Page published on 9th November 2022
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IP Ability committee member Sophia Karim has been sharing her personal reflections following ADHD Awareness Month in October. This is part ii of her three-part article, in which she explores the contradictions and struggles of a person with ADHD who “masks” in order to fit in. She also comments on the impact of gender on masking behaviour. It’s a thought-provoking piece, which we hope will encourage people to think differently if they recognise her experiences, either in themselves or in others.
Undiagnosed ADHD feels like you are a living contradiction. From reception through to my University final year law exams, I was known for always living in the “extreme” camp, and adopting an “all or nothing” approach for every hobby or musical instrument I did, every academic and personal goal I had. I was extroverted yet forgetful, intelligent yet messy, virtuoso but impatient, ambitious but impulsive, creative yet over-emotional, and a perfectionist but indecisive. Everything seemed fine on paper, overall. But in reality, my brain was a whirlwind, longing for peace and stability.
As I excelled academically and musically, no one raised an eyebrow at my work ethic or coping mechanisms. In reality, I was working harder than my peers, by far, out of fear that my unreliable brain would let me down because I was disorganised in other areas of my life. Now I know this was actually me “masking” my symptoms, because I knew my brain could only thrive by being intellectually stimulated and under pressure, with a quantitative and self-defining goal in mind that could unlock my future: the fear of being rejected by society for having an alternative way was frankly intrusive and sometimes crippling. I was so passionate about so many things – from whizzing through grades for the flute and piano at 11 to directing short films at 12, from writing Spanish poetry at 16 to mooting in a US court at 17, from composing a capella scores at 18 to hosting an international law conference at 20 – always picking up new traits and hobbies when the previous one didn’t satiate my hunger for perfectionism to keep me interested.
Imagine if every time you took a plane, after a smooth take-off, the rest of the flight was only turbulence – and worst of all, you could never land on the runway. Living with ADHD is living in an infinite loop of unpredictable turbulence with no indication of ever touching the ground.
Often, I wondered whether people thought like me. But as we are taught as girls, showing any indication of inner frustration, or inability to appease others due to our own inadequacies, is not a fundamental function of our role in society. As women, the unspoken rules command that we must be amenable and mould ourselves to the shape of a woman who is permanently indifferent and always a “pleasure to have in class”. A woman who will stick to the status quo. As such, neurodivergent women “mask” the traits that we acknowledge are neurological quirks, as these qualities will prevent us from sticking to the status quo. Even if these traits and quirks are intrinsically sewn into the very fabric of our being, we will do everything we can to keep them to ourselves, for fear of being ostracized for being different and deviating from the feminine ideal. We yearn to be quirkless, and we envy the joy others find in simplicity.
Just like most people, I spent my entire academic years writing in an exam hall under the same general conditions and timings as set by public exam boards. I would watch those who had extra time and extended academic support from school and university, and think nothing of it. Albert Einstein, Bill Gates and Richard Branson are all highly successful individuals I knew of who also belong to the “special conditions” club. I never once pondered whether I, too, was of this ilk and satisfied the requirements to join the club.
Turning the fan off, at last
When I took my first dose of ADHD medication shortly after being diagnosed, it felt like a fan that I didn’t know was on inside my head my entire life, had suddenly been turned off. Every step I took was lighter. Each thought that passed through was unconstrained by the usual constant whirlwind of intrusive thoughts. A weight on my shoulders that I didn’t even know I had, had been magically alleviated after ingesting a bright pink pill. Unfortunately, a simple bright pink pill isn’t a “fix all” solution to the plethora of issues I was about to face.
After 21 years, for the first time I could finally understand how others are able to think so clearly and behave so freely without second-guessing each action and sentence. It felt unfair. It felt like I had missed out on 21 years of freedom, and this took a mental toll. Would I be in a different place in life had I been diagnosed as a child? Would having that extra time in exams have given me that extra A* and access to a different university?
The real side effects of this bright pink pill at adulthood, are the realisations that come along with it. All the “what-ifs” and labels like “neurodivergent” can be isolating. At this stage in life, there isn’t extra time for exams or extra attention from caregivers – we are grown adults expected to function as dictated by society. We are our own caregivers.
The very nature of the condition is diverse in its purest sense, in that it presents differently in men, women, children and teenagers, and can therefore go unnoticed for years. This also means that, unfortunately, there is no one universal “cure” or “fix-all” coping mechanism that works perfectly for everyone. We all have different bodies and different brains. For many with the condition, “executive dysfunction” is a symptom that can be crippling. It is one of the most common symptoms of neurodivergent or “ND” folk. For example, we are able to distil incredibly complex ideas and legal issues in cross-jurisdictional matters for important clients through our strengths of thriving under the pressure from deadlines… but beyond our desks, we cannot even remember to take the clothes out of the drier. At work, we are praised for achieving successful outcomes for clients by being able to identify and devise compound legal arguments driven by our intellectual stimulation and cognitive interest, whilst totally lacking the skills to perform basic household functions.
For children who are diagnosed with ADHD, it is easier to manage symptoms and trial or titrate medication, depending on approach and symptoms which vary widely. Handing in homework late or missing lessons due to hospital appointments isn’t ideal, but is not detrimental to a child’s academic progress – there are countless, identifiable solutions and resources readily available to ensure these children are receiving an adequate education to supplement and support the brain they have been born with.
But in adulthood, there is so much more on the line. It is far riskier trialing medication and its harsh physical side effects as an adult in the workforce expected to perform up to particular standards with professional decorum. No amount of academic revision or university preparation could have prepared me on how to maintain composure during an appraisal meeting as I was experiencing cardiac arrhythmia, an unfortunate but common side effect from being prescribed a dose of medication that doesn’t agree with you. Concealing these struggles for an extended period of time can be detrimental to one’s career development. Or worse, invoke a vicious cycle of loss in other areas aside from income, such as one’s wellbeing.
Rather than risking a portion of our workforce falling into this category of burnout, we must normalise experiences and share knowledge, so that in future those who knowingly or unknowingly encounter the label “disability” – which, in its very prefix, immediately connotes negativity – view it as nothing more than an able and adaptable brain that will provide an alternative lens on the world.
Hi Julie, thank you very much for your kind message! To answer your questions: initially my journey to diagnosis was not linear, nor intentional. My suspected diagnosis and medical history to corroborate the diagnosis involved many medical professionals before even reaching diagnosis stage. For me, it was during an appointment with my GP in relation to a routine blood test. I briefly mentioned some symptoms - many of which I now know were actually ADHD symptoms exacerbated by the impact of the pandemic, and therefore more visible than ever before. My GP then referred me to see a private specialist consultant to explore these symptoms, and as a consequence, then referred me to a consultant psychiatrist for an ADHD assessment. The doctor who diagnosed me happens to be colleagues with my family friend, also a consultant psychiatrist, who has known my parents since before I was born (therefore confirming genetic suspicion!) Overall, a diagnosis is certainly not easy nor taken lightly by those in the field. There are certainly many routes to take, as no case is the same. To help others who suspect they might be in a similar position, I definitely recommend seeing your GP as a first step. If you have any further questions, please do drop me an email and I will be happy to respond :) Best wishes, Sophia
Thank you, Sophia, for sharing this brilliant (I mean in the sense that a diamond is brilliant) and clear account of what it can feel like and mean in practice to be in a different part of the spectrum of neurodiversity from the norm. One (perhaps two) question(s): how did you get diagnosed in the end and who treated you (in general terms, to help others who suspect they are similarly elsewhere on the spectrum from the majority, not specific names), please? Thank you Julie