By the time I finally hauled myself in to a psychiatrist's office to find out if I had ADHD, I was 28, five years into a corporate career, and totally ready to hear the truth. Honestly, after a lifetime of struggling to multitask and losing literally any belonging that wasn't fastened to my body, an ADHD diagnosis was my best case scenario. (Worst case scenario: I was an idiot and my vagina was actually a wormhole.) In fact, I had set up that appointment specifically for the purpose of formalizing my diagnosis. I was buzzed from recently falling in love, and I felt like total perfection as a human being was within my grasp... if I just finally took care of this whole pesky "my inability to easily focus on work tasks makes me feel like worthless human garbage" thing.
Which is how, in the shadow of my 30s, I spent an afternoon explaining to a psychiatrist that the only way I could keep from constantly losing my keys was sewing lanyard keychains into all of my purses. She was immediately on board for testing, and the results — that I suffered from ADHD — shocked neither of us.
I've read a lot over the past few years about the recent rise in ADHD diagnoses among girls and adult women — according to a report in The Journal of Clinical Psychiatry, ADHD prescriptions among women ages 26 to 34 jumped 85 percent between 2008 and 2012. This bump is tied to new, broader diagnostic standards that include a wider variety of symptoms — though ADHD (the disorder once more commonly known as ADD) impacts the brain's "executive functions" center in people of all genders, women's ADHD symptoms often center more around feelings of being overwhelmed and disorganized, rather than the visibly impulsive behavior and hyperactivity that many of us associate with the disorder, which are actually more common symptoms among young men.
But I believe that being aware of women's unique symptoms is only half the struggle when it comes to making sure that female ADHD sufferers get the help they need — because there are a number of stigmas and stereotypes that encourage women to believe that they can't possibly have ADHD. Here are six reasons I put off getting diagnosed — and why I'm glad that I eventually accepted the truth:
1. People Told Me I Was "Too Smart" To Have ADHD
Stephen Hinshaw, Ph.D., author of The Mark of Shame: Stigma of Mental Illness and an Agenda for Change, told ADDitude (an ADHD-focused newsletter) that many people view ADHD as "an excuse for sloppiness or laziness...[and] the fact that ADHD can undermine academic performance worsens the stigma. Our society seems to think, 'If your grades are poor, you’re not worth much.'This is especially true if the cause of poor performance is hidden, as it is with ADHD." The flip side of this is also true: If people think you're smart, they often believe that there is no way that you can also have ADHD.
Because I always did well in school, no one thought my trouble paying attention in class was the result of ADHD — they thought I was being a smartass. As I got older, I decided that I must be one, too, since everywhere I turned, I was told that smart people "didn't get ADHD."
2. I Was Afraid Of The Economic Stereotypes About People With ADHD
My mother turned a blind eye to the idea that I might have ADHD for a lot of reasons: It didn't seem to be impacting my grades, and she was battling mental health problems of her own and frankly didn't have time for mine. But she was most inclined to ignore it because of some stereotypes about ADHD and socioeconomics.
Here are the facts: Though 10 percent of children ages 5-17 have been diagnosed with ADHD, the numbers are much higher among economically disadvantaged groups, according to a 2015 study. There are a variety of scientific theories as to why economically disadvantaged children are more likely to be diagnosed with ADHD — one holds that children who grow up in economically struggling environments are often end up diagnosed for behavior that is a reaction to their environment, rather than wholly genetic in nature. Dr. Ginny Russell, who led a study on the issue at the U.K.'s University of Exeter Medical School, told The Independent (U.K.) that "[t]here is a genetic element to ADHD, but this study provides strong evidence that ADHD is also associated with a disadvantaged social and economic background."
These actual facts lead some people to believe very toxic myths about ADHD: primarily, that economically disadvantaged people who have the disorder are poor because their ADHD makes them bad workers.
For someone like me — a lower middle class kid who attended a prestigious prep school on an array of scholarships — catering to these biases and covering up my ADHD helped me seem like an "extraordinary" kid who was worthy of these scholarships, not a lower middle class "problem child" who would never make anything of herself. It was far from fair and made me feel ashamed — but if I had been diagnosed as a kid, I'm not sure all those scholarship committees would have taken a chance on me.
3. I Thought It Might Just Go Away On Its Own
My struggles increased through the years, as my life filled up with more and more responsibilities that ADHD made it harder and harder to keep up with. But I believed everyone around me when they told me that my symptoms were a sign of immaturity, rather than an actual mental health condition that could be treated.
Like a lot of mental health disorders, on paper ADHD sounds like something we've all experienced — everyone's had a day when we've accidentally run late for every appointment, lost the only important document on our desk, or somehow gotten distracted and taken four hours to complete a task that should have required around 20 minutes of work. The difference is that, if you have ADHD, that's pretty much every day of your life, unless you're very actively taking steps to treat the disorder. If you haven't been diagnosed, you look much more like an overgrown teenager who doesn't give a sh*t about whose time she's wasting, rather than an adult who needs professional help.
In high school and college — when a lot of people are experimenting with irresponsibility — it was easy to blend in. As a teenager, I threw a leather jacket over my ADHD symptoms and transformed my tendency towards lateness and distractability into a defiant, punkish persona. But when I graduated, things changed. Settling into our first jobs, we were supposed to be ready to cast off the last vestiges of our rebellious adolescence and run full throttle into the world of adult responsibility. I was ready — but I couldn't seem to actually do it, no matter how hard I tried.
4. I Didn't Want To Compromise My Career Even Further
Like many grown women with ADHD, I identified beyond words with the moment in Rae Jacobsen's essay on life with adult ADHD when a boyfriend tells her, “You don’t have ADD. You’re just lazy.” The idea that my struggles were a personal failing, rather than a mental health issue, followed me, like a lost dog, throughout the early years of my career.
Prior to my diagnosis, I lost jobs because of my distractibility. I was disciplined by bosses who were mystified by how someone "as smart as you" could keep blowing deadlines on relatively trivial, simple projects. I was asked what could possibly be wrong with me when I routinely forgot to pass important phone messages on to my superiors, or interpreted a supervisor saying, "Take your time with this project" to mean, "Wait until I ask you where this project is to start working on it." I panicked, constantly, about everything, because the basics of adult life that seemed to come so easily to everyone else — like showing up on time or not dropping projects in the middle — felt perpetually out of my grasp.
This is common among ADHD adults — according to the Attention Deficit Disorder Association, "Adults with ADHD are eighteen times more likely to be disciplined at work for perceived 'behavior problems' and are 60% more likely to lose their jobs."
But an ADHD diagnosis didn't feel like a solution to me at the time — instead, I remembered the way that so many of the classmates who had ADHD were immediately written off by our teachers, who dismissed them as failures even when they tried. I imagined that the same thing would happen in the working world.
So I continued struggling on my own, without any help, and when I felt like I could no longer handle it, I just gave up. I stopped trying to get promoted, and instead devoted my seemingly bottomless energy to supporting my boyfriends in their careers. And, to be perfectly blunt, as a society, we're more than ready for women to give up on their dreams. Some people thought stepping back on my career was a waste, but no one thought it was abnormal.
5. I Was Embarrassed
And still am — though I write jokes about vaginas all day long, the real line I'm afraid to cross is being open about my ADHD. Will my co-workers take me less seriously? Will future employers be less likely to hire me? Will people think I'm covering up for not being all that intelligent? Will friends wonder if I'm just some druggie making it up to get my hands on some sweet, sweet legal speed? (Though people faking ADHD symptoms in order to get stimulant prescriptions is a real public health problem, in my own life, the unpleasant side effects of taking stimulant ADHD medication make it an option of last resort.) I have only shared my ADHD diagnoses with my closest friends; neither of my parents know and I have never mentioned it in any workplace. I was afraid, and I'm still afraid.
This kind of fear and self-loathing can often be as corrosive to your life as the symptoms themselves. As Dr. Sherman noted in his ADDitude interview, "[T]he greatest harm often comes from self-stigmatization — that is, when people with ADHD internalize negative stereotypes." Sherman then went on to mention ADHD-diagnosed students he had worked with, for whom "[t]he stigma has so poisoned their motivation that they’ve given up even trying to be successful." Their counterpart? "The flip side of self-stigmatization is denial. You consider the stereotypes of ADHD and think, 'That’s not me.' You want nothing to do with such a shameful identity."
6. I Thought Women Didn't Really Get ADHD
As a culture, we simply don't think of women as people who struggle with ADHD. When we look at an educated, middle-class woman who keeps finding that she left her bank statements in the freezer, we think "free spirit" or "flake;" we don't think "attention deficit." And the particular stigmas that surrounds ADHD can be extra troublesome for women to deal with.
For women — especially ones working in environments and cultures that expect women to be high-achieving, hyper-organized, and, well, basically perfect — admitting that they have ADHD (and as a result can never achieve the seemingly effortless "perfection" that our culture often demands of successful women) can seem like a barrier to ever achieving our dreams. Admitting that you have ADHD is admitting that you'll never be Sheryl Sandberg — hell, it's admitting you'll never even be GOOP. It's admitting that your "success" will never look the way a lot of people expect it to.
People often stereotype women as both more emotional and more in control of themselves than men; our choices are assumed to be the product of careful planning or our kooky female emotions, with few exceptions, which can lead to a problem of brain chemistry being overlooked in favor of more nebulous causes. When girls struggle, we often assume that, on some level, it's their own fault.
I don't think greater awareness of the fact that adult women can struggle with ADHD is a cure-all — but I do think that, in a world where women throwing in the towel on their dreams is so normalized, it is an explanation that can change women's lives.
I know it changed mine. I'm not saying that everything is magically better, now that I am taking care of myself, sometimes taking meds, and trying to make peace with my diagnosis. Sometimes having ADHD is a pain in the ass; sometimes it feels like it is literally ruining my life; sometimes I really enjoy my ADHD and the unique creative thinking that it affords me. But knowing that there is a reason as to why I struggle the way I sometimes struggle — that I'm not helpless and hopeless — has made all of the difference.