ADHD ISN’T MADE UP, IT’S MISUNDERSTOOD: A DEEP DIVE INTO ADHD, LATE DIAGNOSIS, AND ITS IMPACT ON WOMEN

WHEN someone recently told me ADHD didn’t exist and was something people made up to get benefits, it felt like being hit with a sledgehammer.?

Not only that, but they insisted ADHD couldn't be real because it didn't exist in Victorian times.

This isn't a new story - it's really common for ADHD to be dismissed as a fabrication, or for someone to come out with that classic line about everyone being 'a bit ADHD' and 'on the spectrum'.

Most of the time, I genuinely don't believe statements like these are meant to cause harm or distress - it's a very real sign of misunderstanding, and that's what I'm going to do my best to help with in this article.

For so many of us diagnosed later in life, the idea that ADHD is a modern fabrication, or even an excuse, is incredibly dismissive.

ADHD is very real, and modern research has not only confirmed its existence but also uncovered why so many – especially women – are being diagnosed later in life. I was diagnosed at the grand old age of 50. Happy half century, Taz!

Let's dig in and, first, let's deal with that flippant - and all too common - idea that ADHD is a modern 'invention'. After that, I'll go through it all, point-by-point, and do my best to give a good overview. I hope this helps...

ADHD DID EXIST IN VICTORIAN TIMES – IT JUST WASN’T UNDERSTOOD

ADHD might not have been formally recognised back in Victorian times, but that doesn’t mean it didn’t exist.?

Historical literature contains references to behaviours that align with what we now know as ADHD.?

In the past, ADHD was often misunderstood or attributed to laziness or moral failings.?

Despite some modern claims that ADHD is linked to lifestyle, gut health, or generational trauma, research into its hereditary and neurological roots seems to debunk these theories. ADHD is primarily genetic, and if a parent has it, there’s a 50% chance their child will too (Journal of Clinical Psychiatry, 2020).

WHY WOMEN ARE OFTEN DIAGNOSED LATER IN LIFE

One of the main reasons women are often diagnosed with ADHD later in life is societal expectations and masking.?

For many women, ADHD doesn’t present in the stereotypical, hyperactive way. Instead, it can manifest as inattentiveness, disorganisation, or emotional overwhelm – traits that have often been dismissed as 'normal' for women.?

This has led to generations of women going undiagnosed, only reaching breaking point later in life, often triggered by hormonal changes during perimenopause.

"Research shows that declining oestrogen levels during perimenopause exacerbate ADHD symptoms that women may have previously been able to mask."

Research shows that declining oestrogen levels during perimenopause exacerbate ADHD symptoms that women may have previously been able to mask.?

A 2021 study published in Nature Reviews Endocrinology highlights that reduced oestrogen levels impair executive function and memory, making ADHD symptoms far more pronounced. While HRT can alleviate some menopause-related symptoms, it doesn’t address the underlying ADHD, which needs specific treatment such as medication and behavioural therapy.

This absolutely tells my story. There were areas of my life I’d always struggled with, wondered why I could be so bloody awesome at helping people with life and business, yet couldn’t manage ‘simple’ tasks like keeping a tidy space or managing to show up on time.?

All those ‘quirks’ that used to really leave me stressing about my perceived inadequacies came flooding in, magnified and in glorious technicolour, when perimenopause hit.? I genuinely feared I was going insane and losing myself.

I ended up on the maximum dose of HRT and high levels of antidepressants before the dots were finally joined and my ADHD was diagnosed.?

ADHD AND THE BRAIN: DOPAMINE, NORADRENALINE, AND EXECUTIVE FUNCTION

Let me preface this by saying I’m not an ADHD ‘expert’ or a doctor… I just live with it and went into a bit of a hyperfocus trying to understand what it was all about and what caused it.?

So, this next part is the best of my understanding, after a few conversations with my specialist and becoming best buds with Google et al. I hope I’ve got it all right!

Here goes:?

At the core of ADHD lies a problem with the brain’s executive functions, governed by the prefrontal cortex. This area handles planning, decision-making, impulse control, and attention. ADHD brains experience a shortage of dopamine and noradrenaline, two neurotransmitters essential for focus and motivation.

The gap in these neurotransmitters reduces the efficiency of signal transmission across the synaptic cleft – essentially, it makes our brains need more dopamine to function properly than neurotypical brains do. This deficiency is why ADHDers struggle with procrastination, time blindness, and demand avoidance.

THE CHALLENGES OF ADHD: COMMON ISSUES AND HOW THEY IMPACT LIFE

Here are some common challenges faced by those with ADHD, which can affect both personal and professional life:

? Time Blindness: Difficulty gauging time and planning tasks accordingly.

? Object Permanence: The ‘out of sight, out of mind’ phenomenon.

? Rejection Sensitive Dysphoria (RSD): Intense emotional pain triggered by perceived rejection.

? Demand Avoidance: Strong resistance to doing necessary tasks.

? Emotional Dysregulation: Difficulty managing intense emotions.

? Procrastination: Inability to start or finish tasks.

? Anxiety and Depression: Frequently co-occurring with ADHD.

? Hyperfocus: Intense focus on tasks (or whatever happens to be our current flavour of the month) that can lead to burnout if not managed.

ADHD PARALYSIS AND HOW TO OVERCOME IT

ADHD paralysis is a unique state where, despite knowing we need to take action, we become mentally 'stuck'. This isn’t the same as simple procrastination – it’s an overwhelming sense of not being able to start or complete tasks. Often triggered by too many tasks or perfectionism, ADHD paralysis can feel like a comforting escape, even when we know we need to act.

"It can feel like going into a kind of trance state; I know I’m in it, but it’s like being on pause."

For me, it can feel like going into a kind of trance state; I know I’m in it, but it’s like being on pause.?

You know that move effect, where the protagonist is in focus and the world around them slows right down and gets really blurry? It’s a bit like that.

If you see an ADHDer appearing to be lazily lying on the sofa scrolling their phone, it may be that they're actually in a state of ADHD paralysis and the scrolling is an attempt to focus on something other than their overwhelm. To the outside world, it really can look like someone daydreaming or just lazing about; to the ADHDer, it's a proper state of 'stuckness'.

Here are some of the strategies that can either help us to avoid ADHD paralysis, or shake it off when it happens:

1. Chunk tasks down into smaller, manageable steps.

2. Use the 5-minute rule: Commit to just 5 minutes of a task.

3. Gamify your tasks and reward yourself for progress.

4. Work with a ‘body double’: having someone nearby for accountability.

5. Move your body: Physical activity can help reset the brain.

6. Schedule in plenty of downtime, specifically to meditate, exercise, use breathwork, get outdoors… whatever it is that helps you find your centre, slow down and recalibrate.?

WHY ADHD BURNOUT IS DIFFERENT

People talk about burnout all the time. ADHD burnout isn’t quite the same thing, though it is a real phenomenon.?

It often follows periods of hyperfocus, where we dive into tasks with such intensity that we neglect self-care, leaving us mentally and physically drained.?

Something we need to understand about hyperfocus is that we can't choose to go into it, or leave it. Hyperfocus can kick in with everything from an engaging work project, a book, TV series (it's 4am - let's do one more episode!), hobbies, random topics and even people. Those intense friendships ADHDers often form? Yep, they often seem so extra because of hyperfocus.

Hyperfocus can be powerful, but without regular breaks, it leads to ADHD burnout, which is more intense and harder to recover from.

Tools like the Pomodoro technique, pacing, and scheduled breaks can help manage hyperfocus and avoid burnout.

HEREDITARY NATURE OF ADHD AND PARENTAL MISUNDERSTANDING

Latest research shows that ADHD is highly hereditary. Studies show that if a parent has ADHD, their child has a 50% likelihood of inheriting it (Journal of Clinical Child and Adolescent Psychology, 2022).?

Many undiagnosed parents may dismiss their child’s diagnosis because they themselves grew up with ADHD symptoms and see them as ‘normal.’ This really can feel like a sucker punch at diagnosis stage, where it can feel we’re being dismissed or shut down by those we love most.

If you’re going through diagnosis, you’ll likely be asked to fill out a questionnaire (oh, the irony, when so many ADHDers are hugely form-filling-averse!) and have parents / family members do the same.?

If you have sceptical parents, please do brace yourself and prepare - it might not be the most pleasant experience, particularly for those of us who struggle with RSD (more on this later).?

You might also be asked to dig out some of your old school reports, so those early ADHD traits can be spotted.?

REJECTION SENSITIVE DYSPHORIA (RSD) AND ADHD: THE HIDDEN STRUGGLE

One of the lesser-known but profoundly impactful challenges that many people with ADHD experience is Rejection Sensitive Dysphoria (RSD).?

RSD is an intense emotional reaction triggered by the perception - real or imagined - of rejection, criticism, or failure. While everyone may feel hurt by rejection, RSD takes that feeling to a different level for those with ADHD, resulting in overwhelming emotional pain, deep sadness, or even anger.

RSD can manifest in a few key ways:

? Emotional Overload: Even minor criticism or perceived slights can lead to intense emotional responses, which may seem out of proportion to the actual situation.

? Avoidance of Criticism: Many individuals with RSD go to great lengths to avoid situations where they might be rejected or criticised, often becoming people-pleasers or avoiding risks in order to sidestep the pain that comes with perceived failure.

? Internalising or Externalising Rejection: Some may internalise the feelings of rejection, leading to depression, anxiety, or low self-esteem, while others may externalise their emotions, reacting with anger or frustration.

It’s important to recognise that RSD is not an official diagnosis but rather a common co-occurring condition that many ADHDers experience. Its roots are believed to be tied to the emotional dysregulation that comes with ADHD, where the brain struggles to process rejection in a measured way due to differences in how it manages emotional stimuli.

"Growing up, I couldn’t understand where my clumsily described ‘paranoia’ was coming from. I’d go through intense periods of being convinced people I trusted hated me."

For me, RSD can be absolutely crushing. Growing up, I couldn’t understand where my clumsily described ‘paranoia’ was coming from. I’d go through intense periods of being convinced people I trusted hated me, that I’d said the wrong thing and upset someone, or that minor mistakes were the end of the world and I was THE worst person.?I can look back now and recognise that some of those really dark times I've spoken about before were, in some part, attributable to RSD.

It’s hard to explain just how debilitating RSD can be, though once we understand what’s going on, it can be easier to recognise it, get perspective and trust the feelings will pass. That’s how it is for me, at least. Gotta say, some of those mindset and medicine tools I carry really help.?

SIGNS TO WATCH FOR AND WHEN TO SEEK HELP

Here are some key signs that suggest it may be worth exploring an ADHD diagnosis:

? Constant procrastination.

? Feeling overwhelmed by tasks that others seem to handle with ease.

? Difficulty managing time.

? Forgetfulness or misplacing things.

? Intense emotional reactions to criticism or rejection.

? Struggling to focus on tasks that don’t interest you.

INSULTS AND MISUNDERSTANDINGS

Pre-diagnosis, many ADHDers are labelled with harmful names, such as:

? Lazy: When in fact, they’re overwhelmed.

? Disorganised: Due to challenges with executive function.

? Forgetful: It’s not intentional; it’s ADHD.

? Uncaring: Emotional overload often looks like indifference.

? Unreliable: Missed deadlines aren’t a lack of care but a struggle with time management.

These labels erode self-esteem, but they can be reframed with the understanding that ADHD is driving these behaviours.

THE 'SUPERPOWERS' OF ADHD: WHY IT’S NOT ALL CHALLENGES

ADHD may come with its hurdles, but it also brings a unique set of gifts that can be real game-changers in both life and business. The whole statement about ADHD being a superpower is a bit Marmite - ADHDers either love it or hate it.

My take? Though we do need to be careful not to undermine the very real life challenges posed by ADHD, I'm all for flipping those negatives, so I'm #TeamSuperpower all the way.

When we embrace our strengths and learn to harness them, ADHD can bring some bonus features, rather than just being something to manage.

Here are just a few of the positive traits ADHD can bring:

? Creativity: ADHDers are known for thinking outside the box. That ability to make connections others might not see can lead to amazing ideas and innovative solutions.

? Hyperfocus: While ADHD can make focusing tough, when something grabs our attention, we can dive in deep and achieve incredible levels of concentration and productivity.

? Spontaneity: Being flexible and adaptable means we’re ready for whatever life throws our way. ADHDers often excel in environments that require quick thinking and going with the flow.

? Curiosity and Passion: ADHD brains are wired for interest and stimulation, making us passionate learners and explorers of the world around us.

? Risk-taking: We’re not afraid to take chances, which can be a huge advantage in entrepreneurial ventures and creative projects.

? Resilience: Living with ADHD means we’ve learned to bounce back from setbacks and challenges, giving us the tenacity to keep pushing forward.

? Problem-Solving Skills: ADHDers are excellent at finding creative solutions, especially when facing obstacles that need out-of-the-box thinking.

? Empathy: Many with ADHD have deep empathy and understanding, making them incredible listeners and compassionate friends and colleagues.

? Intuition: ADHDers often have a strong gut feeling or sixth sense about people and situations, making quick decisions based on instincts that are surprisingly accurate.

? Energetic Drive: When passion and interest are aligned, ADHDers can be unstoppable, channelling energy into projects and seeing them through to completion with enthusiasm.

? Visionary Thinking: With the ability to see the big picture and think about the future in a unique way, many ADHDers are great at developing long-term goals and dreams.

THE RISE IN DIAGNOSES – WHY SO MANY NOW?

The surge in ADHD diagnoses, particularly in women, can be attributed to increased awareness, better diagnostic tools, and the understanding that ADHD manifests differently in women. While some private diagnoses have been scrutinised, the vast majority follow a rigorous triage process (BBC News, 2023).

It's a myth that everyone going through the diagnosis process actually receives an ADHD diagnosis though, of course, a proper triage process makes it more likely... it's almost as though trained medical professionals know what they're talking about, eh?

ADHD AND MENOPAUSE: WHY SYMPTOMS SURGE

Hormonal shifts during perimenopause can significantly worsen ADHD symptoms, highlighting issues that women may have masked for years. Oestrogen plays a key role in regulating dopamine, and as levels decline, so too does executive function. This is why so many women experience a surge in ADHD symptoms during perimenopause.

While HRT can help manage menopause symptoms, it doesn’t address the underlying ADHD. This distinction is crucial, as women often report that HRT alone isn’t enough to mitigate the cognitive challenges that come with ADHD.

DIFFERENT TYPES OF ADHD

There are three main types of ADHD:

1. Predominantly Inattentive: Marked by forgetfulness, lack of focus, and disorganisation – more common in women.

2. Predominantly Hyperactive-Impulsive: Characterised by restlessness and impulsive behaviour – often seen more in men.

3. Combined Type: Features symptoms of both inattentiveness and hyperactivity.

These types are seen across all genders, including those who identify as non-binary, who may experience ADHD differently due to the unique social pressures they face.

Mine is Combined Type - though it's important to understand that much of my hyperactivity goes on inside my head, as is so typical for so many women with ADHD.

THE NEED FOR A SPECIALIST ADHD DIAGNOSIS

It’s critical to seek a diagnosis from a reputable ADHD specialist. While there are concerns about people jumping on the bandwagon for benefits, legitimate diagnoses come from thorough assessments, often involving multiple specialists and a detailed history review. Going through a trusted GP or recognised clinic ensures that you’re getting a reliable diagnosis and appropriate treatment.

Please don’t just pick an ADHD diagnosis service you’ve spotted online without checking in with your GP. Here in the UK, the Shared Care protocol means your treatment can be moved back to the NHS once you’ve been through the initial private diagnosis and medication balancing (if you choose to take that route).?

Private diagnosis tends to be the way now, simply because NHS waiting lists are so long. I was referred to my specialist by my NHS GP; right now, it’s costing me an arm and a leg, but in a few months’ time, it should all swing back to my usual doctor and it’ll be business as usual.?

I’ve heard so many horror stories from people who’ve just picked someone online and paid for diagnosis, only to find that the NHS doesn’t recognise the ‘specialist’ and, therefore, ongoing treatment isn’t available. This can result in people being stuck with their initial private consultant choice forever more, with spiralling costs, or having to pay to go through the entire process again after a GP referral.?

Speak to your GP first. And if your GP isn’t sympathetic? Find one who is! Don’t try to cut the corners.?

FAMOUS FACES WITH ADHD: YOU’RE IN GREAT COMPANY

A quick glance around the worlds of business and celebrity (celebrity IS a business anyway, right?) will show up plenty of familiar faces with ADHD. Many well-known figures from various industries have publicly shared their ADHD journeys, showing that it doesn't need to be a barrier to success.

Celebrities like Will.i.am, the Grammy-winning musician and producer, and Emma Watson, best known for her role as Hermione Granger, have both spoken openly about how ADHD has shaped their creative and professional lives.

Olympian Michael Phelps, who has won more gold medals than any other athlete in history, has also credited his ADHD for giving him the focus and drive to succeed in swimming. And let’s not forget Richard Branson, the entrepreneur behind Virgin Group, who has said that his ADHD has played a role in his ability to think differently and take big risks.

Other well known figures who've spoken about their ADHD include Simon Sinek , Mel Robbins , Simone Biles, Nelly Furtado, Trevor Noah, Gwyneth Paltrow , Justin Timberlake, Channing Tatum , Mark Ruffalo and Ryan Gosling .

There's your proof that ADHD doesn’t have to hold us back; in fact, it can be a source of strength and innovation.

I guarantee you will know - and know of - countless successful people who happen to have ADHD, whether you know about it or not!

AND FINALLY…

Please understand that ADHD is real, it’s complex, and it deserves to be recognised and respected. Whether you’re experiencing symptoms yourself or supporting someone who is, it's really important to understand what's going on, hold onto compassion and be patient. Diagnosis can be a rough ride, but it's nothing compared to everything we've lived through so far.

I really hope this article has been helpful - it's only scratching the surface, so please do your own research and talk to people with actual medical training to get the full picture - this is no more than the result of my own experiences and research.

If you have questions, or there's anything you think I might be able to help with, please do feel free to drop me a line and I'll do my best to help.

Good luck out there!

#UnleashYourAwesome

Taz X

References:

1. The Lancet Psychiatry (2018) – Genetic Influence of ADHD

2. Journal of Clinical Psychiatry (2020) – ADHD Symptoms in Women

3. Nature Reviews Endocrinology (2021) – Hormonal Impact on ADHD

4. Journal of Clinical Child and Adolescent Psychology (2022) – Hereditary Nature of ADHD

5. BBC News (2023) – ADHD