Ep2: Mine (and many other women's) mid life ADHD diagnosis journey

Foreign. Hi, and welcome to episode two of the Unmasked Minds podcast. I thought today I would answer one of the most asked questions that slides into my DMs and into my sessions, which is about my ADHD diagnosis and the experience of so many women at the moment, either being diagnosed with adhd in their 30s, 40s, and 50s, or curious about a diagnosis of ADHD in this midlife period. And what I wanted to share with you today was not only my journey to diagnosis and what this provided for me, but also a lot of the misconceptions out there and a lot of the challenges and barriers that women are finding in, in the process of either getting a diagnosis or just being curious as to whether their symptoms may actually be adhd. So it's kind of funny when I reflect on why did I actually get diagnosed. It was interesting because I had been working in this space as a psychologist for about 12 months, and I certainly had ADHD women clients, and I had done a lot of research and a lot of study and education in the area, so I knew it really well. But I was able to see it in others and notice it in others and still hadn't sort of turned that lens on myself. It wasn't until I was in a work meeting. So we were sitting around, we were doing, like, these strategy sessions with these other psychologists, and we'd already had one day that had completely just, like, started a strategy and ended up in this huge, big space, lots of tangents. And the two other psychologists that I was with have adhd. And on the second day, we all sat down and one of them said, okay, Sarah, let's take our meds today because we really want to stay on track. And I was like, what meds? And they looked at each other and were like, let's just all take our ADHD meds today, because yesterday we went off on all of these tangents, and it was great and it was wonderful, but we really need to lock some shit down today. And I looked at them both and I was like, I don't have adhd. And their faces, as experienced psychologists, were just like, oh, darling, how do you not know? I had worked with these women for about two and a half years at this point as a, like, a trainee psychologist. And they had just assumed that I knew that I had adhd. And, you know, it was so eye opening for me for someone else to truly see me on a level that I hadn't seen myself. But I wanted to start with why myself and so many other women are starting to get curious or get diagnosed at this stage in life. There is this whole other flip side where people are saying, oh, it's so trendy to have adhd, everybody wants adhd. Now all women are blaming all of this stuff on ADHD and thinking it will solve all of their problems. Let me be very clear. ADHD is not something that we want a diagnosis of. ADHD for women who have struggled with certain things their entire lives, who have gone under the radar, who have presented multiple, multiple times to professionals and been misdiagnosed as anxiety, depression, eating disorders, even. I've seen people diagnosed with bipolar and BPD who were adhd. It is only the women who need answers who are looking at this and going, wow, that makes a lot of sense. So why are so many women being diagnosed now? Well, the first thing is there is more information available. Everybody talks about how bad social media is, but come on, if you are sitting there and you are looking at reels and all of these women with ADHD reels are coming up and you're watching them for longer than someone that it doesn't resonate with watches it. Your algorithm is going to keep delivering this to you, and if it is resonating with you, then that's happening for a reason. I say to my clients all the time, only you know what it's like to live in your body. Only you truly understand how your brain works and how it feels to live with your brain. And if Multiple Instagram or TikTok reels are resonating with you, then that means something to me as your psychologist. So many women approach me for an ADHD diagnosis and there's this fear, there's this like, oh, I just. I don't know. I'm not sure. Everyone's telling me I don't. But I've watched so many things and something about those reels and something about all of this information that I'm seeing makes sense to me. And one of the first things I say to women with ADHD is, darling, I get it. You second guessing yourself, right? Because as undiagnosed ADHD women when we were younger, we received so much feedback that we were not right or that we were wrong or that we were reading the situation wrong. Be louder, be quieter. Stop fidgeting, stop interrupting, make better eye contact. Could you stop being so emotional? Don't speak to me like that. Don't treat your friends like that. Be a better friend. Be more of a friend. Be less of a friend. Don't, don't, don't, don't, don't. Don't. And so it's no wonder that as adults, when something starts to feel like it makes sense to us, when we start to see these things and go, wow, that makes sense for me, that we start second guessing ourselves. Most women that we are diagnosing in their 30s and 40s have this part of them where they are just so used to being hypercritical of themselves, doubting themselves, and in a lot of cases I actually call it gaslighting themselves. No, you don't think like that. How could you think that way? You know? And so that's the first thing I really want to address is if you are watching all of this information that is now available now, a bit of a disclaimer. Not everything on social media is evidence based and accurate. A lot of it isn't, to be honest. However, watching people's lived experiences of ADHD is just as sometimes even more important than looking at the diagnostic criteria in the dsm. Because when we look at diagnostic criteria in the dsm, which is the big manual that all of us health professionals use, if you want to diagnose someone with a mental health condition, they have to meet the criteria in this manual. But what we're finding, and particularly for women, is that the DSM criteria doesn't always explain the lived experience for an ADHD woman. And so if these lived experiences are resonating with you, if they're making you curious, and that means something. So not only is there more information available now for people to digest and to process, but the information is changing. The research on specifically women with ADHD is happening now and has happened recently. Whereas 30 years ago, when most of these women were 6 to 10 years old at school, majority of the research was done on males. So the research was done on males. And what we're finding out now is that males and females can present very differently with adhd. Now, let me give you an example. When I was younger, the kids with ADHD were the naughty boys in the classroom. They were the ones that when the teacher was talking, they were hyperactive and they were distractible and it was a huge behavioral thing. They were throwing shit around the rooms. And you always knew the naughty boys who had adhd, Right? Now when we're talking about adhd, we talk about two types, inattentive type, hyperactive type, and then we have the combined diagnosis of both inattentive and hyperactive. So historically and traditionally, what we all knew ADHD to be was this hyperactive type where we saw these externalised behaviors in little boys who were being really naughty. So whilst the boys were jumping around the classroom with their hyperactive type, adhd, a few things might have been happening with the girls. Number one, girls present differently. So often what we notice is their hyperactivity and their inattentiveness is more internalized than externalized. It more comes out as, you know, racing thoughts and looking out the window and doing all of this stuff that isn't necessarily obvious to people observing us. The second thing that's really important when it comes to girls and women is society's expectations on girls. I know when I was at school, even though I had the same urges as a lot of those boys, I didn't know it at the time, but when I look back, oh my God, I was so ADHD I wanted to throw a ball at someone's head, I wanted to interrupt, I wanted to do all of these things, but I didn't. I masked that first of all, because I knew that there were consequences and I had the capacity in my brain to go, well, hang on, if I do that, there's a consequence and that's not good. So I would mask to avoid the consequences. But second of all, we were victims of the good girl generation, right? So girls also had this layer of expectation of how girls should behave and we had different consequences if we didn't behave as we were supposed to in a school setting, in a home setting, right? So there were a number of factors at play. Not only did we not have the research that told us how ADHD is different in girls, them boys, but we are also acknowledging that girls had such different layers of pressure and they therefore learnt to mask a lot earlier. So what we say about that now is you look back at those girls, or we look at young girls now in school and whilst they are able to be a good girl and to behave and to get their work done, they are usually doing it and at a much greater expense than neurotypical girls. So it takes a lot more energy, it takes a lot more focus to show up and to focus and to restrict your hyperactivity, but you can do it. So we can mask it. Just now is about recognizing that that takes a lot of effort. So we now know that there is a lot more information available and we also know that girls and women do present very differently to boys and even our diagnostic processes haven't really adapted that much to catch up with what information we know now. I know a lot of women who have gone to get diagnosis before and they've almost said that it was like they had to pass this test. You know, they went to the health professional and the health professional was almost like, I have to disprove you. Um, I certainly don't take that approach. My belief is that if I get a middle aged woman presenting to me and she believes that she has adhd, I want to understand why. I don't want to look straight away to this criteria to disprove her. I want to understand what is it that she's seen, what is it that she feels, what is it that she's relating to or resonating with. Because her lived experience is going to give me so much more information about how her brain works and how it feels to live in her body than checking her off against the list of criteria. So we finally get to the big question, why are we all being diagnosed now in our 30s, 40s and 50s? And I've already gone through some of the reason. The information has changed and it's more readily available now. That plays a huge role in why we are getting diagnosed later. But the second thing that's really important to talk about is masking and mental load. So I spoke earlier. As girls, we learnt to mask a lot earlier. We learned to camouflage and assimilate and be what we needed to be for everybody else in whatever environment that was. But it takes a toll because it takes a lot of effort. When women go through significant life changes or life events, we are noticing that as their mental load increases, their capacity to mask or hold it together decreases. So we're seeing that as women take on more pressure and more stress, particularly within a family unit, their ADHD symptoms are becoming more obvious. It's not because they're new symptoms and it's just postnatal anxiety or postnatal depression or adjustment disorder, although we do look into all of that. But often what we are seeing is this pattern of when life gets stressful, my ability to hold it together and continue masking diminishes and therefore these symptoms become more obvious and more disabling. There are three times in a woman's life where I am seeing a lot of women present for diagnosis number one is often in their 20s or 30s when they are getting promoted into jobs, into careers or jobs or promotions where they need to manage people. And this is a really interesting one that I've spoken to a lot of clients about. And it's almost this sort of shift where when an ADHD woman just needs to manage herself, she often will have lots of rigid rules, lists, routines to keep herself regulated and to allow her to be able to focus and do what she needs to do. The minute you put her in a role where she's got to manage other people, the ability to control all of that and keep herself regulated can be really difficult. So that is the first situation where I'm seeing a lot of women present when their job or their career increases in capacity to a point where they can't control it anymore. The second one is motherhood. So many women, and this was my story as well, when we start to take on the mental load of having children, and all of a sudden we are responsible for all of these kids and all of these things and all of this extra stuff, the mental load is enormous, Particularly if you are going back to work and you've got the pressure of that as well. And we all of a sudden start to feel like this emotional dysregulation is greater, we start to notice more of this. I can't coordinate, concentrate. I am so easily distracted. I can't focus anymore. Again, we often talk about that in the context of mental load. Your load has increased significantly, that your ability to mask and hold it together is decreasing. And the third one, which I'm going to do a whole different podcast on, is in our perimenopause phase. Now, this one is less about the mental load and more about what's happening with our hormones in our body. Very briefly, perimenopause is when is a period for up to about 10 years before you reach menopause. Now, menopause is the one day, 12 months after your last period. Anything up until that, when we're having fluctuations in hormones, which I said can go for up to 10 years before that, we call the perimenopause. So during this perimenopause phase, we can see so many fluctuations in our hormones. Now, estrogen plays a huge role in the female system. What we know about estrogen is it also plays a huge role in regulating our dopamine. Now, for people with adhd, one of our core issues is dopamine regulation. That's why we're so inattentive and distractive and hyperactive, is because we are constantly seeking dopamine. So when you get an ADHD woman and she hits perimenopause, the ability to regulate her dopamine even decreases further. So that is another phase where we are starting to see ADHD women presenting for diagnosis in perimenopause, because all of a sudden it just feels like they can't keep it together anymore. They can't control all of this stuff. And what we're starting to look at now, and there's a lot of research coming out about this. There's some recent research that said that ADHD women experience perimenopause on a much greater scale than neurotypical women, but also that perimenopause exacerbates ADHD symptoms significantly, which is why we're seeing so many women present for diagnosis during perimenopause. Another question that I get asked about a lot is why bother? Why, as a woman in her 40s, should I get diagnosed with ADHD when I've coped, when I've made it this far in my life? And that is a very personal question, and only an individual can answer that. But some of the things I might discuss with my clients would be, what would it mean for you? If you're just looking for a label for the sake of a label, to stick it on you, then, and it's not going to do anything for you, then, yeah, maybe there is no point. But when people say, oh, you just want another label, I often gently say, well, what are the labels you've given yourself or other people have given you that this one label of ADHD could replace? Do you tell yourself you are lazy, you are dysfunctional, you are inattentive, you are distracted, you can't do anything right, you're moody, you're angry, you're sad, you're a bad friend, you're a bad wife. If your symptoms contribute to those labels and we can remove all of those labels and replace it with adhd, then that could be a very, very good thing for you. Because what I noticed, and this was certainly the case for me, having a diagnosis of ADHD allowed me to look at myself and allowed me to look at my symptoms through a different lens. It almost was like a ticket to self compassion. I was now able to look back at my whole life, and I actually did some EMDR trauma work to go back and look at things that happened to me as a, as a child, as an undiagnosed child, and how that affected me and my nervous system for the rest of my life. But. And I can talk about that in a separate podcast if that interests people, but it allows you to go back and look at this little girl who thought she wasn't good enough, who thought she was too much, who thought she wasn't worthy, who thought nobody liked her, who struggled to make friends, who struggled to focus, who had to work really hard for things that other kids didn't have to work really hard for, who was put down for being Emotional, all of that. It allows us to look back and re parent ourselves in a way and look back at those versions of us or those parts that still exist within us and see us and ourselves differently. One of the reasons many women are presenting for diagnosis now is that we are supporting our children. And as our children are going through the diagnostic process, we're like, oh my God, me too. That was my experience. That's me. And what a beautiful thing that we are being such attentive, supportive, wonderful parents, supporting our children. But it's making us realize that we didn't have that level of support when we were younger. Now another reason to get diagnosed would be to access medication. Now I'm not a doctor, so I won't talk too much on this. If you really want to try medication, the go to medication for ADHD is a stimulant type medication, then you will at this stage need a prescription from a psychiatrist. Now I say at this stage because a lot of legislation was passed in 2025 that's going to allow GPS to access this. But I'm not sure where that's at, how many will be doing it and what level of training they need to do to be able to do that. But I hear wonderful, wonderful stories about medication for some people. I have heard countless, countless stories where women have been on antidepressants or anti anxiety meds or even antipsychotics to regulate and stabilize their moods for decades. And when they have been diagnosed with adhd, they've been able to replace all of those medications with one stimulant. Now I'm not saying that's the case for everybody, but I have just through my clients heard so many stories where medication has significantly helped some people. Now other people choose not to medicate, but the diagnosis is important for them not only to access that self compassion, but to sort of open the door to self understanding, self awareness and to accessing the tools for self support. You know, once, you know, I can type into Google or ChatGPT or whatever you're typing into these days. I have ADHD. How can I help with my time management? I have adhd. How can I help with my mood dysregulation? I have adhd. What tools and strategies can I use to plan my day better? To be more efficient, to not be so late all the time. It's almost like when we know we can stop this second guessing of ourselves. I'm just lazy, I'm just this, I'm just that. And we can say, all right, what do I need to support my myself moving forward. So I have a lot of clients who actually don't end up going down the medication, but really just going, okay, now I know what I'm looking for. Now I know how to see myself through this lens, and now I know how to support myself better. I also now know how to advocate for myself better. The diagnosis gives us the language to explain not only to ourselves, but to others what we need and how we're feeling. And this is why a lot of people, after they're diagnosed, will continue with therapy for a period of time to work through what this means for them, to be able to articulate and to put in healthy boundaries with people where you haven't had boundaries in the past because you've thought it was all your fault. So that is a little bit of information that I often share with clients and friends around ADHD and why women are being diagnosed and. And whether they should be diagnosed. I love the saying that says, there's a meme out there on Instagram where it says, everybody's getting diagnosed with ADHD at the moment. And they respond with something like, it's just like all these stars started to appear when we discovered telescopes. Women have had ADHD for a long time. They just have not been recognized. And they have been suffering a lot of the time in silence and in loneliness and with no support from medical professionals or from their friends and family because we haven't been able to put a name to or actually understand what's going on for them. So if you think that you may have adhd, continue to look into it, continue to ask the questions, continue to advocate for yourself. Because like I said, you are the only one that knows what it truly feels like to live in your body. And for so many women, receiving the diagnosis that you have ADHD is life changing. And it was incredibly life changing for me because I started to treat myself and see myself differently. And that is a gift. Thank you for listening.