was mentioned so I sought out a diagnosis. Since it has been confirmed that I have ADHD I am more aware of RSD and how it intertwines with ADHD.”

Stories like Tony’s are too common and frequent. Unfortunately, the ADHD Crux occurs at a time when the devastating effects of undiagnosed ADHD are at their peak.  

Social media has played a part, with increasing awareness around ADHD. Online forums and support groups encourage questioning and appreciative enquiry. For Tony, strength-based coaching propelled him towards taking ownership of his ADHD diagnosis and he now feels empowered and excited for the future: 

“I have discovered so much about me through my diagnosis. Sure, I was resentful and angry for the decisions I made and the way that I was taken advantage of. But, if it wasn’t for the fact that I lost everything I wouldn’t have found out about my diagnosis and wouldn’t be where I am today.

“I found an ADHD Life Coach who has helped me take back control. It has, literally, been life changing.”

The TotallyADD website features an article from Certified ADHD Coach and Nurse Practitioner, Laurie Dupar, who cites Five Warning Signs That Could Be Your Tipping Point: 4

  1. New problems at school.
  2. Inability to cope after significant life changes.
  3. Unable to transition, successfully, into a new role at work.
  4. Change in family dynamics.
  5. Physical injury.

Dupar also says: “…remember, a ‘tipping point’ means that you are at a crossroads and you have a choice which way you will react – you can continue down that path to chaos and overwhelm, or you can get restructured and relearn ways to to cope and get back on track!”

The Crux of ADHD can happen indirectly, as was the case for Claire. Her daughter had been struggling in school and the teacher had mentioned that ADHD may be something to look at.  Claire was blind-sided. Through a series of assessments and observations of her daughter in the classroom, combined with a variety of paediatrician appointments, she was finally diagnosed at the age of nine.

“At one of the appointments, my daughter’s paediatrician commented that I should get assessed for ADHD. I laughed as I thought he was joking. He explained that ADHD was highly heritable and pointed out some observations he had made.  

“I was diagnosed eighteen months later. It’s been a whirlwind of a journey but I feel that I understand my daughter more and can manage her behaviours and challenges so much better than before this all happened. I get it. I know what she’s going through.”

So, the Crux of ADHD can occur at any time. The examples above are quite common and have similar, positive, outcomes. With the increase in awareness and understanding of this much-maligned condition, it is hoped that Claire and Tony’s experiences will become a thing of the past along with the Crux of ADHD.






Written by Beverley Nolker, Education Development Officer for Psychiatry-UK and the HLP.U Clinics.