I read these words shortly after I was diagnosed with ADHD at age 44. Those 15 words, which appeared in a book meant for ADHD families, left me stunned for weeks. They helped me understand my entire life experience far more than any other sentence – or any person, for that matter – ever had.

Growing up with undiagnosed ADHD, I was repeatedly labeled…

Lazy. Unmotivated. Smart but slacks off. Careless. Indifferent. Clumsy. Forgetful. Distracted. Sloppy. Listens but doesn’t follow directions. Doesn’t listen. Won’t listen. Stubborn.

Despite all evidence to the contrary and much work on my part to see myself differently, I still identify to some degree with the above labels. And I know that I’m not the only one. I think of the many women today who learn that they grew up with undiagnosed ADHD, and that girls today still struggle to get properly diagnosed with ADHD.

A diagnosis as a child would have been incredible. But beyond that, I wish I had grown up hearing the following words of encouragement – the things all girls with ADHD need to hear to build their self-esteem and avoid viewing their symptoms as character flaws.

1. “You’ll need to stand up for yourself over and over. And that’s OK.” Though things are getting better, ADHD is still stigmatized and misunderstood. What’s more, girls are still socialized and expected to be obedient and compliant. When we push back, it is viewed a lot differently than when boys do it. Assertiveness and self-advocacy, especially for girls with ADHD, are essential life skills that build confidence and self-reliance.

[Read: How to Raise a Self-Confident Daughter]

2. “We will stand up for you.” Self-advocacy only works if girls with ADHD know that trusted adults have their backs, too. Girls need to know they’re not alone when they stand up for themselves.

3. “Accommodations are a legal entitlement, not a favor.” Growing up, I had family members who genuinely believed that any accommodations, such as extra time on tests, were a way for lazy students to get out of doing schoolwork. Anything that was different “wasn’t fair” to the other students. What critics don’t understand is that a neurotypical environment is already inherently unfair to individuals with ADHD, and the reason we are chronically dismissed and overlooked is because our disability can be largely invisible. No matter how hard we try, most of us will never succeed without external support.

The reason the Americans with Disabilities Act (ADA) became law is to equalize the playing field for individuals with disabilities. My customized accommodations aren’t a special favor; they’re what I need.

4. “Other girls with ADHD need you as a friend.” Shame and isolation have a lot to do with why experts miss ADHD in women and girls. Throughout my entire childhood, every adult in my life blamed me for my symptoms, and my father told me that one of the reasons I struggled to make friends was because other kids knew about my poor grades.

[Read: Protecting the Emotional Health of Girls with ADHD]

But what girls like me need most of all are friendships with other girls with ADHD. Bonding over common problems, social challenges, and struggles at home and at school all reduce shame and stigma while building strong connections. Greater awareness leads to feeling confident in asking for help and support. Most importantly, I wouldn’t have felt so alone for so long.

5. “Other people don’t decide your value.” Throughout my entire life, I let my parents, siblings, teachers, doctors, and bosses decide my value based on their inaccurate and sexist views of me. Now that I know better — that I’m not fundamentally deficient — I want every woman and girl to hear this: No one else decides our value.

Don’t give your power away to someone who doesn’t have any idea about what living with ADHD is like, especially when they don’t care. We all have our strengths, and there are so many different ways for our talents to shine. But we’ll never realize that if we listen to our uninformed critics.

Girls with ADD: Next Steps

• Read: The ADHD Soul Shine Kit — Build Your Child’s Self Esteem
• Read: How to Protect the Emotional Health of Girls with ADHD
• Read: You Are Enough — How to Counteract Imposter Syndrome, Perfectionism, and RSD
• Read: You Are Not the Sum of Your ADHD Challenges

Maria Reppas lives with her family on the East Coast.  Her writing has been in the Washington Post, USA Today, Newsweek, New York Daily News, Ms. Magazine, and Business Insider.  Visit her on Twitter and at mariareppas.com.  

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.

“It takes forever to get these coins when you’re playing,” he said, showing me the game. “I can spend $1.99 and get 800 coins, but only if I do it now! It’s 90% off, but the deal only lasts for 58 more minutes! Please, Mom?”

“Luca,” I said. “When a game tells you something is 90% off, that’s just marketing designed to make you want to spend money.”

“It’s working,” Luca said earnestly. “I do want to spend my money. And it’s my money.”

I sighed.

Luca’s request had come a few days after my husband and I opened a debit account for him and his older brother, Max, for their 9^th and 11^th birthdays, respectively.

“We told you your savings was your money,” I said to Luca. “But we also said we weren’t going to let you spend it on just anything, remember?”

[Self-Test: Could Your Child Be Showing Signs of Gaming Addiction?]

“This is not just anything. It’s only $1.99 and I’ve been playing this game for weeks and this is the best deal I’ve ever seen. Ever.”

“OK,” I finally said. “This is a yes.”

I pressed my thumb on the sensor to authorize the purchase and a delighted Luca raced off to show Max, my ADHD-wired firstborn.

This, my friends, is when all the trouble really started.

The Big Business of In-App Purchases

Max quickly appeared to demand a similar purchase in a game. Eager to allow my boys to exercise their decision-making muscles, I said yes. So when the boys showed up repeatedly in the following days with additional purchase requests, I kept saying yes.

Two weeks later, both boys had spent more than $150. I was getting very worried. Though I tried to dissuade or delay them each time they came to me, their interest wasn’t waning, even as they burned through their savings. But while Luca’s spending eventually slowed, Max’s didn’t. If anything, he was picking up speed — requesting more expensive purchases, more frequently.

[Read: Why Screens Mesmerize Our Teens — and How to Break the Trance]

This was very out of character for Max, who had previously been resistant to spending any money — preferring instead to save it and plot about spending it on completely age-inappropriate things, like spear guns for fishing. After his first in-app purchase, it was shocking to see how quickly he transformed from miser to spendthrift.

When Max came to me for the second time in a single day requesting to spend another $26, I decided I wasn’t prepared to let him spend all his savings.

“I think we need a circuit breaker here — a pause,” I told Max. “I think that I should say ‘no’ to in-app purchases for the next week. What do you think?”

Unsurprisingly, Max did not think we needed a circuit breaker.

We settled on this: Max still had the choice to go through with this particular purchase (which he did) and then we would have a 10-day “no purchases” circuit-breaker.

That original circuit-breaker temporarily slowed things down, but it did not completely quell his willingness to spend money.

I know our family is far from alone in these struggles. In moderation, in-app purchases can be an easy way to have a bit of fun in a game. But in-app purchasing has become a billion-dollar business. Many iPad games are sophisticated marketing machines that use gambling tactics and other predatory techniques to market directly to children. The dopamine rush of leveling up in a game after spending money is addictive and the consequences are profound. Some parents report that their kids have become secretive and deceitful — guessing or stealing passwords, using credit cards without permissions, resetting devices to restore permissions, and finding other workarounds that will enable them to keep clicking “purchase.” Our children with ADHD, who struggle with impulse control and regulation, are far less equipped to resist this powerful temptation.

So what can parents do? What do I recommend as a psychologist, as the mother of a demand-avoidant pre-teen with ADHD, and as someone who’s learned a lot about this the hard way in the last couple of years?

My first piece of advice: Keep this Pandora’s Box closed for as long as possible. If you haven’t yet started down this path, don’t.

• Invest in games, gaming systems, and subscription services such as Apple Arcade that don’t offer in-app purchases and/or show ads. They are worth the money.
• Make it a family norm early on that you don’t download games that offer in-app purchases.
• If and when you do download a game that offers in-app purchases, make it clear that you will never authorize any in-app purchases for this game. Take it a step further and disable in-app purchases on your child’s device.

If you ever do decide to allow your child to make in-app purchases, have some discussions first:

1. Set clear limits – but expect boundary-pushing. Establish how much money they have available to spend and how quickly they can spend it. Even with these limits, brace for fallout, pleas, and arguments when their money runs out, and plan ahead for how you will respond to that fallout.

2. Express your wants. The day that Max came to me twice to make an in-app purchase, I told him I had two wants. “I want to allow you to make your own decisions,” I said. “And I want to help you make wise decisions and teach you how to resist the powerful desire to buy things.”

3. Teach your kid about marketing tactics such as price anchoring, charm pricing, and the scarcity effect. When they come to you about a purchase, challenge them to spot the marketing tactics being used on them.

4. Talk to your child about other dynamics that drive in-app purchasing, such as chasing the dopamine buzz, the social pressure of keeping up with friends, the desire to make progress fast in a game, and so on.

5. Talk to your child about their ADHD brain. They should understand that impulse control challenges come with the territory, which makes it especially hard to resist the temptation to buy.

6. Invite your child to problem-solve when issues come up. Be open with your child about any concerning patterns or behaviors you’ve noticed regarding in-app purchases. Ask for their input as you find a viable way forward.

7. Experiment with different approaches and solutions to limit in-app purchases. Some ideas to get you started:

• X-day/week blackout periods
• weekly or monthly spending limits
• waiting periods for spending (e.g., wait 24 hours before making an in-app purchase)
• written agreements that include consequences for circumventing the rules

8. Don’t be afraid to feel your way forward.
Just because you’ve agreed to a measure doesn’t mean that you will do things this way and forevermore. In fact, don’t expect any solutions you negotiate to hold for longer than a couple of months. Expecting to revisit this issue regularly will help you be more patient and feel less frustrated.

The other day, I asked Max for advice he thought I should give other parents who are in this situation. “Just say no, and NEVER SAY YES,” he responded. “Basically, be way stricter with them than you’ve been with us.”

“But what about families like ours where we’ve already said yes sometimes?” I said. “What can you do then?”

“Well,” Max said, getting more creative. “Tell your kids that the currency for the game has changed, and you can’t get any of that new currency. So, it’s broken. You just can’t do it.”

“So… lie?” I asked. “Yes,” Max said. “Lie.”

In moments when we may be tempted to lie to our kids, I often wish we had in-parenting purchase options — for upgrading patience, boosting problem-solving skills, or short-circuiting conflicts. Alas, the game we’re playing as parents is a no-shortcuts quest.

In App Purchases: Next Steps

• Get This Free Download: Too Much Screen Time? How to Regulate Your Teen’s Electronics Use
• Read: 5 Tips for Teaching Children with ADHD to Manage Money
• Get This eBook: Positive Parenting Tips — ADHD Strategies for Improving Behavior

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Since October 2022, thousands of individuals with ADHD have faced immense difficulty accessing prescribed stimulant medication – the treatment they need to function and lead healthy lives. No relief is in sight.

Make no mistake that the reason for the ongoing stimulant shortage has much to do with how stimulant medication itself is viewed. After all, the Drug Enforcement Administration (DEA) classifies stimulants as Schedule II drugs for their “high potential for abuse” and sets national drug quotas for these substances based on that classification.^{1 2} This drug quota is, arguably, a major factor driving the shortage.³

Like many psychiatrists, I have taken the Schedule II classification of stimulants at face value for most of my career. Prescription stimulants are Schedule II, so they must be very addictive. How do I know? Because they are Schedule II.

This circular thinking has stopped me – and likely others – from noticing the mismatch between this classification and what I observe clinically. And while it may seem like the Schedule II classification is set in stone, it isn’t. In fact, the Controlled Substances Act specifically states that organizations, or even individuals, may petition the DEA to reclassify a substance.⁴ Shouldn’t we at least question whether these medications belong in Schedule II?

Controlled Substances: What We Get Wrong About Stimulants for ADHD

The DEA classifies drugs into five distinct categories depending upon their medical use and potential for abuse or dependency. Schedule V drugs have the lowest potential for abuse, while Schedule I drugs have a high potential for abuse and no current accepted medical use.

[Read: “Stop Treating Us Like We’re Addicts!”]

While working as a community psychiatrist, I used to brace myself for the bad outcomes from prescription stimulants. After all, as Schedule II drugs, they sit way up in the DEA’s scale. But what I found was that carefully prescribed stimulants rarely caused issues, whereas other drugs deemed “safer” often did.

Take benzodiazepines, drugs that are used to treat conditions like anxiety and insomnia. With benzodiazepines, tolerance and dependence are common, the withdrawal syndrome is serious, and overdoses can be lethal, especially when combined with opioids. When used long-term, the taper can be rocky and often requires several months to complete.

Comparatively, standard prescription stimulant treatment has minor problems. Withdrawal syndromes are rare and brief. While I have seen occasional misuse, I haven’t seen prescription stimulant overdoses or use disorders. Rather, I’ve seen people gain control of their lives. They graduate college, they hold jobs, and their relationships improve. Early refill requests are rare.

People who are prescribed scheduled benzodiazepines rarely miss a dose and need no reminders. Most of my patients with ADHD, however, struggle to take medications every day and may forget to fill their medications on time.

[Read: “This Cannot Be the Price We Pay to Function.”]

For All Their Dangers

The stark difference in adherence between benzodiazepines and prescription stimulants likely reflects two things: the symptoms of ADHD itself and the fact that stimulant medications, when taken as prescribed, are much less reinforcing compared to benzodiazepines.

Just ask any child who takes Quillivant, a banana-flavored liquid form of methylphenidate, if they want their morning dose. Many will run, far. Beer and coffee are acquired tastes because the brain pairs their flavors with the good feeling that follows consumption. The ‘drug liking’ effect of alcohol and caffeine reinforces a desire for the taste — a phenomenon that hardly occurs when taking stimulants as prescribed for ADHD. Coffee and alcohol, despite their abuse potential and widespread use, are freely available to most of the public.

Benzodiazepines, for all their dangers, are Schedule IV. Meanwhile, prescription stimulants sit in the Schedule II Hall of Shame, along with fentanyl. Yes, fentanyl – a substance 50 times more potent than heroin and responsible for a majority of the thousands of overdose deaths in the United States in 2023.^{5 6} Surely, there must be a classification error here, right?

National overdose deaths involving prescription stimulants is difficult to track because of a coding issue that lumps prescription stimulants with illicit methamphetamines. Fortunately, one study separated the two by looking at substance-related death certificates from 2010 to 2017. Of the 1.2 million total deaths that involved substances, only 0.7% involved prescription stimulants, often used in combination with other substances. Methylphenidate-related deaths accounted for .02% (295) of all substance use-related deaths, or an average of 37 deaths per year.  Compared to methylphenidate, there were twice as many deaths involving pseudoephedrine (615), which does not require a prescription, and 160 times more illicit methamphetamine-related deaths (49,602).⁷

Stimulants Are Safe – and Life-Saving – When Used as Prescribed

The sparsity of stimulant prescription-related deaths may reflect their essential role in treatment. ADHD is associated with greater risk for accidents, injury, premature death, and suicide.⁸ Multiple studies suggest that treatment with prescription stimulants may lower the risk of these adverse and deadly events.^8-11

Unfortunately, the serious risks of illicit methamphetamine use can drive stigma and fear toward prescription stimulants. Many people with ADHD may be hesitant to start stimulants for concerns about heart problems and addiction. While illicit methamphetamine does cause major heart problems and is highly addictive, appropriate prescription stimulant treatment does not carry this risk.^12, 13 Even in overdose, major cardiovascular events are rare.¹⁴ Multiple studies also show that prescription stimulant treatment for ADHD does not increase the risk of developing a substance use disorder (SUD) and may even have a protective effect.^{15, 16}

Importantly, there are situations, namely non-oral misuse (e.g., snorting, smoking, or injecting), where prescription stimulants do have high potential for abuse. These routes allow stimulants to enter the brain rapidly and cause a rapid spike in dopamine. The faster and bigger the spike, the more intense the “high” or “drug liking” effect that will reinforce use. Oral routes, on the other hand, more slowly deliver drugs to the brain. This is partly why stimulants, when taken as prescribed, hold a much lower addiction potential.¹⁷

Most people with ADHD will never snort or inject their medications. People without ADHD usually won’t, either. Indeed, the Schedule II classification appears to be on behalf of a subset of people, with and without ADHD, who use stimulant medications non-orally. Arguably, a more tailored way to protect this group may lie on the diagnostic side — by taking a careful history, requiring drug screens in adolescents and young adults, and considering non-stimulants when the risks are too high. Many youth will also welcome a matter-of-fact discussion on substance use and harm reduction.

On Stimulant Misuse

A more common issue is oral prescription stimulant misuse — that is, taking someone else’s medication or too much of your own. A 2022 survey showed that 15% of college students reported taking someone else’s prescription stimulant at least once in their lifetime, but most did so less than once a month. Only 0.1% of students reported misusing prescription stimulants more than four times per month.¹⁸

Most college students report misusing prescription stimulants for perceived performance enhancement.¹⁹ The misuse pattern does not tend to escalate and is lower-risk in nature. This is likely because most students who misuse will only do so orally, which is much less addictive, and they are not using to get high. Some of this misuse may also be an effort to self-medicate. A 2010 study showed that prescription stimulant misusers were seven times more likely to screen positive for ADHD compared to non-misusing students.²⁰

To be clear, it is still a bad idea to misuse prescription stimulants. While the health risks do not appear to warrant schedule II classification, that does not mean “risk free.” All prescription medications carry risks, and risks can vary based on factors like dose, route, and the individual. What is safe for one person can be dangerous for another. For instance, someone with bipolar disorder can become manic from a prescription stimulant. Someone who regularly uses illicit methamphetamine may tolerate high doses of prescription stimulants whereas someone else may become agitated, psychotic or go into renal failure at a much lower dose.¹⁴

For those at higher risk for prescription pill misuse, there are also long-acting formulations that were designed to prevent non-oral use. For instance, Concerta (methylphenidate ER) has a hard outer coating that is very difficult to crush.²¹ This will deter most people. In addition, when studied in a group of adolescents with ADHD and an SUD, Concerta rated only one point higher than placebo in “drug-liking” effect.²²

Vyvanse (lisdexamfetamine) is another long-acting formulation that deters abuse. Vyvanse comes as an inactive prodrug and won’t activate until it is converted by an enzyme in the bloodstream. Even if someone snorts or injects it, it will still need to be converted to an active form in the body and will not produce a more rapid effect. Two “drug-liking” studies also suggest lower abuse potential with IV doses not differing from placebo.^{23 24} While a supratherapeutic oral dose had some “liking,” it also measured higher on “drug-disliking.”²⁴

Reclassifying prescription stimulants to a lower tier would more accurately reflect real-world data on addictive potential, health risk, and their public health benefit. Still, any reclassification to a lower tier carries the risk of fueling misconceptions about safety. Some may mistake reclassification as a green light to misuse. Misconceptions on safety may also drive the purchase of counterfeit pills. Make no mistake: Counterfeit prescription stimulants – which can be easily purchased online – kill people. These fake pills are made to look just like real prescription stimulants, but instead contain illicit methamphetamine and/or fentanyl, in unpredictable amounts. Taking even one counterfeit pill can be lethal.²⁵

Prescription stimulant misuse, as a whole, is a problem that deserves our attention. Targeted education needs to occur at the individual, family and school levels. This may include dispelling myths on cognitive enhancement, emphasizing the higher risk with non-oral use, and increasing awareness on counterfeit pills. When young people are taught the actual risks and realities of the current drug landscape, they are given a chance to make safer choices. This strategy is rooted in connecting with at-risk youth and can happen without interfering with the treatment of people with ADHD.

Schedule II Drugs: The Case for Reclassifying Stimulant Medication

Ensuring access to stimulant treatment is essential to the lives of millions of people with ADHD, and it benefits the public at large. While there is widespread oral misuse, the use does not tend to escalate. Non-oral use is higher risk, but less common and rarely fatal, making prescription stimulants an outlier in the Schedule II class.

Prescription stimulants are long overdue for reclassification. For those still on the fence, here is a more conservative approach: Start with rescheduling medications that have abuse-deterring properties, such as Concerta, Vyvanse, and their generic equivalents. By releasing these medications from the chains of Schedule II, more people with ADHD can live their lives.

Do you think prescription stimulants should be reclassified? Share your thoughts in the comments section.

Schedule 2 Drugs and Stimulants: Next Steps

• Read: Who’s Afraid of ADHD Stimulants?
• Read: The Real Reason ADHD Medication Supply Is Lagging Demand
• Read: “The DEA’s Manufactured Crisis”

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.

Sources

¹ Drug Enforcement Administration. Drug Scheduling. DEA.gov. https://www.dea.gov/drug-information/drug-scheduling

² 21 CFR Part 1303. https://www.ecfr.gov/current/title-21/chapter-II/part-1303

³ Committee on Oversight and Accountability. (May 14, 2024) Comer, McClain Probe Shortages of Schedule II Drugs, including Adderall. https://oversight.house.gov/release/comer-mcclain-probe-shortages-of-schedule-ii-drugs-including-adderall%EF%BF%BC/

⁴ Drug Enforcement Administration. The Controlled Substances Act. DEA.gov. https://www.dea.gov/drug-information/csa

⁵ Drug Enforcement Administration. Fentanyl. DEA.gov. https://www.dea.gov/factsheets/fentanyl

⁶ Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2024. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

⁷ Black, J. C., Bau, G. E., Iwanicki, J. L., & Dart, R. C. (2021). Association of medical stimulants with mortality in the US from 2010 to 2017. JAMA Internal Medicine, 181(5), 707–709. https://doi.org/10.1001/jamainternmed.2020.7850

⁸ Li, L., Zhu, N., Zhang, L., Kuja-Halkola, R., D’Onofrio, B. M., Brikell, I., Lichtenstein, P., Cortese, S., Larsson, H., & Chang, Z. (2024). ADHD pharmacotherapy and mortality in individuals with ADHD. JAMA, 331(10), 850–860. https://doi.org/10.1001/jama.2024.0851

⁹ Krinzinger, H., Hall, C. L., Groom, M. J., Ansari, M. T., Banaschewski, T., Buitelaar, J. K., Carucci, S., Coghill, D., Danckaerts, M., Dittmann, R. W., Falissard, B., Garas, P., Inglis, S. K., Kovshoff, H., Kochhar, P., McCarthy, S., Nagy, P., Neubert, A., Roberts, S., Sayal, K., … ADDUCE Consortium (2019). Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence. Neuroscience and Biobehavioral Reviews, 107, 945–968. https://doi.org/10.1016/j.neubiorev.2019.09.023

¹⁰ Chang, Z., Quinn, P. D., O’Reilly, L., Sjölander, A., Hur, K., Gibbons, R., Larsson, H., & D’Onofrio, B. M. (2020). Medication for attention-deficit/hyperactivity disorder and risk for suicide attempts. Biological Psychiatry, 88(6), 452–458. https://doi.org/10.1016/j.biopsych.2019.12.003

¹¹ Chang, Z., Quinn, P. D., Hur, K., Gibbons, R. D., Sjölander, A., Larsson, H., & D’Onofrio, B. M. (2017). Association between medication use for attention-deficit/hyperactivity disorder and risk of motor vehicle crashes. JAMA Psychiatry, 74(6), 597–603. https://doi.org/10.1001/jamapsychiatry.2017.0659

¹² Manja, V., Nrusimha, A., et al. (2023) Methamphetamine-associated heart failure: a systematic review of observational studies. Heart, 109:168-177. https://doi.org/10.1136/heartjnl-2022-321610

¹³ Zhang, L., Yao, H., Li, L., Du Rietz, E., Andell, P., Garcia-Argibay, M., D’Onofrio, B. M., Cortese, S., Larsson, H., & Chang, Z. (2022). Risk of cardiovascular diseases associated with medications used in attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. JAMA Network Open, 5(11), e2243597. https://doi.org/10.1001/jamanetworkopen.2022.43597

¹⁴ Martin, C., Harris, K., Wylie, C., Isoardi, K. (2023). Rising prescription stimulant poisoning in Australia: a retrospective case series. Toxicology Communications, 7(1). https://doi.org/10.1080/24734306.2023.2174689

¹⁵ Quinn, P. D., Chang, Z., Hur, K., Gibbons, R. D., Lahey, B. B., Rickert, M. E., Sjölander, A., Lichtenstein, P., Larsson, H., & D’Onofrio, B. M. (2017). ADHD medication and substance-related problems. The American Journal of Psychiatry, 174(9), 877–885. https://doi.org/10.1176/appi.ajp.2017.16060686

¹⁶ McCabe, S. E., Dickinson, K., West, B. T., & Wilens, T. E. (2016). Age of onset, duration, and type of medication therapy for attention-deficit/hyperactivity disorder and substance use during adolescence: a multi-cohort national study. Journal of the American Academy of Child and Adolescent Psychiatry, 55(6), 479–486. https://doi.org/10.1016/j.jaac.2016.03.011

¹⁷ Manza, P., Tomasi, D., Shokri-Kojori, E., Zhang, R., Kroll, D., Feldman, D., McPherson, K., Biesecker, C., Dennis, E., Johnson, A., Yuan, K., Wang, W. T., Yonga, M. V., Wang, G. J., & Volkow, N. D. (2023). Neural circuit selective for fast but not slow dopamine increases in drug reward. Nature Communications, 14(1), 6408. https://doi.org/10.1038/s41467-023-41972-6

¹⁸ The Ohio State University. (2022). College prescription drug study: Key findings. https://www.campusdrugprevention.gov/sites/default/files/2022-06/CPDS_Multi_Institutional_Key_Findings_2022.pdf

¹⁹ Faraone, S. V., Rostain, A. L., Montano, C. B., Mason, O., Antshel, K. M., & Newcorn, J. H. (2020). Systematic review: nonmedical use of prescription stimulants: risk factors, outcomes, and risk reduction strategies. Journal of the American Academy of Child and Adolescent Psychiatry, 59(1), 100–112. https://doi.org/10.1016/j.jaac.2019.06.012

²⁰ Peterkin, A. L., Crone, C. C., Sheridan, M. J., & Wise, T. N. (2011). Cognitive performance enhancement: misuse or self-treatment? Journal of Attention Disorders, 15(4), 263–268. https://doi.org/10.1177/1087054710365980

²¹ Cone E. J. (2006). Ephemeral profiles of prescription drug and formulation tampering: evolving pseudoscience on the internet. Drug and Alcohol Dependence, 83 Suppl 1, S31–S39. https://doi.org/10.1016/j.drugalcdep.2005.11.027

²² Winhusen, T. M., Lewis, D. F., Riggs, P. D., Davies, R. D., Adler, L. A., Sonne, S., & Somoza, E. C. (2011). Subjective effects, misuse, and adverse effects of osmotic-release methylphenidate treatment in adolescent substance abusers with attention-deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 21(5), 455–463. https://doi.org/10.1089/cap.2011.0014

²³ Jasinski DR, Krishnan S. Human pharmacology of intravenous lisdexamfetamine dimesylate: abuse liability in adult stimulant abusers. Journal of Psychopharmacology. 2009;23(4):410–8
https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=8ead4bf37b0e1111a740fe2ce34ebced83085c3c

²⁴ Jasinski DR, Krishnan S. Abuse liability and safety of oral lisdexamfetamine dimesylate in individuals with a history of stimulant abuse. Journal of Psychopharmacology. 2009;23(4):419–27
https://journals.sagepub.com/doi/10.1177/0269881109103113

²⁵ https://www.dea.gov/sites/default/files/2021-05/Counterfeit%20Pills%20fact%20SHEET-5-13-21-FINAL.pdf

My 9-year-old son has always been a firework, from the very second of his surprise existence. If my pregnancy test could have displayed two zigzags instead of straight lines, it would have.

He has never followed the path well-trodden. Instead, he has swung from the trees shadowing its path, spinning and tumbling over it like a Ferris wheel free from its hinges. His brain is always busy. It darts and daydreams and never tells him to sit, breathe, and just be.

“I was the same as him when I was a kid,” my husband would say. “He’s just a little boy.”

He often spoke of marked similarities between them, and we thought our son had simply inherited a huge slice of his father’s personality. That this was just “them.” So we attributed his behaviors to that – a child who was beautifully energetic. If he wasn’t spinning or cartwheeling, he was singing or asking questions or making funny little noises. The only time he really rested was when he slept, when dreams took over and his compulsion to “fizz,” as he calls it, quelled.

Father and Son: Drawing ADHD Parallels

Analyzing my child’s behavior, helicoptering his nuances and traits, and researching “ADHD in children” until there was nothing left to Google came easy. Turning the lens to my husband, on the other hand, was trickier.

My husband flitted from job to job, struggled to prioritize, became easily frustrated with any task, and was unfocused. But we had gone through a fair chunk of sadness in the last few years — the death of one of our other sons, the loss of parents, our 9-year-old’s meningitis battle when he was a baby. I put my husband’s erratic nature down to stress and trauma.

[Read: “Let Me Tell You How ADHD Runs in My Family”]

All the while, the phone calls from my son’s exasperated teacher mounted, as did the sense that my son’s behaviors in school and at home were indicative of something bigger.

My mother-in-law was a special education teacher for many years. The more I called her to analyze my little boy’s behavior, the more parallels she’d draw between him and my husband. Eventually, the constant joke that they were two peas in a pod became a lightbulb moment for me. I made an appointment with an ADHD specialist – for my son and husband. Sure enough, after a careful evaluation, the specialist diagnosed both of them with ADHD in the same appointment. Their test scores were practically identical, she noted.

Like Father, Like Son

“How do you feel?” the specialist asked my son. She sat next to him on the floor as he clicked LEGOs together and bounced on his knees.

“Exhausted” he said. And my heart sank. Exhausted by trying to concentrate in school and being told off constantly, exhausted by coming home to homework cajoling, exhausted for being reprimanded for his impatience and other behaviors at the outskirts of his control.

[Read: “My ADHD Family Tree — Three Generations of Neurodivergence Revealed”]

I saw my husband’s face crumble a little as he knew that feeling all too well. And I realized that, as a wife and mother, I had failed them. To me, their behaviors were annoying, frustrating, and sometimes inexplicable. I had often said to my son, “Why is it always you? Why are you the one who always gets into trouble?” I sometimes dreamed of an easier marriage to a man who would stick at a job or for a man who would actually listen to me. I had no idea what either of them were going through. It was an incredibly emotional day for everyone.

We walked out of the specialist’s room with a deeper understanding of each other and a feeling that we can all start to be our truer selves.

Our ADHD Family

We’ve only recently entered the neurodivergent universe. We’re perched on a circling satellite looking into a place where words like “disorder,” “impulsivity,” and “disorganization” zoom by. But it’s other zooming words that captivate us — “spontaneity,” “creativity,” “courage.” We are going to run with these as fast as we can.

We’re not alone in entering this universe. We see many other families embarking on this journey, too. Some days we think we have a firm grasp on ADHD – and some days we don’t. And that’s OK, because all we can do is buckle up so the twists and turns don’t jolt the ones we love quite so much.

I would not change my son or husband for anything. We’ll bundle up all of the positives and challenges, stick them into our family jetpack, and navigate the steps, bounces, stumbles, and freefalls of this shared diagnosis together.

ADHD Family Ties: Next Steps

• Get This Free Download: ADHD Empowerment Month Calendar
• Read: 5 Ways to Build Bonds – A Guide for ADHD Dads
• Read: Helping Your Kids Find the “Awesome” in ADHD

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Dear Neurotypicals,

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

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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.

I have a pretty cool job.

A few years ago, I was sitting in an office at Velcro International. They needed a creative ad that would persuade their customers to stop calling their product Velcro.

Yes, you read that right.

I learned the product they sell is actually called Hook and Loop, not Velcro. If people kept calling their product Velcro, they could potentially lose their trademark. So they needed to reach millions of people with this habit-breaking message.

After dropping this bombshell, the executives talked for another 15 minutes about legal ramifications, but I was ZONED out. I know that’s a bad thing most of the time, but for my ADHD brain, it was amazing. My wandering went something like this.

Wait, how funny would it be to write an ad that begs people not to call Velcro “Velcro?”

This is a multi-billion-dollar company. We can’t have its lawyers in a stuffy office doing this ad.

This seems like a pretty ridiculous problem. What if we acted like it was a serious problem?

Oh my gosh, remember “We Are the World?” Everyone was so serious, you know, because it was about starvation in Africa. But what if we did an ad with that vibe, but about something that is clearly a first-world problem?

These lawyers could be making fun of themselves. They could be aware that this is, in fact, a ridiculous thing to ask people!

Ooooh, we could use real lawyers!

Oh boy, here come the lyrics….

It was like a brainstorm session inside my own head.

I am very lucky to have co-workers who have seen this happen to me. They explained to the nice lawyers that I had something cooking, so it didn’t seem rude.

Before I got back to my office, the song was already written in my head. Here’s the final product. (Parental alert: There are some bleeped-out potty words so watch before showing your kids!)

It went viral and got tens of millions of views worldwide.

Still, I know you are probably thinking, “C’mon, Penn. Are you telling me that SPACING OUT sparked the flame of this very good thing?”

Yes, I am. Allow me to explain.

My favorite ADHD doctors are the ones who use creative metaphors to teach me more about my brain. It helps me truly “see” my ADHD. It’s also a fantastic way to explain ADHD to kids.

The Velvet Rope Metaphor

One of my favorite metaphors comes from Dr. Marcy Caldwell of ADDept.org. She was helping me understand how my brain works compared to the neurotypical brain. According to Dr. Caldwell, the neurotypical brain is like a VIP Club with a velvet rope and a bouncer. The bouncer does a great job making sure only elites gain access to the club, while carefully keeping out “less important” partygoers who don’t have a pass. The inside of the club is orderly, a little quieter, and much less cluttered.

The ADHD brain? Well, that is more like Coachella, and everyone gets in! There are countless different sights and noises. Laser lights and fog machines. You can feel the wind and the weather. Sometimes it rains. There are conversations all over the place. You can see, hear, and feel it all; your attention is pulled in countless directions.

[Get This Free Download: Unraveling the Mysteries of Your ADHD Brain]

Our ADHD brains can eventually learn to put up a velvet rope and a bouncer, but it’s not our default mode; it takes real work.

VIP Club vs Outdoor Festival

When it comes to trying to make breakfast, complete a job, or get through school, the VIP club sounds much better, right? That’s the battle we ADHDers fight every day; we try to get our brains out of the open air and into a room with more order.

But…. and it is a pretty big but… (it’s okay if you just laughed reading “pretty big but”) that Outdoor Festival is the perfect breeding ground for one of the most important qualities a human being can ever have: CREATIVITY.

When your brain feels, sees, and smells everything, it is more likely than the neurotypical brain to notice something no one has ever noticed before. It is more likely to go down a rabbit hole and discover a new path. It’s more likely to see something in a way no one has ever seen it.

Biographers speculated that Thomas Edison, one of the greatest creators of all time, had ADHD. Possibilities came to his Open-Air Brain and he was able to harness them by giving us light (yes, literally invented the lightbulb), sound (invented the phonograph), and sight (yep, the camera too!) He struggled just like we do.

According to thomasedison.com; At age seven – after spending 12 weeks in a noisy one-room schoolhouse with 38 other students of all ages – Tom’s overworked and short-tempered teacher finally lost his patience with the child’s persistent questioning and seemingly self-centered behavior. 

Sound familiar? Yeah, schools are mostly VIP Clubs, not Outdoor Festivals or Open-Air Concerts. You may not be Thomas Edison yet, but that same creativity lives within you.

My Open-Air Brain

My Open-Air Brain finds creativity through music. I studied music theory at a very early age, to the point that it became a second language for me.

I stopped learning after two years because my Open-Air Brain was much less interested in being Rachmaninoff and more interested in the brand-new notes, chords, and lyrics popping up in my head. I wasn’t writing Shakespeare; just lines documenting the countless things going on in my world, and in my family. Now just about everything I experience plays like a song in my head.

In the case of the Velcro ad, that Open-Air Brain quickly gave me access to a catalog of every melodramatic music video I’ve ever heard, every lawyer stereotype I’ve ever had, and every funny meme about first-world problems I’ve ever shared. All those ideas were welcome to the party.

Of course, there are times that this is frustrating – it can be hard listening to someone if the story they are telling is turning into a song. I’ve had to do some really hard work to find a VIP bouncer when what a person is saying is important, and I care about that person and their feelings.

But when there’s nothing else going on, no work to do, and no conversations to have, my mind wanders back to that Open-Air Concert. It happens on walks, at night before bed, in the shower, and sometimes in the middle of the day when I have a minute to just sit and let it happen.

Your Open-Air Concert isn’t just a distraction; it could be the key to your success. Now, we don’t have an excuse to get lost in thought all the time; we need to be respectful of our parents, friends, and teachers, and do the best we can to hear what they have to say. But don’t ever discount those wonderfully bizarrely random thoughts coming into your head. Those thoughts are yours and yours alone, they are enormously creative, and believe it or not, they could change the world one day.

The Creative ADHD Brain: Next Steps

• Get the Book! ADHD Is Awesome: A Guide to (Mostly) Thriving with ADHD
• Get This Free Download: ADHD Empowerment Month Calendar
• Read: “We Light Up the Room with Our Sparkles”
• Read: ADHD Self-Empowerment Begins With Finding Your “Right Difficult”

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 my husband and I published a book called ADHD is Awesome we knew we’d have some explaining to do. After all, so much of ADHD is not… awesome. We used the word for its true meaning. Though it’s a writing style cliché to kick off with a definition, I think it’s important here:

Awesome — Adjective — Extremely impressive or daunting; inspiring great admiration, apprehension, or fear.

It’s safe to say our kids get daily reminders of how much ADHD just plain sucks. The world wasn’t built for their unique brains, which are forced to remain still and focused in long classes, amid constant distractions, and often despite unrealistic expectations from teachers and us, their parents. You don’t need to read one more thing about how hard it is to have ADHD, so I’m here to offer ways to shine a spotlight on the pure sunshine that can spark from an ADHD brain.

Just a reminder: I’m not a doctor or a therapist. Our family is like the lab rat that has undergone rounds of testing. Here are the ways we’ve helped our son find the awesomeness in ADHD:

LIVE WEBINAR WITH KIM & PENN HOLDERNESS
Register for this free webinar on Tuesday, October 1, and get an opportunity to ask your questions to Kim & Penn Holderness live. Plus, get the replay link to share.

1. Tell Them What ADHD Is Not

ADHD is not a deficit of attention. In fact, people with ADHD have an abundance of attention and sometimes struggle with how to use it. ADHD is not a shortcoming or a choice. It’s not a result of bad parenting. It’s not a fad or trend. ADHD is a collection of symptoms that vary in every single person.

[Get This Free Download: Celebrate ADHD Empowerment Month!]

In our house, ADHD is the explanation but not the excuse. My husband forgot to put his shoes on when going to pick up our carry-out dinner order. He was on a phone call as he walked out the door and I yelled after him to pick up some garbage bags while he was out. He struggles to prioritize and his system gets easily overwhelmed, so he wasn’t even aware he was walking out of the house barefoot. It’s the explanation but he doesn’t get a free pass to roam freely through stores without shoes.

2. Celebrate What Makes Them Different

I sometimes feel frustrated that the things that seem so simple (turning in homework, putting on BOTH shoes, turning off the stove) can be so hard for the ADHD brain. But the things my son’s brain creates leave me in awe. My son was given a writing assignment at the beginning of the school year on a specific topic. He was so hyperfocused that he wrote a 3,000-word essay defending his theory one Saturday morning, in record time. It was so well-researched and well-written. I said to him, “Your brain is pretty special. I wish I was able to dive so deep into a topic and follow the paths of information like you do. Most brains don’t do this. This is amazing!”

It was truly awesome until I noticed the assignment clearly asked for the written portion to be 500 words maximum. His brain skipped a very important detail, but I was in awe of what he created. His brain solves problems in ways mine doesn’t. He sees the world in a different, wonderful way. Every time I spot something that makes him unique, I make sure to tell him how special his brain really is.

3. Stop the Shame Spiral

When my son realized he didn’t read the instructions clearly, I saw the shame drift up his face. His shoulders hunched forward and his head dropped. The shame a person with ADHD feels when they’ve made a mistake can be overwhelming. Even for my husband, regulating his emotions and, especially, feelings of shame is a real struggle.

[Read: How to Explain ADHD in Positive, Empowering Terms]

A crucial piece of advice on shame was given to me by Dr. Emily King. Dr. King is a child psychologist who has worked with neurodivergent children, their teachers, and their families for more than 20 years. When either of my ADHD loved ones makes a mistake, she advises to offer connection not correction.

As a recovering perfectionist, this was really hard for me. When my husband got distracted and left his suitcase at the airport where we were departing and didn’t notice until he walked off the plane for our vacation, my instinct was to say a lot of curse words very loudly in the middle of a very public airport. When my son overlooked very clearly written instructions, my urge was to say “How many times do I have to tell you?! You have to read the directions!” Instead, in both cases, I offered connection.

To my husband, I said, “Wow. That really sucks. I’m sure you were feeling distracted while we were racing to the plane and trying to get snacks for the kids.” To my son, I said, “I know this is tough. That stinks that you will have to re-work this. Remember when I totally misread the written directions on The Amazing Race and got us lost? It happens.”

When the temperature is lowered and moods have stabilized, then we talk about systems and reminders. My husband says this one tool has been the most motivating for him. When I resist the urge to snap, he wants to work harder to never make the same mistake or overlook the same detail. It’s hard to offer empathy when you feel real rage, believe me. But we’re all better for it.

4. Use the Coach Mindset

Every individual with ADHD has a different collection of symptoms on a vast spectrum. I have such respect for every parent and partner who is an ally to the neurodivergent. I struggled not attaching my own ego and emotions to the actions of my child. I was advised to adopt the “Coach” mindset.

Imagine a coach of a Little League game. Does she yell and scream because your little one strikes out? No! (Or hopefully not). The coach doesn’t get embarrassed or shame a player for a bad game and a parent shouldn’t shame a child for normal behavior – even if it doesn’t fit inside our visions of how a child should act.

We had the chance to meet so many wonderful humans at book signings across the country. Sweet families with ADHD kiddos stood in line so we could take pictures and have a quick chat. Because I wanted to hug and talk to EVERYONE, the lines took longer than an ADHD brain could tolerate. Rather than snap and discipline these kiddos for spinning in circles, jumping up and down, and breakdancing (yes, breakdancing – it was awesome), the parents knew this was how their little ones needed an outlet. They didn’t expect more than their children could give. They were awesome coaches and it was inspiring to witness.

5. Remind Without Nagging

I don’t actually enjoy nagging and offering constant reminders. I don’t want to make the lists. I don’t want to hold every single piece of information for my family. That emotional load is too much. And, obviously, the person on the other end doesn’t want to hear the constant bickering. Now on Sunday evenings, we have a family meeting, and we all answer this question: “What will it take for me to have a great week?”

For the kids, it helps them spot future tests and quizzes so they plan ahead. Then, in the mornings when we’re all a little more frantic, instead of barking orders I have been asking, “What do you need to do to be ready for school?” It gives him the power and he can take ownership of his executive functioning.

I am still learning how to be a supportive partner and parent to my two ADHDers. I love their spontaneity, curiosity, and constant creativity. There are days I wish I could take a peek inside their brains to witness how they see the world. I’m imagining they both see us all as cartoon characters in an animated musical, but I wouldn’t change them even if I could.

Find the Awesome in ADHD: Next Steps

• Get the Book! ADHD Is Awesome: A Guide to (Mostly) Thriving with ADHD
• Read: Holderness Family Values — 9 ADHD Truths (with a Side of Laughter)
• Read: What I Would Never Trade Away
• Read: 10 Things I Wish the World Knew About 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.

My professor had given us clear instructions. I was passionate about (read: hyperfixated on) the subject. I’d been researching for days. But I couldn’t seem to get started — there was too much I wanted to say and, horror of horrors, I couldn’t even use the just-start-rambling tactic that had carried me through high school. The topic was too important, the stakes were too high, and every time I started to write, it came out wrong.

Like many with ADHD, I’m an all-or-nothing type. I haven’t yet found the magic key that lets me put, say, 45% effort into something. I have to give 100% perfection or it’s simply not worth doing at all.

All the same time, in high school, even when I’d make a bulleted outline for an essay and try to follow it, I’d get stuck, delete the outline in frustration, abandon the draft entirely, and write the whole essay in one go. Writing off the cuff produced some beautiful sentences, but I was prone to rambling or leaving things out. When I’d revise, I couldn’t recapture the energy and thought process I had while freewriting. Even with a reverse outline (first draft then outline), I got stuck. My transitions didn’t make as much sense the second time around, my writing seemed clunkier, and I still ended up scrapping everything. For a while, this strategy was workable. My essays, while spontaneous and poorly outlined, were good enough.

Now in college, as the night wore on and my meds wore off – still with no essay in sight – I was frustrated to the point of tears. Then I had an idea: I decided that if I couldn’t write the best version of my essay, or even a good version of my essay, I would write the worst version of my essay. And that’s what I did. I wrote in purposefully irreverent, goofy ways that amused me and kept my attention. In the end, to my surprise, I had a draft that had actually captured my ideas and was fun to read during revision.

I dubbed this strategy The Crappy Draft.

[Read: How to Prepare Your ADHD Teen for College, According to Research]

Why The Crappy Draft Technique Works for ADHD College Students

The goal of The Crappy Draft is twofold. First, it relieves the pressure to Write Something Good and makes the task that’s been driving you crazy into something lighthearted, with stakes so low they’re in the ground. And you get something done. Revising is tomorrow’s problem; tonight, you can sleep knowing you got started.

Second, The Crappy Draft lets you see the shape of your essay. Yes, this version may be nonsensical, but it also holds great wisdom. One of the great skills of the ADHD brain is making connections even where seemingly none exist. If harnessed correctly, this can be a great essay-writing tool: the ways in which you jump from one topic to another when you’re not thinking about writing a polished draft often allow for your best ideas to come forward.

You may be surprised to find how easy it is to turn something from apparent crap into an eloquent essay! For example, in one Crappy Draft of a history paper, I wrote “We can all talk a big game about war, but maybe we mostly just want everyone to have enough potatoes and not get their stuff stolen.” In the final version of the essay, this became “People want to avoid war more than they want to protect territory or follow orders, and sometimes they can even succeed in avoiding it.”

I’ve since used The Crappy Draft approach to great success every time I feel even slightly stuck on an essay. The Crappy Draft allows me the pleasure of writing in my own voice while capturing all of my ideas without censoring myself or succumbing to anxiety. And because my goofy Crappy Drafts are fun to read, they keep me focused when I go back to revise. The process is more manageable, and the final product is more organized, thoughtful, and in-depth.

[Read: “Writing Made Easier for College Kids with Learning Differences”]

How to Write Your Own Crappy Draft

1. Type at the top of your document: THIS DRAFT IS CRAPPY ON PURPOSE. I’LL MAKE IT GOOD LATER.

I type this in bold and highlight the words in red, but you do you. The important thing is that by writing this affirmation, you release yourself from the need to write anything presentable.

2. Write the silliest version of your draft you can possibly write.

Hit the points you want to hit but don’t pay any attention to whether you’re hitting them in the right order. Forgo punctuation. Don’t just write from your inner monologue — write from the most informal, personal part of your brain. Put in as many swears and as much Internet slang as you want. Make yourself laugh. Have fun with it.

Don’t forget the “assignment” part entirely, though. Here’s what I wrote one of my Crappy Drafts when I noticed myself going wildly off topic and getting distracted:

Man, do you ever think about the butterfly effe– [I AM HIT OVER THE HEAD WITH A COMICALLY LARGE HAMMER. NEXT PARAGRAPH PLEASE !!]

Optional step: Change the font to Comic Sans or some other stupid-looking font.

This is also a neat trick for resetting your brain when you’ve been staring at your words for hours and are starting to hate them. Different font? Ooh, it must be a different task! How new and exciting!

3. Get a good night’s sleep and revise another day.

I’m hopeful that your Crappy Draft will surprise you and make you smile. Read your draft with an open mind. Follow what jumps out at you, and you’ll find the makings of a strong, cohesive essay.

How to Write an Essay in College: Next Steps

• Free Download: How to Get ADHD Accommodations in College
• Read: “3 College Tips to Help Students Stress Less, Learn More”
• Read: “Yes, You Really Do Belong in College”

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The mall was chaos. It was December, so everything was decked out in bright lights and brighter colors. The same five cheesy songs played on full blast over the loudspeakers. The halls were packed with loud holiday shoppers who kept bumping into us (and us into them). My sweater, perfect for chilly weather, weighed down on me indoors while my winter coat over my arm made me even more warm and sweaty.

And then, in the middle of the food court that reeked of greasy food and fake pine fragrance, my 3-month-old twin brothers started screaming. Everyone nearby shot us dirty looks, my head hurt from the noise and the smell and the heat and —

I snapped.

“Will you SHUT THEM UP?!”

My dad and stepmom looked at me like I was the jerk, and not the victim.

“Is this about your mouth?” Dad asked. “I told you to ask for more meds.”

ADHD and Overstimulation: My Sensory Meltdowns

That sums up every experience I’ve had with overstimulation or sensory overload: I’m too tired or upset to regulate my emotions, I’m assaulted on all sides with stimuli, I can’t stop anything, and people around me act like I’m crazy when I can’t take it anymore.

[Get This Free Download: Am I a Highly Sensitive Person?]

From an outside perspective, it probably does look like I’m insane. I appear fine until I’m not, over something small, no less. Nobody likes crowded stores or sharing a busy office, but millions of people deal with the chaos without freaking out. Even if there’s too much going on, a bit of deep breathing and mindful realignment should calm me down, right?

Too bad that doesn’t help. The problem with ADHD is that I not only have trouble paying attention, but I also have trouble shutting things out. I am constantly aware and reminded of every odd little thing around me. Like that one coworker who hits “reply all” just to send a smiley emoji, my mind sends unnecessary alerts to let me know that my left shoe is just a little too loose, that my coworker is loudly eating an apple, that there’s a flickering light way across the room, and other status updates I could really do without.

It’s a feeling of being trapped. I can’t turn the world off, can’t stop thinking, and can’t stop feeling worse thinking about how I can’t stop. The more trapped I feel in my mind and body, the harder it is to communicate why I’m upset or how to fix it.

What a fun Catch-22.

This is partially why I really don’t want help solving the problem in the moment. If I’m overwhelmed, my responses are entirely reactionary. I don’t feel comforted by back rubs or someone asking if I’m OK, it only adds fuel to the fire.

[Read: Why You Feel Too Much (and How to Cope)]

What to Do When ADHD Overstimulation Strikes

I’ve learned that it’s better for others to approach me when I’m able to articulate my needs. Asking ahead, well before an overstimulation meltdown, is especially touching.

My best coping strategies were planned significantly far in advance for this exact reason. Demanding that everyone else stops isn’t exactly doable. But I’ve learned how to quietly and successfully remove myself from the situation or prevent overstimulation.

I have an extensive toolkit: noise-cancelling headphones, a mini fan, sunglasses, soft sweaters and jackets, quiet rooms, and a handful of other odds and ends. I must look strange to my coworkers, making dozens of adjustments to my area throughout the day. I’m relieved that my workplace allows me to self-accommodate like this.

This is why awareness matters. The next time you see someone snap over something small, or look increasingly uncomfortable with everything, assume that they’re overstimulated (and that ADHD may be in the picture). Perhaps that will stop you from loudly asking why someone is wearing sunglasses indoors or running for the nearest closet or empty room. Give us grace, and you’ll be able to work with the neurodivergent people in your life and make the world a more accommodating place for us. The steps are small, but the results are magnificent.

ADHD and Overstimulation: Next Steps

• Get This Free Download: Sensory Issues — Triggers, Symptoms & Types of SPD
• Take This Self-Test: Sensory Processing Disorder Signs
• Read: “Please Don’t Hug Me! Seriously. And More Weird Things That Trigger My Hypersensitive ADHD”>

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But I was confused. I associated ADHD with fidgety grade-school boys. Little did I know that I, an adult woman, could also be diagnosed with ADHD. My daughter’s descriptions of time and organizational overcompensation, decision paralysis, procrastination, overwhelm, and hyperfocus resonated deeply with me. When I suggested that I might have ADHD myself, she agreed.

While waiting for an evaluation and the results, I had daily epiphanies as I connected my lifetime of experiences with information about the ADHD brain. Like so many of us, I’d spent years feeling inadequate, hypersensitive, and too ashamed to say any of it out loud. How many paralyzing hours did I lie on the couch, wondering what was wrong with me? My diagnosis came in August 2022.

[eBook: Women with ADHD: How Hormones, Symptoms & Late Diagnoses Impact Females]

Six years earlier, at almost 49, I’d unknowingly set in motion a seismic journey of personal reinvention with the decision to stop drinking (10 years in the making) and enter therapy for the first time. I was finally able to follow through on both steps, even in the face of intense anxiety and self-hatred. My sobriety and therapy unleashed a flood of unresolved issues and traumas. Recovery was just the beginning of my self-discovery.

I ended my 26-year marriage and became an empty nester. My work as a commercial interior designer suddenly felt toxic. I had come to realize that there was a fundamental misalignment between my strengths, interests, and responsibilities. Near crippling self-doubt and fear of rejection had kept me tethered to my career for 28 years. Finally, my ADHD diagnosis shattered the narrative of not good enough, paving the way for self-compassion and newfound confidence and hope.

Standing at the intersection of creative expansion and personal revolution, I found a community of midlife women on similar paths and planted the seed for starting my company, Triple Moon Coaching. I enrolled in a holistic coach certification program so I could build a side practice and phase into full-time professional life coaching.

Empowered by clarity and optimism, I focused on creating my new vision. ADHD impulsivity has been a consistent thread for as long as I can remember. My resignation was bold and necessary, and a bit premature. But I was learning. No regrets.

I am on a solid path to successful entrepreneurship. It’s a joy and a privilege to coach women who are taking charge of their lives and growing into their own unique potential.

ADHD in Women: Next Steps

• Self-Test: Symptoms of ADHD in Women & Girls
  
• Sign Up: Essential Support for Women with ADHD
• Read: The Transformative Power of an ADHD Diagnosis for Older Women
  
• Read: 10 Books Every Woman Should Read After Her ADHD Diagnosis
  

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At first glance, some of my ADHD traits make me very ill-suited to my job as a college lecturer. My slippery focus and shoddy working memory make the piles of admin work painful. Trying to map out a long course makes me want to smash my head into a smartboard.

Few of my colleagues loathe the bits I hate with quite the passion that I do, so I beat myself up for making a meal of the stuff that’s meant to be simple.

But there’s a flip side, too. The more I talk to colleagues about my fresh diagnosis (ADHD, inattentive type), the more I see that others grapple daily with different demons. And some of the things that frighten or frustrate them about teaching come as naturally to me as breathing.

Teaching with ADHD: The Traits That Make Me a Better Educator

1. Improvisation

Like many with ADHD, I work well under pressure. I struggle to focus without it, in fact, so I’ve had a lifetime of practice.

The upshot is that I’m never knocked off balance by last-minute changes or questions I didn’t see coming. I love taking detours in lessons or going deeper to clear up confusion.

[Get This Free Download: Need Help Finding Your Passion? Use This ADHD “Brain Blueprint”]

Learning is a two-way conversation for me. Being happy to improvise helps me keep everyone in it.

2. A Sense of Humor

I try to make people laugh all the time. I think I learned young that it won me approval, preempted mockery, and defused the tension I would otherwise sponge up myself.

And my always-on Default Mode Network loves whispering jokes in my ear. I find it hard not to speak them out loud.

As compulsions go, it’s a lucky one. A sense of humor is a powerful tool in the classroom. It’s so much easier to build rapport, nip conflicts in the bud, and make lessons engaging and productive when you can see the funny side and share it. People learn better when they’re feeling good, too.

[Read: The ADHD Traits I Would Never Trade Away]

I’m also a closet show-off, so making an audience laugh (even if it’s captive) lifts my own mood and keeps my stress levels in check.

3. The Ability to Plan Under Pressure

Long-term projects are my nemesis. Chipping away at a faraway goal deprives me of the hit I need right now, this minute.

Weirdly, that’s where teaching works for me. I don’t sit down on a Sunday to plan. (I can’t. I’ve tried. It’s fruitless.) But the very tight deadline of an imminent lesson gives my distractible brain no choice but to snap into action. When it does, it’s with supercharged clarity and speed.

A sea of expectant faces is a sufficiently scary prospect to kickstart my concentration and wrestle floating, fragmented ideas into an anchored, coherent whole. The last half-hour before a lesson starts is when my plan comes together. Even if I’m still on the bus.

Because I work best this way, weekends are mainly my own.

4. Creativity and Competitiveness

‘Teacher talk time’ is part of my job. Some things just need explaining. But I drift off when I’m talked at for too long myself and I don’t want my learners to check out because I’ve bored them.

So I break up exposition with chats, games, and quizzes to give them chance to think and engage.

Competition cranks my focus up, too, so I use it with students as well. They sit up and dig deeper when victory’s at stake. A lively 10-minute grammar-off can save a lesson from sinking.

5. Deep Empathy

As a super-sensitive person with ADHD, I know first-hand how negative emotions can torpedo efforts to learn.

That awareness is useful because lots of my students have big stresses that mess with their concentration. They come from all over the world and have issues ranging from PTSD and homelessness to fears for family in war zones. Things I cannot imagine.

I can never solve their problems. What I can provide, thanks to empathy, is a warm, inclusive environment where people feel safe and valued.

I can also lend my ear after class where that’s what a person wants. Because of the way I’m built, it never feels like a chore.

Teaching with ADHD: Shedding Shame and Cultivating Gratitude

There will probably always be bits of my job I find hard because they’re dull. I’ve felt shame about that at times and suspected I’m lazy or weak. Now that I’m certain I’m neither, I can be more patient with myself and calmer when I’m tackling the tough stuff. And I can see much more clearly the many upsides of ADHD.

Being up front with others and listening to their own unique challenges has opened my eyes to how well my brain serves me at work. It has taught me to put much more store in the strengths I have — creativity, compassion and last-minute focus, for example —that some others don’t, and which are very likely down to the way I’m wired.

Teaching with ADHD: Next Steps

• Get This Free Download: 25 Things to Love About ADHD
• Read: Great Job! A Career Happiness Formula for Adults with ADHD
• Read: “What If My Intense Drive Is Because of — Not in Spite of — My ADHD?”

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Gus Walz’s expression of pure love and joy should have been seen for what it was: an unfiltered and positive emotional response to a big moment. Sadly, the moment served as yet another opportunity to divide Americans. While most people saw Gus’s reaction as an historic moment for neurodiversity, a vocal minority sneered, criticized, and hurled insults at an innocent young person.

What Does Neurodivergence Mean?

Neurodivergence is a word used to describe naturally occurring differences in how the human brain develops that result in variations in “wiring” and how we process information. These differences may affect around 20% of the population and occur in people with ADHD, dyslexia, autism, and nonverbal learning disorder (NVLD). These and other conditions can lead to challenges with functioning in key life areas. In young people like Gus, these differences may result in variations in how they process nonverbal information, recognize patterns, develop social skills and awareness, process sensory information, and engage in executive function tasks.

[Take This Test: Nonverbal Learning Disorder (NLD) in Children]

It’s not uncommon for the neurodivergent community, particularly children and young adults, to battle stigma, insults, and misconceptions about their conditions. Gus’s reaction to his father’s speech was another example of how kids who learn and think differently are vulnerable to cruelty — even in their most benign or joy-filled moments. Only this moment was televised. Frankly, I’m glad it was.

Neurodivergence is a relatively new term, but it’s becoming more commonplace in American society. This is likely due to increases in diagnoses and perhaps increases in social media use to amplify individuals’ experiences. For example, a 2022 report from the CDC revealed that about 1 million more children received an ADHD diagnosis in 2022 than did in 2016. Even so, neurodivergence isn’t discussed nearly enough, making it easier for people to make false assumptions that impact children and their families every day.

Parents of neurodivergent children often face challenges in accessing accurate and reputable resources to help them in their day-to-day lives, resulting in feelings of isolation and loneliness. In the absence of awareness and widespread education, navigating learning and thinking differences can be a nightmare for the child — and a massive source of stress for their parents. Understood.org’s Neurodiversity and Stigma survey from 2022 found that nearly 70% of parents felt stigmas surrounding their child’s differences affected their mental health negatively. Another 2024 survey revealed that 96% of parents with neurodivergent children reported feeling stressed during the back-to-school season.

How to Help Neurodivergent Children Navigate Stigmas

As a licensed psychologist with more than 20 years of experience working with neurodivergent people, I’ve participated in dozens of programs designed to help educate the public and reduce stigmas for people with differences. Here are a few takeaways I share with parents:

• Educate yourself on current evidence-based information about your child’s learning and thinking differences.
• Talk to your child about their differences and how it affects them.
• Provide an informational bridge between home and school to help educate and inform teachers about thinking and learning differences and to help your child access accommodations.
• Advocate for inclusion and use of Universal Design for Learning strategies to support neurodivergent and neurotypical students in shared learning environments.
• Provide direct strategies for identifying challenges and asking for help. Role-playing or practicing with a script can help kids and adults ask for what they need to thrive.

[Free Download: Signs of Dyslexia at Every Age]

When I watched Gus Walz’s reactions to his father’s nomination, I was brought to tears by this pure and amazing display. Politics aside, this moment provides us with a remarkable opportunity to amplify and support neurodivergent individuals by having an open dialogue in our country about what it means to learn and think differently. Let’s not let this moment slip by.

Gus Walz and Nurturing sNeurodivergent Children: Next Steps

• Free Download: Is It an LD? Your Free Guide
• Read: Why Nonverbal Learning Disorder Is So Often Mistaken for ADHD
• Read: 19 Parenting Tips for Raising Neurodivergent Children
• Watch: “Parenting Styles That Work for Neurodivergent Children”

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I am wildly creative, surprisingly good with a paintbrush, and skilled with words. I know how to make jewelry, soap, candles, and pretty paper. I know how to put together elaborate floral displays and decorate cakes. I can research like an analyst and draft essays like an academic.

I know how to make proper barista coffee, complete with foamy milk hearts, and I can pour a mean tap beer. I can change brake pads on Volvos, paint houses perfectly, as well as clean them like I have OCD. (I can totally say that because I do have OCD.) I have some fun unpolished vocals recorded on a retro pop album floating around cyberspace along with some long forgotten “crazy cat lady” improv clips with five views total (probably all due to me).

I am good at a lot of things, but, by the world’s standards of success, I am a failure. And a big one at that.

No five-year plan here. (Time blindness will do that to you.) I have no idea what I am doing in the next five minutes, let alone in the next five years. And I certainly have not been commended in any field or selected as employee of the month. Let’s just say that if holding the record for shortest time employed were a thing, then my 15-minute stint as a bartender at a bowling alley would win the title.

I have studied acting but I am not an actor. I am a qualified English teacher, but I do not teach. I write poetry, but few read my work. I sometimes author stories or articles, which some people read, for which I’m eternally grateful. People often see how capable and organized I can be and think I must slay at life, but often, life slays me. This is the nature of the brain beast that is ADHD.

Where Is My Mind?

One of the many bosses I have had over my multi-faceted career once said of my job performance, “When you’re on, you’re brilliant, creative, unstoppable. But when you’re off, it’s hard to remember how good you are.”

[Get This Free Download: What to Ask Yourself to Find the Perfect Job]

Harsh, but fair. This was the story of my life — bosses wondering if I was intentionally not doing what they said, why I did things the complete opposite way I had been shown, or if I really was just that confused and forgetful. Most did not have the time or resources to spare on figuring me out, so I would end up fired over and over.

Some bosses asked where my mind went during meetings. Others would scratch their heads, puzzled that I’d be on fire one day, and frazzled, late, and disoriented the next. (It wasn’t uncommon for me to forget my lunch or even the name of the store where I worked.)

Once I even walked into the wrong workplace to clock in. I had previously worked in a jewelry store a few doors down from my new workplace, a skincare store. Easy mistake to make, right?

And don’t get me started on my wonderful, spontaneous, but often inappropriate workplace banter. Time and time again, I would blurt out a thought that would offend others – for its tone, timing, or crudeness. Sometimes, though, people would laugh or even join in with my shenanigans.

[Read: “Did I Overshare by Telling My New Co-Workers That I Habitually Overshare?”]

When I think I am being honest or funny, most people think I am being rude. When I am good at something, I do not know how to pace myself or set boundaries, so I burn out quickly and become incredibly bad at the thing I was good at. When I witness injustice, I am compelled to speak up (thanks, RSD and justice sensitivity), which has seen me in all kinds of deep water in the workplace.

Jack of All Trades, Master of Some

I have had some interesting jobs. I remember riding my motorbike to a fancy mansion dressed as Cleopatra when I worked for a catering company that specialized in themed events. I’ve worked in delis, clothing boutiques, florist shops, fast food joints, call centers, hardware stores, and markets. I’ve worked in education, childcare, and cleaning services. I’ve designed logos, posters, and t-shirts. I’ve directed musicals, weeded gardens, washed cars, and mowed lawns.

I did all this unmedicated, so I want to congratulate myself on making it through. After my ADHD diagnosis at age 38, I went on medication and saw significant changes in my time management, organization, memory retention, and emotional regulation skills. Today, I am finally doing something that I am good at and really enjoy. (Not to brag, but I am kind of my boss’s favorite.) I am kicking ass at the most important job I’ve ever had: being a mama.

My neurodivergent brain makes everything a lot harder, but I have accepted that I’ll just have to work with it and learn on the job. I try to see mistakes as opportunities to improve. I am not perfect at anything because that is the stuff of mythology. But I am brilliant at many things, and I aim for good enough where I can. I have learned not to overthink opinions about my performance on any job, sometimes not even my own. I am a lifelong work in progress – I have my work cut out for me, and if life has taught me anything, it is that I can do hard things.

ADHD and Job Hopping: Next Steps

• Free Download: Need Help Finding Your Passion? Use This ADHD “Brain Blueprint”
• Read: Great Job! A Career Happiness Formula for Adults with ADHD
• Read: Fostering Neurodiversity in the Workplace

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“In talking with Maria, it is clear that her family and instructors have historically viewed her as being intellectually quite bright and an underachiever.”

These are not a passive-aggressive bully’s words, a sibling’s backhanded compliment, or careless remarks delivered at a parent-teacher conference. These are the very deliberate words of a neurologist, neuropsychologist, and medical-education specialist following my ADHD evaluation in childhood. The intended audience: my parents, my family physician, and my teachers.

The clinic’s problematic “assessment” and cruel words still haunt me years later. I didn’t read their words until I was in my 40s, and I finally understood why I had a decades-long habit of telling people I have no special talents. The specialists stated in scientific terms that I, a child, was a talentless loser. My parents and my family physician believed them without question. What could my parents have done differently?

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

Set in Their Ways

Despite education and experience, we know that experts make mistakes all the time. It’s why we frequently seek second medical opinions. My parents certainly needed one when the politely insulting report described my problems as “common” with ADHD, but the tone of the recommendations was “do better.” A second opinion would have offered my parents another analysis of my behaviors. Most importantly, I could have had a chance at a better life.

But my parents – education experts – were inclined to go along with what the evaluators said, as they shared similar vocational backgrounds. Though my mother still harbored some suspicions that I had ADHD, she and my father ultimately assumed that I was failing my classes on purpose. They made sure to share their theories about my behaviors with my teachers, who were more inclined to default to their opinions rather than their own judgment about my classroom behavior they saw every day.

What I Cannot Forgive

I can forgive science not catching up in time. (After all, it’s been more than 30 years since that evaluation and we’re still working to better understand ADHD in girls.) What I cannot forgive is my parents and the clinic for the cruelty, sexism, and failure to recognize the fact that I didn’t want to do poorly. In any setting, telling someone they do not have any special talents or that they’re an underachiever is an appalling insult.

[Read: “11 Things I’d Tell My Younger Self”]

The rest of the report would eventually prove hilariously inaccurate. “During the evaluation Maria did not demonstrate many of the learning deficits often observed in adolescents with a primary attention deficit hyperactivity disorder,” reads part of the report. Thirty-one years later, I received my ADHD diagnosis at age 44.

Ironically, the experts who wrote the report that detailed my carelessness and sloppiness also committed typographical, punctuation, and grammatical errors along with listing my incorrect home address on every page and misspelling my last name. Perhaps they were gifted in other areas? Unfortunately, those doctors didn’t provide their full names in the “scientific” report they authored, so I was never able to track them down to find out. What a relief for them.

Undiagnosed ADD: Next Steps

• Free eBook! We Demand Greater Research on Women with ADHD
• Read: “I Could Have Been Myself for So Much Longer.”
• Read: Stop the Cycle of Shame for Girls with ADHD

Maria Reppas lives with her family on the East Coast. Visit her on X and at mariareppas.com.

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.