ADHD in women: A shitty name and a shitty reputation

Have you recently received an ADHD diagnosis? Or are you wondering about the symptoms of ADHD in women?

I'm a 35-year-old woman who has, by all external measures, a relatively successful life. When I say by all external measures, I mean I have a good job, a tidy house when people come over and a well-trained poker face to avoid anyone seeing any shred of vulnerability that I might have. And, I was just diagnosed with ADHD. Read on to see what that looked like for me, you might find some similarities in your own experience.

I went looking for help because by internal measures everything was an absolute fucking disaster. I have a long history of anxiety and depression. I've been chronically ill for more than half of my life with autoimmune disorders (more posts about this soon) and everyone, I mean absolutely everyone (myself included), assigned my mental health issues to the fact that I was medically unwell and that was the reason for being 'behaviourally disrupted' as I tried to move into some kind of functional adulthood. She had so much health stress during those important developmental years, and that's why she's acting up. No one looked any deeper than that.

I didn't know that it's not actually 'normal' for your brain to race across 78 storylines, in 12 different timezones, presented in 6 different mediums all at once. ALL of the time. And that's on a good day. On a bad day, there are no storylines; just endless, overlaid low-res flashes of thoughts, pictures, songs, sounds, memories, future possibilities, anxieties, conversations, birdsong, fan noise, that dripping tap and the heightened awareness of body sensations that chronic illness brings.

I can see, feel and hear all of it at once but I can't grab onto any of it willingly for more than a brief moment. I have no idea what a quiet or still mind looks like. I meditate, and I find it helpful, but boy is it a tricky practice. I constantly feel restless while simultaneously being overwhelmed. I fidget anxiously, I have a hard time finishing anything and I never have work, bills and food sorted all at the same time. I can't even fathom what it would take for me to support anyone outside of myself, I can't keep up with the most basic of self-management consistently. But, I can colour inside the lines and make it look like I'm coping. I don't need you, nothing to see here. Pathological independence stems from garden variety childhood trauma; being raised by baby boomers who tried as best they could but who were damaged by their shell-shocked parents, and so the cycle continues.

I was told I was a smart kid and I just thought that's how smart brains were supposed to feel, I never thought about it as pathology. And actually, I still don't think of it like this - ADHD is also the reason I've found success in some facets of my life but it is something that I needed help managing and understanding. It's a diagnosis I'm not particularly comfortable talking with my people about, and if you've come here to read this, you'll probably be familiar with some of the rhetoric you could expect:

Why is it only a problem for you now? ADHD is a childhood thing so I think your problem is that you're depressed or that you have unresolved trauma

(it was a childhood thing, it just wasn't disruptive to my life then)

You did fine at school when you were young, your teachers were never worried. You were a quiet kid, you weren't bouncing off the walls or being disruptive.

(no, but my mind was bouncing off the inside of my cranium and I was internally disrupted constantly)

ADHD is just an excuse for people being lazy or to outsource their responsibility to drugs and therapists.

(grrr)

Isn't it genetic? The rest of us are fine!

(um, no you're not)

What a lot of people don't understand is that ADHD is one of the most researched neuro-developmental conditions going but it suffers from heavily biased research, stigmatised social attitudes and a definition problem. Much of the earlier data is based on results from boys, not girls. Boys are diagnosed much more frequently in childhood than girls at a rate of 9:1, that doesn't mean there's less ADHD in girls, it means it's getting missed. Unfortunately, a lot of medical research has gender representation problems for various reasons, ladies we get the short end of the stick yet again.

Women have large hormonal fluctuations, and instead of tracking that within the research to make sense of their differences, some studies just exclude women and base their results on males. Much tidier data, much less meaningful. The other issue affecting ADHD specifically is that girls and boys are likely to present very differently with this condition. Boys are more likely to be outwardly hyperactive and disruptive, meaning they get the attention of parents and teachers. Girls are more likely to be inattentive or internally hyperactive; they slip under the radar, especially if they are coping with school or work commitments. We mask, hide, adjust, shrink and bend to fit the expectations placed upon us until we can't anymore. That's the delta between divergent thinking and a disorder.

Let's flip back to where it began. Pre-turn-of-the-century (ew), 90's country Australia (so, basically the 70's still). A little kid, a 'quiet achiever' who never actually managed to complete tasks unless the fear of punishment was overlaid on top. I would skate the line until I was so anxious about the consequences that I could finally find some motivation to start the thing. But I was also pretty sneaky about this (cue: shame and temperamental parents), only occasionally being caught completing homework two minutes before getting in the car to go to school, and even though the work was rushed, my brain absorbed information easily and my grades didn't suffer much. I got caught enough in this behaviour to label me as an occasional truant, not enough for someone to consider there might be an underlying reason for my actions.

I had a hard time making friends with the social, chatty large groups of kids at school, I didn't fit in, always felt ostracised and never really could figure out why. I did often have a best friend, some other weird kid with who I usually became inseparable. Until something changed, like a new school year, which would see me drifting into solitude again, waiting for another strange child to come my way so we could try and figure out together why we didn't fit. Home life didn't help. More than once I was labelled as being stupid, lazy or just plain idiotic, while also being told I was bright; what a way to confuse a child. I still have this internal argument with myself; self-doubt and imposter syndrome echoing the past like a broken record in my mind.

Then come the teenage years. Ohh the teenage years. I go off to high school. I still do well enough academically, my grades excellent in the subjects that I liked and dwindling behind in subjects I was less fond of, but I was broadly keeping up. I never got any better at doing work ahead of time: Due tomorrow? No problem I'll start at midnight! Or tomorrow morning. Can I write 1000 words before school starts if I get up early? I think I can, yeah I'll leave it for now. I was passing as a functional enough person with this behaviour, it wasn't yet a disorder for me. Constant procrastination (not just here and there: every. single. task. ever.) overlaid with intense periods of hyper-focus meant I was getting things done, but I was doing it completely 'wrong', and setting myself up for a lot of confusion and mismanaged time as an adult.

At this time I get sick. Really sick. I was diagnosed with Crohn's disease at age 14 after I spend my days, weeks and months hiding in the bathroom, wasting away, twisted with pain and feeling intense shame about the fact that there was something wrong with me. I already felt so outside of life and this illness pushed me further into the well. I could see the light but there was no way to climb out. It was incredibly disruptive; hospitals, doctors, surgeries, medications, pain, depression, and body image issues.

My school grades got a whole lot worse. That was to be expected considering the circumstances, but, as I understand my mind now I think that would have happened regardless. I think my descent into unmanaged ADHD chaos was masked by my other health issues and as such, my mind was left to its own devices, already not coping in a world that wasn't made for me and I continued to sink further and further into the void. I ended up finishing school, just. I didn't do well. I could not find any focus or drive, and my previous procrastination tactics weren't working for me anymore. Subjects I liked were cast aside, I just gave up on making myself try. I was so tired and emotionally unregulated. My support network had no idea what to do with me and was largely unsupportive. I frustrated them. They didn't understand why I couldn't figure it out. I couldn't understand why I couldn't figure it out. We all decided it was just the way it was and I was left to float into adulthood with some seriously unresolved issues.

So with family relationships in tatters, an absolute truckload of body image issues and no idea of where to go next, I attempted adulthood. I wandered directionless for a while, but after a few years of reckless drug taking, smoking, partying (dopamine, anyone?) and a couple of false starts, I managed to get myself a degree and a job in the real world. Still, not once while studying did I start an assignment earlier than the day before it was due and I came close to failing/dropping out of a few subjects a few times. I tried so many times to be different, but my brain's ability to rationalise out of being organised, even when I knew that the consequences of my actions were going to result in a significant amount of stress, always overrode any well-laid plans.

ADHD, or Attention Deficit Hyperactivity Disorder, is not a deficit of attention. It's such a shitty, frustrating, misrepresentative name. It's regulation of attention that's the problem. Sensory overload, all the signals are coming in and up; and there's no traffic controller telling my mind where to look. So it looks at everything all at once.

Except, for those beautiful moments of hyper-focus. For whatever reason (I still can't figure out a consistent trigger for this) there are moments where all I can do is the one thing that my mind is stuck on, I can do a week's worth of work in a 12-hour day with no food or water only to feel like an empty genius husk at the end of it who is so overwhelmed that I spend the next three days foggy, exhausted and needing to be supine away from the world. But I didn't get fired because I finished the thing, so what's the problem, man?

The other frustrating part of ADHD is that you are more than capable, academically speaking, of achieving the thing that your brain is fighting so hard against. Most of it you could do in 5 minutes with your eyes closed, and while you know this and are actively chastising yourself over not doing the task, you watch your mind make a separate decision not to engage. You feel like a failure again, and again, and again, and assume you are broken and bent, to be thrown into the recycling, there's no hope for you now.

I felt like I was going to break. I felt alone, confused, a little bit crazy and like I just wasn't built for the world we live in. I found some help, I got an ADHD diagnosis and it started to make sense. These disparate, stressful experiences over my lifetime labelled as my personality, my illness, or my disposition; were actually ADHD symptoms rampaging away with no one to guide my brain into a better realm of understanding.

I still feel like it's a secret I need to hide from most; lest someone try to tell me it's not real or judge me for being incompetent. But this diagnosis hasn't turned my mind into pathology. It's given me an instruction manual to understand the world, my perceptions and my senses. It's just the beginning of my ADHD journey, and I'm excited about getting to know and trust my mind, now that I understand she's wired differently.

PS. This was getting too long and I have much more to say. I'll be back, baby.

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