Living with Undiagnosed ADHD

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What comes to mind when you hear Attention-Deficit/Hyperactivity Disorder? For most people, it’s hyperactive elementary-aged boys who can’t be bothered to sit down and who teachers can’t seem to manage. But for many women, the stereotype does not ring true. As a young girl, I noticed the same comments in all of my report cards. “Ayaan has so much potential but she wastes her time” or “If only Ayaan could utilize her free time instead of daydreaming…” Despite all this, I still did remarkably well in classes. I was the kid who never studied for an exam and somehow managed to exceed. I just figured tests came easy to me and did not think twice about it. By the way, I will be using ADHD and ADD interchangeably since they are two sides of the same coin. Although for the record, I seem to be lacking the hyperactive part.

Then I hit a roadblock. When I became a high school student, my carefree days were over and I spent an unhealthy amount of time thinking of ways to get my teachers to like me so they could over look my unimpressive marks. Paying attention, reading textbooks, studying for tests, and completing assignments became a mission. For years I struggled with understanding why I was putting in extreme amounts of effort and receiving none of the pay off.

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This year, I was diagnosed with Attention-Deficit-Hyperactivity Disorder. According to the American Psychiatric Association, “Attention-deficit/hyperactivity disorder (ADHD), a neurobiological condition characterized by a persistent pattern of inattentive, hyperactive, and impulsive behaviors, was once perceived to be exclusively a childhood disorder (American Psychiatric Association). Some symptoms of ADHD may include feeling frustrated, scattered, unfocused (R. Waite and M. Tran). Most days I felt like I was walking around in a cloud of haze. I had a hard time forming sentences, thinking of the right words, or remembering appointments and meetings. It followed me everywhere.

Later in life, ADHD can “impede their academic success, employment stability, personal relationships, and friendships. Students reported emotional symptoms from depression, anxiety, substance abuse, stress, worry, and eating disorders.” (R. Waite and M. Tran). In my case, I could definitely relate. Unfortunately for me, most research thus far has been conducted with mainly white male participants (R. Waite and M. Tran). However, according to researchers, there are reports that women represent a large part of adults with ADHD (R. Waite and M. Tran). The director of the University of Utah Mood Disorders Clinic, Dr. Fred Reimherr says “ADHD is still presumed to be a male disorder. The women had a much more frequent history of having been diagnosed with other emotionally based psychiatric illnesses, such as depression or anxiety. I think those symptoms are often the things that a physician treating adults focuses on. A woman might come in presenting emotional symptoms, and the ADHD that’s underneath might be missed.” (Sigler). This could be one explanation of why women are underdiagnosed and undertreated when it comes to ADHD.

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Stress has a lot to do with ADHD. There a basically three ways in which people respond to stress. There is a somatic response in which the body acts out by inducing stomach pains, diarrhea, headaches, and assortment of ailments. Another response is externalized feelings where we physically act out how we feel. A young boy might be frustrated by his homework and throw a tantrum. Teachers are very quick to either discuss a medical evaluation with parents or have the student expelled (if they’re black). The often ignored response is internalization. Internalization may include low self-esteem and inattentiveness. Teachers rarely catch onto internalization and the person doesn’t realize that their symptoms are unusual or can be treated. So the problem goes unchecked.

According to Doctor Carol Watkins, “Inattentive or impulsive girls often feel that “something” is wrong with them. Feelings of shame and guilt can layer themselves into a young woman’s personality as she grows up. When a woman is first diagnosed with AD/HD, she may feel relief and a temporary euphoria. She now has a name for her guilty secret. But a diagnosis does not change an ingrained personality style. After the diagnosis comes the real work. She must gain an in-depth understanding of how the AD/HD affects her own unique strengths and weaknesses” (Watkins).

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According to Waite, the first line of treatment is medication. (Waite). There are stimulants such as amphetamine and methylphenidate as well as new non stimulants that are gaining popularity. Some other options are therapy, life coaches, and using aids such as planners or technology (Watkins).

One of the biggest issues I face with my ADHD is completing tasks. I have a hard time getting started and when I take a break, I end up returning 6 hours later wondering where the day went. Or I might lie in bed for hours mustering the mental wherewithal it takes to get to my desk and start. After a long day of fighting with my mind, I lie in bed too anxious to sleep considering all the work that needs to be done.

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Forgetfulness is a serious problem that people with ADHD face. One way to battle this is to use a planner. We can’t always remember what our future plans are or use proper time management and estimate how long activities will take. That’s why a planner can be useful. A planner can track all our future goals, dates, and other important things we need to remember but can’t consciously do so. A trick I use is that if I know I will forget something later, I try to plan for it while I can. Lists are a godsend.

The most frustrating part of inattentiveness are conversations. Sometimes when someone is speaking to me, my mind wanders elsewhere and I come back to find them still talking with no clue that I was not with them. After about 30 seconds of someone talking to me, I feel that familiar tug, waiting for the word that will lure me back into my mind. It’s pretty embarrassing when I am listening to a friend and a question gets launched at me. It always happens when I am desperately trying to refocus on what’s being said but not quickly enough!

I’ve definitely had an issue with internalizing my ADHD. After being disappointed time and time again by my grades, it was hard not to take it personally. But I’ve learned that blaming myself for things I can’t control won’t change anything.

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Something I noticed was that I am not the only Somali girl I know with ADHD. In fact, I’ve discovered that I have a few diagnosed and many undiagnosed friends with ADHD. These girls are bright, personable, and most had no clue what they were dealing with until adulthood even though the symptoms were there since childhood. Not only that but each girl told me how no one had guided them to seek care.  In fact, no doctor or teacher in their many years of living had even once mentioned ADHD. Even more infuriating is the response that some girls received. One in particular went to an appointment with a Doctor who is a so called ADHD specialist who by the end of their session denied her medication. Instead, he refilled antidepressants and completely disregarded her medically evaluated and diagnosed ADHD. When she attempted to discuss her concerns, she was invalidated and dismissed. This type of negligence and mishandling is all too common with black patients and only further fuels the distrust among patient and care provider. Especially since doctors have no problem writing a prescription for their Caucasian patients.  There is evidence that doctors routinely under prescribe pain medication, especially to black women. It’s not a stretch to imagine what else they under prescribe because of their paranoia of drug abuse.

Many Somali girls are tasked with big responsibilities at a young age. We have to do well in school, work in order to contribute to the household income, babysit (more like parent) our siblings all while living in poverty. Somali girls are warriors by any definition. But I can’t help but imagine how differently our lives would be if we received the care we needed as children. Where would we be today? How many untold consequences arose from undiagnosed mental disorders?

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I wanted to learn more about ADHD after my diagnoses but I felt paralyzed into inaction. I began collecting books I would not read, articles I would ignore, and procrastinate learning about how to understand ADHD. With all things, it took time to get used to the idea of it. One thing that has helped medication. Coupled with cultivating time management skills, experimenting, and a healthy dose of forgiveness, I’ve been able to work on the matter. I’ve been tremendously blessed in getting a diagnoses and treatment from a caring team. Not all girls are so lucky. My mind sometimes hovers on this thought. Thankfully, I’m in a position to do something about it.

One of my goals as chairperson of the Healing Committee in the Young Muslim Collective is to bridge the gap between disadvantaged communities and the care we need. This experience has given me perspective I can use to best serve my community. The experience has given me some much needed perspective and hopefully something I can bring to the table. After all, I can focus for more than 30 seconds now.

And there is something else I can do. If you’re reading this and you relate to my story, please consider getting treatment. The first step is to talk to your health care provider. If you don’t have a doctor, don’t worry, you don’t need a referral. You can go to straight to a licensed provider and get testing done directly. If you make an appointment with someone and don’t feel comfortable with them, leave. You are not obligated to continuing seeing anyone you would rather not. The number one, most important objective is that you feel comfortable and safe. I have attached below ADHD resources that would useful if you live in the Twin Cities area.

 

ADHD RESOURCES

For testing and evaluation, go to:

https://therapists.psychologytoday.com/rms/prof_results.php?city=Minneapolis&state=MN&spec=303

https://www.nystromcounseling.com/our-services/psychological-testing/

http://www.augsburg.edu/class/prospective/sources-for-testing/

http://www.addreferral.com/minnesota/

http://www.roger-olsen.com/adult-adhd-evals.html

 

 

 

References

American Psychiatric Association. 2000. Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

Waite, R. (2010), Women With ADHD: It Is an Explanation, Not the Excuse Du Jour. Perspectives in Psychiatric Care, 46: 182–196. doi: 10.1111/j.1744-6163.2010.00254.x

Waite, Roberta, and Mary Tran. “Explanatory Models and Help-Seeking Behavior for Attention-Deficit/Hyperactivity Disorder Among a Cohort of Postsecondary Students.” Archives of Psychiatric Nursing 24.4 (2010): 247-59. Science Direct. Archives of Psychiatric Nursing. Web. 20 Mar. 2016.

Roberta Waite EdD and APRN and CNS-BC & Mary Tran BA and MPH (2010) ADHDAmong a Cohort of Ethnic Minority Women, Women & Health, 50:1, 71-87, DOI: 10.1080/03630241003601095

Sigler, Eunice. “Women with ADHD: Why Girls and Moms Go Undiagnosed.”ADHDitude Magazine. ADHDitude, n.d. Web. 24 Apr. 2016.

Watkins, Carol, Dr. “Treating Girls and Women with Attention Deficit Disorder.” Northern County Psychiatric Associates. Northern County Psychiatric Associates, n.d. Web. 1 Apr. 2016.

http://www.nytimes.com/2015/08/25/us/higher-expulsion-rates-for-black-students-are-found.html

https://rewire.news/article/2014/03/04/chronic-pain-denial-care-black-women/

 

 

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