The first semester of my senior year was, academically, the worst semester of my life. I was enrolled in only six credits but found myself in a deep depression spiral, unable to do anything — to focus, do any work, care about my passions like writing and The Michigan Daily, but mostly I couldn’t take good care of myself.
Writing and photography are the only things that come naturally to me and are what I want to spend my life doing. But when my journalism professor messaged me on Slack to say, “We missed you in class today. Could you respond to this message so I know you’re okay?,” my partner had to draft a response as I drifted away, lost in the shame and embarrassment of it all.
“I can’t have another semester like this one,” I said to her after she sent the message.
“I know. You also don’t have to. It doesn’t have to be this bad,” she said.
And after months of resisting, believing I deserved it all, that was the advice that clicked. I made a psychiatry appointment to see what was happening in my head. Hopefully a doctor would know. It was certainly a deep depression slump, something I know well, but also a new surprise: an attention deficit hyperactivity disorder diagnosis. Combined, the two knew exactly how to turn my brain into scrambled eggs, but I didn’t believe the therapist, and I didn’t want medication.
How can a deficiency of norepinephrine in my brain cause me to lose my object permanence; brown out or dissociate during sober, everyday conversations; forget to eat and struggle to even start basic tasks? I understand the chemical imbalance of my depression, and I’m finally starting to accept that it is, in fact, an imbalance, and not me making it up. But the day I was diagnosed with ADHD, I left the Zoom call, closed my laptop, and thought, I know ADHD exists, and I wouldn’t doubt someone else who has it, but for me, it’s not real. The therapist was personable and the session informal. I sat there fidgeting, worrying I was wasting her time, wasting insurance money and calling attention to myself.
My partner, of course, found the right words again:
“Whether or not you believe the diagnosis, or whatever the diagnosis is, you just don’t have to struggle like that,” she said. That’s true, I thought. I can accept the help while retaining the stubbornness my mother gave me.
“I’ll try medication temporarily,” I said. “But this isn’t a long-term thing. And I don’t believe that everyone’s brain doesn’t work like this.”
I’ve watched my mother’s organizational habits my entire life, haunted by her ability to just cross things off lists and get things done. Coupled with her inability to understand how I can’t just do the same, I’ve chalked it up to having less self-discipline. I’ve come back to the feelings of laziness and incompetence.
Or, people will scoff at the topic and say something along the lines of, “Well, now everyone has ADHD apparently. Did you know that diagnoses have skyrocketed lately? It’s just ridiculous.” There’s even an Atlantic article professing that ADHD is actually just childhood narcissism. But in reality, there are around 4 million, or about 50-75% of women with ADHD, living undiagnosed with ADHD in the United States.
There are two realms of the disorder: hyperactive and inattentive. Hyperactive is the stereotypical image of a young boy who can’t sit still in his seat, is loud and can’t focus enough to get work done. This demographic was the preliminary demographic for the first ADHD clinical studies in the 1970s. In her Atlantic article, “ADHD is Different for Women,” Maria Yagoda quoted Dr. Ellen Littman, who explained these initial studies.
“These studies were based on really hyperactive young white boys who were taken to clinics,” Littman said. “The diagnostic criteria were developed based on those studies. As a result, those criteria over-represent the symptoms you see in young boys, making it difficult for girls to be diagnosed unless they behave like hyperactive boys.”
But for women, ADHD may present itself differently. Dr. Priti Shah, a professor of psychology at the University of Michigan, explained to me that women are more prone to the inattentive type of ADHD, making us more forgetful, scattered, sometimes impulsive and, more importantly for diagnosis, introverted. I call it my scrambled egg brain. And it wasn’t until reading this article that I realized how much cultural expectations for girls had delayed my diagnosis.
“Whereas boys with ADHD tend to externalize their frustration, blaming the ‘stupid test,’ acting up and acting out, girls are more likely to blame themselves, turning their anger and pain inward,” Rae Jacobson of the Child Mind Institute writes. “Girls with ADHD are significantly more likely to experience major depression, anxiety and eating disorders than girls without.”
All of this results in later diagnoses, conflation with other mental health issues and a starkly shaped self-esteem for young women.
“It’s this sense of not being able to hold everything together,” Littman said.
Art & Design junior Erin Ruark began running into problems during her first semester of college. She only pictured the aforementioned stereotypical ADHD that many of us are used to imagining, and that still causes problems in her coming to terms with her own diagnosis.
“I’m torn between (feeling like) an imposter,” Ruark said. “Maybe I’m just faking it. Maybe I’m exaggerating these problems. Maybe it’s not a big deal. And I’m just going to be wasting everyone’s time.”
It was as if she’d plucked the words from my own mind.
***
Like many others, I’ve spent a decent chunk of the past year scrolling through TikTok. I’d initially resisted downloading it, but a friend made me an account when I wasn’t paying attention. So I dipped my toe in.
And I found people living all sorts of lives, showing them to others in 1-minute increments. I stuffed my liked videos page with people explaining their mental health symptoms, as I slowly realized other people’s brains do work like mine.
One video was a woman with ADHD explaining her concept of time. “It’s either ‘now,’ or ‘not now,’” she said. And again, someone’s explanation clicked. Unless something is pressing — as in currently in my hands, due in the next hour or in my line of sight — it’s part of the “not now.” And “not now” tends to be a wasteland of forgotten dates and deadlines, unanswered texts, unwashed dishes, coffee gone cold, leftovers abandoned in the microwave, four dramatic lost wallet stories, bags of spinach gone moldy and Trader Joe’s frozen food for when I forget to eat until 6 p.m.
I explained my theory of time to LSA senior Ellie Scott and watched her laugh on my computer screen.
“I’ll clean my room or I’ll eat or something,” Scott said. “And then I think to myself, why do I have to do that again? Didn’t I just clean my room, didn’t I just eat lunch? Why is my room dirty again? Why am I hungry again? But it turns out (with my room) it’s been two weeks and it’s been three hours (since I last ate).”
What began as an interview turned into a conversation between two girls in their bedrooms, and at times the Zoom screen became a mirror.
I wish, like a lot of other things in life, that I could’ve been handed a manual next to my diagnosis. “Here are the things that are ADHD,” it would say. “Mark which ones happen to you, and now you know why, and you can start fixing it.” But that obviously didn’t happen — so I made my own. It’s a running Notes application list in my phone called “Is it ADHD or am I just weird,” currently resting at 500 words. It always elicits a laugh when other people see me adding to it. But I’m genuinely confused at what’s normal anymore, and since I have ten seconds before it becomes “not now,” I have to write it down.
“I constantly have struggles that people don’t realize are part of ADHD, like I have no object permanence, I have tics and am just constantly moving around … and people think it’s just not being able to focus,” Scott told me.
I agreed. The second half of the Notes list title seems like a joke, but I genuinely don’t know what is normal anymore. I’ve spent 22 years in this brain — of course, it’s all normal to me.
“It’s just so frustrating and it feels very unfair that other people are born with normal brains that function and have the right amount of chemicals and do all the right stuff at the right time,” Scott said during our conversation. “And I have to take a bunch of pills to even everything out and then have to deal with side effects. It’s a whole other arena of life that I have to constantly monitor.”
That said, it’s not all bad, of course.
“There seem to be some strengths associated with ADHD,” Shah told me. “There has been a lot of speculation over the years that people with ADHD are more creative than the typical person, and also that they sometimes have these special abilities to focus even more.”
ADHD and creativity is something that sparked Shah’s interest nearly 20 years ago. She and her team at the Basic and Applied Cognition Lab began studying college students with ADHD compared to those without using standardized measures of creativity, like “thinking of as many uses that you can for a bucket,” she said with a laugh. The students with ADHD had come up with more ideas for the bucket and more creative ones than the students without.
But Shah also went on to test real-life creativity by having two groups of students invent a new kind of cell phone. And, as she’d expected, the group with ADHD “created more unique, novel features of cell phones and things that hadn’t been invented, but were still thought of as useful.”
“So students with ADHD also had greater creative achievement in life,” Shah said. “We have a series of papers that show that people with ADHD performed better on creativity survey measures and laboratory tests.”
Shah and her team also began studying hyperfocus, a part of ADHD that can be both helpful and harmful. My hyperfocus mostly strikes when I’m supposed to be doing something else — if I have all the time in the world to think about my photography, it’s more of a task. But if I’m avoiding something else, it’s an indulgence. Hyperfocus is something that’s commonly talked about with ADHD, but there wasn’t much research on it until a few years ago.
Consulting with her colleagues, Shah developed a scale to measure it, and determined that there are both positive and negative aspects to exhibiting symptoms of hyperfocus.
“Sometimes it can be negative, when you’re going down a rabbit hole on the internet and come out and don’t do your homework,” Shah said. “But it could also be a positive, like you’re able to write a new piece of music because you’ve been able to focus on it so deeply.”
Ruark told me about her afternoons spent in the School of Art & Design studios, fueled by her hyperfocus. At times, it can be the secret ingredient in the work process, especially if the work is creative. And I wouldn’t be able to call myself a writer without it, because honestly, I would never finish an article.
***
Ruark and I spoke over Zoom, of course, and she walked me through her thoughts. We were diagnosed around the same time, but following the statistics, it should’ve been much earlier.
“I first started to suspect things back in high school, because I would have these moments where I’d be trying to talk to someone one-on-one. I’d want to show them that I’m listening and be attentive, but I could not stay focused during our conversations,” Ruark said. “It was really frustrating. And I did well in school. I still do well on tests. And I was polite. So before I was diagnosed, people really doubted it a lot.”
“And that was part of what made it difficult for me to feel like I should go get help,” Ruark continued.
“It’s a little delegitimizing,” I chimed in, too excited that someone was sharing my thoughts while trying to remember proper interview etiquette. “‘You’re doing well in school,’ they say. And I’m saying, ‘Yes, but my brain is scrambled eggs. It’s not good up here!’”
Ruark’s face lights up on my computer screen. “That’s exactly what I say!” she laughs.
I’m at a point now, several months into working with a psychiatrist, where I’ve started to see improvement. But the stigma around ADHD runs deep — far deeper in me than I’d anticipated. I couldn’t do basic tasks, like keep track of due dates or my keys, and the endless to-do lists weren’t helping. But the worst part was my explanation for these stresses: that they were my fault. I was lazy, unmotivated, apathetic and incompetent. Except, I did care. Why couldn’t I get the two forces in my brain to cooperate? I didn’t want to turn in a paper late, but it felt like I wasn’t the one in control. I wrote emails to my professors, explaining that I did care about their class, time, profession and respect, and apologized over and over. I must just be a bad person.
Shah explained this feeling of operating outside the realm of normal and feeling as though it’s our own fault.
“We’ve created a school system in a world that is really well-designed for neurotypical individuals,” Shah said. “But I think there are also people that will think outside the box, think of another way to do it, will question why you’re doing it. I think that there are all these strengths that we don’t necessarily value.”
The idea that a person didn’t “care” because they didn’t reach expectations was something I’d internalized long ago. It seemed to be the only explanation I was offered, and when you’re operating like a neurotypical among neurotypicals, it’s impossible for others to understand something like badly wanting to start a paper, but feeling physically unable to begin. Or forgetting a deadline for your favorite class, and being so consumed by letting your professor (and yourself) down that you can’t attend the next class and look them in the eye.
“I have a really hard time writing emails to professors. It’s my worst nightmare,” Ruark said. “It’s like, if I bring this up now, I’m going to just sound like I’m trying to get out of something. So sometimes I just don’t bring it up. And it’s my fault. But it’s also a little bit like a stigma thing and a guilt thing?”
She ends with a question, not a statement. Where does this shame come from?
I’ve been working on how I see ADHD and mental illnesses. In my mind, there’s a circle of what’s considered normal, and then people with anxiety, depression or other disorders are outside the circle, existing incorrectly. But really, we just decided that the circle is “normal,” which is not the same thing as “correct.” The people who exist outside of it just happen to be there.
“The biggest thing I’m realizing, the more I learn, is these things I thought that everyone did, they don’t do,” Ruark said.
“Exactly! And it’s nice to know that this struggle I’ve been having in my own brain happens for a reason, and not just because of who I am as a person,” I said. She laughed again.
“Yeah! It’s like, ‘Okay, good. I’m not inconsiderate of people when I’m zoning out. It’s not because I don’t care about them.’ That’s really nice to hear,” Ruark said.
It’s certainly affirming, especially coming from a doctor — and one who isn’t prescribing any patient with ADHD any medicine. For some reason, speaking with someone studying the disorder purely for research gives it more validity in my mind than a physician only treating the disorder in patients.
“I feel as though there are some biases, where you could say ‘Oh, this kid doesn’t care,’ ” Shah said. “Or maybe (you could say), this kid has ADHD. Let’s help them figure out how to help them. I think that young people can shine when they sort of find their space. This interpretation of laziness is one that really bothers me, especially if teachers think that. It affects people’s self esteem and perceptions of themselves.”
As a second-semester senior, I wish empathetic teachers and mentors for everyone, but particularly those who have felt lazy or incompetent at any point in their academic career.
As I write this, my roommate, Charlotte, finishes her Zoom class and walks into the living room. “What do you need?” she asks. Writing Annie usually isn’t a pretty sight, she’s learned, and I’m sprawled out on the couch, face unwashed, glasses on, wearing my mother’s childhood sweatshirt.
“Water?” I point to the water on the table a few feet away. “Water closer to you,” she smiles, pulling the table towards me. “Food?”
“I’m kind of shaky. I should probably eat. But I have a bagel on my desk,” I say. “I made it and then didn’t eat it, so it’s been sitting out.” She immediately picks up the plate with an hour-old bagel and puts it next to my water.
“You’ve left food out all night, so I’m not taking this as an excuse,” she laughs, then makes her way through the living room to our front door, taking her dog out for his second walk of the day.
Of course, the pandemic has made everyone’s work lives unrecognizable. Some have adapted to the work-from-home, all-day-on-a-screen workday with delight, either because it clicks better for them, or it fits their lifestyle better. Others, not so much.
When I started working with a new, ADHD-specific therapist, she told me that the pandemic had dramatically revealed people’s, especially women’s, symptoms. Of course, everyone’s been more stressed, inattentive and fatigued, but it was helpful to hear that on some level, my brain had been fighting the changes especially hard.
“Zoom classes themselves are really, really hard to pay attention to,” Ruark said. “I’m just constantly — off screen — playing with something with my hands. I have these magnets that I play with, and I have Play-Doh, but I also like drawing and doodling things.” Personally, I’ve bought a sketchbook specifically for drawing lines in — just lines. I’m no artist but am a perfectionist, so I found a middle ground. I draw patterns in black ink while my professors speak, engaging my hands and part of my brain enough that the rest has no choice but to listen.
“It’s really hard to remember everything because it feels like there’s so much happening,” Ruark said. Due dates are suddenly arbitrary: 5 p.m. in one class, every Friday, but 2 p.m. in another, Mondays and Wednesdays. “I’ve forgotten an entire test before,” Ruark stated.
When I used to go to classrooms, instead of them coming into my home, the “now” was physically surrounding me. Papers were due at the start of class or old school — under my professor’s door. But today’s pings of Canvas notifications and Slack messages blend into an amalgam of “not now,” too many individually and too much collectively.
***
I began the medication saga with instant-release Ritalin and immediately hated it. It was worse than my worst anxiety, which I’m already on medication for. And that doesn’t happen for some people. For a lot of people, medication helps and clears their thoughts, whereas mine were spiraling out of control.
The Netflix documentary “Take Your Pills” paints Adderall as the “get rich quick” answer to life. Students, athletes and programmers all take the pill and can magically focus, run faster or sit and code for hours without needing to eat. They produce more, more, more until the pill wears off.
Scott spoke to me about her own experience with this medication.
“I’ve talked to some people and they’ll have stories of the first time they ever really took ADHD medication, and it was like they were a whole different person and just could suddenly get so many things done,” Scott said. “I felt an improvement, but it was never like that magical transformation for me.”
Part of me bought into this Adderall craze, and though I was worried about starting yet another medication, I figured stimulants were more one-size-fits-all than depression meds, based on the cultural obsession with them. Once again, Scott’s experience suggested a more nuanced reality.
“I feel like there’s an idea like we want stimulants to be super students or whatever other people use them for,” Scott said. “When I’m taking that medication, it’s to get me to just a base level. A semi-functioning human being. And I still have bad days, even when I’m taking my meds. It’s not like a perfect cure-all.”
I agreed. I’ve been on and off stimulants, different dosages, different kinds, because something has yet to fit. I get anxious or nauseous, and I might be able to do more work in one sitting, but not in a good way. More of a my-heart-might-stop-but-also-here’s-a-bunch-of-Spotify-playlists-that-are-fun-to-organize kind of way. I worked with my ADHD therapist on coping strategies, which supplement medication or completely replace it for those who decide not to take pills.
Shah said that on average, medications do help people with ADHD, but they might not help everyone.
“If it works for you, it’s fantastic,” Shah said. “I don’t think one should feel bad about taking the meds that are effective and necessary for them to function. But coping strategies are also really important. Medication shouldn’t just be taken as a cure-all. You have to try really hard to do (the strategies) at the same time while taking the medication.”
The strategies are different for everyone. My therapist suggested printing out emails —maybe I wouldn’t forget to reply if they were sitting on my desk, staring at me. I spent $50 on two Tiles, or little devices you can attach to your keys and put in your wallet that emit a loud beep, trackable from your phone. My Google Calendar is outrageously detailed, and I get notifications all day long about what’s coming next.
With coping strategies, it’s similar to depression. What’s weighing on you the most, and how can we fix it? I once read a story somewhere on the internet of a woman whose biggest depression side effect was an inability to wash her dishes. They were so dirty and they piled up, and the longer they sat, the more effort it would take to clean them. “Run the dishwasher twice,” her therapist said. “Run it three times.” We can do things differently if we want to, but sometimes it takes someone else to point that out.
For some, this is the first stop after a diagnosis.
“I am a little nervous to be on medication. The idea of it makes me a little nervous,” Ruark said. “So I want to try coping strategies first.”
I don’t have a dishwasher in my apartment, but I do often forget my laundry in the washer for a few days. Run it again.
***
My therapist once joked that in America, we tend to rack up diagnoses when other cultures might take a more holistic approach. I certainly wasn’t excited to have a third one, but some people find comfort in knowing and naming it — and having an explanation.
“I definitely feel like people think that if you have ADHD, you can’t do anything, which is not true,” Scott said. “It definitely causes me problems. It definitely is a disability. But I’m still smart and succeeding in my school and in my work.”
I can see some positives as well. ADHD is associated with depression and anxiety, and I find that people with mental health issues tend to be more empathetic. They know themselves much better because they’ve spent so much time contemplating what’s going on. They know how they work. They know how they function.
As much as I’ve felt alienated lately, my brain is also starting to feel like home. I’ve spent so much time with myself, my thoughts, my brain, and ultimately, I think it’s worth it for how I’ve learned to see the world.
Statement Correspondent Anne Klusendorf can be reached at aklus@umich.edu.