fashion

Why are women so often ignored when it comes to ADHD diagnosis?



Welcome to April’s mental health column by writer and author Beth McColl, where she explores why ADHD in women is so often ignored. Beth is the author of ‘How to Come Alive Again’ which is a relatable and honest practical guide for anyone who has a mental illness. She’s also a v funny gal on Twitter.

ADHD is a neurodevelopmental disorder affecting impulsivity, attention, and organisation. It was first recognised as a valid condition in the UK in 2000, but not in adults until 8 years later. In 2018 ADHD Action estimated that although only 120,000 adults were formally diagnosed, around 1.5 million adults in the UK have it. I’m one of them. I was diagnosed about 5 months ago, when I was 27 years old. I’d begun the assessment process twice before in my 20s, but had abandoned it for reasons I didn’t completely understand at the time. Avoidance seemed easier than concrete answers, easier than the financial and emotional toll of learning to manage a disorder that could explain so much about who I was and why I was struggling. I was also afraid to confront what it had already cost. I’d shaped a freelance career around an inability to handle a traditional job and turned down dream roles because I knew I wouldn’t cope. My childhood love of reading had calcified into disinterest and frustration after three years of struggling to understand University texts and I no longer felt hopeful about what I could achieve. By the time I eventually sat down with a specialist I was overwhelmed and had been for a very long time.

My story isn’t unusual. Women and girls with ADHD are often well into adulthood before they begin to search for answers. Though 12.9% of men will be diagnosed with ADHD in a lifetime, only 4.9% of women will be. This may be related to how the disorder presents across genders, with girls more likely to have inattentive type ADHD and boys more likely to be hyperactive. Inattentive ADHD lacks the more well-known (and easier to spot) markers such as hyperactivity and ‘disruptiveness’. Instead, it often manifests as difficulty focusing or staying organised, memory or co-ordination issues and an inability to understand and complete tasks. Because girls and young women are still socialised to be quieter, more polite, and more generous, these symptoms can be kept hidden for years. They may be misdiagnosed with BPD, Bipolar, or a mood disorder, told they’re hormonal, depressed, oversensitive, not trying hard enough.

Disparities in access to care are also informed by racial medical bias, as Chanté Joseph explores in her article ‘How My ADHD Diagnosis Changed The Way I Live My Life As A Black Woman’. Modern ADHD criteria are still informed by early studies into the disorder, which were done half a century ago on predominantly young, hyperactive white males. As she explains, the further you exist outside of this expected image, the harder it is to place yourself within it and access help or support.

I have a ‘quiet’ presentation of ADHD and I learned to mask symptoms as they became more pronounced. I wasn’t disruptive at school, and my grades were consistent, but in private I felt increasingly out of control. At University things got very bad very quickly. Without the routine of school I missed dozens of deadlines, filling out the same mitigating circumstances form every time. I slipped behind, feeling more depressed, more unhappy with myself. I’d work in 12-hour bursts to make extended deadlines, staying up for days at a time to study for an exam on a module I’d barely attended the seminars or lectures for. The idea that the rest of my life would be spent taking these same last-minute leaps, masking my deficits, and making myself secretly sick with stress was unbearable. Instead of being excited about the rest of my life, it seemed like a dead end.

Years after graduating I read an article about Inattentive ADHD. What it described was immediately familiar: a lifetime of missing key details, losing things, struggling to process information, having an extreme sensitivity to rejection. There were terms for what I struggled with, explanations that didn’t involve a life doomed to falling short and hating myself for it.

Still, getting a diagnosis has been a lengthy and difficult process. NHS waiting lists are long, and after years of repeating myself, I decided to go private. It’s been expensive. The assessment was £360. The initial titration for medication (that may or may not be working) has cost almost £200, with a private prescription costing up to £70 each month. For most people this would be a significant expense, for many, it’s completely prohibitive. I’m lucky it’s an option at all, and I’m grateful for the framework of understanding that diagnosis has given me. When I’m near tears, unable to begin a task, I know that it’s unrelated to my intelligence or commitment. When I feel undone by a ‘silly’ mistake, I practice self-compassion. I’m far from a place where I can consider it ‘well-managed’ but I’m getting there. But it’s hard not to think about what it’s taken, the years I spent believing it was a choice not to cope, not to be productive, or profit-making in the way that I believed made me worthy. I’m not angry that things were missed, that my frustration and genuine inability to focus were misinterpreted as laziness or lack of care, but it is a cost incurred. It is something that I have to face.

ADHD is incredibly challenging. It’s poorly understood and stigmatised. It costs me time and opportunities, as well as actual money in forgotten invoices, subscriptions I fail to cancel, bills I don’t pay, last-minute shipping when something important slips my mind. It makes things hard in calculable ways, but I’m also quick and creative, compassionate in ways I’m not sure I’d be had I not spent a lifetime learning to exist with this brain, this way of seeing the world. I am a woman with ADHD, and I’m happy to explain or offer context for that, but I’m not here to defend myself or prove it. I don’t have the time. I am busy learning how to be at my best, at my most self-supportive and forgiving. I am busy, at last, building myself a future that can contain me exactly as I am.





READ SOURCE

Leave a Reply

This website uses cookies. By continuing to use this site, you accept our use of cookies.  Learn more