I’m a Black Woman with Adult ADHD: 3 Integral Aspects of My Treatment
Thesis: Treatment for ADHD is more than just taking pills before I head into class or my workspace. It is a spiritual, emotional, and physical process. I’m a better person today because of it. However, I’m still a work in progress and that is the most beautiful part of it all.
First, I must give thanks. There isn’t a way to express how grateful I am for the outpouring of love I’ve received in the past week. It has been touching, affirming, and motivating. I was moved by the number of you who reached out and shared with me intimate stories of your own diagnosis, avoidance of testing/therapy, and experiences with stigma. I cherished you all opening your hearts, many of whom I have never met in person. Thank you for showing me that there is an undeniable power within storytelling.
Treatment is one of the most interesting, nonlinear, life-giving, yet stress inducing aspects of living with ADHD. What I thought would be a relatively simple experience, has been a long journey of trial and error, adjuvant interventions, and lifestyle changes. Here are three foundational aspects of my treatment that have made my journey successful so far.
1. My Treatment Involves Support
After I came back from my week long hiatus, I sat down with my program director to talk. I updated her on how my summer really went and gave insight on the chaos that was actually occurring behind my smile.
“This PhD program will always be here, but we need Morine to be well first”.
I heard that numerous times in the weeks to follow and I am beyond grateful that my institution saw me as more than a research minion. They saw me as a human being with needs. In the kindest way ever, she and my mentors gave me the option to take the remaining half of the semester off and regroup. I chose to stay, possibly part ego and part I was 4 years into graduate school at that point and I was ready to be done. Looking back, although I do not regret continuing, I definitely underestimated the amount of work it would take to get my treatment plan in order. Nevertheless, I have realized that the levels of kindness, empathy, and immediate support I received and still continue to receive are an atypical response to ADHD. For this, I am forever grateful.
However, my support wasn’t all a bed of roses outside of the nursing school. After I got tested, I shared my diagnosis with a couple close friends.
“Oh no girl, we aren’t speaking that over your life!”
“Be careful with those diagnoses, you know they just tryna label people all the time.”
“So you answered all the right questions to get them to give you pills?”
Besides access and finances, I would say the biggest barrier to treatment of these neurodevelopmental issues is… you guessed it… stigma. Stigma is defined as a negative attitude towards a group of people based on a specific characteristic. The effects of stigma can vary, from not disclosing your diagnosis to full on refusal to participate in life saving interventions because of the negative perceptions of society. Stigma within different areas of healthcare is variable and affects some groups more than others. For example, consider your reaction to someone stating they have cancer and they are receiving lifesaving treatment. Now, consider your reaction to someone stating they have HIV and are receiving lifesaving treatment. I’d guess you probably were sympathetic and saddened by the cancer diagnosis, yet you may have been taken aback by the person disclosing their HIV status, even questioning how they may have gotten infected and what about their lifestyle led to their current state. If so, you just proved the theory of stigma correct.
Disclosing the results of my testing made me not want to share it with more people and made me hesitate to take my medication some days.
“Do I really have a problem?”
“Is this just a placebo effect of the medication; is this a real issue for people?”
Besides a couple close friends and someone who I consider my spiritual mom, most didn’t know. To be honest, most of my family found out from last week’s post. So for a while, I just chilled on the whole idea of sharing. However, living in silence made things difficult for me because I was habitually being triggered to resort back into the person who never asked for help. Many were stigmatizing the disorder and couldn’t comprehend how there could be any associations with me. THE Morine, the one who always kept it together but just needed to try harder. However, I often reminded myself of the raw emotions and experiences from the day of testing. I came as my truest self, no one could take that experience away from me. Overtime, I have developed some AMAZING friends who are in the ADHD trenches with me. Encouraging me, swapping new ways of studying, and new ways of accepting the positive aspects of our diagnosis. Social media has also been helpful in this as I’ve found several accounts that share graphics and articles about ADHD specific interventions.
Since I am a young Black woman in America today, I understand I can’t refute many of their hesitations and I don’t want to be tone deaf to the history of medicine in the U.S. I can understand many of their fears as medicine has a long history of mistreating Black and Brown citizens within health sciences research. However, in the case of ADHD, it is a disorder that is actually underdiagnosed in African Americans and Latina groups in the U.S despite studies showing similar rates of prevalence when compared to Caucasian populations. The overdiagnosis of our communities is not supported by statistics and many people may be confusing the overrepresentation of minority groups in special education classrooms with ADHD outcomes. However, ADHD is not a learning disability. It is a disorder that affect the brains ability to remain attentive. In fact, many people with ADHD have an average of above after IQ.
Implicit bias (the soft way of saying RACISM) of healthcare providers is a well-established factor perpetuating much of the diagnostic and treatment disparities in African American communities. Furthermore, the lack of resources in some communities often has young students with ADHD placed alongside children with learning disabilities when they actually need behavioral modification coaching and medical care. Unfortunately, this is not unique to ADHD. The disparities in diagnosis, treatment, and outcomes are known to pervade in other specialties in medicine as well. However, it is the stigma of mental health disorders in general that has led to the pushback of ADHD and other disorders being accepted as valid.
Being fully aware of the stigma within my community and within my own self, I took on the task of finding providers who not only were qualified to care for my ADHD, but who were also well-versed in my entire identity as a Black woman.
2. My Treatment Involves A Provider I Trust
Securing a psychiatrist I trusted was the most annoying aspect of treatment because the process (in my geographical area) is completely antithetical to the way people with ADHD operate. My school has a strict policy on in-house psychiatrists not prescribing ADHD medications, so I got a list of providers in my area who accepted my student insurance and it was up to me to find someone to manage my care. Many mental health providers have independent practices, so they often handle their own scheduling through voicemail boxes without the help of an in-office secretary. It was aggravating at worst, frustrating at best. When someone with ADHD sets out to do something, they expect immediate results and if it doesn’t happen quickly, it can be pushed by the wayside for days, even weeks. Some called back within a day or two, while some didn’t call back at all. It was frustrating because when I would get the phone call back, I would have to ignore it because I was giving my attention to something that I was probably running behind on with a fast approaching deadline. Also, the phone number listed for the only psychiatrist I could confirm was Black, was not updated with her new contact information so I had very little desire to speak to my “backups”.
As time passed by, I bit the bullet and got myself an appointment with a provider basically walking distance from my apartment, but something didn’t feel right. He was an older white male who was well-accomplished, but I feared he wouldn’t understand my hesitancy about taking medication, the emotional barriers I was going to face within my community, and I didn’t want to deal with him possibly not taking my symptoms seriously. I did more digging and found the same Black psychiatrist’s email address. When I emailed her, she responded within 24 hours and I was in her office a few days later discussing treatment and ways to get me back on track.
Many believe that ADHD is simply treated with these crazy stimulant medications and nothing else happens. When I was given the Adderall prescription the first time, that was all sorts of terrible practice. I was given twice the baseline dose and no follow up treatment to discuss how I felt. My current psychiatrist told me to expect coming in every 2 weeks until we found an effective dose and a plan that worked for me.
Over time, I realized that I had to be very patient. I would become productive with a medication, however, sometimes those doses wouldn’t keep up with certain demands of my program. We tried short acting, long acting, low doses, maximum doses, and different classes. I even tried just taking the medication Monday through Friday. I had to become more aware of myself. I had to figure out what was working and for how long. Some medication would be great for maybe the first 4 hours of my day and then I would begin drifting off in my thoughts losing productivity. Other doses, I would become very jittery and constantly felt like I was coming off a caffeine high. It took about 4ish months for me to settle on my class and dose of medication where I go in every other month to touch base and see if it has remained effective. I take it every day including weekends because ADHD wasn’t just affecting my schoolwork, it was also affecting my person life and spaces. Along with my depression medication and regular therapy, I’ve got a good thing going so far. When I have the heat of my dissertation phase on the horizon, I may try to augment my therapy to meet those stressful demands until I submit the final manuscript. Again, ADHD isn’t a learning disability, so it isn’t like this pill gives me the superpower to write fantastic essays or the ability to interpret my logistic regression models better. It does, however, help me to clearly and consistently write for a block of time and not make careless mistakes in rushing to write my statistical results.
Also, I’ve incorporated MANY non-pharmacological interventions. On the broader landscape, I have a planner to help me keep my appointments and assignment deadlines. It also has space for me to write all my daily tasks that I can spend time prioritizing in the morning or when I get my day started. Before any calendars are checked, I have some quiet time through journaling and prayer. Setting my mind on the present with calm Christian worship instrumental music to slowly get my mind working, but not over stimulated is also helpful. I’m still trying to figure out the best time to work out in the gym. Sometimes it’s a good way to overcome writer's block during the afternoon or a nice way to wake me up in the morning. I’ve been playing around with timing but overall, I have been able to get through a good hour to hour and a half work out without interruption. While doing school work, the MOST effective technique has been the Pomodoro method. It is where you set a timer for 35 minutes of intense focus and 10 minutes of break. Even if you are in a good groove, you still take the break. It will reduce the risk of you getting burnt out later on and just not finishing your work.
My personal space has gotten revamped too. When you are constantly forgetting items because you pack 1–2 hours before you head to the airport, you tend to buy multiple items over and over again or items you wouldn’t normally like. For example, I had so many toothbrushes, toothpastes, half used deodorant bottles, or random hair products that took up unnecessary space. I had several dresses, pants, and tops that didn’t fit me right because I bought them last minute to complete an outfit moments before an event. Luckily, just months after my diagnosis, Netflix blessed me with the show Tidying Up. I binged the episodes, watched YouTube videos, and studied free guides to minimalism. I then used the KonMari method and purged many clothes and random items to final give some order to my spaces. Cleaning up my room is a breeze these days because everything has a place and space to reside. I spend more time trying on clothes at stores and really make informed decisions based on how often I will wear it and what can I take out of my closet to replace it.
3. My Treatment Involves Viewing and Showing Up for Myself Differently
This is the part I’m still figuring out yet loving the most. I spent nearly two decades coping through self-deprecating statements and negative self-talk. Although I often said these phrases in a joking manner, I actually began believing it. After the diagnosis, I had a hard time reconciling that for so long, I didn’t ask for help. That was a life changing period of the journey because it revealed so much about me and the ways I have navigated my world since I was a 12-year-old little girl.
My therapist, separate from my psychiatrist, was integral in helping me develop self-compassion for myself and the tools to help me develop my communication skills. My inability to speak up for myself was an issue that had seeped into my adulthood and it was eye opening pinpointing the early roots of this personality trait. Sure, you’d see me picketing or arguing for civil rights of the less fortunate or demand administrative changes for issues around my workspaces or campuses. However, if there was a season where I felt emotionally drained, mentally overwhelmed, or simply not myself, I’d mask it for as long as I could tolerate but then eventually blow up in tears or seclusion. Those would also be the seasons where my inattention was so crippling, I would just lay in bed in avoidance of any and all responsibilities. To this day, I still have a hard time asking for help or saying how I feel on matters that truly bother me and hurt my feelings. When I have a desire to say something and I feel threatened or convinced that someone won’t listen, I retreat back. On the contrary, I can also find myself so aggressively trying to tell my point so no one will have the audacity to challenge it. Both are toxic and don’t work. I’ve been slowly working to find a middle ground that allows me to show up for myself clearly without any guilt or shame attached.
I’ve learned self-compassion and have embraced the beauty in my story. My “get it done no matter what” mentality, on the spot problem solving skills, and resilience to adverse situations make me into the woman, scholar, and future powerhouse I am today.
It has been a beautiful, peculiar, and enlightening year. For next week, I’m not sure what else I can touch on in terms of ADHD. I started this Medium to talk more about my research and life as a graduate student. However, if there is more on ADHD I can expand on, let me know. This has been a rewarding experience and I enjoy helping others anyway I can. ❤