ADHD and me: Getting diagnosed as an adult woman

October is ADHD Awareness Month. ADHD is a chronic neurodevelopment disorder that can cause hyperactivity and executive function impairments, such as challenges with attention, organization, time management, impulsivity, working memory, processing speed, and emotional regulation. It isn't an illness or a behaviour disorder and it isn't a choice or a character flaw. But it can be a superpower.

A couple of months ago, just after my 38th birthday, I was diagnosed with ADHD. If you grew up in my generation or earlier, you might be thinking: “She’s not a boy so she can’t have ADHD.” “She graduated at the top of her class so she can’t have ADHD.” “She’s a high performer with a great career so she can’t have ADHD.” Or you might even be thinking: “ADHD isn’t a real diagnosis.” “Everybody struggles with focus sometimes.” “Just try harder.”

And frankly, I wouldn’t blame you for having these thoughts because I was equally ignorant until very recently. That’s why it’s so important to me to share my story and help build awareness and understanding of ADHD, and particularly how it can affect adult women.

If you only know symptoms for men, you’ll only find symptoms in men

ADHD has been a diagnosis for over 100 years, but like so many medical conditions, the diagnostic criteria was biased towards white men and boys. That’s why, if you’re like me, you grew up thinking that ADD, or ADHD, was exclusive to hyperactive little boys who misbehaved and struggled at school. Unsurprisingly, boys are three times more likely to get diagnosed with ADHD than girls.

But the tide is starting to change thanks to the advocacy of researchers and clinicians who recognized this gender bias (though there is still more to be done to address inequity faced by people of colour). They’ve made huge strides in assessing symptoms in girls and women, including finding a link to female hormones and symptom fluctuation throughout the menstrual cycle. As a result, there was a 55% increase in ADHD diagnoses in girls between 2003 and 2011, according to The Journal of Clinical Psychiatry. And among women aged 26 to 34, ADHD prescriptions shot up 85% between 2008 and 2012 alone.

“The average age of diagnosis for women with ADHD, who weren’t diagnosed as children, is 36 to 38 years old.”

“The average age of diagnosis for women with ADHD, who weren’t diagnosed as children, is 36 to 38 years old,” the director of the U.S.-based National Center for Girls and Women with ADHD, and author of?Understanding Women with ADHD, told ADDitude magazine. “Before that time, girls and women are often misdiagnosed as having a mood disorder or an anxiety disorder. Even if these are secondary conditions, treating them does not get to the root of the problem, which is ADHD.” In fact, nearly half of women are misdiagnosed with another mental health condition before being diagnosed with ADHD, according to the Centre for ADHD Awareness, Canada (CADDAC). ?

There isn’t something “wrong” with me after all

I’m no stranger to the mental health space – those who know me well know that I’ve struggled with anxiety, post-traumatic stress and depression. But what they don’t know is how much I haven’t told them, particularly about what I struggle with the most. These are things that I’ve locked up in a box my whole life, too shameful to share with a friend, let alone a therapist or a doctor. Things that I felt were my fault, or at least faults in my character. For example, I thought I was lazy – a trait that is seen as a choice and that society teaches us to frown on with disgust.

With a long list of awards and accolades spanning academia, athletics and the arts, I became accustomed as a child to being told that I was bright, gifted and that I could achieve anything. Ability has never been my issue. ADHD symptoms can often begin to manifest in puberty in women, as a result of the hormonal link, and I can now reflect back on how the impairments of ADHD began to affect me as a teenager. When I moved away from home and left school at 18 – without routine, structure and accountability, my impairments began to grow, but the severity didn't truly manifest until I eventually began “adulting” in my 30s.

As a result, I’ve spent my 30s trying to hide these flaws from the world – not wanting anyone to know how much I struggle with things that seem to come so easy and naturally to others. Fueled by the shame and embarrassment of feeling inherently “broken,” I developed crippling anxiety about failing and not being good enough – things I hadn't worried about in my 20s, when I prided myself on the novelty and risk of my atypical lifestyle and decisions. I now desperately wanted to appear “normal” – but as many neurodiverse people will tell you, it’s not easy to know what “normal” or “good enough” is when your brain doesn’t work neurotypically.

Without that built-in benchmark, I eventually became a perfectionist at work, often working double or triple time to ensure that I never fell below the bar. For me, this looks like hours upon hours of additional time spent labouring over whether a PowerPoint presentation is up to par or whether an email is phrased diplomatically enough, and over-preparing notes for meetings and scripts for presentations to ensure that I remember everything I need to say – and more importantly, that I won't look stupid or unprofessional when my brain inevitably goes blank. All things that can easily lead to burnout when coupled with an already overflowing workload and calendar.

Interestingly, 80% of adults with ADHD have at least one other mental health condition, according to CADDAC. This isn’t surprising, given what I just described – I literally developed an anxiety disorder from trying to hide what I thought was something wrong with me. I’ve learned this is typical in girls and women with ADHD and a big reason why our symptoms fly under the radar for so long. Women are often conditioned from a young age to be “good girls” – and that pressure and expectation can generate performance anxiety that drives us to great lengths to achieve, resulting in the struggles that often lead to an ADHD diagnosis being masked from parents and teachers.

In many ways, my true life is just beginning

Over the last couple of months, I’ve been grieving what my life could have been like if I’d been diagnosed over 20 years ago. It’s hard not to think about how much easier things could have been or how much more I could have achieved if I’d had the awareness and tools to overcome these challenges earlier in my life. If you’d like to understand how this feels, I highly recommend watching this TikTok video about late-diagnosis trauma:

For now, I’m focused on understanding myself better and developing those tools. I recently began taking ADHD medication and seeing a therapist who specializes in ADHD, and I’m looking forward to seeing how much more my life will improve, both in and outside of work, as I continue on this journey. Each day, I’m working on reducing the mountain of shame I’ve felt my whole life by practicing self-compassion. I’m grateful to finally have an answer to a question I didn’t know I needed to ask – and I have no doubt that life will continue to get better as I get more answers.

I’m also grateful for all the ways that ADHD makes me unique, including my deep empathy for others, my imagination and creativity, my zest for innovation and my ability to hyper-fixate on things that fascinate me – many of the qualities that not only make me “me”, but are also what have driven the success I’ve achieved in my career. If you Google “ADHD superpowers,” you’ll see that there's a very positive side to this disorder that's often overlooked.

Thank you for reading. It’s not easy posting something so vulnerable on a professional network, but if my story helps one person to feel less alone or helps others to have more understanding and empathy towards those with ADHD, it’s so worth it.?

Updated October 8, 2022: I was blown away by the incredible response I've received since posting this. I realized that this story was equally worth sharing, so I wrote this follow-up post: Courage is contagious. Let's go viral!