Have you ever felt like you are stuck to the sofa in your living room? You know you have lots of things to do, washing, housework, tasks for your job, school tasks, commitments you’ve made to people, but for some reason you just cannot motivate yourself to do them. Or maybe you have one single commitment to attend to, but it doesn’t happen until late afternoon and until then you are entirely unable to focus on anything at all? If you have, you may have ADHD traits.
In my personal experience of learning about ADHD, it can be easy to believe or even perpetuate the idea that ADHD is something that exclusively affects children, and disproportionately boys over girls. But this is not the case at all.
ADHD is still a condition that is touted as simply an excuse for children to get away with bad behaviour at school which is, in all honesty, complete nonsense, and quite frankly
really sad. ADHD as a disorder can be extremely frustrating, isolating, and if untreated and misunderstood can have a hugely detrimental effect on the person’s overall wellbeing.
So, how can we start to change this? Well, simply by educating ourselves a little more. What better time to start than Mental Health Awareness week? I was lucky enough to sit down with a wonderful friend last week, on the loudest street in our town, to discuss her experiences of undiagnosed ADHD as a child, the process of diagnosis as an adult, and the difficulties that stemmed from being a girl in terms of detection and diagnosis.
Let me preface this by telling you a little about Chloë and the reasons why I knew she would be a great person to discuss this topic with. I met Chloë about three years ago, fast forward to now, and she’s one of my absolute closest friends. She is unbelievably intelligent, open-minded, accepting, and shares a common love of writing and mental health awareness with me.
She also has an incredible talent for phrasing complex topics in eloquent and palatable ways. Chloë and I have had various discussions surrounding the lack of education and awareness about ADHD over the past year. As someone who has now almost completed two degrees in mental health and psychology, I have never had a lecture dedicated
to the disorder and will admit that I am woefully unaware of all the intricacies that entail living with ADHD.
Let’s start at the beginning. Chloë knew from a young age that she was struggling and believed it was ADD (ADD and ADHD are now combined into one term and subtypes are identified). She benefitted from pre-existing knowledge of ADD and ADHD due to her brother’s diagnosis, although their symptoms presented differently, as they often do between boys and girls.
When describing the ways in which ADHD manifested in her life, Chloë talks about being a major daydreamer, excelling at the coursework side of the classes she enjoyed at school but struggling with the restrictions of exam settings, and battling against talking her classmates’ ears off.
Herein lies the issue of a lack of formal diagnosis. Chloë recalls a time at school where she was moved to a lower set for English (one of her favourite subjects!) unilaterally by the teacher because she had been talking a lot in class and was disrupting another student, “it was a punishment” she says, the outrage still palpable in her voice even now. Her ardent tone is absolutely justified, it’s abhorrent to know that a child can be punished simply for being unstimulated by a lesson.
Add to that the fact that the punishment is likely to make the problem worse and actively stifles the individual’s education and prospects in life. This made it glaringly obvious that an increase in education around identifying and
accommodating ADHD behaviours in school is desperately needed.
Chloë specifically states that she would have benefitted in some ways from having a formal diagnosis when she was at school. For example, she would have been given extra time during exams to allow her brain to plan in the way it needed to in order to get thoughts onto paper in a coherent manner.
We both agree that a general increase in knowledge of ADHD among educators is the major step needed in helping kids who are struggling with ADHD symptoms. The ability to identify, as mentioned above, allows for the necessary accommodations to be put in place for a child.
It also means that steps can be made towards obtaining a diagnosis, parents can be informed about why their child may be struggling to thrive within the school environment, and even if nothing huge changes, a child can feel seen and understood when they are at school which in itself is a huge stride and can have massively positive effects on a child.
But what about acquiring a diagnosis as an adult? And as a woman? To say that the process has been laborious is an understatement, although a slight benefit of the doubt has to be given due to the pandemic disrupting mental health services. From setting the process in motion to the point she is at now, Chloë has been fighting to get diagnosed for two years.
She describes what her mental state was like at the start of her adult journey with ADHD. A trigger for a significant depressive episode was the culmination of four conflicting university deadlines. Trying to split her focus across the different topics seemed almost impossible. Now she can recognise that as Hyperfocus which is a common symptom of ADHD and trying to fight against it was exhausting. Ending up only having three of the four papers ready in time, she felt like a failure, “I was like: why can’t I just do it?!”.
The confusion of not understanding why she was unable to complete her assignments, combined with symptoms of Rejection Sensitivity Dysphoria (Another common symptom of ADHD sufferers) proved to be just too much to handle alone. She says, “It got to a point where I was sleeping for twenty-two hours a day”, she would also lean on substances to help alleviate the anguish in her brain.
She began where I think most people begin their mental health journeys, she was prescribed antidepressants and began a course of therapy to help her work through the issues she was facing. In addition to this, she began to take notice of her diet and lifestyle, changing up the kinds of food she was eating, making a conscious effort to exercise more. So far, so textbook.
Chloë still wasn’t seeing the results she wanted or would reasonably expect from all the work she was putting into her mental health, so she turned to research. Normally Dr Google is a physician I would never recommend to anyone, but armed with pre-existing knowledge of mental health conditions, a strong knowledge of peer-reviewed papers, and a steely determination to find out what was truly going on in her head, she came to the realisation that all of the symptoms she was experiencing, all the habits and behaviours she had, all the ways in which she reacted to situations fit into a neat diagnosis.
Chloë speaks about discussing the research she’d done with her friends and sharing what she’d learned, for them all to say the same thing: ‘that’s so you!’.
Once she was satisfied with her own, informed conclusions the next step was to talk to her GP. Initially, she was met with a doctor who was receptive to her concerns but underwhelming in their confidence of diagnosis. The first assessment completed by Chloë and her doctor was unfortunately rejected, which is not the way anyone would wish to start the journey to mental health diagnoses.
A return visit to the doctor after the initial rejection was met with a heartening level of support, and with the added information that there were pre-existing diagnoses of ADHD on both sides of her family the doctor was a lot more enthusiastic about the prospect of diagnosis.
After being asked by the doctor to bring along paper evidence of the traits that Chloë had experienced for as long as she could remember, such as school reports and letters from friends, she responded in the wonderfully ADHD way of presenting the doctor with a huge mind map and 8 solid pages of reasons why she was a model ADHD case.
A sense of urgency was applied to the referral and assessment process after admittance of previous suicidal ideations as a result of the negative symptoms of ADHD. It is sad, but not unexpected that people’s mental health has to have gotten to such a desperate point before any level of importance is applied to getting a diagnosis. This is where the timeline ends, for now, it’s simply a waiting game and a fight against Covid delays to get the diagnosis that Chloë has been working so hard to get.
“Whether that means that I just have a piece of paper that says I have it, or whether that means I go on medication, or whether that means I can find a therapist that specialises in coaching and management of ADHD. I don’t care, I don’t have a preference, but I just want that diagnosis so that I don’t feel like such a fraud when I say to people: I’m sorry if I’m talking too much, I’m sorry if I drop out of this conversation. I want to be able to say: and yes I am diagnosed”.
This is the quote from our conversation that I could almost repeat word for word without the recording because it resonated so much for me and I’m sure it will for so many others too. Sometimes a diagnosis is all we need to help alleviate some of the struggles that we face with our mental health. And sometimes, as sad as it is, we need that piece of paper to feel valid, because more often than not people are just not believed if you don’t fit an outdated, offensive stereotype of a mentally ill person.
When asked about the stigma surrounding ADHD, especially as a woman, or someone who does not present with physical hyperactivity, it’s lovely to hear Chloë tell me
that she thinks it is improving steadily as more awareness is created, as more conversations happen surrounding the ways in which ADHD can manifest in people.
She also notes that one of the reasons it may be more difficult for girls to get diagnosed with ADHD is that girls are expected to mature quicker than boys and are made to learn how to effectively conceal the hyperactivity that they are feeling, and how to navigate the world in socially accepted ways.
“When you’re told that’s not you, that must be wrong, you have no idea how complex the behaviour is and the root of that behaviour and where that behaviours come from and why it’s there and it can be for a million different reasons, but the masking behaviour is doing its job if you can’t see that they have it”.
This is a perfect example of that eloquence I mentioned at the start. This feels like such a perfect explanation of the barriers faced by girls who suffer from ADHD and the reason it can take so long for someone to even begin the process of reaching out for help.
There is really only one last quote from our conversation that I want to leave you with and I hope that it is something
that sparks a conversation among people reading this, especially this Mental Health Awareness Week and Month. On the topic of stigma, Chloë uttered these wonderful words of wisdom!
“I think that’s come off the back of the mental health stigma lifting, and I think this will be the next thing, neurodiversity will be the next thing that becomes way easier to talk about and be understood especially with the links to depression. It’s like we can talk about all having depression, but the next logical step is to talk about where that depression comes from, and for me, it’s that”.
A simple depression or anxiety diagnosis should not be the end of the discussions we have around our mental health. We need to normalise exploring the root causes of the issues we are experiencing and to add to what Chloë said, we need to normalise the idea of comorbidities. It should not be shameful to have more than one, or even change mental health diagnoses over time.
Mental health is complex and almost impossible to compartmentalise, comorbidities do not necessarily make someone ‘more mentally ill’, it just means that diagnostic criteria is broad and vague and sometimes things like to go hand in hand. To get better, or simply to understand what you are experiencing, you need to have comprehensive diagnoses. It is nothing to be ashamed of.