Diagnosed With Adult ADHD

The library is quiet as we wind our way through the dusty stacks to a quiet corner with a  table and a power outlet. “Peggy” (not her real name) sits across from me in a wooden desk chair that creaks and wobbles as she settles in. She fidgets with the cuff on her colorful hand-knit  cardigan sweater while waiting for me to finish setting up my computer. She picks up her  smartphone but sets it back on the table facedown when her glance shows no new activity. In the  two minutes it takes me to unpack my laptop, find the nearby outlet, and boot up, she has  checked her phone for alerts six times. She pushes everything to the side of the table when I say  I’m ready, then picks up the phone again. She seems nervous and needs the comfort of it in her  hands. 

“There’s no need to be nervous,” I assure her as I push the computer to a spot on the table  where I can see both the screen and her face. I want to talk about your experience with ADHD— how you were diagnosed, how long it took, and things like that.” 

“I’m sorry,” Peggy apologizes and checks her phone screen. “I haven’t been interviewed  before. It’s a little weird.” The apology isn’t necessary, but her ADHD brain has most likely  initiated and impulsively sent the words out before Peggy has even considered whether they are warranted. 

“No worries,” I tell her. “You and I are in the same boat. Try to relax.” I smile at her to  convey that I understand and can empathize. She smiles back at me and relaxes in her chair,  though she continues to work the cuff of her sweater between her fingers. With her back against 

the bright window, Peggy’s silhouette sits in shadow, as if purposely lighted to hide her identity.  It’s an appropriate setting for the interview. While not ashamed of her diagnosis, Peggy is not  ready to let the world know she has a mental disorder. 

* * * 

I met Peggy a couple of years ago in a local bookstore, where we struck up a  conversation and a friendship or kinship of sorts in the middle of the women’s health section.  Like Peggy, I am also one of the approximately 3.2 percent of adult women in America diagnosed as an adult with attention-deficit/hyperactivity disorder, or ADHD, as it is most  commonly termed. We both happened to be at the bookstore searching for information about the  condition. It was a treat for me to meet her, as after moving to South Carolina twelve years ago,  it has been difficult for me to form adult friendships. After my ADHD diagnosis, I discovered  that a lack of close and lasting friendships is just one of the commonalities among adult women  with this condition. Though Peggy and I are not what I would call best friends, it is a comfort for  us both to have someone in our lives with whom we can occasionally text about our condition  and who can be sympathetic. 

The similarities between our situations were many. Peggy and I were both diagnosed  around 2020, within months of each other. Both of us had been taking classes at the time. She  was taking a real estate course, and I was finishing a bachelor’s degree that I had begun thirty  years before. We both had similar issues with concentration and getting through the reading  materials. Both of us initially thought our concentration problems were due to our age. This  discouraged us both, nearly causing us to give up on schooling. Both of us went to our  physicians seeking help and were initially treated for other issues before finally being diagnosed with ADHD. 

As it turns out, obtaining an ADHD diagnosis is a widespread problem for adults,  especially women. As children and adolescents, males are often diagnosed and treated  appropriately for ADHD, while females are instead misdiagnosed with depression, anxiety, or  both. In adulthood, the number of women appropriately diagnosed is even less.  

ADHD is a very misunderstood condition. Unlike a medical issue that shows a physical  disability, such as a condition requiring a wheelchair, people with ADHD suffer from a constant  mental battle. Since the disorder cannot be seen, people often make incorrect assumptions about  the person with the condition. When many people hear “ADHD,” they usually picture unruly  boys who cannot sit still in their seats at school or who are constantly jumping around, playing,  or making messes. While that can be an accurate picture of ADHD in certain moments, the  condition itself is much more than just hyperactivity. The National Institute of Mental Health  (NIMH) says there are three major symptoms of the condition: inattention, or difficulty paying  attention; hyperactivity, exemplified by excessive energy or moving and talking more than  expected for a situation; or impulsivity, either acting without thinking or having a lack of self control. These are broad terms that are used to describe any number or types of symptoms or  behaviors. For instance, hyperactivity can be anything from the inability to stand in one place  without fidgeting to interrupting people during conversations or simply talking too much. 

For people who have ADHD but have not been diagnosed, particularly adults, these  symptoms can either be mistaken for or lead to other issues. When people are unable to pay  attention, teachers, parents, spouses, and bosses will often call them out for their uncaring or lazy  behaviors, which can lead to feelings of anxiety, depression, and low self-worth. Impulsivity can  lead to poor decision-making with school or work, money, and relationships or sexual situations. 

Treatments for depression and anxiety may help with some symptoms but do not address the  actual cause, leading to further issues. 

* * * 

In Peggy’s case, symptoms of ADHD presented themselves when she was a young girl.  Growing up in South Carolina, Peggy was raised by parents who always expected good manners  and behavior. Peggy was a bright child, scoring report cards with As and Bs without overly  trying, but with notes like, “Peggy is a daydreamer” and “Peggy has good grades, but chatters  constantly.” It was also the 1970s, and after the passage of Title IX in 1972, expectations of  women in many parts of the U.S. started to include excelling at sports. Peggy tried out once for  high school softball and track but found both boring pursuits. This disappointed her father,  something that still bothers Peggy. She unconsciously rubs the cuff of her soft sweater between  her fingers as we discuss her relationship with him. I recognize the fidgeting action as stimming,  a coping mechanism some people with ADHD develop to manage stressful or tedious situations. 

“I was never really athletic,” she said, balling her hands into fists and making the motions  of a runner as she remembers. “Sports bored me back then. I think my dad would have liked me  to play a sport, especially since I don’t have any brothers. Don’t get me wrong—he didn’t try to  make me the son he never had or anything. I just think he would have liked me to do something  he could have been part of, too.” 

Peggy believes that emotional dysregulation may have kept her from being closer to her  father. People with ADHD often have difficulty identifying and regulating emotions. This can  mean anything from rapidly switching emotional states to feeling overly intense emotions or  other issues like negative thoughts and intense frustration. 

While she had friends in their tract house neighborhood, she preferred reading books or  working puzzles to playing outside with others. “You could check out puzzles at the library then,” she says, smiling at the memory. “It was frustrating sometimes because you never knew  for sure you’d have all the pieces. I finally started counting the pieces before working the puzzle in case they weren’t all there. It saved time.” When asked if she worked puzzles with her friends,  she shrugs. “Not really. I didn’t think about asking them to do it. I guess I thought it wasn’t cool  enough, or I wasn’t cool enough. I was kind of embarrassed about it.” 

“What do you think about those times now?” I ask quietly as she turns to look out the  window at the traffic below. 

“I think I wasted a lot of time and friendships being worried and embarrassed about  things. I just wish things could have been—different.” Tears replace her wistful expression. “God, I wish things had been different.” 

“What would you do differently?” I ask gently, remembering my own internal battles  with all the things that might have been. 

She looks back at me and sighs. “I would have played with my friends. I would have  called them. I wouldn’t have been so afraid of—rejection, I guess. I always thought feeling left  out or different was normal. Like on TV shows, I suppose. Teens that don’t fit in and all that.” 

“Did your parents ever think something was wrong? Did they suspect ADHD?” “I don’t think so. I think they just thought I was loud and hardheaded.” She laughs a little,  then looks around us to ensure she hasn’t disturbed anyone. “Oops,” she says, “I guess the loud  hasn’t changed much. I just wish they were here to ask.” Peggy lost both of her parents to illness  over the last decade, something she has a difficult time coping with. She pauses and takes a deep  breath to help keep her emotions in check. “I wish they were here so I could tell them why some 

of the things I did as a teen weren’t entirely my fault. I couldn’t seem to make good decisions.  They thought I was rebelling, but I was just trying to be happy. To survive.” * * * 

Her words strike a resonant chord inside me. “I was just trying to be happy. To survive.”  How many times have I had similar thoughts? Countless, I suppose. I was a good kid, always  trying to obey and please my parents, and also an overachieving student. I participated in every  high school play, musical, and choir. I joined every school club that seemed remotely interesting.  I even played a year of varsity tennis, all while working my afterschool job at the local burger  joint and maintaining a relationship with my high school sweetheart. I was a straight-A honor  student until my senior year of high school when I started sleeping through my first-period physics class. I broke curfews, blaming it on my job, but I was really running around with my  coworkers after clocking out. And though I realize now that much of that uncharacteristic  behavior was my unconscious quest for dopamine, I still can’t help but chide myself for not  doing better. 

Dopamine. The name sounds more like a street drug than a vital compound acting as a  brain neurotransmitter. The average or neurotypical person makes adequate amounts of  dopamine on their own, but neurodivergent people with conditions like ADHD and autism have  brains that work and process information differently. Studies have shown that people with  ADHD don’t produce adequate amounts of dopamine on their own, so they unconsciously pursue  activities that increase dopamine levels. They also often procrastinate on projects their brain  perceives as “boring” because time spent on those things could be otherwise used on something  that provides a dopamine hit. For instance, most children, even those without ADHD, would 

prefer to play than do chores. However, when adults with ADHD have to make such choices,  they may choose shopping or clubbing over paying utility bills or cleaning.  In extreme cases, people with ADHD may seek out behaviors that are considered  unacceptable by much of society. For instance, some people with ADHD become sexually active at an early age or may participate in sexual affairs that are not appropriate, such as an  extramarital affair. Some thrill-seekers may seek that dopamine rush by participating in extreme  sports like rock climbing, while others may commit crimes rather than search for a “boring”  regular job. An estimated 25.5 percent of incarcerated inmates are believed to have ADHD.  But what about the average Joe or Jane who doesn’t exhibit extreme behaviors but may have ADHD? The severity of the condition is based on the presence of specific symptoms and  their effect on a person’s quality of life. For instance, someone whose house is immaculate but always runs late picking up the kids from school may have mild ADHD. So might the person who buffs their car until every inch shines and then rages if someone touches the finish, but that  can only be determined by a clinical diagnosis. It also has a high heritability rate, so the chances  of inheriting the disorder are high. Peggy isn’t sure whether either of her parents had the  disorder, though she says her mother was a high-energy person, always finding something to do  around the house.  

* * * 

Though she’d had symptoms of ADHD since childhood, Peggy remained undiagnosed  until she was 45 years old. Looking back on her life, she now recognizes how certain situations  were affected by the condition. For instance, she met and married her first husband during a  particularly lonely period in her life. Peggy says she realizes now how unsuited they were as a  couple. Though their initial relationship was enjoyable, they had completely different interests, 

life goals, and belief systems. Despite their incompatibility, she believes the relationship turned  to marriage because of ADHD masking, particularly mirroring behavior. Peggy says that she  took on his interests and desires as her own in order to prolong the relationship. Their marriage  fell apart quickly.  

“We never should have married.” Peggy shakes her head as she runs her finger along the  wood grain on the tabletop. “I was so lonely. I’d had so many failed relationships that I thought  maybe no one could love me. When he and I met and hit it off, I was determined to make this  relationship work. So, whatever he liked, I liked. Whatever he hated, I got rid of. I made myself  the perfect girlfriend.” 

“How long did you date before getting married?” I ask as she bounces her legs up and  down under the table.  

“About six months,” she sighs. “Much too fast. I was so happy to get married and have a  secure relationship. It barely lasted a year. I know now it’s mostly because I wasn’t the person he  thought he married, and he resented me for it. We fought all the time. But even after the fighting  and name-calling, there was a time I would have gone back to him. I was that afraid no one else  would ever want me.” 

Three years after her divorce, Peggy met and married her second husband. “He was a  much better match for me. I had grown up a little and took more time to get to know him. It turns  out he genuinely liked me for me. Loves me. Despite my quirks, he loves me.” Her second  marriage has thrived, something she attributes to her husband’s “infinite” patience, and they  share two children. However, their relationship took a dramatic turn once Peggy became  menopausal. That’s when her life changed entirely.

“I just thought I was going through something normal. Everyone talks about becoming  grouchy during ‘the change.’ I just thought it was hormones or something. I’ve always had a  little bit of a temper, but it took a lot to set it off. But menopause made me feel more than a little  angry. I sometimes went into rages. I felt like I was going crazy.” 

“My husband recognized that I was struggling and encouraged me to find an outlet. He  thought a hobby or doing something I enjoyed would help me find a purpose. My kids were all  out of the house by then, so I decided to take real estate classes. The trouble was that I couldn’t  concentrate on the materials. I had similar problems when I was a kid, but back then, I thought it  

was normal, so I just dealt with it. But as an adult, I couldn’t just deal. I can usually read fiction  without too much trouble, but the real estate jargon was confusing. I would read a page four or  five times and still not remember what I just read.” 

“What made you decide you needed to see a doctor about your concentration issues? Did  you suspect ADHD?” I’m curious as to whether she ever suspected the condition. “No,” she replies emphatically. “ADHD never crossed my mind. I thought I was stressed  out, so I saw my doctor. After several visits, lots of questions, and bloodwork, he told me he  suspected I had ADHD. I thought he was joking at first. I always thought it was a child’s issue,  so I couldn’t believe someone my age could have it. I’m so thankful now that he figured it out.  After just one dose of Adderall, I could tell the difference when I tried to read. But it changed my  life in many other ways. The racing thoughts, the crying, the anger. I don’t feel like I’m going  crazy anymore.” She stops and wipes the corners of her eyes. “That’s the best part. I’m starting  to develop a sense of normalcy for myself.” 

Some cases of ADHD do not require drug treatment, but many do. Physicians can  prescribe either stimulants or non-stimulants based on an individual’s needs. Peggy’s 

prescription, Adderall, also known as mixed amphetamine salts or (D)-amphetamine, is just one  in a class of stimulant drugs that help increase dopamine levels in the brain. Non-stimulant drugs  are also available but generally prescribed in cases where stimulants are not effective or  appropriate and are sometimes paired with antidepressants for people with additional disorders.  They also take a longer time to show results.  

* * * 

While her parents are no longer living, Peggy has a great support network at home. Her  husband and children fully support her as she learns to manage her condition. “My kids are  grown and don’t live at home, so I’m not sure they notice much difference. They’ve been  incredibly supportive, though. My husband is relieved for me. He knew I was struggling after  menopause started and didn’t know how to help. After my diagnosis and treatment, our  relationship has improved in ways I didn’t know it needed.”  

While diagnosis of ADHD in adults is on the increase, there are still many adults who  remain undiagnosed. Continuing research and education about the condition has helped, but it’s  still important to keep health professionals and the public informed about the condition and  provide any new information. Famous and notable figures who come out about their struggles on social media help increase awareness about the condition. Athletes like Simone Biles and Terry  Bradshaw, entrepreneurs like Richard Branson and Elon Musk, and celebrities like Justin  Timberlake, Johnny Depp, and Solange Knowles have spoken publicly about their struggles with  ADHD, helping remove the stigma around the diagnosis.  

Peggy’s diagnosis came several months before my own, so it’s been heartening to hear  her story and watch her progress. During our conversation, she only picked up her phone thirteen  times, an improvement over the last time we sat down together. As for myself, I have high hopes 

that I will thrive as she has. Peggy is sort of a role model for me. Though I’m still learning how  to manage my own condition, her success makes me feel optimistic about my future. I’m not  ashamed of my diagnosis; in fact, I’m relieved. The more I learn about my neurodivergent brain,  the more I like myself. It’s been a difficult road—one I’ll always travel—but the journey is worth  it. Though Peggy isn’t ready yet, I feel like I can now share with the world that I, too, have a  mental disorder.