When I was diagnosed with Attention Deficit Hyperactivity Disorder (inattentive type) two years ago, at the age of 42, a friend asked me if I was going to write about it. Maybe in the future, I told her. I needed time to process the diagnosis. It felt scary and shameful to disclose having a condition that’s so stigmatised and commonly associated with uncontrollable young boys – not a fortysomething former solicitor and mother of two.
And yet my overwhelming response to being diagnosed was ultimately a feeling of relief and a sense of peace. I’d finally found the self-acceptance I’d been searching for since I was a teenager.
You might not have even realised that October is ADHD Awareness Month – especially among adults, the disorder remains stubbornly hidden within society. While the most prevalent diagnoses are in children – around five per cent – and most of them male, between the ages of six to 12, it wasn’t until as recently as 2008 that the UK’s National Institute for Health and Care Excellence (NICE) recognised ADHD as an adult condition.
Earlier this month, NICE published guidelines to help doctors recognise the disorder in certain previously under-diagnosed groups, noting that girls and women often have their ADHD missed or misdiagnosed because they do not exhibit the “classic” symptoms of hyperactivity. This is certainly true in my case. My symptoms – overthinking and overfeeling – are standard for someone with the inattentive type. In February of this year, a major imaging study published in The Lancet Psychiatry concluded that the brains of people with ADHD are smaller in five key regions, including those governing emotions and motivation. This reinforces what has has previously been widely accepted: that ADHD has a physical cause and adversely affects a person’s executive functioning skills, like organising and planning, regulating emotions, processing and prioritisation, initiating tasks and staying focused without getting distracted.
With a distorted concept of time, despite the condition’s name, people with ADHD don’t have an attention deficit, we have an attention allocation deficit. It’s not that we can’t pay attention – often we spend far too much on the wrong things. Where we struggle greatly is paying the right amount of attention to the right thing at the right time.
It’s imperative we learn to see the signs – research shows that girls with ADHD are at least four times more likely than other children to self-harm and attempt or commit suicide
Rather than being disruptive in the classroom, girls like me sat quietly and politely, being mentally rather than physically hyperactive. Our bodies might not have been bouncing off the walls but, as chronic daydreamers and worriers, our thoughts were certainly bouncing about inside our heads. We kept silent about our problems with organisation because, well, wasn’t it something we were meant to be good at? After all, it was women who were traditionally tasked with basic and mundane “upkeep” duties, either in the home as a wife and mother, or in the office as a secretary. Generally speaking, boys tend to express their restlessness, anxiety and anger outwards, while girls tend to direct theirs inwards – which makes it difficult for others to spot the problems that girls themselves may have noticed. But it’s imperative we learn to see the signs – research shows that girls with ADHD are at least four times more likely than other children to self-harm and attempt or commit suicide.
Typically for a woman who found out she had ADHD in her forties, I was first diagnosed with depression and anxiety. I’d grown up assuming – and often being told – that the reasons why I never did well in school exams, reacted intensely to situations and chronically daydreamed were because I was stupid or lazy or crazy… or simply strange. After sitting my maths A-level paper, a classmate asked why I’d got up during the middle of the exam to get graph paper that no one else had needed. “Oh, that’s just Ness doing something weird as usual,” another classmate remarked, snidely.
Looking back now, however, I can clearly see that me going off on a tangent that day – in a test about tangents – was my ADHD in action. I’ve come to accept that this trait of mine to do things differently and go my own sweet way can be a strength. Thinking creatively and abstractly, I see connections and patterns in disparate concepts and objects, and am good at coming up with metaphors and analogies.
Despite repeatedly failing to meet my academic potential, I persevered and managed to become a lawyer and writer. It wasn’t until I began to suspect that my daughter had ADHD that I realised I had it, too. What I read about the condition, which has a strong genetic component, seemed to be describing me. My GP, however, didn’t believe I had it and refused to refer me for an assessment. When I was eventually diagnosed as having “moderate-severe” ADHD, both the psychiatrist and I were surprised at how high my overall score was. He said that, like many intelligent women with undiagnosed ADHD, I’d managed to overcome some of the limitations of the condition by adopting coping strategies and working incredibly hard. It’s true, but it’s taken me a while to fully appreciate all the effort I must have put in over the years to compensate for my ADHD.
At the start of this summer, my 12-year-old daughter was also diagnosed with ADHD, after years of investigation. (If you were under the impression that it’s easy to get a diagnosis, you are gravely mistaken.) When I asked for permission to mention her ADHD in this piece, she said I must, to “help raise awareness about how ADHD is different for girls”. And so I’m writing about mine in the same hope – that it’ll help others not to feel as inadequate and misunderstood as I did.