Getting Diagnosed with ADHD Changed Everything and Nothing
The doctor said she knew in the first five minutes. In eighteen years of schooling and thirty-nine years on the planet, no one else had ever noticed.
This isLate Bloomer, a column byCarla Cicconeonher experience of being diagnosed with ADHD in adulthood, and how it made her reevaluate parts of her past.
On a sunny day in eighth-grade math class, my eyes darted between the blackboard and the softball in my classmate Tyler’s* hand. Math was one of my worst and most dreaded subjects, so I wasn’t rapt with attention at the problem our teacher was writing out, but rather at the promise of chaos from our class’s most reliable agitator. After three fakeouts, Tyler launched the ball with incredible precision at the clock just above the teacher’s head; it ricocheted off the door and bounced on the floor before rolling triumphantly to the back of the classroom. The teacher’s chalk stopped moving and he turned around, red with rage. The pin-drop silence broke when he pointed at Tyler and yelled, “Principal’s office.”
My heart sank for Tyler, whose laughing eyes turned dark as he dragged his feet out of the classroom, but I was also grateful that he’d caused a distraction that interrupted the midclass tedium. Tyler spent much of his time at school in the principal’s office or the hallway, and though I was often aghast at the lengths he would go to to relieve his ceaseless boredom, deep down, I also intrinsically understood the impulse that made him do things like throw that ball. He had what’s now known as ADHD (Attention Deficit Hyperactivity Disorder) but was called ADD in the ’90s. For decades, he remained the only person I knew who’d been diagnosed with the disorder. He could’ve been the poster boy for it, given its prevailing stereotype: a white boy who did poorly in school, maintained little to no control over his frequent disruptive urges, and constantly bounced off the walls and got into trouble. Owing to a lack of more inclusive research on ADHD, Tyler’s case was the dominant representation of the disorder until very recently.
I thought of him seven months ago while I sat slouched on my bed scrolling through Twitter, because I saw an ADHD meme that was so affronting it made me sit up straight. It was an illustrated flowchart by an “ADHD artist” named Dani Donovan comparing the respective storytelling styles of someone without ADHD and someone with it. The non-ADHD trajectory was straightforward: start of story, arrow, end of story. The ADHD section was a maze of confusion that began with a “pre-story prologue for ‘context’” before getting to the “start of story,” which was quickly hijacked by various crooked lines that branched off to things like “too many details,” “semi-related side story,” “lose train of thought,” and “something I just now remembered.” By the time I got to “what was I talking about?” I laughed, and then I panicked. As much as I enjoy telling stories, I’ve dreaded doing so out loud for as long as I can remember. Another of Donovan’s ADHD comics I found jarringly relatable was titled “Are they mad at me?” It’s a question that has plagued me since fourth grade, when I returned to school after a week away with a bad bout of asthma and was informed—by Tyler, of all people—that my friends had decided that they weren’t my friends anymore. A few years later, raggedly surviving the devastating lows of the middle school mean-girl cycle solidified shame as a part of my personality repertoire, and every relationship I’ve had since has been haunted by my relentless questioning of the other’s affection for me. Visions of Tyler being disruptive from almost three decades earlier raced through my head now. It was easy to see manifestations of ADHD in his behavior. Harder to trust was that my erratic storytelling and low self-esteem could be signs of the neurological disorder too.
But thinking about Tyler’s experience led me to go deeper into my own. I often felt so understimulated in middle school that I would focus all of my energy on not acting out during my classes, or walking out of them altogether, which felt akin to trying not to itch a pulsing mosquito bite. That forced focus took my attention away from what was being taught, and my grades suffered. I also perfected the art of staring through the teacher, so I appeared to be listening intently but was actually totally lost in the alternate dimension of my imagination. And although I was a shy kid who generally feared teachers, a couple times in science class when Mrs. Hamilton’s slow, monotone voice made me vibrate with an acute restlessness I couldn’t contain, I was gripped by an impulse to talk out of turn. Twice I was kicked out of class for being a loudmouth, and though I lived in fear of running into our sadistic principal in the hallway, I was also blissfully relieved to be away from the agony of the classroom. If I had ADHD, my symptoms were experienced more as a war within myself than Tyler’s outward anarchy. I wasn’t destructive to anybody or anything, really, other than myself and poor Mrs. Hamilton’s Bunsen burner lectures. Had I been hyperactive, it might’ve been noticed by teachers or doctors, but instead, I was labeled a sensitive dreamer with authority issues. I told myself I struggled at school because I was bored, lazy, dumb, and, by the time high school rolled around, stoned. No one told me otherwise—in fact, many authority figures only reinforced my unfavorable self-assessments, so I had no reason to question them myself.
My symptoms were experienced more as a war within myself.
Now, at thirty-nine, I was questioning everything. I might’ve started reframing my entire life based on a Twitter meme, but it would take me months to actually do something about it. I considered making an appointment with my doctor to discuss the possibility of having ADHD, but I promptly forgot about it and moved on with my life. Actually, those are lies. I didn’t forget to call my doctor so much as the task got buried in the recesses of my mind, not seeming urgent enough for fast action or important enough to warrant a calendar reminder. I didn’t really move on with my life because for as long as I can remember, I’ve been stuck here, rapping on the walls of my busy brain, trying to force it to behave. Ultimately, even as research, social media, and speaking with acquaintances helped me become aware of a growing community of people diagnosed with ADHD in adulthood, it seemed indulgent to even consider myself one of them—just another excuse for a life chock-full of mistakes.
Months into the pandemic, I, like many people, was struggling with the ramifications of multiple lockdowns and a changed world. My career was stalling and I was at home, trying my best to care for my toddler without much outside support. I would wake up dazed and sleepwalk through uniform days with my ballooning anxiety as an unwanted but reliable companion. To stay afloat I upped my SSRI dose, and then I upped it again. Finally, I sought out the help of a psychotherapist—someone impartial to talk to about all the things weighing on me, including my own trauma history. I wanted to learn about my patterns, my stress responses, and how to treat myself more compassionately, but the ultimate goal of going to therapy was always to become a better example, and a better mother, to my two-year-old daughter. Parenthood arrives fast and hard, and for those of us who possess enough self-doubt to fill a very large lake, learning to trust our instincts and bounce back after setbacks is like trying to teach yourself a new language without the help of Duolingo, or a teacher, or books, or anyone to converse with.
I’d tried therapy a few times in the past, but only during moments of acute distress, when my life felt like a hurricane I was lost in the whirl of. In these cases, I didn’t stick with appointments once the storm passed, mostly because I didn’t want to be reminded of whatever bad thing had landed me there: a breakup with an emotionally abusive ex who took my house, money, dog, and dignity; a concussion, followed by clinical depression and a years-long downward spiral, all jazzed up by alcohol abuse and reckless behavior that led to an unwanted pregnancy. I was living that avoidant life, but also, therapy was a drag. I never got “better” and I never felt truly heard or understood—and I didn’t think that was an option for me. Plus, finding a good therapist is rare, therapy is expensive, and, as I now know, results of any kind take time and patience.
My current therapist happens to be a good one (thank you, Psychology Today). She provided a safe space to open up about how hard it was to simply get through a day—she didn’t try to fix my life but rather listened, urged me to dig deeper, and called me out as needed. In addition to telling her the major traumas of my past, I also honed in on my day-to-day life: caring for my daughter at home, with the struggles of trying to work and plan for the future filling me with an unshakeable anxious dread. It was through this exploration that she first suspected I might have ADHD, and since symptoms of untreated trauma can sometimes mimic those of the disorder, she urged me to get assessed by a psychiatrist for an accurate diagnosis.
Four months later, I did. In the world of adult ADHD diagnoses, that’s really fast. My family doctor, like many general clinicians, didn’t have the training to assess me. If she referred me to a healthcare-covered psychiatrist, I might wait more than a year. I was surprised at how difficult this was going to be. Getting assessed for depression or anxiety in the past had only taken a quick chat and an even quicker test, but ADHD requires lengthy questioning and a skilled interviewer.
I didn’t want to wait a year for what could be a life-changing diagnosis, so based on Twitter-sourced advice, I looked into private ADHD clinics. They ranged from $1,500 to well over $3,000 out of pocket for an assessment, making that option a pipe dream. In short, there are many steps to getting a diagnosis for a condition that makes taking many steps to do anything quite difficult. Fortuitously, my therapist had recently joined a collective called Psychotherapy Matters, a virtual platform that helps patients avert the labyrinth of Ontario’s mental healthcare system by connecting therapists and their clients with psychiatrists. Two months later, on the Friday morning of my appointment, I buzzed nervously around my apartment, tidying, trying to find something to wear and making sure I had tissues nearby because it was almost 8:00 a.m. and I was about to log on. I had no idea what to expect, but the psychiatrist was kind and asked me specific questions about my history and present-day issues. I mostly held it together but had to reach for the Kleenex while recalling how I’d always felt unworthy and accepted long ago that an easy, productive, or good life was always going to be just a little out of my reach. I’d never said those words aloud, even though I’d felt them all my life.
One week after my assessment, it became official: I definitely have ADHD. The doctor said she knew in the first five minutes, which means it took her five minutes to recognize a disorder that no one else in eighteen years of schooling and thirty-nine years on the planet ever noticed. She recommended I take a stimulant medication to help me focus, and it has miraculously turned down the loud rumble of doubt in my brain that forces me to abandon projects, problems, and relationships before they’ve really begun. I don’t feel “cured” at all, and may never, but the extra focus and awareness has lent me a freedom that I haven’t experienced before—it’s the permission to stop blaming myself for everything and anything.
For much of my life, especially once I started struggling to pay attention in elementary school, I’ve considered myself less than my peers or just not very smart. These self-taught mistruths are hard to unlearn. My internalized shame around not being good enough follows me everywhere, and in moments when I let myself reimagine my childhood, I can see how a diagnosis back then could’ve helped me avoid that ball and chain.
Girls often present the symptoms of hyperactivity differently—more internally.
Research conducted from the early aughts until recently posits that in childhood, boys are diagnosed with ADHD over girls at a ratio of 3:1. And in the ’90s when I came of age, that discrepancy was even higher, with boys diagnosed nine times as much as girls. This isn’t because girls didn’t have the disorder; it’s because they often present the symptoms of hyperactivity differently—more internally. Compared with their peers, girls with ADHD report increased anxiety, distress, and depressive symptoms, and I had them all growing up. In adulthood, however, the ratio of diagnosis by gender is closer to 1:1. Though I can only speculate now, knowing these stats makes me wonder whether a childhood diagnosis actually would’ve made much of a difference in my life. ADHD was surrounded by massive stigma, as most mental illnesses were in the ’90s. I might’ve only retained the shame of the diagnosis had I gotten one as a kid. Things might’ve been worse.
It’s maddening that girls are still diagnosed less than boys, especially affluent white boys, and that adults often have to advocate for themselves in order to get assessed, but I’m ultimately grateful that I’ve made this discovery at this moment. I have enough mental health awareness now to respect and research my diagnosis; there are great books, articles, and online resources about ADHD available; there’s a strong community on social media;, and, in general, mental health professionals are more insightful about the disorder. On the advice of a Twitter friend, I looked up TikTok’s ADHD creators, many of whom have dealt with late diagnoses. As with other corners of the internet, one must parse through a certain amount of misinformation, but I’ve also discovered a vocabulary previously foreign to me. Among symptoms I cope with that I can now name: dissociation, masking, sensory sensitivity, sensory overload (and aversions to lines, crowds, and noise), and, most poignantly for me, rejection sensitive dysphoria, or the reason why I’ve always been told I take everything too personally.
All of this new knowledge seems like the missing key to unlocking essential information about why I am the way I am. It’s changed everything. It’s also changed nothing. Turns out, suddenly finding out you have a disorder you’ve associated with wild little white boys for twenty-eight years is not easy to talk about, especially with people who don’t have an up-to-date understanding of it. Women openly exploring their late diagnoses might be a trend on TikTok and Twitter, but it’s one that few in my circles are aware of. I haven’t found a good way to discuss the diagnosis with my parents, because it can be hereditary and that possibility brings up a lot of difficult emotions. I’ve largely defaulted to joking about it, as many with ADHD have done before me. I joked with my aunt about how at least now I know why I’ve never been able to hold down a job, and I laughed with my partner about finally understanding my puzzling habit of placing piles of paper all over our house.
But I haven’t been able to joke my way out of some people’s responses. One friend told me “everyone has a little ADHD,” as though occasionally forgetting where your phone is means you have a tinge of the disorder. Some have ignored reacting altogether and moved the conversation along to a different subject. Other people have been genuinely curious, making me feel like I should become an expert on the subject, stat, since public knowledge is lacking. I can’t blame anyone for having skewed views of ADHD—I used to, as well. Since the core symptoms were first discussed in the early 1900s, what we now call ADHD has been labelled: “defect of moral control,” “postencephalitic behavior disorder,” “brain damage,” and “brain dysfunction,” to name a few.
I wrote to my editor at 9:00 p.m. the day this piece was originally due, filled with regret and shame that I hadn’t made my column deadline. I share this with you in the spirit of transparency, because how can I write a column about finding out I have ADHD without addressing the very real consequences it has on my life? Despite my best efforts, my diagnosis and medication haven’t transformed my relationship to time overnight. I want to let go of the shame of getting stuck and being late sometimes, and instead embrace that failing to meet a deadline doesn’t mean I’m failing as a person. My editor was kind and understanding, and I’m trying to be, too.