The ADHD Iceberg, Explained
Practical strategies for what you see—and what you don’t.
Posted August 21, 2025 | Reviewed by Abigail Fagan
“ICEBERG! Right ahead!!!”
Perhaps you remember this famous line from the iconic 1997 movie, “Titanic.” Panicked, the ship's captain alerted the passengers and crew that they would soon strike a nearby, mostly invisible iceberg with 90% of it obscured underwater. Within 30 seconds of sighting the iceberg, the ship made impact, sending everybody scrambling for safety amid the frigid waters. Had they been able to see more than only 10% of the iceberg and adjust their course, disaster might have been averted.
The lessons learned from the ship’s collision with the iceberg also offer a glimpse into the seen and unseen challenges of ADHD. The tip of the iceberg — the 10% we can see — represents behaviors and symptoms that are characterized as being “external”. Often these are seen in the hyperactive /impulsive type of ADHD. Meanwhile, the largest portion of the iceberg (what we can’t see) — represents those hidden symptoms and challenges that go unseen, characterized as being “internal”. These tend to be associated with inattentive ADHD or are evident in the combined type of ADHD.
As we enter a busy fall season, let's explore the visible and hidden ways ADHD may impact your life, work and relationships. By understanding the ADHD iceberg model (first coined and depicted by Chris A. Ziegler Dendy), you'll be better prepared to create tools to manage its challenges, avoid unforeseen dangers and have smoother sailing.
The Iceberg We Can See — The External
Externalizing behaviors are frequently seen in the classroom, at the workplace and at home. They are easily observable and measurable, typically manifesting in inattention, impulsivity, and hyperactivity. They are related to conscious executive functioning skills such as verbal, behavioral and emotional impulse control, organization, time management , initiation and prioritizing. In children and teens, we see this tip of ADHD more in boys than girls in common behaviors such as fidgeting , talking too much, interrupting others, moving around the classroom and physical aggression .
In adults, externalizing behaviors can manifest as missed deadlines, trouble with finances, tardiness, disorganized living spaces, difficulty remembering important dates or events, interrupting others, talking too much, job instability and strained relationships.
The Iceberg We Can’t See — The Internal
Internalizing ADHD behaviors are characterized as being less observable to others and frequently rely on someone’s self-report of their challenges in managing them. These internal traits include a restless or wandering mind, low self-esteem , distractibility, inability to sustain attention , trouble with shifting or flexibility, overwhelm, limited self-awareness, poor working memory and shame .
Both types of these challenges exist in some form for everybody with ADHD. What’s under the surface of the water often shows up in combination with anxiety or depression , especially in girls and women with inattentive ADHD. Dealing with all of these issues requires patience, sensitivity, and a genuine desire to understand the “whole person.”
Masking and the ADHD Iceberg
When the symptoms of ADHD remain hidden within the ADHD iceberg model, people rely on a coping response called “masking.” Both children and adults can engage in masking behaviors. Masking allows the person to conceal how their condition affects and limits their functioning.
ADHD masking is about conforming to neurotypical standards to avoid the shame and stigma related to being neurodivergent. It typically develops as a coping tool in childhood that continues into adulthood, even though it may no longer be useful. Over time, masking becomes tough to maintain and prevents people from sharing who they really are. Cady, age 36 (concealed identity ) says: “I appear very organized to the outside world but underneath I’m a hot mess.”
Some of the consequences of masking can be serious and negatively affect your daily life, relationships and work. These can include:
5 Tips to Navigate the ADHD Iceberg
Now that you have a better understanding of the ADHD Iceberg and what it represents, let's explore the steps you can take to address emotional dysregulation, masking and low self-esteem while promoting healthy well-being and authentic acceptance.
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Katie Kerwin McCrimmon, Uch. (2024, July 30). Try identifying “three good things” each evening to boost happiness . UCHealth Today. https://www.uchealth.org/today/identify-three-good-things-daily-to-boos… ’s%20clinical%20trial%20showed%20that,11%2C%202020.
ADHD iceberg: Chris A. Zeigler dendy consulting . Chris Dendy | ADHD. (n.d.). https://www.chrisdendy.com/iceberg
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Sharon Saline, Psy.D. , is a clinical psychologist and an expert in how ADHD, LD, and mental health affect children, teens and families. She is the author of What Your ADHD Child Wishes You Knew .
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.