By Caroline Keep

This year I was diagnosed with ADHD at the age of 39. So how did I get to this age, without a diagnosis, since my specialist described me as being a “A Classic Case“?

For many, the idea of attention deficit hyperactivity disorder is summed up by the myth of hyperactive young boys, something I’m familiar with as a teacher… so how could I have possibly missed this in myself given all those CPD training sessions too? On top of that, I have worked with some wonderful SENCOs over the years and nobody mentioned it – perhaps they were just being ‘polite’. Apparently not! Having spoken to several of them after my diagnosis they said, ‘Well, we assumed you knew…’ I did not. Neither did my parents, they assumed I was just ‘quirky’.

Now you would think my doctors may have spotted something during those endless sessions for depression in my youth. But again, no. My husband suspected I was ‘different’, but that’s just how he saw me…’different’ and it never dawned on him that all those hours of intense hyperfocus was anything other than a desire to succeed.

So, what happened? I fell between the cracks and it turns out that these cracks are well documented. We fail young women and girls all the time because of the male-centric ADHD stereotypes with which most of us are familiar i.e. boys bouncing of the walls, which itself is a terrible oversimplification of ADHD. The myths surrounding it has moreover allowed me to go through most of my adult life confused. 

So, here are a few tips on how to spot ADHD in women and girls in an attempt to dispel the myth that it is all about hyperactivity.

It isn’t a real thing.

Let’s get this out the way.  It is estimated that 1.5 million adults have the condition, but only 120,000 of these have been diagnosed. It is affecting as many as 5.3% of all children. So, if you have a class of 30, it is likely that at least one of them has ADHD. It is a neurological condition which, as shown by a study in 2017 in The Lancet, has profound effects on the brain. Yes, those of us with ADHD are wired differently – we’re not less as a result, just different! 

You can’t possibly ‘have it’ – you’re too bright.

We do well at school, are quiet and study hard. We can’t possibly have ADHD, right? Wrong. I, for example, was top of my class and a “first-rate student”. ADHD in girls can be a hidden disorder, with many having the inattentive presentation. The quiet girl (or boy, yes boys can have this too…) seems lost and cannot seem to pay attention. These pupils are often described by teachers as bright young people, who cannot seem to “get it together”.

But you’re not ‘bouncing off the walls’…

Correct. Most girls don’t – you’re more likely to see that in boys. When you do see hyperactivity in girls, it often manifests as ‘chattiness’ rather than physical disruption, and we don’t see that in the same light as hyperactivity in boys — it’s more of an internal mental restlessness rather than an external physical one. Our minds can be racing even though our bodies may be quite still and so therefore, we miss your conversation, struggle with too many instructions, or just ‘lose time’.

It’s just teenage hormones or anxiety…

Going down this route can lead to years of misdiagnosis. Girls and women with ADHD can have difficulties regulating their emotions, a hard time socially and low self-esteem, after years of being told “try harder”, but this pressure to fit in comes at a cost.  Girls can be more socially capable, as they often mirror, copy or imitate the skills of peers, thus making them harder to spot, but meltdown and exhaustion can quickly follow. Moreover, undiagnosed ADHD can cause anxiety, depression, conduct disorder, substance abuse, and sleep problems. So, check with your SENCO before chalking it up to “Teenagers”.

But they’re fine in my class…

What we’re missing here is the emphasis on my class. In other words, in classes that give us that wonderful dopamine hit (that means we’re interested) we can be fine, whilst in other settings… not so much. That my friends, is the result of something called hyperfocus. It’s our superpower! Hyperfocus is the ability to zero intensely on an exciting project or activity for hours at a time. I personally love it. Unfortunately, most of us with ADHD struggle to direct this… and often forget to eat during such periods as well.

People with ADHD have low levels of dopamine in the brain’s frontal lobes and this makes it harder for us to change tasks, especially when enjoying the current task more than a suggested new one. Hyperfocus is our way of boosting our dopamine levels from the enjoyment we get from something that really interests us. So, I might do brilliantly in for example, English Literature when reading Frankenstein, but fail completely in History if it’s not a topic I like. I can’t pick and choose. It’s not that I don’t have attention, I just can’t regulate where that attention goes.

It comes with friends…

When I was diagnosed, the shock came not from the ADHD being confirmed. After a while of researching for teaching my pupils, I had long suspected I was different. But the results from my autism diagnosis. I could not be dyslexic, have ADHD and have autism? Well, actually, yes.

Studies have shown 60%–100% of children with ADHD also exhibit one or more comorbid disorders. Estimates of up to 30 per cent of those diagnosed with dyslexia also have ADHD and up to 42% with ADS. So, being told I was highly likely to be autistic too means I am now undergoing the whole process of getting diagnosed again, just this time for ASD. This happens quite commonly apparently.

Supporting ADHD pupils

Suppose you’re trying to help a student with ADHD. There are many brilliant resources to help, including some fantastic resources from the wonderful ADHD Foundation  https://adhdfoundation.org.uk/, which we all should be reading and was incredibly helpful in my diagnosis. The attitude magazine is brilliant in understanding the entire spectrum of symptoms and challenges we face  https://www.additudemag.com/. Both have been a godsend, so hopefully you will have a look at them.

Getting yourself checked out…

What happens when you DO have a look at the resources above and think… “That sounds like me”? Well…  please speak to your GP and take the short diagnostic criteria test for ADHD. Life is much easier with a confirmed diagnosis if you have ADHD. You may not. But if you do, don’t be frightened of telling your school. Mine was very supportive, and we need more teachers and role models for our young people. The phrase “I have ADHD too” has never been more powerful.

Last, but absolutely not least… ADHD role models

Pupils and teachers with ADHD can often feel that ‘the world out there is not like me’ and so struggle to relate to traditional role models. Thankfully, there are a lot of neurodiverse people out there, some of whom have publicly spoken about their experiences, from Simone Biles, Dave Grohl to Sir Richard Branson.

You see, although we tend often to focus on the difficulties of ADHD, there can be a real positives too and Forbes described ADHD as the entrepreneurssuperpower.  ADHDers (as they’re sometimes known) see the world and its potential entirely differently to neurotypical people and this can lead to unique perspectives. It’s been suggested for example that Albert Einstein and Leonardo da Vinci both had classic ADHD, although we’ll never know for sure…

As the world-leading animal behaviourist and autistic Temple Grandin says, “The world needs all kinds of minds”. As tricky as it is negotiating through a neurotypical world, I wouldn’t trade my neurodivergent brain. I experience and see the world differently from my neurotypical counterparts, and for me, whilst this has sometimes meant hardship, it has, with support also brought success.

I wouldn’t trade my ADHD for anything.

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