In the latest installment of her monthly column, writer and author, Beth McColl, explores explores the stigma that still exists around more ‘taboo’, less palatable mental health illnesses. Beth is the author of 'How to Come Alive Again' which is a relatable and honest practical guide for anyone who has a mental illness. She's also very, very funny on Twitter.
I was diagnosed with ADHD in 2020 at the age of 27. By then, I’d started and abandoned the assessment process several times – an unsurprisingly common occurrence among people who are eventually diagnosed.
The process itself is an ADHD nightmare, requiring that you fill out seemingly endless forms, keep up to date with appointments and correspondences, remember to pay the correct fees on time, and collect supporting evidence from various sources, all the while enduring a berating from your own mind, long practised in receiving and repeating negative messages. Pre-diagnosis, my brain felt separated into two warring factions: one side knowing that I was working myself to the bone and struggling, the other convinced I was wasting people’s time and just needed to try even harder.
The diagnosis was both a relief and a source of real grief. I had spent my teens and adult life quietly but deeply suffering, mis-characterising myself as lazy and less disciplined than my peers. In reality, I had simply not had access to the accommodations, tools and patience that would have allowed me to cope and even to thrive.
Like a lot of people with ADHD – and many without – I have measured difficulty with executive functioning. Executive functioning refers to the skills that help a person to manage a human life- to organise their time, think and act flexibly, focus, set priorities, rely on memory, regulate their emotions and just feel like they’re coping in general. When these skills are compromised or incomplete, living day to day can be hard, requiring more workarounds and ‘life hacks’ just to stop everything – work, relationships, mental health, sense of self – from collapsing like a poorly built beach house sliding into the sea.
Many women have waited years for a diagnosis.
Executive dysfunction can have a serious impact on academic or professional performance, in part because most schools and workplaces are not built with neurodivergent working and learning styles in mind. As a result we’re forced to make frequent, private improvisations – working weekends and after-hours or utilising as many “helpful” apps as our phone’s memory will hold – all the while trying to obscure the worst of our struggles to avoid detection. This is incredibly exhausting and alienating, and leads many of us away from what we’re truly passionate about and towards more ‘suitable’ environments. It may be that we’re even encouraged to do this by managers or educators who are unable to see beyond the executive dysfunction to the natural talent or genuine skill.
My own executive dysfunction looks like struggling to organise my time effectively, transition between tasks and keep up to date with admin (even exciting admin – I once fumbled the bag on a huge PR package from my favourite chocolate brand because I couldn’t get it together enough to reply to a simple request for an address). I rely on a rotation of apps, lists and organisational techniques – a complex juggling act because of my brain’s need for novelty. Even the most effective and seemingly groundbreaking systems needs to be shelved and replaced after a few weeks or months.
I also struggle with processing sensory information. Instead of filtering out what is clearly relevant and important to me, my brain instead presents it all – lights going on in a house over the road, dog barking two streets away, slight breeze, car exhaust smell, coughing toddler, itchy label on the back of my neck, my future self appearing through a rip in time to tell me this week’s lottery numbers – as vitally and equally important. In other words I’m uncomfortably aware of everything but struggle to direct my focus in any one direction.
A traditional five-day week just causes resentment and procrastination.
Living with executive dysfunction is frustrating, and I’d wager that across my almost 30 years of living it’s been the source of more shame and self-hatred than anything else. Even now that I have a name for it and can understand it in relation to my ADHD, my brain and my nervous system, I still find myself behaving as though it’s something I’ve inexplicably opted into, a delivery service specialising in same day difficulty and embarrassment. I can’t help but imagine a life where this wasn’t a daily concern. I imagine it not taking me 14 business weeks to fill out a simple form. I imagine not having to absorb the cost of another forgotten return, another unpaid fine. I imagine myself doing a weekly food shop without it feeling like trying to solve the enigma code with only a blunt Ikea pencil and a Fisher-Price Xylophone.
There’s no off switch for ADHD, but fortunately there is plenty to be done to manage a life alongside it. Since my diagnosis I’ve worked with ADHD coaches and therapists to learn how to manage both my executive dysfunction and the related attacks of shame. I’m honest about it when I join a new project, letting others know my working style and trying to find compromises. I’m more comfortable asking for the necessary accommodations from bosses and companies (firm deadlines, flexible work hours, certain accessibility tools for my computer etc.). I can seek help and advice far more freely and if I’m faced with a list of tasks and obligations and can’t see where to start or how to sensibly prioritise, I simply ask my most organised friend or family member for a bit of their time.
I’m also committed to being fundamentally decent to myself about it all, and if I slip up and give myself a hard time I act as I would if I snapped at a friend: by apologising and making genuine amends. Because I’m learning that I’m not in combat with myself and that people with ADHD are not a list of flaws or shortfalls – we’re whole and trying our best. Just as we have been all along.
“Screaming may, to some degree, help relieve your stress.”
