Millions of Reddit users seeking reliable, science-backed advice about living with ADHD have been barred access to a valuable resource. The ADHD subreddit has blocked content from ADDitude, a leading source of trusted, evidence-based support for the ADHD community.

Moderators of the ADHD subreddit have blocked any post or comment that mentions ADDitude, preventing people — including newly diagnosed adults, families seeking help for loved ones with the condition, educators, and medical professionals — from obtaining expert guidance to improve ADHD understanding and outcomes. In addition, when a subreddit user attempts to cite information from ADDitude on the platform, the moderators distribute an auto-response message attacking ADDitude with false statements and defamatory language.

The ADDitude team’s request — that the subreddit moderators immediately discontinue distributing its inflammatory automated message — has been denied. No reason was given.

For 27 years, ADDitude has worked to bring the latest evidence-based practices and guidance to support adults and families touched by ADHD, coexisting conditions, and learning differences. Earlier this year, Media Bias / Fact Check rated ADDitude as “pro science” with high marks, citing its commitment to providing evidence-based information on ADHD and related conditions.

Despite this, the subreddit auto-response message continues to propagate these false claims:

• That ADDitude solicits donations from people with ADHD to fund their operation. This is false. ADDitude has never solicited or accepted donations from individuals or organizations of any kind.
• That ADDitude prioritizes advertising dollars over people’s best interests. This is false. ADDitude provides free of charge 8,400 articles, weekly webinars with leading experts, numerous newsletters, and hundreds of downloads to help people with ADHD live better. Our small, dedicated team is guided not by profit but by a passion and dedication for helping people.
• That ADDitudeMag.com is “full of articles promoting the use of homeopathy, reiki, and other unscientific quack practices.” This is false. Six articles out of thousands mention homeopathy, and all of them clearly state that it is not recommended for treating ADHD. In contrast, ADDitudeMag.com houses more than 1,000 articles about treating ADHD with medication and complementary approaches, such as cognitive behavioral therapy, parent behavior training, and mindful meditation.
• That ADDitudeMag.com contains “sketchy advertising.” This is false. All three examples cited by Reddit are invalid URLs; these pages do not exist.
• That ADDitude publishes “junk science.” This is false. The URLs cited by Reddit contain a combined 40 footnotes and links to credible, respected research. ADDitudeMag.com publishes fully footnoted content written by leading experts in the field of ADHD and we take very seriously our responsibility to serve this community with accurate, credible information.

The moderators’ criticisms of ADDitude distributed to untold numbers of Reddit members are not only baseless; they appear to be motivated by an intent to harm our publication and community.

It’s important to note that section 230 of the Communication Decency Act protects social media companies from defamation lawsuits for statements made by their users and moderators. Publishers like ADDitude are left with few legal options for fighting defamation and bias, despite the injury to their reputation and business.

As such, ADDitude encourages its community members to reconsider their membership and participation in the ADHD subreddit. The Reddit Moderator Code of Conduct requires moderators to “moderate with integrity,” and users may report moderators for violations here.

Above all, individuals living with ADHD deserve access to reliable, expert information that supports their wellbeing. Blocking trusted guidance does a disservice to the very communities these platforms claim to serve.

Thank you,
Anni Rodgers
General Manager of ADDitude

First, I would encourage you not to be defensive during your visit. Clinicians have to follow a process to give you a diagnosis. This may seem like a waste of time, but a full differential diagnosis requires more than just asking neurodivergent-related questions. You may be asked questions that you feel are irrelevant, but that are important nonetheless.

There might be something you can learn, and something that you can teach the clinician. I have thanked patients for correcting me about certain things and I think that those interactions have been transformative for them too. I know I’ve learned from them.

[Take the Autism in Women Self-Test]

Having said that, it is important for all of us to feel respected, and that includes respect from your clinician. If you feel your provider is cynical or not listening to you, or they’re not acting in a collaborative way, then you can say thank you and move on.

Q: “What are the common misdiagnoses given to girls and women with ADHD and autism?”

Autistic girls and women with ADHD are often diagnosed with borderline personality disorder. This is a difficult differential diagnosis because it entails so much — dichotomous thinking, emotional reactivity, and fears of rejection and abandonment.

They also get misdiagnosed with bipolar disorder and, more commonly, with obsessive-compulsive disorder (OCD). This is because many neurodivergent individuals like repetitiveness, or like to systematize things, and have trouble interrupting a sequence, but that doesn’t necessarily mean they have OCD. It’s also not uncommon to have co-occurring conditions.

Q: “Are autistic girls with ADHD more likely to experience emotional dysregulation than their neurotypical peers?”

Emotional dysregulation is not part of the diagnostic criteria for ADHD or autism, but it is very much a part of the lived experience for both conditions — and it can be very impairing. Rejection sensitivity (the tendency to intensely react to real or perceived rejection), along with spiraling emotions or thoughts, impairs a person’s functioning and ability to interact and listen.

[Get This Free Download: Your Autism Evaluation Checklist]

According to society’s gender roles, girls and women are not supposed to get upset or display anger. When faced with rejection, we may hold it in and mask — only to eventually explode. So being unable to understand our emotions and know when we need to breathe, or step away, is important.

AuDHD Diagnosis: Next Steps

• Take These Self-Tests:
  • ADHD in Women
  • Autism in Women
• Learn: How to Get Evaluated for Autism as an Adult
• Read: Autism and ADHD in Adults
• Read: “Women Need Better, More Accurate Diagnostic Tools for ADHD”
• Read: “What to Expect After Your AuDHD Diagnosis”
• Read: ADHD, Autism, and Neurodivergence Are Coming Into Focus
• Read: “A Living Contradiction” — The AuDHD Experience
• Free eBook: The Truth About Autism in Adults
  

Karen Saporito, Ph.D., is a licensed clinical psychologist who has been in private practice for more than 20 years.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Despite earning the nickname “Busy” as a child because she rarely stopped moving, she had long dismissed her ADHD symptoms as personal weaknesses. Today the Dawson’s Creek, Freaks and Geeks, Cougar Town, and Girls5eva star reflects on life before and after her ADHD diagnosis at age 39.

Q: How has being diagnosed with ADHD as an adult made a difference in your life?
A late diagnosis allows you to look back at all the times when people in your life or career attributed certain ADHD traits – lack of organization or time management – to your not being able to get it together. I spent a great deal of my life not fully understanding why “easy” things were so difficult for me.

[How is ADHD Diagnosed? Your Free Guide]

The diagnosis has changed the way I view my past self. I’m so grateful that I know now. So many feelings of low self-worth have dissipated. With an earlier diagnosis and treatment plan, I probably would not have had the same kinds of struggles that I had in my 20s and 30s.

Q: Juggling motherhood and a career can feel like a precarious balancing act for just about any woman, let alone one with weak executive function skills. How did you manage when you were undiagnosed and untreated?
When I was a young mother and had small kids and was working full time on a network television show, I couldn’t keep appointments straight. I’d find myself double-booked or unable to make it at the last second. You really feel like you’ve let down your kid when you miss gymnastics class by an hour.

[Read: ADHD Symptoms in Women Aren’t ‘Hidden;’ They Are Misinterpreted]

I spent a great deal of my kids’ early lives being very weighed down by my own feelings of inadequacy. I felt I was failing them and myself. I thought that I couldn’t keep these things straight because of my lack of concentration, because I wasn’t trying hard enough, because I was tired, because all these other moms have it figured out and I don’t. I was very hard on myself.

Q: Some people with ADHD struggle with working memory. In your acting career, was it especially difficult to learn a new script and remember your lines?
If it’s something I’m interested in, I have no issue remembering that information. I recall my math teachers saying to me, “You can remember all those lines for the school play; why can’t you remember your times table?” I do think that has to do with my ADHD. I’m actually great at memorizing lines. I have a real gift for it.

Being an actor was something I was interested in, and so my ADHD let me focus on it. Even with time blindness, I was never late for a call time. This career that I loved so much and wanted to do – that took over and it was my only focus.

Q: Do you have any advice to help people with ADHD live better?
Make sure you’re able to get the treatment that works for you. You shouldn’t feel shame or stigma. There’s real power in owning it, even at work, even with people you love.

Adult Women with ADHD: Next Steps

• Free Women’s Health Month Calendar: 31 Days to Demand Attention!
• Read: Hormonal Changes in Women with ADHD — 4 Gaping Holes in Research
• Watch: Roundtable on ADHD in Women
• Read: “You Are Way Too Hard On Yourself…”

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.
Carole Fleck is Editor-in-Chief at ADDitude magazine.

Grown-ups write a weekly meal schedule on a Sunday and do careful calculations before drilling holes. They make sandwiches the night before and remember to take them to work.

Grown-ups quell their transient urges in the pursuit of long-term goals. They commit, they save, they resist, and they toil. They get where they were planning to go.

Tedium does not torment the regular grown-up. If a boring job needs doing, they simply get on and do it. They are not hijacked by the urgent need to be anywhere else but the present.

Grown-ups don’t pull their phone-charger cable out while chatting and distractedly plug it into their mouth. They hardly ever go to bed with their keys left hanging on the outside of the door, and I very much doubt that they have 14,000 unread emails. Grown-ups absolutely do not tell someone they’ve just met that their underwear is stuck up their bum.

So, nope. Not much grown-uppery going on around here.

Even motherhood has failed to rebirth me as a convincing adult, if I’m honest. I love with abandon, but I do not have the skill set of an executive PA, despite what my children’s school might assume.

I’m the parent with the kid in full uniform on wear-whatever-you-want day and no cash for the cash-only book fair. I’m the mum at the bounce party who demos an illegal maneuver and then watches as a 6-year-old copies and knocks out his tooth.

[Read: Diaries of “Adulting” (or Not) with ADHD]

I Don’t Feel Like an Adult: The Fallout from Falling Short

Like lots of people acutely aware of their flaws, I’ve learned to jump in and laugh at myself before others can take a shot. But I still feel small when I fail to measure up to societal norms, no matter how many jokes I churn out at my own expense.

I am also reduced to jelly by the ice-cold dead eye of those proudly logical humans repulsed by malfunctions of common sense. I see their disdain as a sign of deep self-loathing, but I nonetheless crumble at their condemnation of me and the faults I may well never fix.

My lack of adulting acumen has cost me. Failure to plan, persist, and apply what I learn from experience has thwarted my ambition and harmed my self-trust. It limits my capacity to meet my potential and avoid repeating mistakes. It hurts.

Why Can’t I “Adult?” It Was ADHD All Along

I cannot describe how I felt when I read about the symptoms of inattentive-type ADHD in women. I ticked almost all of the boxes and made sense to myself for the first time ever. A single condition explained what I had always viewed with quiet shame as manifestations of immaturity, weak character and sloth.

I waited 30 months for an assessment and then sobbed the whole way through it. When my diagnosis came, it felt like a big “welcome home” by people who finally got me. You are not alone! Come on in! Sorry about the mess. It was truly the biggest relief of my life.

[Take This Self-Test: ADHD Symptoms in Women]

Now I’m busy learning how my traits and behaviors conspire to keep me feeling like a child.

Of course I have trouble resisting temptation. My brain yearns for dopamine to bolster its fragile supply. And I leave things to the last minute not out of preference or bravado but because concentration evades me until a deadline is so close I can smell it.

There’s a reason too why I struggle to stay on-task when a job is neither urgent nor appealing. My filter for blocking out irrelevant stimuli has the authority of wilted spinach. Distracting noises and thoughts roll in freely while I’m trying to focus and the effort it takes to ignore them leaves me feeling drained and frustrated.

I am not devoid of reason (though I never really thought I was). My prefrontal cortex is clear-thinking and analytical. But when my lizard brain floods with emotion, the rational part of me doesn’t carry sufficient clout to talk it out of a spiral.

It’s empowering to have language and insights about ADHD to help me understand and convey to others what I’ve always known but lacked the words or concepts to explain.

Learning How to Be an Adult

My ADHD diagnosis hasn’t magicked me into a grown-up. But it has made me feel happier and more in control of my choices. I’ve grieved for lost dreams and stopped beating myself up all day long. Decades of self-castigation, it turns out, yield little positive change.

And ADHD is not all bad, let’s be honest. My neurodivergent strengths and leanings make life a lot more fun. They predispose me to creativity, which brings me joy and flow. It can feel like the meaning of life itself when ideas spill forth with apparently mystical ease. I’m entertained by my daydreaming too, which helps me spot links and patterns that don’t always jump out at others. I’m flexible and adaptable and I come alive under pressure. I’m pretty sure ADHD makes me more tolerant as well. Being aware of my own annoying quirks makes it natural for me to cut others some slack over theirs.

I’m not sure I’d swap any one of these traits for an immaculate car or the ability to tell you what I’m having for dinner next Tuesday.

Will I ever feel like a grown-up? Never completely, I hope. I’m pleased my diagnosis has helped me find ways to manage. But I plan to grow more than just upwards. I intend to grow outwards, inwards, and in any direction that my passion and curiosity take me. That is the most authentic, and surely therefore the most grown-up thing I can do.

“I Don’t Feel Like an Adult:” Next Steps

• Sign Up: Essential Support for Women with ADHD
• Read: The Adult in the Room — I’m Not It!
• Read: 42 Raw Confessions from Women with ADHD
• Read: “I Learned I Couldn’t Trust Myself, Then I Found I Had Undiagnosed ADHD.”

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

ADDitude magazine asked practitioners who specialize in ADHD about their clients’ toughest problems, and the strategies that move them in the right direction. Here is what they said.

Identify the Benefits

Ari Tuckman, Psy.D.

As Russell Barkley, Ph.D., has famously said, ADHD is not about knowing but about doing. This is especially true with co-occurring conditions that make it even harder to get going. I have engaged in some great conversations in session about what to do and how to do it, but then faced disappointing weeks when clients struggled to follow through – again.

It’s easy with ADHD to feel like too much of life is about avoiding negatives, so I make a point of talking about the positives that clients will gain from doing what we discuss. For example, walking into a work meeting feeling confident rather than hoping to be ignored. Or getting into bed earlier tonight so you’ll be more effective tomorrow and then have time after work to meet up with friends.

We all benefit from working toward something that is important and meaningful. Anxiety and depression can steal this sense of purpose, so you need to figure out what that is for you. This will become your source of real, lasting motivation.

Value Persistence Over Perfection

Sharon Saline, Psy.D.

I really enjoy the outside-the-box thinking that people bring to our sessions – their humor, their intelligence, their candor about their strengths and limitations, and their sensitivity. In my office, laughter is often mixed with personal insights, curiosity, and tears.

[Get This Free Download: Get the Adult’s Guide to Treating ADHD]

The main challenges I see in my work with clients with ADHD: consistently inconsistent motivation, a hallmark of ADHD, mixed with perfectionism and helplessness. All of my clients sincerely want to change but wrestle with how. They are willing to try a new technique or take a risk, but they struggle with persistence, unrealistic standards, and self-esteem. They become discouraged and give up.

When this occurs, we begin by exploring the obstacles they face, patterns that might be recurring, and any past successes that could be applied to this situation. We work together to adjust their expectations about “success,” look for something to re-engage them, and then pivot to trying again with new tweaks and a different perspective. This process helps them regroup, aim for steadiness instead of perfectionism, and feel empowered.

Determine the Conditions at Play

Roberto Olivardia, Ph.D.

ADHD rarely travels alone. Yet many patients are unaware of the hand that ADHD plays in the etiology, presentation, and/or course of their other conditions – which may be unidentified or misdiagnosed. This is particularly true of ADHD in adults, since many symptoms mimic and overlap with traits of other disorders.

Patients are perceived as complicated when previous treatment methods seem ineffective. However, a primary reason for this is the clinical underappreciation of ADHD. Even when ADHD has been diagnosed, many patients are told that ADHD treatment is secondary to treatment of “more serious” problems. Meanwhile, untreated ADHD often undermines the treatment of other conditions. Patients feel unfixable.

[Read More from Dr. Olivardia]

My role is to empathically work with a patient to place all the pieces of the diagnostic puzzle on the table. You have to inquire about each of the problems to capture the story of the symptoms. For example, not sleeping for three consecutive days could be a symptom of a manic episode, a cocaine-fueled bender, a depressive episode, or because you were writing your senior honors thesis (and I have experience in this) after your ADHD had you put it off until 72 hours before the deadline.

As clinicians, we always have to ask, “What diagnosis is driving the bus?” – especially when multiple diagnoses are present. Only then can we properly put the puzzle pieces together and deliver to our patients the heartfelt message that they are not broken but simply needed more time and examination for the proper treatment to be effective.

Put On Your Own Oxygen Mask First

Dawn K. Brown, M.D.

Women of color with ADHD carry an immense load. They balance careers, family life, and societal expectations while managing ADHD, not to mention other conditions like anxiety or hormonal imbalances. I always tell my patients that taking care of themselves is not optional. In a world that often expects them to be last, they must intentionally choose to put themselves first. Without that, everything else falls apart.

I begin by helping them create a personal roadmap for managing life with ADHD. For instance, I had a patient who was a single mother with a demanding career. She felt overwhelmed, always chasing her to-do list but never catching up. We started by breaking down her day, prioritizing tasks, and integrating time for self-care. I introduced her to time-blocking: setting specific times for work, family, and herself. She also used organization apps, like Todoist, to break down tasks into smaller, manageable steps. Over time, she learned to delegate more responsibilities at home and let go of the pressure to do everything perfectly.

We also focused on setting boundaries. For many women of color, there’s pressure to be everything to everyone. I encourage my patients to set limits and say “no” without guilt. This might mean communicating with family about their need for quiet time or asking for help at work to lighten the load.

Unite and Conquer

Paul Mitrani, M.D., Ph.D.

My adult clients report frequent problems in relationships, especially when they have ADHD and their partner does not understand the difficulties it brings, like forgetting to do things or neglecting to share responsibilities. When must-dos fall by the wayside, that’s when trouble begins. It’s important for individuals and their partners to think about how to delegate – this is my strength, this is yours, and this is how we’ll partner up. I also work to educate the partner that this is a medical condition and not just the other person forgetting or not seeming to be as interested in things.

How to Set Emotional Boundaries: Next Steps

• Free Download: Who Can Treat ADHD?
• Read: Realistic Solutions for Managing Life, Time & Emotions
• Read: 33 Ways to Prioritize Your Mental Health

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

October 24, 2024

Finding a clinician who takes your insurance has become a daunting task, largely because providers have abandoned insurance networks in droves. As a result, patients with ADHD and other conditions are forced to navigate a shrinking pool of in-network providers or pay out-of-pocket for care.

According to an August ProPublica report, more than 500 psychiatrists, psychologists, and therapists said they left insurance networks in recent years because insurers made it too difficult to properly care for patients and maintain a viable practice. The providers said it was often the insurers that determined who is eligible for treatment coverage, what kind, and for how long — not the professionals providing care. Some added that insurers pressed them to reduce care when patients were on the verge of harm. ¹

Many of the clinicians interviewed said they struggled to stay in business as insurers denied claims, withheld reimbursements for months, or otherwise made it nearly impossible to provide care and maintain financial viability.

A shortage of mental healthcare providers has severely limited patient access to affordable, high-quality care.

Source

¹ Why I Left the Network. (2024, August 25). ProPublica. Retrieved October 25, 2024, from
https://projects.propublica.org/why-i-left-the-network/

Strong self-advocacy skills — i.e., the ability to ask for and secure support when it matters — is a strong indicator of success for people with ADHD. Everything from executive dysfunction to the emotional impact of ADHD and its comorbidities are made more manageable with the right kind of help. But the same ADHD characteristics that make assistance so important also make asking for it really tough.

So we asked ADDitude readers to share their experiences with self-advocacy and offer any tips, hacks, or hints that have helped them get helpful help. Here’s what they told us:

Why We Ask for Help

“I see requests for help as opportunities to build relationships and connections.” —Catherine, Washington

“When I ask for help, it makes me feel like a failure. But I remind myself that I need to set an example for my kids, so I will ask my husband for help by explaining that I need to prioritize something else so can he please cook dinner?” —Kate, Australia

[Read: The Fear of Failure Is Real — and Profound]

“I’m midlife and the gig of doing it all by myself is up: I have crashed and have to ask for help now. The trick is choosing relationships in every area of life with people who have high standards of relations, reciprocity, and compassion. I choose now, rather than hoping others will get me. It changes everything!” —An ADDitude Reader

“I think having a background in addiction recovery is an asset to ADHD coping. I am already aware that in some areas, I need support outside of myself. Therefore, I am already practiced in asking for support. I know that if I try to cope on my own, it may lead to unhealthy behaviors.” —Krysta, Canada

“I have a 15-minute rule. If I am stuck for more than 15 minutes, I ask for help. I instill this in my employees as well. Asking for help tells me that they are comfortable with communication, and humble.” —John, Florida

“If I notice my RSD is preventing me from asking for support, that often indicates that I’m not getting what I need from that relationship to feel safe.” —AJ, Utah

[Read: How ADHD Ignites RSD – Meaning & Medication Solutions]

How We Ask for Help

“I prefer typing out a text or email rather than orally asking for help, but if text/email is not an option, writing a script can help me prepare for a face-to-face request.” —Chandler, Pennsylvania

“Ask for something super tiny to get practice at asking for help.” —Katrina, Australia

“I have set up keywords with my husband, so when I say those words he knows I am feeling lonely and I need help.” —April, Oklahoma

“My ADHD can make me quite impatient, so I need to give people time to process my request, or take the action I’ve asked for. It helps to remember this isn’t rejection, and they don’t have to drop everything then and there in order to be willing to help.” —Trish

“To address loneliness, I have learned to say ‘I need a hug.’ Often it opens the door for me to share more about what is going on.” —Claire, Pennsylvania

“I identify a person with complementary skills, and I spontaneously contribute to our shared objective by doing the tasks they find laborious. The reciprocal task division follows naturally. Nobody has to ask, no gift debt is engendered. We are actively helping each other.” —Dettie

“I imagine that I’m giving someone good news when I’m about to ask for something I feel nervous about.” —Kelsie, Mississippi

“I have to just accept that asking feels awkward, and it probably always will.” —Sarah, Georgia

“I always express gratitude to any person who is willing to body double with me and I describe how it was helpful. For example, ‘You read your book while I was doing bills and I got sooo much more done. Thank you. Let me know when you are reading your next book.’” —An ADDitude Reader

“I offer help, often. That makes me feel better about asking for help. In my mind, I’ve kind of already paid for the help that I need by helping others, and now I’m cashing out.” —Helen, Maryland

“I practice a lot of ‘I statements,’ like, ‘I feel so overwhelmed by the number of tasks I have to do and I need extra hands.’ It’s not easy, but if you start with positive ‘I need’ statements, and practice, it’ll start feeling like second nature.” —Vanessa, Texas

“I try to set up check-ins with team members at work so it’s easier to ask for help while working on a specific project.” —Christina, Louisiana

“Give yourself 10 seconds of bravery. Start counting backwards from 10 and, before you hit one, say what you need to say to the person.” —Charlie, Australia

“Before asking for help at work, I always make sure to have a list made up of things I need help with. It shows my boss and team members that I have come prepared, with a plan.” —Melissa, Minnesota

“I have realized that I need to be very concise and direct when asking for help, instead of talking about how much I need help and giving reasons.” —An ADDitude Reader

“I use an app such as Goblin Tools to break down tasks, then I ask for specific help. I find that if I say I need help in a non-specific way, people are less ready to help, but if I say, ‘Can you declutter this one drawer please?’ then I’ll get help. The act of breaking the task down helps reduce my overwhelm, too.” —Laura, New Zealand

“One thing that helps is to talk to friends about what is going on, just to gauge what their capacity is for listening or coming up with solutions I am blind to. More eyes and brains on a problem are a good thing.” —Sarah, Germany

“With my teenager, it is mostly a choice-based, task-related ask: ‘Would you be willing to help me with Option A or Option B and at what time?’” —Kristen, Michigan

“At work, I have a personal checklist of resources to exhaust. If I can’t find the answers after doing due diligence, I reach out to an appropriate team member. Having researched on my end allows me to reach out with a more informed and confident ask for help.” —Sharon, Ohio

ADHD Self Advocacy: Next Steps

• Quiz: Rejection Sensitive Dysphoria Symptom Test
• Quiz: How Severe Is Your Loneliness?
• Download: The Emotions of ADHD

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

More than half of individuals with ADHD — and significantly more women than men — were diagnosed in adulthood, according to new data published in the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR).¹ These findings constitute the CDC’s first update on the prevalence and age of diagnosis for ADHD in nearly 20 years.

The CDC report, which found that 6 percent of U.S. adults have a current ADHD diagnosis, identified several gender-based discrepancies regarding the age of diagnosis. Sixty-one percent of women received their ADHD diagnosis during adulthood, compared to 40 percent of men. One-quarter of women received an ADHD diagnosis before age 11, compared to 45 percent of men.

“Taken together, these data highlight the significant public health burden of ADHD and challenges experienced by adults with this diagnosis,” said Greg Mattingly, M.D., president of the American Professional Society of ADHD and Related Disorders (APSARD), and Ann Childress, M.D., past president of APSARD, in an article published in Psychiatric Times.²

The MMWR analyzed data collected from the National Center for Health Statistics Rapid Survey System (RSS) from October through November 2023 on the prevalence, treatment barriers, and telehealth usage of adults with ADHD.

Consequences of Undiagnosed Adult ADHD

Once considered a childhood condition, ADHD is now recognized as one of the most common mental health conditions in adults, affecting men and women almost equally. ³,⁴ A new national survey of 1,000 American adults by The Ohio State University Wexner Medical Center and College of Medicine revealed that as many as one in four adults suspect they may have undiagnosed ADHD, however, only 13 percent have consulted a doctor about their suspicions. The researchers say the findings raise concerns that self-diagnosis may lead to incorrect treatment.

“In recent years, the number of adults diagnosed with ADHD has risen significantly – thanks, in part, to decades of research that has advanced awareness of ADHD as a lifelong disorder,”⁵ wrote APSARD secretary Maggie Sibley, Ph.D., in the ADDitude article, “Why We Need U.S. Guidelines for Adults with ADHD.” “Though ADHD is commonly detected in childhood, later-in-life diagnoses are providing clarity and relief for many adults with once unexplained, misunderstood, or overlooked lifelong struggles.”

Untreated adult ADHD symptoms may impair individuals personally and professionally, and they may exacerbate comorbidities like depression, anxiety, bipolar disorder, insomnia, substance use disorders, and trauma-related conditions. ⁶, ⁷

“ADHD does not happen in a vacuum, and its effects are far more impairing when the condition goes undiagnosed, untreated, or improperly treated,” said Nelson M. Handal, M.D., DFAPA, in the ADDitude webinar, “New Insights Into and Treatments for Comorbid Depression” “It’s not difficult to see how untreated symptoms of ADHD — from impulsivity and emotional instability to poor planning and execution skills — compromise one’s ability to find success in school, work, relationships, and other parts of life.”

Even with an ADHD diagnosis, adults face barriers to care amid the ongoing stimulant shortage. Approximately 7 in 10 adults treating ADHD with stimulant medications reported difficulty obtaining their prescriptions, the CDC found.

The CDC’s findings suggest that telemedicine may improve access to healthcare and decrease systemic discrepancies in care. Nearly half of adults with a current ADHD diagnosis said they received some of their ADHD healthcare via telemedicine.

“These benefits must, however, be balanced with the need for thorough diagnostic evaluation and follow-up for both the in-person and virtual models of care,” said Mattingly and Childress.

“Some telehealth companies are under federal investigation for their prescribing practices, highlighting a need for clarity on appropriate practices for the prescription of stimulants – a first-line treatment for ADHD,” Sibley wrote. “APSARD’s forthcoming adult ADHD guidelines will address this urgent need for providers and patients alike — making evaluations more thorough, diagnosis more reliable, and treatment safer.”

Importance of Adult ADHD Guidelines

The Ohio State study and CDC data underscore the need for adult ADHD diagnosis and treatment guidelines, which APSARD is working to finalize by late this year or early 2025.

“These will be the first U.S. guidelines for the diagnosis and treatment of adults with ADHD, and they will provide a valuable framework of treatment for clinicians and families,” said Mattingly and Childress. “While many unanswered questions remain, these findings bring us one step closer to a deeper understanding of the needs of adults with ADHD.”

The impact of the APSARD guidelines may be felt most profoundly by adult women.

“Many women do not recognize that they have ADHD or seek evaluations until their children are diagnosed,” wrote Childress in an ADDitude article earlier this year. They are often treated for anxiety or depression that developed secondarily to ADHD. Helping clinicians recognize the difference in presentation of ADHD symptoms in women is important.”

Sources

¹taley, S.B., Robinson, L.R., Claussen, A.H., et al. Attention Deficit/Hyperactivity Disorder Diagnosis, Treatment and Telehealth Use in Adults – National Center for Health Statistics Rapid Surveys System, United States, October – November 2023. MMWR Morb Mortal Wkly Rep. 2024;73(40)

² Mattingly, G., Childress, A. (2024). Clinical Implications of Attention-Deficit/Hyperactivity Disorder in Adults: What New Data on Diagnostic Trends, Treatment Barriers, and Telehealth Utilization Tell Us. J Clin Psychiatry; 85(4): 24com15592. https://doi.org/10.4088/JCP.24com15592

³Ayano, G., Tsegay, L., Gizachew, Y, et al. (2023). Prevalence of Attention Deficit Hyperactivity Disorder in Adults: Umbrella Review of Evidence Generated Across the Globe. Psychiatry Res; 328:115449. https://doi.org/10.1016/j.psychres.2023.115449

⁴Faraone, S.V., Bellgrove, M.A., Brikell, I., et al. (2024). Attention Deficit/Hyperactivity Disorder. Nat Rev Dis Primers; 10(1):11. https://doi.org/10.1038/s41572-024-00495-0

⁵Sibley, M.H., Arnold, L.E., Swanson, J.M., Hechtman, L.T., Kennedy, T.M., Owens, E., Molina, B.S., Jensen, P.S., Hinshaw, S.P., Roy, A., Chronis-Tuscano, A. (2022). Variable Patterns of Remission from ADHD in the Multimodal Treatment Study of ADHD. American Journal of Psychiatry;179(2):142-51. https://doi.org/10.1176/appi.ajp.2021.21010032

⁶Kessler, R.C., Berglund, P., Chiu, W.T., et al. (2004). The US National Comorbidity Survey Replication (NCS-R): Design and Field Procedures. Int J Methods Psychiatr Res; 13(2):69–92. https://doi.org/10.1002/mpr.167

⁷Katzman, M.A., Bilkey, T.S., Chokka, P.R., et al. (2017). Adult ADHD and Comorbid Disorders: Clinical Implications of a Dimensional Approach. BMC Psychiatry. 17(1):https://doi.org/10.1186/s12888-017-1463-3

Share your stories of ADHD resilience in the comments section.

“I lost my three-year-old daughter to a rare form of cancer. I remember wanting to die, too. A voice in my head said, ‘You have three other kids who need you to find a way to go on. Because if life hits them the way it’s hit you, they will know they can overcome.’” — Tracy, Canada

“I struggled with depression and anxiety in my first semester of college because of major imposter syndrome and ended up having to go home on medical leave for suicidal ideation. No one expected me (maybe not even myself) to get up the next morning and apply for a job. Hitting what seemed like rock bottom helped me find a hidden, gritty, scrappy fighter within me. I knew I needed time and experience outside of the academic arena to show me that there is more to life and that I have value and talent beyond what any classroom grade might assign me.” — Rebecca, Connecticut

“I failed out of college. Then, I took a semester off, went to community college, eventually enrolled in a four-year program, and graduated with a Bachelor of Science in accounting.” — Erin, Missouri

“Being diagnosed late in life, raising three kiddos with ADHD, surviving a high-conflict divorce, running a school, and navigating a teen through trauma and treatment — ADHD resilience, it’s a real thing.” — Katie, Arizona

[Get This Free Download: Secrets of the ADHD Brain]

“Having ADHD and dealing with setbacks has made my teenager resilient and allowed him to build strong boundaries. When he realized he was being mistreated by ‘friends,’ he recognized that their negativity was contagious and dangerous to his mental health because he was emotionally sensitive. Recognizing his sensitivity to unpleasant behavior gave him the motivation to end old relationships and seek out new ones that are positive and more rewarding. This is a life skill that more teenagers need to live happier lives.” — Jane, Tennessee

“I was told I might not be able to walk again. Yes, I suffered from depression, but I had small goals and kept going. I worked hard. I pushed myself (with my high expectations), and now I can walk with a walking stick. It was one of the most challenging things I’ve ever had to do. It has taken me years to get to where I am today. But I did it because I’m resilient and strong. I’m grateful. I’m proud. Thank you, ADHD.” — Sam, U.K.

“A childhood full of bullying, misunderstanding, and criticism drove me to seek out therapy. That self-exploration gave me an early advantage in self-acceptance and how to deal with others, especially in the decades when I went undiagnosed. I’m a veteran human being now.” — Dee, Canada

“I have fallen on my face so many times over the years, but each time, I climb back up and get a little more success — money, lifestyle, health, etc. I have endurance tattooed on my back (I should add resilience).” — Angie, Virginia

[Join the ADDitude Support Group for Adults with ADHD]

“I try to be resilient by giving myself grace when I forget things and try to complete multi-step tasks. I tell myself it’s ‘OK if I don’t get it right the first time.’ Allowing myself to try again took a long time to accept because I like to get things perfect the first time.” — An ADDitude Reader

“I taught a class of 16-year-olds who hated my guts. Going to work was like entering a war zone. My work colleagues could not believe how I kept going. At home, I also took care of my husband, who suffered from a work injury. I refused to give up. Former bosses still talk to me, and some former students smile and publicly say, ‘Hello.’ My marriage and career continue to thrive.” — Louise, Australia

“I have big emotional reactions to setbacks and rejection, especially involving others. Since learning more about RSD and ADHD, I try to allow myself to feel my feelings so I can build resiliency and move forward. I remind myself that, while people may not understand me, I know who I am.” — Ellen, Massachusetts

“My 10-year-old son faced significant challenges when he developed arthritis and severe asthma following a post-COVID infection. This condition made physical activities like running and playing soccer and basketball difficult, often leaving him in pain and short of breath. Despite his efforts, some teammates were unkind, telling him he was hopeless and suggesting he should quit. When he shared his feelings with me, he showed determination, leaving me in awe. He said, ‘I’ve heard what they’ve said, but I want to finish the season because I made a commitment. I’ll keep doing my best, stay positive, and not let their comments get to me. After the season, I’ll find an activity that better suits my abilities.’ True to his word, he persevered through the season and eventually discovered jiu-jitsu and ninja training, activities that he loves and excels at.” — Jo, Australia

“I have learned that my value is not determined by what I do or have not done or how much I weigh or what others say about me. I have learned to forgive myself and move on. I’m also not afraid of admitting and taking ownership of my mistakes. I try to teach my son this, too.” — Glenda, California

“I don’t know how I survived the five years of my life when I was pregnant, had two young sons, and worked in an industry where an 80-hour workweek was expected. As an ambitious advertising executive and new mother, I flew more than 100,000 miles a year, breast-pumped on the road, and stayed up until 3 a.m. working on new business pitches. I had no clue that I even had ADHD until this year!” — Tyra, Arizona

“I continue to write despite never finishing a single project. I have three unfinished novels, an overflowing drawer of unpublished poetry, and ideas for more. Despite the unsuccessful struggle to complete or publish any of this, I am actively working on a non-fiction book, mostly because I can’t not do it.” — David, Oregon

“I can think of several times in my adulthood where I was resilient: Going to nursing school at age 27, finishing at the top of the class, completing college at age 43, becoming licensed in the state and nationally as a nursing home director, and becoming a director of a bankrupt facility. Despite wanting to drown many times, my mind would rebound, and I kept swimming.” — Enola, Oklahoma

“I had five different majors in college. I spent my 20s jumping from job to job, unsure of what I was good at or wanted. I returned to school and got my Ph.D. at age 39. Ten years later, I am tenured and an associate dean at a major university. I work with people who know that they benefit from my ADHD superpowers and accommodate my less super ADHD symptoms. I regularly get to use my position to help neurodivergent students.” — Ted, California

“I co-founded a charter school 22 years ago. Keeping it on track through many challenges required a lot of perseverance.” — Morgan, California

Perseverance & Resilience: Next Steps

• Read: Building Resilience Begins Here – 6 Motivation Strategies for ADHD Families
• Download: How Well Are You Handling Stress?
• Read: “I Am What I Choose to Become!”

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

So, when a last-ditch effort to score a ticket to your favorite band’s show lands you backstage, or a late entry into a neighborhood Super Bowl pool means winning $750, you can thank your ADHD propensity for spontaneity.

Here, ADDitude readers share more stories of when they reaped the rewards of spontaneity.

Have you ever benefited from spontaneous decision-making or a failure to plan? Share your story in the comments.

Rewards of ADHD Spontaneity

“On a vacation with my husband a few years ago, I got rewarded for failing to plan. Upon arriving at the Mammoth Cave National Park, I realized that I needed to order tickets to tour the caves weeks in advance. As a result, we could only enter the public park areas. Once the initial ‘Oh no, we drove here and can’t go in’ feeling solidified into reality, it allowed for total spontaneity. We explored on our own and enjoyed a nice lunch. Instead of the trip being about the destination, it was about the journey. To this day, we still use the expression ‘It’s a Mammoth Cave day’ to describe how a failure to plan resulted in a good outcome.” — Lisa, Wisconsin

[Get This Free Download: 25 Things to Love About ADHD]

“I was given the task of planning the family vacation. I kept putting it off, paralyzed by the thought of wading through travel brochures and finding a deal within our budget. Three days before the holidays, I saw a local travel agency advertise a reduced-price trip to Florida for two weeks that was a cancellation. It turned out to be the holiday of a lifetime. My grown children still talk about it being the best trip ever!” —Jacinta, Lancashire, England

“When my kids were little, I took them on midnight runs to IHOP on their birthdays.” —An ADDitude Reader

“I forgot to submit my entry to a neighborhood Super Bowl pool and had to take the last block available. I ended up winning $750!” — Kate, Pennsylvania

“I wrote a poem for my parents’ 25th wedding anniversary in the bathroom of the banquet hall 20 minutes before the toast. It was so well received that my parents still gush about it 30 years later!” — Beth, Colorado

[Self-Test: Do I Have Hyperactive-Impulsive ADHD?

“After I finished an aerobics class at my health club, I asked for a job — and got it!” —Terri, Colorado

“Any sort of travel is always fun with a touch of spontaneity! I traveled alone in Thailand once, and I came across so many experiences and people just by winging it and wandering around!” — Kayla

“During COVID, I spontaneously moved to a new city without a job or knowing a single soul. In the three years since, this new place has offered me wonderful friendships, a career switch, and a more authentic life.” — An ADDitude Reader, Netherlands

“Despite being a huge fan of the band Wilco, I never followed through and bought a concert ticket when they came to town, and it sold out. On the day of the show, I went to the venue to search for a ticket. I started watching the soundcheck when a guy asked me what I was doing. When I told him I was trying to find a ticket, he said he was the show’s opener, and I could be his ‘roadie’ to get into the show. Afterward, he invited me and others, including Wilco members, for drinks. As I’m leaving, another guy asks me if he can catch a ride — and it turns out to be Leroy Bach, the multi-instrumentalist for Wilco at the time. Leroy invited me to Wilco’s Seattle show the next night. All of this happened because I failed to plan!” — Josh, Utah

“I met my husband on a blind date, and we got engaged two weeks later. We’ve been together 20 years.” — Vanessa, Australia

“One time at work, I did not sufficiently study the plan for a large project and could not contribute to the discussion. However, my ADHD brain spontaneously proposed a different and better solution that we used instead of the original plan.” — Allen, Michigan

“I randomly stopped at a neighborhood estate sale and bought a bag of costume jewelry for $1. After it was sitting in my drawer for three years, I finally took four or five gold pieces to a pawn shop. I made $300.” —Lisa, Virginia

“Being the mom of a 10-year-old, I can be rigid with plans to get everything done. But when I go off the list or veer from what we have planned, my daughter loves the spontaneity. An unplanned trip on our way home to get ice cream in a never-visited town recently was a lot of fun.” — Christine, Michigan

“During a deeply unhappy time at work, a recruiter called me out of the blue and offered me a job. Despite giving up a well-paid permanent position at a time when I struggled to make ends meet as a single parent, I took the position. It became one of the best moves I ever made.” — John, Yorkshire, U.K.

 “I convinced my husband to move us and our four young children to Greece. It wasn’t easy, but what a year or so we had!” —Julia

ADHD Spontaneity: Next Steps

• Free Download: Your Free Guide to All the Best Parts of ADHD
• Read: Who Says One Kind of Thinking Is Better Than Another?
• Read: Decision-Making Advice for Impulsive or Indecisive Adults with ADHD
• Blog: “Riding Motorbikes and Contemplating Death with ADHD”

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

When I reveal that I have ADHD, I often hear about how “brave” I am for being so “open” and “vulnerable.” Granted, I like hearing that because I’m human and I like compliments. Plus, it’s better than fending off stereotypes about ADHD.

To be totally honest, though, I’m not telling you about my ADHD diagnosis to promote diversity, make you feel more comfortable confiding in me, or whatever other altruistic reason you’re thinking. I’m telling you as an act of self-preservation, often after days of deliberation over whether I will hurt or help my case. Disclosing my ADHD is a carefully calculated risk that’s more about substantive outcomes than feel-good moments.

Explaining ADHD to Someone Who Doesn’t Have It

Disclosing my ADHD is really about showing you the inner workings of my mind. My day-to-day life reminds me of my choir teacher’s advice for onstage performance: “Be like a duck: calm on top and paddling like crazy under the surface.” You can’t see my constant struggles to stay on top of employment, housework, and personal affairs; you can’t hear my every thought scream for my total attention as I fail to hold onto a single one; you certainly can’t feel the smaller effects of ADHD pile on top of each other to create a web of executive dysfunction.

[Get This Free Download: Secrets of the ADHD Brain]

No matter how calm I seem on the surface, underneath I am paddling through constant self-assessments and adjustments.

Without the context of a diagnosis, I’m a mess. I can’t get anywhere on time. My apartment is filled with projects that I dove into, lost interest in, and can’t bring myself to put away. Efforts to reach out are too easily put off and forgotten. And heaven help you if I’m having more trouble with my emotional regulation than usual.

So, in more casual settings, my telling you about my ADHD is to let you know that nothing’s personal. I didn’t show up 10 minutes late and yawn when you were talking because I hate you and want to disrespect your time. While you certainly have the right to boundaries and shouldn’t just put up with certain behaviors, you should also know that my shortcomings do not reflect how I view our relationship. And, hopefully, you don’t hate me as much after I’ve confided in you.

When Disclosing ADHD, Context Matters

From a professional perspective, my honesty about ADHD could mean the difference between remaining employed or yet another job hunt. I’m sure that never occurred to my managers as they went on about my courage and whatnot – that I had actual goals beyond reveling in feel-good honesty. Not that I would recommend that everyone with ADHD should disclose their diagnosis to employers. Most sources suggest not doing so, and for good reason.

Conscious and unconscious biases are inevitable, and anything that could make me stand out as a problem could also be my undoing. Though I have been open about my diagnosis and received ADA accommodations, I will always wonder if my managers are now keeping a closer eye on me for any slip-up that would go unnoticed if made by a co-worker.

Disclosing a diagnosis, especially one like ADHD that forces me to confront some of my deepest insecurities, is unpleasant at best. I don’t do it for fun. My decision to open up to you was difficult and ultimately made in hopes of some sort of action. Maybe that’s just a bit of patience, or some help navigating a world that was not designed for me.

I trust you enough to give you a chance to understand me better, and, in turn, learn how we can grow together. Please take that chance.

Explaining ADHD: Next Steps

• Get This Free Download: ADHD Empowerment Month Calendar
• Read: How Adults with ADHD Think — Uncomfortable Truths About the ADHD Nervous System
• Read: “Does Everyone Have ADHD? No. And Why It Hurts When Neurotypicals Claim an ‘ADHD Moment’”
• Read: Your Rights to ADHD Accommodations at Work

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Rachel Feinstein finds herself in some ridiculous situations courtesy of her ADHD. Because she’s been gifted with a razor-sharp sense of humor, she takes these unlikely, sometimes absurd moments and turns them into comedy gold in her stand-up routine.

Rachel is a nationally touring comedian and actress whose newest hour-long comedy special, Big Guy, is now streaming on Netflix, where it premiered in the Top 10. In it, she talks about everything from her aggressively liberal mother and Facebook-blundering dad to the odd-couple relationship she has with her fire chief husband, who affectionately calls her “Big Guy.” In vivid detail, Feinstein illustrates how perplexing and frustrating her annoyingly neat husband finds her chronic messes.

“One morning, I walk into the kitchen and my husband is just pacing,” she recounts. “He goes, ‘One question. I got one question for you: Why are there three open seltzers? I’d love to hear the story behind that.” And I’m like, ‘It’s not gonna be a good tale. It’s not like I’m gonna tell you ‘Well, there was blow and hookers and then three open La Croixs!’”

Feinstein’s been praised for her “amazing impersonations” (Vulture), “acute observations,” and ability to be “subtly, exquisitely attuned to her audience” (AV Club). She’s had three Comedy Central specials, co-hosted The View, and been a guest on The Tonight Show with Jimmy Fallon and Last Week Tonight with John Oliver, among other late night shows, not to mention her slew of TV and film appearances. And she’s the mother of a three-year-old, who provides plenty of comedy material. “My daddy’s a hero,” her daughter likes to say. “And my mommy’s sarcastic.”

Below, Feinstein opens up about the good, the bad, and the funny of her ADHD journey.

[Read: In Praise of the ADHD Funny Bone]

Q: What does your ADHD look like?

I am insanely disorganized. I am always running late. I shed debit cards. I’m always leaving a shoe in somebody’s car. I lose a passport almost every year.

My husband, who is OCD, always says to me: ‘Why don’t you just put things back in the same place?’ And I’m like, ‘You’re assuming I know where I put them. My hands take trips throughout the day. It’s like my hands are not connected to my body.’

I’m a workaholic — but only if someone’s sitting with me. I always have to have a babysitter for myself. I pay people to sit with me.

[Read: Get More Done With a Body Double]

So, for example, an editor expressed interest in working with me on my Netflix special, but I knew I was never going to go through it and email him time codes. So I said to the editor: ‘I’m going to come to your house and sit with you and edit every line with you.’ I don’t think he thought I was going to really do that. Then I was over at his place — just me and him and his wife in his little apartment. I’d leave and bathe and give him time to implement notes, but we were together for two weeks and we got it done. I think we were common law wed by the end of that process.

Q: What was school like for you?

When I even smell a school now, it brings me back to all these weird bad feelings about myself. Ever since I can remember, I was always doing so terribly in school. I was failing, getting Ds and Fs in my public school. They couldn’t stuff information into my brain. I had no idea what was going on in any of the classes. I remember getting 23% on a quiz and thinking, ‘Wow! I can’t believe I know 23% of this!’

I felt like a quaking, throbbing mess in school. It created my core self-esteem issues. When I was 11, I was diagnosed with ADHD, inattentive type.

Then, junior year in high school my parents took me out of the local public school and got me into a tiny Quaker school. There were 60 kids in the whole school, 8 kids in each class. I was able to learn there. I wasn’t distracted and confused. I had a 3.8 GPA for a beat.

Q: When did your love of comedy begin?

From very early on, I loved accents and imitating people and affectations. My parents got me into acting classes and I’d put on living room plays and impersonate everyone in my family.

I always thought I had to entertain people. I remember trying to make everybody laugh in school — and being good at that. That was one thing I could do.

Q: How does ADHD inform your comedy?

I think about things in a funny way. I wasn’t able to think about things in a straight way, so that was the only option left available to me. I need things to hook on to that are funny; that’s what helps me pay attention. So, if someone uses a weird word choice, I’m going to notice what’s funny about it, otherwise I won’t retain anything.

My mom said I was always friends with people who had very distinct personalities and accents — it woke me up, jolted me. That’s true to this day; I’m married to a Brooklyn firefighter pronounced “fiya fida.”

Q: What’s your favorite part of your job?

When I’m on stage, I get a very immediate reaction: it either works or it doesn’t. I am addicted to it, the way my husband’s addicted to the adrenaline rush of being a firefighter. This also helps me as an editing process: I know what works and what doesn’t, and I shed, shed, shed as I go.

The other great thing about stand-up for somebody with ADHD is once you’re booked, you have to do it — you have to be on stage. It’s not something you have to turn in; if it was, I’d never turn it in.

Q: Your least favorite part of your job?

The constant rejection, which mimics all those bad feelings I had about myself in school. There’s always a new insult, even when you think you’ve gotten past that and you’re accepted.

I have to retrain my mind every day to not focus on the person that isn’t into me, that doesn’t like what I’m doing. When the rejection starts to take its toll, I go to the Comedy Cellar and have an immediate connection with the audience.

Q: Where have you found inspiration or encouragement along the way?

I had a therapist who told me that I could juggle a lot of things and that I could grow up and do something where I could be thinking of a million things at once. I remember thinking, ‘This is a man with a desk, who went to graduate school, and he believes this?’ I thought. ‘If Dr. Castellano thinks I won’t be in a Gray Gardens situation for the rest of my life, maybe I won’t be.’

Later, when I was 17, I moved to New York with this random guy and his band, which was named ‘Dick’s Sister.’ I was very obsessed with guys at the time, thinking more about them than what I was going to do with the rest of my life. I had a vague idea of being something funny.

I really didn’t know how to keep a job and I kept getting fired from everything — waitressing, bartending. Then I started nannying for this five-year-old boy with autism. That was the one job I could keep. I really related to his struggles.

I remember I’d tell him, ‘Go put that in the trash can and come right back,’ and he’d get caught between where we were sitting and the trash can. I’d see him get almost there and then get lost. I really related to the feeling of making it halfway to what you were supposed to do. I still do that — I do most of the work and it falls apart at the end.

I worked really hard at the nannying job because I just had this feeling that he had really complicated thoughts, that he was really smart. I didn’t know if I was projecting onto him, but there really was something very special and creative and gifted about him. He ended up going to Harvard. We’re still in touch. He came to my wedding!

It was the first successful experience I had of following something through, until I did stand-up full time. He taught me a lot more than I taught him.

Q: What’s your advice to other people with ADHD?

For anyone who struggles with those old bad feelings from school, my message would be what a lovely therapist said to me: Believe in the way your mind works. Do what you need to do to support yourself.

What might be considered indulgent or lazy might be your own weird route to success. When I was getting started, I did stuff like take cabs everywhere because I was always late. That’s the way I had to do it. I knew I would never be the person who was going to take two buses and be there on time. I spent money to make money. I bet on myself.

ADHD and Comedy: Next Steps

• Read: Laughter Is the Best Medicine
• Watch: “ADHD is Awesome – The Holderness Family Guide to Thriving with ADHD”
• Read: Laugh It Up
  
• Read: Stifled Creativity and Its Negative Impact on the ADHD Brain

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

But what we often fail to consider is how these fires are sparked.

Before the consequence of unmanaged ADHD blows up in our faces, there is a long progression of unnoticed action that gradually stokes such a blaze. Unchecked ADHD, then, is more of a slow, silent, invisible flame that heats and bubbles under the surface. Everything may appear smooth on the surface, but the hushed activity below tells a different story.

This quiet simmer is a vast collection of kindling – of distractions, impulsive actions, lack of initiation, and other issues that eventually spark and rage into an inferno — a missed deadline, a failed relationship, a lost job, a failed class. To the person with ADHD, simmers are so easy to ignore or miss altogether. Fires are undeniable.

When the fire erupts, everybody runs wild in a panic, which increases our chances of acting upon the situation. The crisis revs up the brain chemistry that provokes fear, which makes us move and do. We run around in circles trying to extinguish the awful thing, engaging serious damage control. This usually includes saying we’re desperately sorry, groaning to ourselves that yet again we’ve screwed up. Sometimes we hide under a rock.

This is one reason why ADHD is so hard for the larger community to accept. “How can you act like this sometimes but not all the time?” If we were blind, we wouldn’t see some of the time. The consensus among all affected by our fires — parents, teachers, spouses, friends, bosses — is that to prevent the next one, we must remain in freak-out mode because that’s the only thing that will keep us in check.

[Read: To Infinity and Beyond, Powered by Self-Awareness]

The problem, of course, was never the raging fire. That was only the most obvious consequence of the slow-burn of hundreds of small decisions prior to it, when we decided to do the wrong thing at the wrong time, one on top of the other. That is at the heart of what it means to suffer and struggle with ADHD.

Living with ADHD: The Importance of Self-Awareness

The work of preventing these self-defeating fires is more subtle and consistent than a handful of panic episodes, and more fine-tuned to the specific issue with which we struggle. The solution rests on one thing and one thing only: Self-awareness. You can’t change what you don’t see.

It’s hard to learn how to become aware of those subtle, quiet seconds of mis-decision, especially when there’s panic in the room. Awareness is a quieter practice. It prefers to act on a stage of self-compassion, self-honesty, and wanting to change. It involves figuring out how we’re going to help ourselves to notice in the first place. But how do we build awareness when the landscape seems so unknowable, so unmapped?

When people run from fires, nobody slows down to map the area. Self-awareness happens when we have extra bandwidth to catch ourselves deciding to do the wrong thing at the wrong time. These are those classic moments when we decide “just for now” not to study, or when we “just have to” blurt out a secret, or when we decide we’ll put away our coat or the dinner plate “later.”

[Read: 10 Things I Wish the World Knew About ADHD]

It’s true that negative reinforcers are so enticing, and we’ve used them since we were kids. But wouldn’t it be amazing if we could notice when we do the wrong thing at the wrong time without the fire department having to clang its bell next to our ears? That fire department – us or others – works great for fires, but not for lasting, inspired, intentional human change.

How to Build ADHD Self-Awareness

So, how do we build awareness around the decisions we make, especially when they seem to happen reflexively in the background? Bring to the fore in detail an understanding of what happens at the precise moment when we make these decisions. What is the setting? What are we doing? What else is going on? What do we choose to do instead? When will this most likely happen again?

These are the kinds of things we talk about in ADHD coaching, but none of us live in a coaching call forever. These are the tricks and skills we can learn and develop. Learning to become aware might involve visualizing, talking it over with someone or with ourselves, and then asking curious questions about how to put into place support systems to help us pivot and make optimal decisions. The support options are plentiful. It all rests first on building awareness around how ADHD shows up in us.

Then it’s practicing and tweaking so there are fewer, less intense fires — or maybe no flames at all.

How to Be More Self-Aware with ADHD: Next Steps

• Get This Free Download: The ADHD Healthy Habits Handbook
• Read: Self-Sabotage and ADHD — Are You Your Own Worst Enemy?
• Read: Has ADHD Warped Your Sense of Self? It’s Time to Reclaim Your Story — and Power

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Rebecca Makkai is a New York Times bestselling author whose books have been translated into more than 20 languages. She is a Pulitzer Prize and a National Book Award finalist. She teaches graduate fiction writing at Northwestern University, among other places, and is artistic director of StoryStudio Chicago. A review of her accomplishments would leave you wondering: What can this woman not do?

The answer? Laundry.

Putting away clean laundry, according to Makkai, is an “insurmountable task.” So is making doctors’ appointments, keeping track of her keys, tolerating conversational lags, and opening a package neatly with scissors. These are the parts of ADHD that Makkai, who was diagnosed just three years ago, finds frustrating. But for Makkai, these annoyances are just a small part of the big neurodivergent picture.

Makkai says ADHD affords her the hyperfocus, bold instinct, and associative thinking that’s allowed her to craft novels like I Have Some Questions for You and The Great Believers, lauded as “spellbinding, “enthralling” and “emotionally riveting” by media outlets including The New York Times Book Review.

“My mind goes in 17 different directions at once, and I’m constantly reaching for new ideas. Everything in the world contains a million things behind it and they’re all fascinating,” Makkai explains. “I’m sure that there are certainly plenty of artists who are linear thinkers but, to me, that feels like a disability. You’re trying to make art and you can only think of one thing after another in a straight line?”

[Download: Your Free Guide to All the Best Parts of ADHD]

Below, Makkai talks about her recent ADHD diagnosis, the gift afforded to her by an unusual education, and how she harnesses the powers of her neurodivergence to create unforgettable stories.

Q: When were you diagnosed?

I was diagnosed two or three years ago, mostly because I have a daughter who is not neurotypical and I was doing these online quizzes for her.

The diagnosis was almost entirely a relief and a revelation. Now, when I lose my keys or mis-manage my time, I know I have reasons other than ‘I’m lazy, I’m spacey, I don’t care.’ It offered me the ability, in certain situations, to stop masking and to help my daughter, who got diagnosed after I did.

[Read: Not Ditzy. Not Lazy. And Definitely Not Dumb.]

It’s been amazing to look back and acknowledge how much of my life I’ve faked, how often it’s like I’m listening to a radio with very poor reception, catching three words and pretending I know what’s going on.

Q: What does your ADHD look like?

I live in a world in which objects move behind my back. I put down my keys and they’re gone. Streets rearrange themselves.

My physical hyperactivity is subtle. If I stand near the food at a party, I will not stop eating — not because I have food issues, but because eating is something to do with my hands. I can only slow down my rapid speech with effort, and I panic at conversational lags. It takes everything I have not to interrupt people constantly.

I have a highly associative brain and a tendency to start several sentences at once. I’ve learned to explain this to my writing students on the first day of class. I’ve learned to start a lot of sentences with “Sidebar” and hold up one finger so students understand that I’m not permanently derailing the conversation.

Q: What was school like for you?

Traditional school can be an ADHD torture chamber. I went to Montessori School until 8th grade, and it was perfect for this kind of mind. It was like, ‘OK, you’re not in the mood for math? You’ll have to do it eventually, but right now, you can go do a report on hedgehogs and knock yourself out doing that for three days. When it’s time for math, you can write your own word problems, or you can do it with a friend, or you can do it in the hall.’

There are so many plusses to this, the biggest one of which is that I learned how my brain works and how I get work done. I’ve been able to carry that with me.

I’m not someone who writes every day. Why would you write every day? If I sit down to work and I’m not in a place to write, then I research. I can do other stuff all week and then I can write for 16 hours if I’m in the mood, so I’m not going to beat myself up for not writing 1,000 words every day.

Before I published my first book, I taught Montessori for 12 years, and that was great for me. There are 30 things going on all the time and you have to pay attention to all of them. I’d be helping a kid with long division, keeping an eye on a discipline issue, answering a question for another kid. Give me that all day long.

Q: How does your ADHD inform your writing?

I’m happiest when I’m doing five things at once. If I could somehow ride a bike and do a Sudoku puzzle and watch a movie and drink a smoothie at the same time, I’d be in heaven. The great news is that the mental juggling you have to do in order to hold a 300-page novel in your mind — ADHDers were built for that.

I teach a lot of really talented writers and I’ve noticed that one of the things that really holds a lot of people back is a dearth of ideas. They start something and they have a couple of elements going on, but they don’t have the urge to add more things that might enrich this. They are marching along this straight and predictable path, which can make for boring writing.

I think a lot of people don’t have good boredom detectors. People who have an above-average sense of patience are going to overestimate the patience of most readers. I am so easily bored that, if I can manage not to bore myself, I probably won’t bore anyone else.

I don’t have infinite patience with a text that’s beautiful but there’s no real craftsmanship to the plot. It’s an art to be able to keep hooking people.

Q: Do you have any ADHD hacks for getting work done?

Deadlines are fantastic for me; they kick me into high gear. Often, I really can’t bring myself to do it until the day before and then I suddenly put my cape on and fly at it and it’s great.

For example, I have a writing group and I know that, if I’ve told them I’m going to get them pages by our meeting on October 1, I have to get those pages to them by then. That helps a lot.

I’ve learned to lean into the sprint in little ways, too. I’ll fail to plug in my computer, realize it’s running low on power, and then try to see how much I can write before it dies. One of the reasons I write well on an airplane is I know I only have so long before they say you have to put away your laptop.

Then, too, so much of the business of writing is not writing. It’s blurbing and interviewing and answering emails. An assistant helps a lot with those things.

Q: What’s your advice to other people with ADHD?

I am so fortunate that I was able to figure out how my mind works at an early age. I’m trying to do that with my daughter now. I tell her, ‘You don’t have to do the same thing everyone else is doing, but you do have to get this done. Let’s analyze: What is your plan? Where do you need to be to get work done? What’s a distraction? What’s a useful distraction? What’s a good break?’

Yes, we need to acknowledge the challenges. And, yes, I frustrate myself, but I love the way my brain works. I love my career and how my career is going — and it’s largely due to the brain I have.

The Upsides of ADHD: Next Steps

• Read: Stifled Creativity and Its Damaging Impact on the ADHD Brain
• Buy: I Have Some Questions for You and The Great Believers by Rebecca Makkai
• Read: 10 Things I Wish the World Knew About ADHD
• Watch: “ADHD is Awesome – The Holderness Family Guide to Thriving with ADHD”

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

So we asked ADDitude readers to put their creative ADHD brains to work by brainstorming the most important lessons they’ve learned about living well with ADHD. From the pragmatic — set your clock ahead by 10 minutes — to the profound — guidance on fostering self-compassion — readers offer up hard-won wisdom that they’ve found transformative, in the hopes you might benefit from it, too.

“Grace. Give yourself grace. The everyday mistakes you make can distract you from more important things. Know that doing right by the humans around you is far more important than having your laundry done or being all caught up at work.” —Kate, Texas

“It is essential to find a medical professional who you trust and who is an ally. Do not tolerate doctors who don’t listen to your symptoms or concerns.” —Suzanne, Canada

“Like a fingerprint, ADHD is different for each individual. We can learn from doctors’ opinions and others’ experiences, but we must discover for ourselves how to best deal with our own ADHD.” —Philip, Ohio

[Download: Rate Your ADHD Coping Strategies]

“Find your people! There is nothing that helps more than sitting in a room with a group of others saying, ‘Me too!’ You finally feel validated and less alone as well as understood and accepted.” —Nicky, Scotland

“Don’t resist medication if it will help. It’s not a character failing to take it. On the contrary, it shows your bravery in facing your condition.”  —Richard, Maryland

“Actively search for things to celebrate in yourself and others. It’s natural to be critical but noticing what’s good takes intentionality. The fruit of that is peace and joy.” —Shari, Tennessee

[Watch: “ADHD is Awesome – The Holderness Family Guide to Thriving with ADHD”]

“Write everything down.” —Jennifer

“It’s imperative to learn all you can about how ADHD affects the brain, so you can better understand (and be less judgmental) about your thoughts and behaviors.” —Louis, California

“Find help — and don’t settle for the wrong help.” —Dorothy, Ohio

“Do what you need to do to recharge. I take a 15-minute nap at lunch everyday, which brings up my dopamine so that I’m still productive at work in the afternoons.” —An ADDitude Reader

“Find people who can relate to your struggles and, if you feel safe doing so, share stories of successes and failures. You may be pleasantly surprised by the number of people who feel the same way you do, regardless of whether they have ADHD.” —AJ, Minnesota

“Always divide tasks into very small turtle steps — something that you can easily do.” —Marietjie, South Africa

“The brilliance of ADHD is that our minds and talents can be a playground. ‘Not possible’ isn’t a thing if it is something we are interested in. Want to learn how to build furniture? Done. Make macarons? Done. Run a marathon? Got it. We absolutely thrive when we can chase the dopamine high associated with our areas of interest. I may be awful at adulting, but I wouldn’t want to live any other way.” —Suzanne, Tennessee

“The most important thing I’ve learned is to change my inner monologue of ‘I’m lazy’ to ‘This is just extra hard today.’” —Kendel, Indiana

“Finding what you love may be more important to ADHD people than to non-ADHD people. Being quick to boredom and having quick tempers means if you don’t like your job, you won’t be at it very long.” —Tim, North Carolina

“One trick that changed my world was the concept of a ‘catch-all’ area near the door where I put everything I need to leave the house; and where everything will go once I walk in the door. I have saved so much time over the years not constantly looking for my keys, sunglasses, and wallet.”—Dana, Michigan

“You have ADHD; you are not ADHD. It is an attribute you have but it does not have to define who you are.” —Craig, Oklahoma

“I set my clocks forward 10 minutes. Somehow it always tricks my mind and gives me extra time.” —Karen, Virginia

“I have learned that for every storm, there is a rainbow. My ‘problems’ — sensory gifts, ADHD daydreaming, and deep processing abilities — made me an excellent teacher of 38 years. I have learned to embrace my differences and view them as positives that have enriched my life.” —Jane, California

“Many judgmental people just can’t stand that I am hyperactive, talk a lot, and interrupt without meaning to — but judging others is far, far worse than any symptoms ADHD might cause. Try not to let anyone’s attitude make you feel bad about yourself. You are beautiful. You are valuable. You have been born with your own special talents and abilities that will help to advance mankind.” —Janet, Texas

Self Love, Self Acceptance & ADHD: Next Steps

• Read: You Are Not the Sum of Your ADHD Challenges 
• Read: Self-Compassion – The New ADHD Treatment
• Read: ADHD at the Center – A Whole-Life, Whole-Person Condition

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.