The other day, I walked from my kitchen to my bedroom to do something and by the time I reached my destination, the task in my mind had evaporated. And by “other day,” I mean yesterday. And the day before yesterday. And the one before that too.
This challenge of holding on to plans and details and basically anything smaller than a loaf of bread has become tricky enough for me lately that I’ve found myself employing strategies we give to patients with memory-impairment. I’ll repeat the task out loud all the way there and I have more sticky notes going than any reasonable person probably should, for example.
Given that I spend a lot of time online, I’ve of course considered whether my challenges can be chalked up to some kind of neurodivergence. Indeed, just a minute and a half these days on social media will reveal that the only condition being diagnosed more often than narcissistic parents is ADHD. (I’ve written quite a bit before about the pros and cons of this.)
To be honest, I’m still sorting through whether ADHD fits as a description of how my brain works. But in navigating my own journey, while being front row for the similar journeys of friends, family, and patients, I’ve been struck by how quickly we can come to assign – formally or informally – a diagnosis of ADHD when there are so many other factors at play, especially for women.
The reality is that girls and women have been missed almost entirely when it comes to ADHD for the last many decades. Girls with ADHD spent generations being labeled as lacking intelligence, considered under-achieving, or turning to unhelpful or even dangerous methods to try to manage their symptoms on their own.
Trained to look exclusively for the more stereotyped physical rambunctiousness, teachers and medical providers doled out ADHD diagnoses nine times as often to boys. Today, boys still get the diagnosis more often, but it’s about twice as often.
Finally studying and better understanding ADHD in females has meant that girls and women who have long struggled to understand their own neurobiology are at last empowered with the knowledge of their own brains. It’s also meant, perhaps, a bit of an over-correction.
On the one hand, we might wonder what’s the harm in women finally having access to a concept that helps them take charge of their executive functioning? Indeed, at this point, I’d rather us be more liberal with that diagnosis than not.
But here’s where it gets tricky for me. If we can – once again – attribute the way many women are functioning to biologically-based and individual disorder, it lets society off the hook – once again – for the conditions that exist that could actually be causing many of the symptoms.
If we’re considering a diagnosis, it’s worth considering if the following are true, because they each can produce experiences and symptoms that are a whole lot like ADHD.
- Your sleep is complete garbage. Show me a woman who is sleeping well right now and I’ll show you a unicorn. With everything from alcohol to kids to anxiety spirals to night sweats to stress delaying the onset of sleep and diminishing its quality, most of us don’t even realize how much it’s impacting us. But being under-rested is probably the number one culprit in our day and age of memory problems, irritability, emotion dysregulation, and low motivation. It can prompt us then to seek out dopamine and adrenaline just to stay going, which can make us feel impulsive and more scattered, much like ADHD might present.
- You’re carrying far more than your share of the mental load. Most of us see the condition of ADHD being marked by inattention, but it’s actually a condition of hyper-attention. People with ADHD are attending quite a lot, it’s often just to many things (or focusing in sharply on one thing of interest). This can mirror what happens when we’re in a chronic state of having to hold tons of details in our mind. It can feel like we’re always dropping the ball on one thing or another and like we can’t make progress on the things that most need our attention.
- You’re experiencing hormonal shifts of pregnancy, perimenopause, or menopause. It can be easy to confuse “pregnancy brain” with ADHD because they do share many of the same symptoms – a harder time multi-tasking, difficulty following a conversation, feeling zoned out. Hormonal shifts caused by any transition or biological change can also produce a number of these experiences.
- You live in a red state. Okay, maybe that sounds provocative, but hear me out. If you are experiencing actual or perceived threats on your rights – whether to bodily autonomy, marriage to your partner, or healthcare – your body is going to respond by being in a state of hypervigilance. When we are threatened and stressed, our brain is operating in fight/flight/freeze mode, meaning we don’t have as much access to our executive functioning. The hallmark of ADHD is difficulty with executive functioning.
- You’re grieving. Grief is one of the most misunderstood human experiences, particularly for something that we will all endure at various points. Its impact can look a lot like depression, anxiety, ADHD, and a host of other emotional and behavioral challenges. It would be wise not to assume that you have a neurodivergence if the symptoms are happening in the context of a recent life change or stressor. What’s often trickier is when we have unresolved grief that’s never really been addressed.
- You’ve experienced trauma that’s not been addressed. Similar to grief, but often even more enduring is having the experience of trauma. If we have trauma that continues to impact us, it can show up as distractibility, inattention, hyperactivity, rejection sensitivity, and other ADHD symptoms. A lot of these symptoms could actually be ways that our bodies and brains have learned to adapt in the wake of a traumatic experience or set of experiences.
- You’re constantly over-stimulated. This one has major implications, and I see it most often in parents. The level of noise, smells, and touch endured by parents, especially ones of younger kiddos, on the regular is enough to make anyone’s brain feel fried. It makes sense that in this context we would struggle to be able to effectively think, plan, remember, and execute on our goals. To make matters more complicated, if you do have ADHD or have sensory sensitivities, you might have an even more challenging time with this phase of life.
To be crystal clear, you could be experiencing any or all of the above and have ADHD. You could also have a number of other issues that could mimic some of the struggles experienced by those with ADHD.
The point here is two-fold. First, a diagnosis of ADHD should not be made solely via TikTok. I realize it takes more resources to consult with a mental health provider on this, but it’s truly worth differentiating what’s going on so that you can be empowered with the right solutions and tools.
Second, many of our worlds are shit-shows right now. Our households feel chaotic, our country feels chaotic, our world feels chaotic. It makes sense then that our minds can feel that way too. When we realize that things are not as they should be and we start calling that out, it gives society a free pass to stay in free-fall and under-support us if it can point the finger back at us as individuals.
ADHD is a complicated condition. It, like all of us, deserves to be thoughtfully considered and well-understood.