I can’t count the number of times someone has said to me “I think I have ADHD.”

Most of the time it’s women and AFAB non-binary people. And always those people are busy professionals, parents, activists, community members and any combination thereof.

Because these people are resourceful and creative, they start on the internet with a google search.

“How to tell if I have ADHD”

Then a big list of assessments and articles come up and they start clicking around. They learn that ADHD is harder to diagnose as an adult, even harder to diagnose if you are female. They learn that some people use it as a catchall term to describe feeling scattered, some people joke about “feeling ADHD,” and that finding a doctor who can diagnose you as an adult is very, very hard.

For these people, if they get into a doctor, they are right about half the time. About half of them have come back to me and said “I was right. I have ADHD.” The other half come back and say “I don’t have ADHD, but I got medication for…”

And this is the part that’s interesting. The thing they get medication for is often symptoms of ADHD: anxiety, depression, panic disorders, fatigue, hormonal imbalances. All can come with ADHD, but for some doctors it’s very hard to tell what is a stand-alone diagnosis and what is a subset of something bigger.

Google could tell you this in a bunch of different ways, but in brief, ADHD stands for Attention Deficit Hyperactivity Disorder. It’s a disorder of the brain that makes it difficult to switch from the default mode network of the brain to the task network of the brain. These two modes are what allow us to switch from focused work to something else relatively easily. ADHDers don’t make enough dopamine in their brains, which is the neurotransmitter associated with motivation and therefore the thing that gets us to switch from something we’re focused on to something new and back.

For example, right now I’m focused on writing this. But in a few minutes my laundry will be done drying. It’s not all that difficult for me to pause my thought here, go take the laundry out of the dryer, and return to my writing. My brain makes enough dopamine for the most part and I can go into various depths of focus because of it.

For an ADHDer, this switch would be difficult or almost impossible. Their brain either gets deeply focused on something to the exclusion of all other stimuli, or it can’t get into a state of focus and just switches from task to task very quickly.

For people with ADHD, the brain is always looking for dopamine. So what feels good to the brain is what it will want to do more of (remember, dopamine is associated with motivation). Sometimes that’s a deep dive and sometimes that’s superficial. The challenge is that most modern lives require us to go back and forth to tend to our families, jobs, and other community obligations.

But more than the folks who turn out to have ADHD, I want to examine the folks who think they have ADHD when they actually do not. What is it about their lives and experiences that makes them think this highly-stigmatized, very complicated disorder could be an easy answer? Nothing about it is easy and yet I hear people inquire about this with solid regularity. I’ve got some theories.

First, most of us have outdated ideas and representations of what ADHD is. We remember the overactive kid in elementary school who stopped at the office to get their medicine every day. The kid who couldn’t sit still. The kid who couldn’t stop talking. We think of it as a thing related to speed, distraction, and something that was bad. These kids who couldn’t sit still and couldn’t stop talking were often yelled at. A lot. They were put in the corner or sent to other rooms or made to sit out of recess because they couldn’t follow directions in a traditional classroom set up. We were told that speaking up, moving our bodies, wanting to do a lot of things, particularly things that were interesting to us and were different than what the class was supposed to be doing, was bad.

And we carried those ideas into adulthood.

Second, remember how I said most of these people who make this inquiry out loud are women or AFAB non-binary folks? That’s not a coincidence. These folks are far less likely to have gotten an ADHD diagnosis in childhood because it can present differently in girls. It’s unclear how much of that is because of genetics or socialization, but I’m gonna lean hard on the socialization of it all.

Think of all the messages people born female are given about taking up space. Be small physically, vocally, emotionally, mentally. We are rewarded for those behaviors and punished if we take up too much space in the ways our culture and society have decided. If we are big physically, have a lot to say or a big voice, feel deeply, and want to only focus on that tasks that are interesting to us, we’re punished, ostracized, and gaslit.

So not only is it more likely these folks were missed in an ADHD diagnosis as children because of these cultural values, but it’s also likely that as an adult you might associate these things with divergence in some way. Because you are being divergent when you forgo dieting, spread out, speak up, feel deeply, and ignore things that don’t bring you joy.

And these folks are often in caretaker roles that have some deeply patriarchal programming behind them. They are asked to cook and clean and track schedules and make sure everyone is healthy and feels happy and that their appointments are made and their clothes fit and that there’s enough toothpaste and the project got done on time and that the email went out and the lunches got made and the bills got paid and and and…

It’s enough to make a person feel, well, scattered, overwhelmed, and like they can’t ever focus on anything. And instead of seeing the faults in the system, these folks see fault in themselves. And it’s too much for it to be anything but something diagnosable, right? No one who is neurotypical can feel this much overwhelm, right?

In reality, once we start to break down the tasks, we see how much this person is managing and how stressful that is. And how imbalanced it is, particularly if they have a male-bodied partner. The distribution for this work often starts unequitable and has to get righted. And it is often in the discovery of the unfairness that someone might start to question if their feelings are medically diagnosable. And maybe therefore fixable. And certainly a pill is easier than toppling the patriarchy, right?

Oof. Yeah. It hurts.

But, like I said, only about half the time does someone actually get an ADHD diagnosis. That other half could still have ADHD, but most likely, they are a product of a deeply fucked up system that is designed to not only put all the household and care tasks on women, but then makes them feel guilty, inadequate, and mentally ill if they can’t keep up with the impossible job of pleasing everyone around them.

Really, all of this is in service of some requests.

  1. Avoid using ADHD as a catchall term for feeling overwhelmed, scattered, and unfocused. Because for folks who actually have the disorder, it undercuts the actual challenges they face where they are both asked to do the same things neurotypical folks are asked to do and still have a disorder making it hard to do those things.
  2. Examine if your overwhelm is a product of societal expectations for what it means to be “enough.”
  3. Dismantle the patriarchy.
  4. Go see your doctor or see a therapist. Because whether you have ADHD or not, clearly something is going on and you need support. Making change is hard and no one should do it alone.

Now take a breath and unwind with your favorite carb-heavy snack. We all could use more dopamine right now.