A different look at ADHD
This was originally written for and published on It’s Not Your Journey on blogspot in 2019. I am reposting it here for my personal blog because I think it is a good post. Please follow It’s Not Your Journey for other mental health blog posts and interviews.
“I know that if I asked you to tell me about the picture on that easel over there you’d be able to tell me something no one else could. You’re very smart, Gabriela. You see things differently.”
He’s smiling at me, the man who’s been my psychiatrist now for the last year or so. I blink, look at him and then at my mother, wondering how much of that I heard. It goes into my brain and sits for a second, but before I can register I’ve just been complimented I look at the picture on the small easel in his office and tell him that the painting looks something like a bird.
He laughs. “That’s exactly my point, that’s exactly my point.”
He and my mother agree that my current medication dose is working while I stare off again at the clock and think about what book I’m going to read when I get home.
The psychiatrist I saw as a child, who began to help us out after my first hospitalization at the age of 13, was a good doctor. He was a good listener, skilled, a rational thinker who cared deeply for each of his patients, even the ones who were repeatedly resistant to treatment. I met him during my first hospitalization, at which time he diagnosed me with major depressive disorder. I continued to see him over the next couple of years and even saw a therapist. I was privileged to be surrounded by a competent, intelligent care team who helped me to see my own self worth through my depression. But even with a competent team, even with my hospitalization and 24/7 care, even with the partial hospitalizations that came after and the group therapy and medications — none of them figured out I have Attention Deficit Hyperactivity Disorder. I doubt they even considered it to be a possibility.
I am 26 now. I was diagnosed in October at the age of 25 after roughly 6 years of mood stabilizers meant to treat bipolar disorder backfired. After asking repeatedly about the possibility that I had been misdiagnosed and getting no answers, I went to see a new psychiatrist. She read through my history, which she called “rich” in the friendliest way she could, and at my request decided to try adderall as a way of finding out if I had ADHD.
“This isn’t normally how I’d do this, but it’s hard to tell with your history and how you present, so… call me if anything goes wrong, okay?”
“Okay.” I nodded and smiled at the small woman who had agreed to take me as a new patient, suddenly feeling incredibly nervous, my fingers gripping my pants tightly. “Thank you.”
Later my mother told me that my father had previously been on adderall and found it quite helpful. I knew that ADHD is usually genetic, meaning that usually at least one parent will also have the disorder, but I had never been told my father had been diagnosed. He had told me that he had been diagnosed with bipolar disorder, and it is true that the two can be comorbid, but ADHD had never been discussed. Looking back, it definitely made a lot of sense. The more I learn about ADHD it’s strange to me that he never truly sought treatment. My father always had intense, years long obsessions, something my sibling and I noticed when he went from toy trains to power tools and then to old literature and then to graphic novels after he had told me in high school that I was “getting too old for comics and should read a real book”. He could not sit still for long periods of time, something that caused him to sit near the edges of the aisles in church and stand near the back if he was getting restless, or walk around while showing me a movie he had told me he truly wanted me to see. This, along with appearing to not listen while being spoken to, talking a lot, and being difficult to carry a true conversation with — it all seemed so obvious.
Something else that strikes me as why is ADHD seems obvious and mine does not is our gendered socialization.
More than once as a child I can remember being told to quiet down, that I was talking too much, that I was too candid with a stranger. My mother told me that I needed to stop telling our hairdresser that I didn’t like her haircuts, that I would make a good reporter because I was so blunt. Once on a family vacation that we took to see Mammoth Cave, there was a short cave tour the day before, where my young self reportedly “talked up a storm”. Another time, I was laughing wildly in my history class, rocking back and forth, and just having a great time until my teacher called me out on it and I suddenly felt like I’d been hit in the stomach with a bag of rocks. Another time when I was about four, I tried to get my father’s attention when he was speaking to a friend and he snapped and yelled at me. There are many more, and all of them share the same feeling, the same pit of shame in my stomach upon being told that I was too loud, too rambunctious, too much, too me. I felt embarrassed, ashamed, and wondered why the people around me could so easily talk over me, or why they asked my thoughts if they didn’t want me to share them in my own time. Everything in my life was on someone else’s terms — what I learned, what I could do, what I could do, when I could speak or not speak; it took a toll. I was perpetually self conscious and scared of making the next person angry, of being too much, of being too… myself. I had to hide it to survive.
Young me, between about the ages of 3 to 9, was a lot like Mabel from Gravity Falls. If you haven’t seen the show, she’s a fun loving, dramatic, emotional girl who sees the good in everything that she can as often as she can, laughing easily and acting like a total goof. Something that the one summer we see of Mabel, however, that often happens in particular to young girls with ADHD is being told off for being ourselves. Behaviors that young boys can get away with are things we’re scolded for, creating cognitive dissonance between who we are and who we’re “supposed” to be. I was encouraged to be quiet, attentive, and focus on reading. The only part of myself that was truly me that my parents, teachers, and peers seemed to encourage was my innate artistic ability and creativity, but even that was something that other kids would tease me for now and then.
Sometimes it would be positive — kids wanting me to be on their team for our annual sidewalk chalk art contest at school, or people volunteering me to be the person reading the main part of the play Faust. I was known by everyone as being an artistic person, something that reflected in my extracurriculars — I could sing, draw, act, and play instruments. I was in the band and one year even did choir and band every other day, the only way to do both because the classes for my age group took place at the same time. I did 600 hours of theater and even landed the part of Jan in the play The Unexpected Guest before our director figured out that casting someone who was on the track team in the lead and holding rehearsals at the same time as track practice wasn’t the best way to put on a play. Creativity was, and is, a large part of how I define myself.
Other times, however, it wasn’t so positive. Kids pointed and laughed at me for the way I got lost in my own thoughts, staring at a spot on the floor, thoughts turning over and over in my head as I halfway dissociated through math class. I wasn’t thought of as “pretty” or “hot”, but “weird” and “gross” by the boys in my class, simply because I didn’t want to care about makeup or if an old shirt I loved had a hole in it. For a short period of time I tried to go to school in all black with white stockings, but I felt like such an outcast simply for how I chose to dress myself that I quickly stopped in favor of dressing like the other kids. Sometimes weird was used as a compliment, but more often than not it meant “you’re not like us, and we don’t like you because of that.”
I didn’t know I wasn’t doing anything wrong, or that my quick and clever thinking, my unusual way of looking at the world, was in fact a strength. I couldn’t have known that at the time. When you’re a child and your parents, teachers, and friends are looking at you with raised eyebrows because you can’t see things how they do, you begin to want nothing more than to be like them, and you begin to take it as a personal fault if you’re not. I learned recently that this is a commonality among people with ADHD, both by those of us diagnosed in adulthood and those of us diagnosed as children. We are socially aware enough to know that we’re being looked at differently for a reason, but we can’t see the world from a neurotypical perspective and therefore we can’t determine what our differences actually are. It becomes an internal monologue of self loathing, one that we often carry into adulthood. As I used to say to my friends as they begged me to take a break and not be so hard on myself, “No one is going to push me to be better except me.”
My dad and I took many walks when I was growing up, going nowhere in particular, simply circling the block and getting out of the house. When I was very little, he would carry me on these walks, allowing me to simply think about things and listen to him talk to himself. He would often talk negatively to himself, scolding himself for missing this or not doing that, muttering under his breath about being a failure as an adult. To this day, my father varies between praising himself for his intelligence and clever thinking before going back to scolding himself for not doing something, even a small thing, correctly.
In middle and high school I continued to get good grades, to be a good student, to be a creative thinker. I hid my depression in high school from my parents as best I could, relying wholly on my emotionally abusive boyfriend to listen to my problems. He did, for a long time, listen to me about them, but eventually he became bored of me and left me crying myself to sleep and wondering what I was supposed to do about my loneliness. In eighth grade, my mother had begun to hint that my depression treatment was getting quite costly, and I couldn’t bear going back if it meant feeling again that I was placing an undue burden on my family. I was getting good grades, I was popular, I was fit and pretty — who would have suspected a serious problem like ADHD could have been a part of it?
In college, though, my exoskeleton cracked and broke; I fell apart.
This often happens to young persons with ADHD who are not correctly diagnosed before college — we get there, ready to take on the world, and soon find ourselves cracking under immense pressure that we feel we can’t escape from. It’s funny to me that ADHD is associated quite often with being lazy; I do not know anyone with ADHD who I would call lazy, and never have.
ADHD is incorrectly thought of as a learning disability because when it affects children in a learning environment, that is when it is usually diagnosed. Professionals in the field of psychology don’t usually think about the ADHD brain’s problems with emotional regulation, our problems with regulating our attention, or our problems with obsessive thinking and rejection sensitive dysphoria — instead, if a child is smart, gets good grades, and seems well behaved, well, how could she have a learning disability? ADHD and depression or bipolar disorder can also be comorbid, which complicates matters further — but, regardless, those of us who have unwillfully learned to be quiet about our symptoms aren’t considered for diagnosis of the disorder.
I went to a psychiatrist in my second year of college for help with what was becoming severe bulimia, but my eating disorder only got worse. I was misdiagnosed with Borderline Personality Disorder, Dysthymia, and Generalized Anxiety Disorder. Bulimia Nervosa was my only correct diagnosis at the time. ADHD was not considered a possibility. Later, with a new psychiatrist, I was misdiagnosed with Bipolar Disorder Type I, Borderline Personality Disorder, unspecified anxiety disorder, and Eating Disorder Not Otherwise Specified. ADHD was, again, not thought of. During my first, second, and third hospitalizations, I was diagnosed with major depressive disorder. ADHD was, again, not thought of. I was hospitalized three more times for episodes of major depression and given anti depressants alone during two of these stays, being given a mood stabilizer during a different hospitalization in which the psychiatrist simply asked me what my diagnosis was without evaluating me at all. If you haven’t guessed the pattern yet, ADHD was again not thought of as a possibility during any of these stays.
I had been asked by many friends in college if I had ADHD, but always answered no, because I didn’t know yet how it could present itself. When I realized I needed to be seen for a psychiatrist concerning my trauma, I went to an outpatient intensive therapy program. Three weeks in, I met with a psychiatric nurse, prepared to ask questions about both my ADHD concerns and my concerns about Depersonalization Derealization Disorder. I was quickly shut down, the psychiatric nurse telling me arrogantly that he thought we had made good progress as I walked out of the little room, tears in my eyes. Later when reading his report about me, I almost filed a complaint, as he had incorrectly written down my previous, incorrect diagnosis, and had also given himself undue credit for listening to my questions. The only reason I didn’t was that I didn’t have the money for a lawyer to pursue him with.
Over the next few weeks, I found a different psychiatrist and presented my concerns and medical history to her. About a week after that I found myself in my room, sitting on my bed, nervously holding a bottle of Adderall XR. I had heard many times that the pills were used by college students to stay awake and get things done and even that they could be abused to drink more alcohol than was safe. I popped open the cap, took a deep breath, and took a singular pill.
Forty-five minutes later, I knew I had ADHD.
I will try to describe to you the difference I felt.
Imagine:
You are sitting in a room. You can hear everything in the house, even though you are home alone, and everything outside of the house as well. You can hear people getting in and out of their cars at the gas station, the people walking, the house’s air conditioner kicking off and on, and the television in front of you. All these sounds muddle together and you can kind of choose which one you’re listening to, but it’s mixed in with everything else. In addition to this, you’re reading a blog post, and there’s a song in your head mixing with another song. Your thoughts are very loud and seem to be bouncing off each other like ping pong balls. You don’t quite feel sleepy, but you don’t feel awake, either, like there’s a fog around your senses. And then, suddenly, your television sounds much clearer, like the volume has been turned up. But no — the volume of the inside, the volume in your head, has been turned down. You didn’t even know there was a dial. Your eyes widen as the things you see suddenly feel a bit sharper, even though you already have your contacts in. There’s something else, too — your anxiety is slowing, quieting, as if there is less to worry about. You blink, suddenly realizing what this means, what the medication working means, and then you begin to feel very happy. Something worked! Something finally worked for you!
Now imagine going your entire life with all that extra noise, all the time, with extra strong reactions and extra strong emotions, being called sensitive at every turn and teased for your sensitivity, being told you’re too emotional, being told you’re too dramatic, and never knowing what the fuck was wrong with you because you couldn’t turn the volume down.
Young girls, women, anyone trans and nonbinary who is assigned female at birth is put into this box that we are “emotional” creatures, that we are incapable of reason and our opinions should be listened to second while opinions about us are listened to first. We’re taught to do this even to ourselves — sit up straight, don’t sit that way it’s unladylike, think of your future husband first and foremost, don’t sleep around, don’t explore your own identity and personhood, not unless someone else gives you permission, and be quiet, your life will never be easy and you need to get used to that. It’s an incredibly difficult thing to break out of. Harder to realize you’re even doing it at all.
It isn’t that we aren’t emotional, or that some of us aren’t more emotional than others, or that we can’t think irrationally. We are by no means perfect. The trouble is that when we have a serious problem of any kind, it’s easier to brush us off as just being hysterical and irrational, rather than having a problem that does in fact need treatment, whether rational or not. We’re told both to play into our emotions as a strength and to ignore them in order to pursue some strange ideal woman that no woman has ever been or can ever be.
ADHD is a serious problem, especially when left untreated. For many, this struggle comes from not being able to see a psychiatrist or specialist, but in my case I saw many for years and it just wasn’t thought of by any of them. My life would be very different, and probably much better, if one of my doctors over the years had thought outside of the box of what is expected of ADHD. It is easy to ruminate on the what-ifs and maybes; it is harder to do something productive with them.
I haven’t been in acute psychiatric hospitalization in two years now, partly thanks to my own stubbornness but also thanks to my ADHD and depression treatment. I still struggle with severe dissociation, something that unfortunately cannot be medicated, but I am not as lost as I once was. I do still have days where I am unproductive and I simply lay in my bed feeling sorry for myself, but they are less than they once were. My brain is finally getting a tune up after all this time and it feels very, very nice. It’s like living when you didn’t know everything was on pause, like something finally hit the “play” button, and I’m moving again.
My life is better with correct diagnosis and ADHD treatment. I hope that if you read this and it sounds familiar, you get correct treatment as well, no matter what the root cause is; we all deserve a chance, at least, to be able to live full lives.
Thanks to a correct diagnosis, I have a better shot than I ever did.
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