“You can’t have ADHD,” my mother insisted when I told her about my diagnosis. “You went to Amherst.”
Like many people diagnosed as adults, I do not fit the stereotypical image of the disorder: a hyperactive boy jumping off the walls. Dr. Jonathan Schwab ’81, a pediatrician, explains: “I think the classic example and reason for boys being more diagnosed with ADHD is that the kids who are acting out very impulsively are usually diagnosed at a younger age, because they’re problems in the classroom.”
But hyperactive ADHD is only one presentation of the disorder. There is also inattentive type and combined type. Most girls with ADHD are diagnosed with inattentive type. “A girl who’s doing fine, she’s not acting out, she’s not a problem in the classroom—she’ll be overlooked,” Schwab continues. “People think, ‘They’re just not trying hard enough.’ That’s a big one. Many people with inattentive ADHD, teachers might think that they’re smart but they’re not trying, which we know is not the case.”
“If I’m going to generalize,” Kensington says, “it’s mostly smart women getting diagnosed later in life—people who have enough resources and social skills and aren’t getting into trouble.” But, of course, women aren’t the only people with inattentive-type ADHD. Julian Damashek ’09 recalls that his wife thought she might have ADHD and started reading up on common symptoms in women. “But then she was like, ‘This sounds a lot like Julian,’” Damashek says. “My symptoms track very well with what seem to be stereotypical ADHD symptoms in women.” Before being diagnosed with ADHD, Damashek had been treated for anxiety, which he now understands to be related to his ADHD symptoms wreaking havoc in his work life.
“Most individuals do their best to mask it,” says Dr. Ilan Goldberg ’00, a psychiatrist. Many students with undiagnosed ADHD rely on social skills to compensate for their academic struggles.
Indeed, says Zoe Fenson ’09: “I’ve always been pretty good at charming the teachers and getting by on charisma and earnestness. I wasn’t always the best at retaining the reading or actually doing the assignments or showing up to class on time, but I knew how to develop a strong rapport with my professors.”
Rebecca Ramer ’10E was similarly strategic, showing up to every class and conveying respect to professors, “because I knew,” she says with a laugh, “you’ve got to like me at the beginning of the semester, because very soon you’re going to think I’m an idiot.”
“People just assumed that I was a slacker,” Erica Gangsei ’00 says, when I ask her to tell me the ADHD story that resulted in her withdrawal from Amherst. “Everything started sliding off the rails, and I got to the point where I was too behind on my work to catch up.”
During conversations like these, I started to more deeply understand how many areas of my life had been impacted. I recalled my husband’s dismay when I’d forget about something we’d planned to do together, or when I misplaced something of value to him. On more than one occasion, he’d lamented my thoughtlessness and inattentiveness—and I did, too. Working with a therapist, I tried to uncover the reasons why I couldn’t be a better—more attentive—partner. The possibility that I might have ADHD never came up.
It’s a dynamic that Siegel, the clinical child psychologist, described to me. “In the context of a marriage or an intimate romantic relationship,” he says, “where the person with ADHD is constantly forgetting to do things, it’s like their partner becomes an auxiliary frontal lobe who has to redirect them, which can be maddening and exhausting for the partner.”
Julian Damashek can relate. He says he’s tried to stop getting mad at people—including his wife, Kendahl Damashek ’10—when they remind him of tasks. “If there’s something important that’s out of my routine, Kendahl might need to remind me about it two or three times. And I need to remember that she’s not pestering me. In the past, I would get really annoyed and I’d be like, ‘Just trust that I’ll do it.’ But then half the time I wouldn’t do it.”
Speaking to alumni who have also received later-in-life ADHD diagnoses has been a profound experience for me. As I interviewed them, we commiserated about all-nighters during our Amherst years (time constraints being a great motivator for people with ADHD). It’s been illuminating to speak to people who struggle in many of the same ways that I do, and who are finding creative strategies to manage this wide-ranging disorder. “It’s one of those devious diagnoses,” says Goldberg, the ’00 psychiatrist, “because it rears its head in lots of different ways. It’s not just professional functioning. It cuts across domains.”
At the same time, everyone is different. “People will commonly talk about ADHD like it’s a well-understood entity,” adds Siegel. “ADHD is incredibly heterogeneous. I could show you five different patients. They have certain things in common that merit the diagnosis, but they are a lot more different than they are similar.”
As I interviewed Goldberg, Siegel and other Amherst experts, I realized how often I’ve instituted accommodations for myself without knowing that they were ADHD strategies. Overwhelmed with moving out of my dorm sophomore year, I enlisted a friend to help me get organized, a strategy I now know is called “body doubling.” After many kitchen snafus, I got a sense that setting timers was helpful when it came to not burning every pot in our house; now I understand that, due to an ADHD phenomenon called “time blindness,” alarms are essential to completing everyday tasks, like making my son’s lunch or putting out the trash. I worked on organic farms for years but could never seem to successfully execute a home vegetable garden, which requires many facets of executive functioning that I struggle with. Now I share a vegetable garden with a neighbor who helps me break down a season of work into smaller tasks.
“The adult ADHD brain needs organizational structures that are usually internal to be externalized,” explains Siegel, “like using Post-it notes to write the series of tasks you have to do in order to get out the door. It’s nothing to be ashamed of.”
Angelica Oung ’03 was diagnosed with ADHD after making some big mistakes at work. Since then, she has learned what does and doesn’t work for her: “A lot of traditional productivity advice can be toxic for those of us with ADHD. You know the advice: Eat the frog—do the thing you hate the most at the top of the day. Well, guess what? If I put the thing I don’t want to do at the top of the day, not only am I not going to do it, I’m not going to do anything else either.”
The more I learned about ADHD, the better I understood myself and my limitations. For example, I always thought my husband was more domestic than I am. As it turns out, meal planning and keeping a clean house are not an ADHD forte. These are not personal failings, as I had previously internalized. But this knowledge also made me wonder: What is ADHD and what is just me? I have always been a night owl. I now know that sleep issues are common for people with ADHD. It makes sense: We procrastinate on everything, even bedtime. Those quiet hours in the middle of the night are when I feel most grounded, when the frenzied stimulations of the world that I cannot filter out are turned off for a little while and I can feel some peace.
People with ADHD often speak about the grief that accompanies an adult diagnosis: all the things we could have done if we had known more about the way our brains function. Maybe I would have written a thesis at Amherst or followed through on one of my entrepreneurial ideas. “I’ve always had these nagging feelings of regret,” Damashek says. “Instead of doing a million things, I wish I had focused on one or two extracurriculars and gotten really good at them.” Like him, I bemoan the fact that I am an apprentice in many areas but a master of none. Almost everyone I interviewed shared a sense of pain and shame around not being able to achieve their full potential.
Goldberg has made it his life’s work to help college students, including many with ADHD. He has developed a program that employs wellness approaches to mental health while also teaching executive functioning skills such as time management, effective planning and self-regulation. “Self-advocacy is an essential component of executive functioning,” Goldberg says. “We talk about metacognition—knowing who you are as a learner, what kind of teaching and learning styles work for you.” According to Goldberg, developing self-awareness is the first step to developing the skills and ability to advocate for what you need.
When I first received my diagnosis, I was elated. This was the answer to all my problems! I was going to be a better partner, parent and person overnight! I was going to finish my long-overdue projects! The reality is not so simple. In my interviews, I have learned that ADHD is manageable, but it will always be something that needs to be managed.
Still, receiving this diagnosis has given me a different perspective from which to understand myself and my challenges. For so long, I was struggling without truly understanding the extent of my struggles. This was my reality, and I didn’t know that it could be any different. I was too busy operating on overdrive as a way to mask my deficits and beating myself up for not functioning at a higher level. My ADHD diagnosis has empowered me to treat myself with more compassion and grace. Now, I can be realistic about my capacity. I am witnessing a certain kindness and gentleness toward myself that is new—and refreshing.
As I worked on this project, I devised a complex strategy to keep me focused and free from internet distraction—a strategy that involved multiple computers, as well as a thumb drive on which I saved all of my work. In the midst of writing, I took an extended trip to Europe, and you can guess what I left behind: the thumb drive. I remembered to bring my electric milk frother but didn’t remember to bring the transcripts and drafts I had been working on for months. Even with the bullet journaling and the Post-it notes, this highly important object fell through the cracks. I had to laugh at the irony of it.
Carmella de los Angeles Guiol ’09 is a part-time writer and full-time mother. She lives with her family in Durham, N.C.
Illustrations by Adam McCauley
