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My ADHD Diagnosis Took Nearly 30 Years
The signs were there growing up, so why was it so difficult to spot my symptoms?
I knew something was desperately wrong with my memory the morning I forgot to attend the first day of classes in my second year of grad school.
I didn’t merely oversleep — my brain simply didn’t register that going to school that day was even an option. In my nearly 20-year educational history, I had never missed the first day of a new term. As I lay in my bed and thought through all of the options, I settled on setting up an appointment with my therapist. The morning’s rigamarole confirmed what I had suspected for the previous few years — that I had ADHD, and now it was affecting my life in ways that seemed beyond my control. It was time to get answers.
After graduating from college, I was diagnosed with bipolar II disorder. (ADHD is typically comorbid with various mood disorders.) Due to my previous diagnosis, doctors chalked up my increasing inability to concentrate as a symptom of bipolar depression. It took me a few years to admit to myself that while, yes, I suffer from bipolar depression, not being able to concentrate was depressing me further — it had become a feedback mechanism. I could take inventory of my life before the onset of my bipolar II disorder and the present, and I knew there had been some major changes in my day-to-day life. I had gone from a college student who never needed to keep a calendar to remember my appointments to a young professional who would leave my keys on top of my refrigerator. At work, I would constantly lose time — I’d start a task and instantly begin daydreaming, and before I realized it, hours had gone by. Working as an editor proved difficult when I couldn’t concentrate long enough to thoroughly read everything — or even realize that I hadn’t read everything. At home, it meant that my room was in a constant state of disarray. I constantly felt like I was playing catch-up and that I was expending every modicum of energy I had just to keep up — it was exhausting.
According to the statistics, I’m not alone. I was one of an estimated 4 million women with ADHD who are undiagnosed. Fortunately, that underdiagnosis rate is slowly changing. A 2018 study from the Centers for Disease Control and Prevention determined that between 2003 to 2015, prescription rates for ADHD increased by 700 percent among women ages 25 to 29, and by 560 percent among women ages 30 to 34. But why do women so often reach their late twenties before getting the help they need?
Speaking to the Atlantic, Ellen Littman, PhD, author of Understanding Girls with ADHD, posited that early ADHD studies are to blame for the underdiagnosis phenomena for women. “These studies were based on really hyperactive young white boys who were taken to clinics. The diagnostic criteria were developed based on those studies. As a result, those criteria over-represent the symptoms you see in young boys, making it difficult for girls to be diagnosed unless they behave like hyperactive boys,” Littman says.
The signs of ADHD in young girls often manifest as daydreaming, disorganization, and introversion — not the behavior disruptions that often lead to diagnosis in boys. Additionally, when women approach their medical providers with clear symptoms of ADHD, they are often diagnosed with mood disorders instead. Additude, a online publication focused on ADHD, relayed this information from therapist Sari Solden, author of Women with Attention Deficit Disorder. “Even if they go to their doctor or complain to their therapist of feeling overwhelmed or disorganized, they’re much more likely to be given a diagnosis of a mood disorder instead of ADHD,” Solden says.
To get my own diagnosis, I had to actively advocate for myself with medical professionals and make it clear that my memory lapses were much more than bipolar depression. I went to my psychiatrist and told him that I suspected I had ADHD and requested to take a diagnostic test. The test confirmed my suspicions, and I left the doctor with the answers I needed.
Getting an official diagnosis opened a floodgate of emotions. I was relieved to finally have an answer for why my life seemed to be devolving into disarray. Like many undiagnosed women, I had internalized my illness’ symptoms as me being irresponsible. It angered me that I didn’t get a diagnosis until the very end of my educational career. How was it possible that my symptoms went unidentified for nearly 25 years?
Looking back, I can see the signs were there. I’ve always been a daydreamer and introverted, but I was tracked into gifted classes in early elementary school. I was never a behavior problem, and I think my teachers assumed that I fit the stereotype of quiet, socially awkward, smart girl. I had a very structured home life with parents and grandparents who were invested in my education and made sure I was organized and doing my homework. As a child and teen, it was always impossible for me to keep my room tidy, but that was identified as a personal failing, not as indicative of a larger problem. The warning signs were also clear in college if anyone had been looking. It was very hard for me to stay organized and to prioritize; my room was never together, and I often spaced out in class. I managed to graduate with a solid B average, but I can’t help but think about how well I could have done with an earlier intervention.
Life post-diagnosis is clearer. With the much-needed information about how my brain works, I have been able to set parameters in my personal and professional life that set me up for success. I know how to ask for help and how to say no to activities that will drain me and throw me off track. I just wish it hadn’t taken nearly 30 years to get the answers I needed.