Understanding Inattentive ADHD: A Hidden Struggle Behind Misunderstood Behaviours

Inattentive Attention Deficit Hyperactivity Disorder (ADHD) is a frequently overlooked neurodevelopmental condition that affects an individual’s ability to focus, organise, and sustain attention. Unlike the more widely recognised hyperactive-impulsive type of ADHD, individuals with the inattentive subtype often internalise their struggles, leading to a host of misconceptions and interpersonal challenges.

The Complexity of Inattentive ADHD

Inattentive ADHD is characterised by persistent difficulties with attention, concentration, memory, and executive functioning. Those affected may appear forgetful, disorganised, or even disengaged in social or professional contexts. This presentation lacks the overt restlessness or impulsivity commonly associated with ADHD, which often delays diagnosis, especially in adults.

Because symptoms are largely internal and less disruptive to others, people with inattentive ADHD may be mislabelled as lazy, careless, self-absorbed, or emotionally volatile. These misinterpretations can have a damaging impact on self-esteem and social confidence, often leading to a sense of chronic self-doubt or “not quite fitting in.”

Case Study: Emily’s Experience
Emily, a 34-year-old marketing consultant, came to the clinic expressing deep frustration and confusion about how she was perceived in both personal and professional settings. She shared:

“I’ve been diagnosed with inattentive ADHD recently, and it’s like suddenly my whole life makes sense. I always thought I was just bad at life. I talk too much and get excited, and then feel like I’ve overshared or come across as showing off. Other times I’m low-energy and people assume I’m being a miserable cow. It’s exhausting trying to manage people’s perceptions while also trying to manage my own brain.”

Emily’s story is far from unique. Individuals with inattentive ADHD often mask their symptoms by overcompensating—talking quickly to keep up with thoughts, using humour to distract from anxiety, or withdrawing altogether when the social load becomes overwhelming. These strategies, though adaptive in the short term, can lead to further misinterpretation and emotional fatigue.

Through a comprehensive assessment and subsequent diagnosis, Emily was able to reframe many of her experiences. Her impulsive speech wasn’t arrogance—it was a symptom. Her emotional fluctuations weren’t moodiness—they were the result of cognitive overload and executive function fatigue.

Why Recognition Matters
A diagnosis of inattentive ADHD can be life-changing. For many, it provides a long-overdue explanation for years of difficulty, shame, and misunderstanding. Recognising the condition allows individuals to:

• Understand the neurological underpinnings of their behaviours and emotional responses

• Develop self-compassion and reduce internalised blame

• Access appropriate therapeutic strategies and, where appropriate, medical interventions

• Communicate more effectively with others about their needs and experiences

Importantly, diagnosis opens the door to evidence-based approaches that help individuals manage their symptoms rather than mask them. Cognitive-behavioural therapy (CBT), executive functioning coaching, and mindfulness-based practices can support emotional regulation and task initiation. Adjustments in the workplace, such as structured routines and visual planning tools, can also significantly reduce overwhelm.

Living Well with Inattentive ADHD

Living with inattentive ADHD involves not just managing symptoms, but embracing a different cognitive rhythm. For Emily, therapy helped her recognise when she was “masking” and taught her to set boundaries around overstimulation. She began using task management tools tailored to ADHD and worked with her employer to structure her workload in a way that played to her strengths—creativity, strategic thinking, and empathy.

Importantly, Emily also learned to rewrite the internal narrative. Rather than seeing herself as “too much” or “not enough,” she began to recognise the richness of her inner world as part of her neurodivergence.

Inattentive ADHD can be an invisible source of daily struggle, yet with the right support, individuals can learn to thrive—not in spite of their differences, but because of them. Understanding the condition, reframing past experiences, and embracing neurodiversity are crucial steps towards living with authenticity and confidence.

If you recognise aspects of yourself in Emily’s story, consider speaking with a psychologist. Diagnosis is not about labels—it is about liberation.

You said:
How does it interact with alcohol use? what causes it and how does it present in childhood are there childhood issues that cause it or is it genetic?

ChatGPT said:
Great follow-up questions. Let’s expand on the article with a section that explores the causes of inattentive ADHD, how it presents in childhood, and its relationship with alcohol use, particularly in adults. This will maintain the professional tone and relevance for your psychologist clinic.

Causes of Inattentive ADHD: Nature, Not Nurture
Inattentive ADHD is primarily a neurodevelopmental condition, meaning it originates in the brain's development—most often with genetic roots. It is not caused by poor parenting, trauma, or social factors, although these can influence how the condition is expressed or managed.

Genetics play a substantial role, with studies showing that ADHD tends to run in families. Specific genes involved in the regulation of dopamine—a neurotransmitter critical to attention and motivation—are commonly implicated.

That said, certain prenatal and early life factors can increase the risk or severity of symptoms. These include:

Premature birth or low birth weight

Prenatal exposure to nicotine, alcohol, or environmental toxins

Traumatic brain injury during early development

While trauma or adverse childhood experiences (ACEs) do not cause ADHD, they can mimic or exacerbate its symptoms, leading to complex diagnostic challenges. Children who have experienced neglect or inconsistent caregiving may appear inattentive or emotionally dysregulated, making a thorough psychological assessment essential.

Childhood Presentation: The Quiet Type
Inattentive ADHD often goes unnoticed in childhood, especially in girls, due to its subtle presentation. Whereas hyperactive-impulsive children may draw attention through disruptive behaviour, children with the inattentive subtype may be described as:

Daydreamy or “off in their own world”

Forgetful, losing belongings, or missing instructions

Slow to start tasks or complete work

Disorganised and poor at time management

Struggling to follow multi-step directions

Sensitive to criticism and prone to internalising failure

They may be mistakenly labelled as shy, anxious, or lazy. Their academic performance may fluctuate widely, depending on interest and structure. Unfortunately, this often results in delayed diagnosis—sometimes not until secondary school or adulthood—when executive demands increase.

ADHD and Alcohol Use: A Risky Relationship
Adults with inattentive ADHD may be at increased risk for problematic alcohol use, for several reasons:

Self-medication: Alcohol can temporarily reduce anxiety, restlessness, or social inhibition. Those with undiagnosed ADHD may use it to cope with feelings of inadequacy or overwhelm.

Impulsivity and emotional dysregulation: Even in inattentive types, impulsive decision-making and poor emotional regulation can lead to binge drinking or difficulty moderating intake.

Executive dysfunction: Challenges with planning, foresight, and memory can contribute to unsafe or unstructured drinking habits.

Interestingly, while hyperactive-impulsive ADHD is more strongly associated with substance misuse overall, the inattentive subtype is also vulnerable, particularly among individuals who internalise their struggles and may drink to “switch off” or escape.

Early diagnosis and support can mitigate these risks by helping individuals develop healthier coping strategies, increase self-awareness, and reduce shame around their behaviours.

Integrating Insight into Clinical Practice
At the London Psychologist Clinic, we approach ADHD not as a deficit, but as a difference in cognitive style—one that can be understood, supported, and even leveraged with the right interventions. Our assessment and executive coaching pathways provide clients with the clarity and tools they need to manage their symptoms, improve relationships, and make meaningful behavioural changes.

Understanding the developmental trajectory and common comorbidities of inattentive ADHD allows us to offer holistic care that goes beyond symptom control—towards long-term wellbeing and empowerment.