Do you have a history of shoplifting?
Do you start things without reading the directions first?
Do you finish other people’s sentences?
These are the kinds of questions that the psychiatrist who diagnosed my attention-deficit/hyperactivity disorder — whose initials I have considered tattooing on my forearm because I love him so much — asked me from a computer screen three years ago, a week into pandemic lockdown.
That meeting was full of surprises, not only because at almost 40, I felt pretty sure I knew everything about myself, but also because I was usually the one asking people these questions.
As an educational psychologist, I have taught people with ADHD, researched them, led workshops about how their brains work, and diagnosed dozens of them. I have sat in an office across from many parents and children, detailing the strengths and challenges that come along with ADHD. Over years and years, not once had I wondered if my own rapid-fire thinking and speaking, my tendency to swing between overly ambitious plans or no plan at all, and my history of saying the wrong thing had any connection to ADHD, the very thing I advertised to clients as my top area of expertise.
Why? Not because I’m an idiot (though I do sometimes leave my keys in the fridge), but because everything I’d learned about ADHD was wrong.
In the countless hours I had spent poring over ADHD studies, dense theoretical tomes about ADHD, and practical books full of suggestions to help people with ADHD, I had rarely seen myself reflected. I had seen images of boys jumping out of their seats and struggling to make friends, of ADHD as a disorder, something that incapacitated people unless they had access to a steady supply of Ritalin. I didn’t see myself.
Then one day, a friend, a fellow mother and one of the smartest people I know, told me she’d received an ADHD diagnosis and it had changed her life. She straightforwardly said she thought I, too, had ADHD and pressed me to get an assessment. I agreed, but I didn’t for a moment consider that a professional would diagnose me. I knew the assessments, I knew the criteria and I knew myself, didn’t I?
In receiving my diagnosis, I learned two critical things about ADHD that have profoundly influenced my understanding of myself and of the people with whom I work. The first is that ADHD does exist in girls and women, but it manifests quite differently. For example, “H” in ADHD, which stands for “hyperactivity,” classically conjures an image of a child bouncing off of the walls.
Though I do have trouble sitting still, my hyperactivity mostly shows itself in the form of extremely fast thinking and talkativeness. If I get going on an idea, my mind races over a thousand related ones. When people talk, I often finish their sentences or cut them off, not because I don’t care, but because it feels like ages since I figured out what they were going to say. I monologue. I interrupt. I explain things, to my husband’s frustration, in several different ways before I feel I’ve made my point. There are positives to all of this, of course — incredible productivity at times, effective brainstorming, lively conversation.
Another example of how ADHD can manifest is impulsivity, which doesn’t make it into the moniker but is in many ways the hallmark of ADHD. In several of the ADHD-diagnosed children I’ve worked with, this takes the form of doing things without thinking, as well as grabbing or hitting. In teens and adults, this sometimes looks like extreme risk-taking — experimenting with excessive drugs or driving way too fast.
But for girls and women, who are more likely to internalise things compared with boys and men, this impulsive behaviour may turn inward. Girls with ADHD are more likely to have anxiety or self-esteem issues, to self-harm or attempt suicide, and to binge eat.
The second thing I learned is that girls and women are more likely to compensate for their ADHD-related challenges and appear more functional than they really are. I came to understand that I had exerted incredible effort over the years to keep myself afloat. Because I had been socialised, more than my male family members, to please and be liked, to be helpful and social, I had pushed through. But all that masking had taken its toll. Becoming a mother had only expanded the gulf between what was expected of me and what my brain was actually good at, until swimming across it was no longer tenable.
One of the other reasons I believe that my diagnosis took so long, even for someone who had been seen by countless therapists and psychiatrists, was that I was not alone in my misconceptions about ADHD. Many ADHD questionnaires, which are sometimes the only piece of evidence a professional uses to bestow or withhold a diagnosis, don’t really cover the manifestations of ADHD that women like me demonstrate. Many are denied diagnoses for this reason, or for the reason that they are “too successful” to actually have what is still widely considered a disorder. This doesn’t take into account the ways that women are taught to compensate for and mask such behaviours. The rates of adult ADHD are rising, and this increase is likely due in part to women learning more about what ADHD can look like for them.
In classic ADHD fashion, and because I continue to write and teach about ADHD in a variety of settings, I haven’t been able to shut up about my diagnosis. I tell my story as a plea for humility among professionals ― that there is so much we are still learning about conditions like ADHD. Things that I never thought twice about, like how I never stay in one place while leading a three-hour seminar, or how I drag my feet on one assignment but complete another like a fire is under me, now become teachable moments to take back to my colleagues and my family, with my children and I talking openly about the wonderful and tricky sides of my “ADHD brain.”
And of course, as I share my story, other women tell me theirs. The tribe is deep and growing, and includes scores of wise women who have given me windows into my own experience — like writer Joan Wilder, cartoonist Dani Donovan, coach and podcast host Katy Weber, and therapist K.C. Davis.
Everyone tells me my daughter, who will be 5 next month, is my double. She is spunky, sharp and social. She knows all the lyrics to an entire Carly Rae Jepsen album, and when we put it on, her whole body lights up. Like me, she can turn a straightforward task like getting her shoes and socks on into a journey of epic proportions. There is always a question to ask, an idea to entertain, a hummingbird outside the window that bears recognition. I don’t know if she, too, has ADHD, but unlike a few years ago, this is not something I fear.
Slowly, women are changing the narrative by finding well-informed professionals and good diagnoses, accepting partners and support groups, humour and empowerment, and, through all this, finding relief.
Sarah Wheeler is a writer, educational psychologist and consultant based in Oakland, California. She publishes the online newsletter Momspreading.