You are reading this article towards the end of (or after) ADHD Awareness Month because I failed to file it mid-month, like I was asked to. When we discussed the piece in our team meeting, a manager made a joke to that effect, and mentally, I promised myself it wouldn’t happen. I would prove myself. But here I am, again.
It’s hard to explain to people what has gone on when I let them down in some way. I’m late, again. I didn’t get back to them for weeks, or months, or forgot to get back at all. My copy is late. Why don’t you wake up earlier? Start earlier? Reply straight away? Why can’t you learn from your mistakes?
ADHD tends to elicit eye rolls when you bring it up. There’s a bootstraps mentality – everyone has been late before, no one likes doing work, everyone loses things… so just get your shit together. It’s part of the frustration: how silly it looks, how simple it should be, how personal a failure it feels. It is a disorder that you pay for tenfold: not only with the bitterness of not achieving your goals, but also the shame of letting others down. You suffer the punishment you’re handed in the moment, as well as potentially missing out in the long-term – on a promotion, on a relationship, on your dreams, on time.
An example: in college, before I had any explanation for it, I didn’t get my Education Maintenance Allowance pay most weeks because I’d be late too many times. A teacher would keep me waiting outside of her morning class while she taught out of earshot, and I’d feel the humiliation of my classmates’ eyes on my back, and of being made an example of. Finally, she’d come out and yell at me – once with tears in her eyes – for not taking her class seriously. I was missing out on money, her lessons, my time, anxious each day about coming in, shamed, and then would feel even worse that I’d hurt her. But try as I might, I couldn’t consistently change.
Neurologist Dr Russell Barkley, a leading expert in the disorder, explains that “people with ADHD cannot use their sense of time as part of their frontal lobe deficit”. That part of the brain is smaller, and the neurons have a weaker function. This leads to time blindness – being unable to perceive the passing of time in the same way as others – or what he calls a “near-sightedness to time… that precludes you from organising across time”.
Research shows that all of the brain’s executive functions are affected by ADHD: behaviour inhibition, visual imagery and verbal working memory (causing short-term forgetfulness), planning and inhibiting strong emotions. This last function, Barkley sees as a big key to the disorder – leading to impulsivity, but also the inability to regulate your emotions.
For most, neural networks naturally moderate the initial anxiety around a task in order to face it, but a brain with ADHD struggles to do so. The emotion can be so strong, you’ll turn to anything to relieve yourself – whether from a reaction to replying to a message from someone you like, or the worry of how you or your work might be received. This is termed Rejection Sensitivity Dysphoria (RSD), an extreme emotional sensitivity to potential rejection or criticism. It becomes a catch-22 that, compounded by focus issues, holds you back from executing your plans with its painful fear, then punishes you with more due to the inevitable rejection and criticism that results from failing to do so.
Some end up avoiding these tasks altogether, and let their goals dry up like the proverbial raisin in the sun. Others might try to combat it through cycles of pain/distraction/attempt, which can take over more of their day as they try to keep up. I’ve worked through evenings and weekends, agonised through all-nighters and still come in to work the next morning to finish tasks that colleagues typically complete within office hours. While work might take over more of an ADHD sufferer’s life, because the visible results are more limited, or slower to arrive, the perception is that they are not working hard enough.
Instead of attention deficit disorder, Barkley suggests, intention deficit disorder might be more accurate: “I don’t seem to be able to accomplish most of the things I intended to do.”
My first day on the medication methylphenidate opened my eyes to what not having the disorder might feel like. Instead of feeling overwhelmed by my emails, messages, and deadlines, which spur several simultaneous, disorganised thoughts and feelings that are then bounced between as they’re remembered and forgotten, I felt a quieter brain – and a newer anxiety in my stomach. It felt so straightforward. My thoughts were linear: this email is in, I want to write back straight away, now on to the next. My deadline is at the end of the day, so I feel an urge to act on it now, rather than the overpowering, unwieldy feelings that can push me off a page for a brief reprieve in the futile hope that they will be cured upon my return.
It is a genetic neurodevelopmental disorder. My father’s ADHD might be the reason I was born. He was at the airport in Sudan, ready to start a new life elsewhere, when he ran into a friend and got lost in conversation, turning his attention away from his suitcase. All of his life belongings were stolen. He ended up staying in Sudan and teaching at a university, where he met my mother.
Closely related to autism (if you have either disorder in a family, you typically have the other, too – they also share traits and are frequently concurrent), ADHD is as varied in intensity and the ways in which it can manifest. A cousin of mine is nonverbal, while other people you wouldn’t know had autism unless you asked them. Likewise, ADHD has a spectrum.
Similarly, its repercussions are unequal. As a Black woman, I feel the pressure of being one of few representatives in a media landscape that is 94 per cent white. When you’re trying to impress people that have been taught, however unconsciously, to expect little of you to begin with, failing them can feel like confirming their suspicions, potentially closing doors for others instead of opening them. It’s likely the reason that ADHD has, for generations, been seen as a white boy disorder, and was under-diagnosed across ethnic minorities and women (this led to an awakening for those demographics through social media last year). When white men struggle, people tend to look for a reason, rather than chalking it up to a personal failing. When you’re already fighting racial stereotypes of being lazy, stupid, or cheating the system, ADHD symptoms might appear to confirm all that your critics secretly, or subconsciously, think.
And it’s terrifying to admit. In a corporate culture where we’re pressured to parrot the same strengths – time management, organisation, the ability to excel under pressure – it’s scary to say those areas can sometimes be difficult for you. What if you’re not trusted with any more responsibility? What if you’re never employed again? What if you scare investors off? What if people decide you’re not worth the potential hassle?
But more than ADHD awareness, we need genuine understanding – that rather than a quirky trait, or an excuse to do less, it is a disability that can have maddening, painful consequences. Usually, you pay for it. You lose big. You fall on your sword. Almost every friend I know with ADHD has experienced at least one crushing personal failure. Getting a third-class degree, or never completing their university course at all. Getting fired from every job they’ve had (really, every one). For me, it’s when I accidentally missed one of my A-level exams and was subsequently rejected by both of my university options.
If it were taken more seriously, it might help to equalise access to treatment. Over a year and a half after my friend Atila first pushed me to look into getting diagnosed, I’m still on an NHS waiting list. In that time, I signed up for my company’s private health insurance, which covered the first consultation and led to a prescription, but every follow-up to get the dosage right costs hundreds of pounds. For a disorder that can hold you back in such extreme ways, it’s disheartening that treatment is so hard to find, and can be so expensive.
We can create systems to help everyone succeed in ways that benefit us all. As with autism, there are areas in which people with ADHD have particular strength – inventive solutions, hyper-focus on their interests, a creativity that is reflected in its overrepresentation in the arts. At work, I feel lucky to have one manager who recognises what I do bring to the table, and forgives much of what I sometimes can’t. For people with a neurological oversensitivity to rejection, that can be a great encouragement.
Empathy is the first step. Dr Barkley explains that for this chronic disability, “the success of any treatment is contingent on the compassion of people in that environment; how willing are they to help you modify at the point of performance” (ie building “prostheses” that support their weaknesses). The amount of people I have accidentally hurt, or pissed off, or let down, and the fear that I’ve been written off, or that I’ll never be forgiven, has kept me up many nights. I want to apologise to everyone I know, anyone I have affected, and to apologise in advance for behaviours I might struggle to change. I just ask for a little compassion in return.
This article was originally published on Vogue UK.
