By Rae Jacobson
Years ago, with the start date of a new job closing in, I made the mistake of trying to explain my mounting panic to the guy I was dating at the time. "I'm so afraid of screwing up," I told him, trying to keep my voice even, "with the ADHD stuff. I'll forget something or get it wrong or ..."
"Juuuuust chill out," he interrupted, patting my knee in a fatherly sort of way. "You don't have ADD. You're just lazy." His tone suggested this was a compliment. "Besides," his smile widened, "isn't that a little-boy thing?"
I wasn't surprised by his reaction. Start talking about a disorder people can't see and you learn to expect a certain amount of doubt, along with the occasional conspiracy theory involving drug companies, gluten, mass delusions, and other byproducts of this, our modern age. I understand (some) of where they're coming from. ADHD, a chronic behavioral disorder, is complicated, confusing and undeniably overdiagnosed.
If you're female, the conversation is even more fraught. For decades ADHD was seen as a young boy's disorder. New evidence suggests that it likely affects males and females equally, but that girls are far less likely to be diagnosed. For years the diagnosis ratio of males to females was 10:1. These days we're looking at a slightly brighter 3:1.
One reason for the discrepancy is that, in girls, the disorder doesn't always look the way we think it should: fidgety, energetic, distracting. In her book 100 Questions & Answers About Attention Deficit Hyperactivity Disorder, Dr. Patricia Quinn, one of the great gurus of women with ADHD, writes that girls tend to be less disruptive than boys, manifesting their lack of attention in subtler ways -- disorganization, distraction, and difficulty following directions. Even more hyperactive girls are less likely to be noticed. Instead of bouncing off the walls, "A girl with ADHD may be hypertalkative or hyperreactive (crying a lot or slamming doors) -- behaviors one may not typically think of as being associated with ADHD." Then there's the sexist skepticism: She's just a ditz.
Diagnosis can be tricky, because the disorder, which is likely genetic, can look more like a disciplinary problem than a medical one, and because everyone has these behaviors to some extent: You have a hard time paying attention to boring things? How awful and unique! Oh, man, you lost your driver's license? That is so demoralizing, and never happens to anyone else. An hour late to something important? Burned dinner? Missed half the lecture because you were daydreaming about being a crane operator? Haven't we all?
Part of what separates ADHD-havers from the merely forgetful is that for us, to use DSM parlance, the symptoms "have a significant impact on daily life and functioning." When I was a kid "significant impact" meant being in perpetual trouble: always being late, never hearing the assignment, enduring depressingly frequent teen-magazine "It Happened to Me"-type moments (I was often surprised by my period's arrival). Teacher's pet I wasn't: "Clearly Rae has not been," snapped my sixth-grade math teacher, flinging an eraser at my desk, "PAYING ATTENTION, so the whole class will have to wait while I go over this again."
By high school, I had fully internalized the fact that I was a screwup and began acting the part with teenage gusto. "Fuck you, fail me," I spat at a particularly hateful teacher, middle fingers aloft. "It's not my first time."
Then I'd go home and cry. Repeated failure is destructive. It chips away at your self-confidence and eats at your resolve. It makes you hate yourself.
"Why am I like this? Why am I fucking like this?" I'd ask myself, over and over.
My whole life, I was not once early -- not on homework, not on planning, not on anything. If I was on time, it appeared as though I'd been recently airlifted from a desert island. Beyond my failures at school and work, not being able to focus made me feel like I'd failed at being a girl. Having ADHD is challenging regardless of gender but in a world predisposed to undermining women, not having your shit together can feel like a dereliction of feminine duty. "Practically perfect in every way," trills Mary Poppins, that great betrayer, showing us all how fun cleanliness can be.
Once, upon seeing my apartment, a potential suitor raised an eyebrow at the ransacked living room, "You live with dudes?" he asked, dubious.
"Yup," I lied.
Bombing at Stepford Wifery would have been fine, except that I was also far from being a successful, capable ambassatrix for who-gives-a-fuck feminism. I felt useless: not professional or brilliant enough to be the academic outsider, not confident enough to be a punk-rock rebel, not cute enough to be an endearing space cadet. The more I tried to hide how much I was struggling, the worse it got. Every lost thing and new mistake was another chance to confirm my increasingly obvious worthlessness. Why, why, why, I asked myself, am I so dumb/useless/pathetic?
Dr. Quinn notes that women and girls with ADHD, often undiagnosed and overlooked, are prone to blaming themselves for the negative feedback they get going through life. Without a diagnosis, the disorder's fallout -- bad grades, poor time management, a sense that basic life skills are out of reach -- read as character flaws, a suspicion often confirmed by outside sources: You're just lazy!
Women with ADHD show consistently lower levels of self-esteem than our neurotypical counterparts and report correspondingly higher rates of depression, anxiety, and feelings of shame. The social pressures that tend to make women overly apologetic are compounded by ADHD, because you can never be sure it really isn't your fault. My mistake? Probably. Yes.
At 21, I was finally diagnosed. "Your testing is bell-clear," the brusque psychiatrist told me. She looked surprised when I started to cry.
I still have ADHD. I'm still disorganized. My room isn't what you'd call clean. I still have to fight to stay on top of things that seem easy for others. Getting diagnosed wasn't a cure, it was a key; I finally have the missing information I need to manage my life. I suck at time management so I've become a Google Calendar devotee. The phone plays snippets of "Bizarre Love Triangle" 20 minutes before it's time to leave, then ten, then five. I've got four copies of my birth certificate and six sets of backup keys. I take medication when I need it.
A lot of these little strategies sound like common sense, but for me, they were revelations. In retrospect, I see my fuck-ups for what they were. Not intrinsic, horrible failings, just symptoms, patterns made by a brain that works a little differently. You don't grow out of ADHD. It's a lifelong thing. But these days I don't mind that so much. The disorder has its upsides: creativity, a tendency to view the world from odd angles. And the blaring anxiety I used to feel just trying to get through the day is slowly quieting, turning into the regular white noise of a life.
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