By Nicole Clark, NY Times
“When I was a kid, I had the sense things were more difficult for me,” Tiffany Bui recalled. It was hard for her to focus in school, and she was often forgetful. Throughout her life, she said, members of her family criticized these traits as faults.
In the fall of 2020, when she was a senior at the University of Minnesota, Ms. Bui, 21, was struggling with anxiety and depression. She visited the school’s health clinic, where she was prescribed an antidepressant, but her attention troubles persisted. When she later returned to the clinic, the doctor asked if she had considered that she might have attention deficit hyperactivity disorder or A.D.H.D.
“I started reading up, just doing some self-research about what A.D.H.D. looks like in women, and it was like, ‘Wow, no one’s ever talked to me about this before,’” Ms. Bui said. She wasn’t exclusively consulting medical websites; on social media, she saw posts from women talking about their experiences with A.D.H.D., which she said were “incredibly specific and so relatable.”
Ms. Bui was referred to a psychologist in Bloomington, Minn., where she sat for a neurological assessment sometimes used for diagnostic purposes, most often in children; it included word association tests, math problems and pattern-recognition exercises. Finally, following a lifetime of symptoms, Ms. Bui was diagnosed with inattentive A.D.H.D. (A.D.H.D. falls on a spectrum of three “types”: inattentive, hyperactive or combined type. Inattentive is used to describe symptoms like forgetfulness and other traits related to concentration.)
Ms. Bui’s story is not uncommon: Many women and people of color are only now learning, after years or even decades of difficulty, that they may meet the diagnostic criteria for A.D.H.D., thanks in part to a wave of creators on social media trying to spread awareness.
These creators are sharing webcomics (like Pina Varnel, 31, who is known as the A.D.H.D. Alien on Twitter), videos (Dani Donovan, 29, does so on TikTok, and Jessica McCabe, 38, on YouTube), newsletters (like 26-year-old Rach Idowu’s Adulting With A.D.H.D.), blogs (such as 36-year-old René Brooks’s Black Girl Lost Keys) and memes (“tell me you have A.D.H.D. without telling me you have A.D.H.D.”) that aim to help people identify symptoms and find community.
Dr. Lidia Zylowska, a psychiatrist and the author of “Mindfulness Prescription for Adult A.D.H.D.,” said that she had not observed an uptick in women of color being diagnosed with A.D.H.D. However, she noted, “there is an increasing trend in awareness in the A.D.H.D. field and the general public that people of color, and especially girls and women of color, maybe overlooked and not given the A.D.H.D. diagnosis and treatment.”
Though medical researchers found, in a recent review of more than 300 studies, that A.D.H.D. was overdiagnosed (and overmedicated) in children under the age of 18, those diagnoses skewed toward certain demographics. White children are more likely to receive diagnoses and treatment for A.D.H.D. then children of color, as diagnostic models have long been based on research focused on young white boys.
Symptoms of the disorder may present differently in girls, and the emotional toll can be intense; one longitudinal study focused on girls and young women found that subjects who had been diagnosed with A.D.H.D. as children showed marked impairment 10 years after their diagnoses, including a high risk of self-harm.
“Eventually you hit a wall academically or professionally, and then you need to address all of these layers of built-up failed coping strategies,” said Leah Islam, 28. Mx. Islam had struggled with depression since age 13 but did not receive an A.D.H.D. diagnosis until turning 21. Their parents hadn’t supported their search for mental health care; it wasn’t until recently that Mx. Islam began discussing medication with their mother.
For some people, A.D.H.D. content represents a step toward identifying or explaining the ways they have felt different. It has also helped them advocate for their own evaluations; because A.D.H.D. is thought to be diagnosed in childhood, getting evaluated as an adult can be challenging (especially for people of color, who face implicit bias when seeking health care). People with A.D.H.D. are also more likely to be unemployed and therefore uninsured.
When Ms. Idowu, who lives in England, sought a referral for an evaluation through the U.K.’s National Health Service, her family’s general practitioner said that she didn’t match the profile of a person with A.D.H.D.
Ms. Idowu had read on Reddit about the difficulties of getting an evaluation and had come prepared with anecdotes from her childhood, as well as more recent workplace examples. She was given a referral, and nine months later she was able to see a specialist. Her most popular newsletter send details this process; some subscribers have told her it helped them navigate their own diagnostic processes.
A.D.H.D. has been diagnosed in 9.4 percent of children in the United States, according to a 2016 study from the Centers for Disease Control and Prevention, with rates rising in the past two decades. It is debated whether children grow out of it in adulthood, an attitude that is evolving as recent research shows diagnostic rates growing rapidly among white adults.
By adulthood, many without diagnosis or treatment have spent years feeling isolated or different. Dr. Courtney Pflieger, a private-practice psychologist who herself has A.D.H.D., said that people with the disorder often experience negative feedback as adults. “It really feeds: ‘What’s wrong with me, I must just be broken,’” she said.
Ms. Bui’s own symptoms went unnoticed for years because she was able to do fine in school. Like many others who aren’t diagnosed until adulthood, she was “masking” her symptoms — adapting to neurotypical behaviors and standards in order to fit in. (Masking forgetfulness, for example, might mean privately relying on a bulwark of organizational strategies — like setting phone alarms for every step of doing laundry.) She still doesn’t feel comfortable telling her family about her diagnosis.
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