ADHD in Athletes: A Double Edged Sword
As a sport psychologist and former director of an Attention Deficit Hyperactivity Disorder (ADHD) assessment program at a Division I institution, I have seen the unique challenges and advantages that athletes with ADHD experience in the sports environment. Though many people don’t realize it, research has consistently found that athletes are more likely to have an ADHD diagnosis than the general population¹ ² ³. In this blog post, I discuss why this is the case, how ADHD symptoms can show up in sports, and what athletes can do if they think they may have an ADHD diagnosis.
ADHD is a neurological disorder that affects attention, impulsivity, and executive functioning. Executive functioning refers to a set of cognitive skills that include the ability to plan, organize, prioritize, and control impulses. These skills are essential for success in sports, as athletes need to be able to plan their training, organize their equipment, prioritize their time, and control their impulses on the field or court.
Why Athletes May Be More Likely to Have ADHD
Though there are a number of theories regarding the higher prevalence of ADHD diagnoses in sport, many scholars agree that the nature of sports may attract individuals with ADHD³. Sports are high-energy, fast-paced, and require quick decision-making. These characteristics can be appealing to individuals with ADHD who crave stimulation and excitement. Parents are also likely to notice the benefits of sport participation for their child’s ADHD symptoms, leading them to strongly encourage continued participation in sport for their children.
The structure and routines inherent in sport environments are also helpful for athletes with ADHD. People with ADHD are successful when working with clear expectations, routines, and structure. As they progress in sport, they are likely to face higher expectations, more routines, and stronger structure for participation and competition. Athletes with ADHD are likely to excel in these environments because the routines allow them to focus their energy and attention toward what they love: the training and competition.
How ADHD Symptoms Can Appear in Sport Environments
ADHD symptoms can show up in sports in a variety of ways, both positively and negatively. Here are some examples:
Negatively:
Forgetting or misplacing important gear: Athletes with ADHD may struggle to keep track of their equipment or forget to bring necessary items to games or practices. At times, they may misplace their gear. Their lockers typically aren’t known for their organization!
Difficulty with the logistics of traveling: Traveling for games can be particularly challenging for athletes with ADHD, who may struggle with planning and organization. Waiting in lines or at a gate for bus and plane transportation can also lead to restlessness and frustration.
Difficulties with time management: Athletes with ADHD tend to struggle with time management, which can lead to missed practices, late arrivals, or difficulty adhering to a training schedule. Note that it’s not uncommon for athletes to understand that this is a weakness for them and to compensate by setting multiple alarms or developing compensatory strategies (e.g., relying on Athletic Trainer or roommate) to support their time management.
Difficulties watching film: Athletes with ADHD may have a hard time sitting still and focusing for long periods of time, which can make watching film sessions a challenge. Over the years, I’ve noticed a number of athletes with ADHD find it helpful to stand while watching film because they fear they’ll nod off unintentionally due to the lack of stimulation.
Difficulty prioritizing sport responsibilities with other areas of life: Balancing school, family, and social obligations with sports can be overwhelming for athletes with ADHD, who may struggle to prioritize their time and responsibilities.
Difficulty remembering sets or learning playbooks: Athletes with ADHD may find that it takes them longer to learn playbooks. They may also regularly forget the assigned sets for their weight workouts or the structure/splits of interval workouts.
Positively:
Hyperfocus: Individuals with ADHD often have the ability to hyperfocus on tasks that are highly stimulating or rewarding, such as sports. This can lead to a strong focus and intensity during practices and games.
Creativity: Athletes with ADHD may have a unique perspective on the game and be able to think outside the box, leading to creative and innovative play. Coaches often appreciate this in an athlete because it leads to innovative approaches in competition.
High Energy: Athletes with ADHD may have a surplus of energy that can be channeled into their sport, leading to high levels of enthusiasm and excitement. They can serve as a great hype person on and off the field.
Impulsivity: Athletes with ADHD often excel when thinking and acting on the fly, which works great in sport—particularly when they have high levels of confidence and familiarity with the sport. They may be less likely to get in their head during competition, thus leading to very fast reactions and responses in important situations.
What Athletes Can Do if They Think They Have an ADHD Diagnosis
If an athlete suspects that they may have ADHD, the first step is to consult with a mental health professional who is trained in assessing and diagnosing ADHD. This will likely involve psychological testing, which can help to confirm the diagnosis and identify areas of strength and weakness.
If an athlete decides to pursue testing and competes at the collegiate level, it will be important for them to work with a Licensed Psychologist who is familiar with NCAA regulations, as athletes with ADHD may require a therapeutic use exemption (TUE) for stimulant medication. Stimulant medication is a common treatment for ADHD and can help athletes with focus, attention, and impulse control. However, the NCAA considers stimulant medications to be performance enhancing drugs, which means that athletes must apply for a TUE in order to use them.
A Licensed Psychologist who is familiar with NCAA regulations can help athletes navigate this process and ensure that they are in compliance with the rules. Ideally, the psychologist will know how to structure the psychological assessment report to ensure it meets all criteria for NCAA. They can then ask the athlete and/or parent to sign a Release of Information to communicate with their medical team (e.g., athletic trainer), who will then complete the documentation needed to take stimulant medication if desired.
In addition to seeking professional help, athletes with ADHD can take steps to manage their symptoms and improve their performance. These may include:
Develop a routine: Establishing a consistent routine for training, practice, and competition can help athletes with ADHD to manage their time and prioritize their responsibilities.
Use visual aids: Visual aids such as calendars, to-do lists, and reminders can help athletes with ADHD stay organized and on task. I’ve had some athletes keep a checklist of items near the front door of their door or inside of their locker so they can double check everything.
Practice mindfulness: Mindfulness practices such as deep breathing, meditation, and visualization can help athletes with ADHD improve their focus and attention.
Get enough sleep and exercise: Regular exercise and adequate sleep are important for managing ADHD symptoms and improving overall mental health. Sleep deprivation decreases executive functioning levels, so it’s essential for athletes with ADHD to prioritize rest & recovery.
Conclusion
In conclusion, athletes with ADHD face unique challenges in the sports environment, but they also have the potential to experience benefits that neurotypical athletes may not. Understanding how ADHD symptoms can show up in sports and seeking professional help can help athletes with ADHD to manage their symptoms and improve their performance. If you suspect that you may have ADHD, don't hesitate to reach out to a mental health professional for an assessment and guidance on how to manage your symptoms. With the right support and strategies, athletes with ADHD can thrive in sports and achieve their goals.
References
¹ Poysophon P, Rao AL. Neurocognitive deficits associated with ADHD in athletes: a systematic review. Sports Health 2018;10:317–26.
² Putukian M, Kreher JB, Coppel DB, et al. Attention deficit hyperactivity disorder and the athlete: an American medical Society for sports medicine position statement. Clinical Journal of Sport Medicine 2011;21:392–400.
³ Hyun Han D, McDuff D, Thompson D, Hitchcock ME, Reardon CL, Hainline, B. Attention-deficit/hyperactivity disorder in elite athletes: A narrative review. Br J Sports Med 2019; 53:741-745.
