Smart, female, severely ADHD
Image: Unsplash ("That's Her Business")

Smart, female, severely ADHD

Smart, female, severely ADHD - wait what? Someone like me can't have ADHD. Right? Well, recently diagnosed, I decided to use #adhdawarenessmonth to shed some light on a condition that everyone seems to have an opinion on without knowing much about it. If, like me, you can't read long articles, just read sub-headlines & scroll down to the video.

ADHD is much more serious than you think:

  • Children with ADHD are nearly twice as likely to die by age 10
  • Young adults (23-32) are 11x more likely to be unemployed (and not in school)
  • ADHD students are less likely to go to uni overall and < 20% graduate
  • Driving with untreated ADHD is akin to driving under the influence
  • There's a big predisposition for many serious problems such as substance abuse, eating disorders, burnout & comorbid conditions like OCD or anxiety
  • Other risk-seeking behaviors can destroy careers, credit, health & relationships
  • ADHD individuals are 2x as likely to die an unnatural death & life expectancy can be reduced by over a decade

In Europe, ADHD is under-, not over-diagnosed, esp. in females

Yes, there are also milder cases, but given the dangers of severe ADHD, it's imperative to improve diagnostic rates in Europe. While science estimates that ca. 5% of the population have ADHD, in Germany, only 1.8% are diagnosed. A lot of people suffer without knowing why. This is especially true for girls. Since they tend to have more internalized symptoms and feel more pressure to mask them, they often don't fit the hyperactive stereotype. Also, gifted kids don't always fit the struggling student stereotype and only fall apart in (early) adulthood, when they face less structure and higher demands.

There are other symptoms besides being loud & fidgety i.a.:

  • Trouble listening to a person talking directly to you (esp. when trying for eye contact)
  • Inability to focus on things that aren't extremely exciting
  • Distractibility, daydreaming (e.g. frequently missing stops on the train)
  • Tunnel vision (hyperfocus) when things are exciting, i.e. blending out everything else
  • Extreme physical or mental restlessness, feeling always "on", unable to relax or sleep
  • Trouble with organization, frequent procrastination & poor sense of time
  • Feeling tortured by the mundane & routine; always seeking novelty & extremes
  • Inability to mono-task or work sequentially
  • Disproportionate emotions & intense rejection sensitivity
  • Impatience, lack of frustration tolerance & longing for immediate gratification
  • Poor working memory
  • Constantly forgetting, losing or misplacing things & often losing your train of thought
  • All sorts of impulsive behaviors (shopping, eating, interrupting others etc.)

Everyone struggles with some of the above issues sometimes but that doesn't mean everyone has ADHD or that ADHD isn't real in the same way that everyone gets sad sometimes but not everyone has depression (yet depression is still a real thing). A diagnosis looks at frequency, magnitude & impact of symptoms. While diagnoses differentiate between primarily inattentive, primarily hyperactive-/impulsive & combined types, the concrete presentations of ADHD will look differently in everyone and can change over time.

My personal highlights (lowlights?)

  • Only being able to study in front of the TV, late at night & spending at least 30% of high school asleep on my desk (since I had straight As, I got away with everything)
  • Skipping 10th grade, but losing several years because I couldn't decide on a major after high school or a career after uni
  • Finishing an English 1000+ page HP book in 3 days as a kid, but being unable to complete 90% of the assigned reading in HS/uni
  • Self-medicating with 6 Red Bulls a day for years (up to 10 for exams)
  • Almost dropping out of uni every semester
  • Regularly sleeping in the library out of guilt about not getting anything done, then procrastinating further until blind panic pushed me into hyperfocus
  • Keeping the blinds down for 3 years at uni, so neighbors wouldn't realize my room looked worse than Jake Peralta's locker
  • Binge eating to a point where I was once 20kg heavier than now, despite doing up to 20h of exercise per week at the same time
  • Missing dental appointments until I ended up with a broken-off piece & 4 root canals
  • Not writing my Master's graduation speech until noon of graduation day
  • Not taking a job opportunity because it would have involved driving
  • Not being able to take a break from exercising for 950 days straight despite several illnesses, injuries & a wisdom tooth removal (a streak only broken by Covid)
  • Almost stepping on a cobra while distracted...

I could go on forever. The only thing that was more exhausting than having so many impairments was keeping up a facade about not having them. I tragically lost out on many experiences and friendships because I didn't want people to get close enough to realize the struggle. I did eventually graduate top of my class but the question was never whether I'd get an A or B but whether I'd hand in anything or nothing.

ADHD is a well-researched neurobiological divergence

Throughout my life, many people referred to me as the "smart, driven one". Yet, before the diagnosis, I called myself an idiot at least 50 times a day. In reality, ADHD doesn't affect intelligence. Some things are just harder. And that's not due to a lack of discipline, either:

  • Simplified, ADHD is caused by a chronic problem with dopamine & norepinephrine
  • The prefrontal cortex - the brain area responsible for "adulting" - is underdeveloped
  • The default mode network of the brain, which should decrease activity when a person goes from nothing to starting a task, remains activated, providing constant distractions

ADHD can also be an asset to employers

Why the hell would I put all of the above on LinkedIn? Am I actively trying to become unemployable? The fact is, many people would tell me to shut the hell up about such a condition. There's a reason, I'm publishing this on the last possible day of the month (oh, the irony). But that intense fear of being written off is precisely why I've decided to publish after all. Writing off ADHD individuals would be stupid. The accommodations for more productivity of ADHD employees are often a minor inconvenience - flexible hours, the option to go for a walk during lunch, clear instructions & prioritizations, interim deadlines & permission to turn off notifications during certain times of the day go a long way. Also, firms can reap huge benefits from certain gifts that often accompany ADHD such as:

  • Vivid imagination, a wellspring of creativity & having boatloads of ideas
  • Excitability, passion and ability to motivate others
  • Entrepreneurial mindset; ability to think outside the box & devise novel solutions
  • Seeing patterns others miss
  • Ability to hyperfocus (if the task is right)
  • Extreme work ethic (from years of overcompensation)

I didn't want to include bragging, but feel it serves a purpose here: While I spent a lot of time procrastinating, I not only eventually left uni with top grades, I had also used the time I put off studying to found an MUN society, joined several student boards, won debate awards, competed in 2 cheerleading competitions, and several half marathons. I got my first consulting gig because I was the only case study competitor that convincingly argued for a different solution than the one the firm had had in mind. I got into a Big 4 and all my performance reviews are top notch, plus I started many initiatives beyond my job description. Those make my work-life more interesting, sure, but also benefit my colleagues. Having ADHD doesn't mean someone doesn't have potential or shouldn't get a job.

Conclusion: The stigma needs to go

In order to live up to their potential long-term, however, ADHD individuals should be diagnosed. Good news: while serious, ADHD is seriously treatable. Bad news: there are very few specialists and 'normal' doctors usually know nothing of ADHD, esp. regarding how it presents in women, leading to many misdiagnoses. Education needs to be improved and waiting times (usually many months for just the 1st appointment) need to be reduced.

More importantly, though, the stigma that prevents individuals from seeing the few existing specialists needs to go. Let me be clear: Those who aren't struggling with neurobiological issues aren't stronger - they just got lucky. It's ridiculous that many Germans still judge psychiatry more harshly than prostitution. Anyone seeking a diagnosis should walk into their appointment with their head high (not feeling as though they're entering a brothel, like I did). And if it does turn out to be ADHD, they should feel free to share this information without fears of ruining their professional reputation and career.

Disclaimer: I am not a doctor. If you suspect you might have ADHD, I would take one of the quizzes/checklists and then decide if it's worth it to see a specialist.

The best video: Never felt more seen than by the one saying "ADHD is like being the smartest, stupidest, most motivated, laziest person in the room - all at the same time"

References:

  • ADHD at Work. (2022). Providing Accommodations for ADHD at Work. Link
  • ADHD Institute. (2021) Epidemiology. Link
  • Barkley, R. (2022). What are the long-term health implications of ADHD? Link
  • Bertin, M. (2018). ADHD and Its Impact on Longevity. Link
  • Biederman, J. (2022). Driving with ADHD: Pumping the Brakes on Vehicle Safety Risks. Link
  • Boissiere, P. (2018). Thriving with Adult ADHD: Skills to Strengthen Executive Functioning. Link
  • Brown, T.E. (2022) Exaggerated Emotions: How and Why ADHD Triggers Intense Feelings. Link
  • Cronkleton, E. (2021). What are the differences between an ADHD brain and a neurotypical brain. Link
  • Erskine H.El, et al. (2016). Long-Term Outcomes of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder: A Systematic Review and Meta-Analysis. Link
  • Flippin, R. (2022). Hyperfocus: The ADHD Phenomenon of Intense Fixation. Link
  • Franke, B. et al. (2018). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. Link
  • Hallowell, E. (2021). Default Mode Network. ADHD’s Secret Demon – and How to Tame it. Link
  • Hemenway-Forbes, M. (2013). For ADHD students, transition to college is tough. Link
  • Kessler, Z. (2021). Real Stories of ADHD and Triumph. Link
  • Knouse, L.E. (2022). ADHD in adults is challenging but highly treatable. Link
  • Kravit, A. (2022). Everything You Never Knew About the ADHD Brain. Link
  • Kuriyan, A.B. et al. (2013). Young Adult Educational and Vocational Outcomes of Children diagnosed with ADHD. Link
  • Lavelle, D. (2018). People with ADHD can be incredibly valuable at work. Link
  • NHS (2022). Symptoms of attention deficit hyperactivity disorder (ADHD). Link
  • Posner, J. (2022). 9 ADHD Myths and Fallacies that Perpetuate Stigma. Link
  • Reinblatt, S.P. (2015). Are Eating Disorder Related to Attention Deficit / Hyperactivity Disorder? Link
  • Sherman, C. (2022). The Truth about ADHD and Addiction. Link
  • Sigler, E. (2022). ADHD Looks Different in Women. Here’s How – and Why. Link
  • Totally ADD (2022). 23 Signs You Do Not Have Adult ADHD. Link
  • White, H. (2019). The Creativity of ADHD. More insights on a positive side of a “disorder”. Link

Julian J. Rossig, Ph.D.

It's all about results | Making retail processes work

2 年

Thanks for sharing!

Lukas Burchhardt

Political Communications and Campaigns @ Cosmonauts & Kings | PR #30u30

2 年

Thank you for your courage!

Eric Holst

+7 years in Web3 ????

2 年

??

Antonia K.

Solution Engineer at Tableau, a Salesforce company

2 年

Thank you for being so open and vulnerable Christina! And also for summarizing everything so comprehensively. I am certain this will help a lot of people. Especially in being more empathetic with their fellow human beings. ??

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