Health
Why does it feel like every middle-aged woman I know has ADHD?
All her life Rachael has been forgetful, disorganised and chaotic. Turns out, it was ADHD all along… and she's far from alone.
By Rachael Mogan-McIntosh
When I was diagnosed with ADHD at the age of 51, my whole life flashed before my eyes. I felt as though a camera had pulled back to re-examine everything I had always believed to be true about myself.
I wasn’t alone in this strange experience. It felt like all the women I knew – and half the ones I didn’t – were making teary Instagram announcements or sharing the news on WhatsApp.
ADHD is suddenly everywhere.
The rise in ADHD diagnosis
The number of patients on ADHD medication in England has tripled in the last 10 years, according to a recent NHS survey reported by the BBC. The fastest rising population with the diagnosis? Women in their 40s.
In Australia, the rise is similar, and the National Australian Institute for Ageing (NARI) has opened a national conversation about neurodiversity in aged populations, highlighting the need for awareness and support in this under-served population.
ADHD lightbulbs at 51
Like so many women diagnosed in midlife, the light bulbs of ADHD started flashing for me as I pursued a diagnosis to help one of my kids. It took me a minute to accept. I was a busy woman, not a Tik Tok teen! What next? Would I develop an unreasonable obsession with my makeup routine? Film myself dancing in the aisles at Bi Lo?
Still, I could not deny the specificity with which I saw myself in every symptom checklist. Commonly it shows up for women in midlife because when oestrogen starts to drop in perimenopause, ADHD symptoms intensify, so difficulties that have previously been managed with white-knuckling and remorse and new notebooks become overwhelming – and women seek help.
And so there I was: 51, a whole life lived, before I learned the critical information that my brain had a structural difference that impacted significantly on how I functioned, and always had. This inherited neurobiological condition was highly treatable, but had gone unrecognised for 5 decades. It was quite a discovery.
A broadening definition of ADHD
ADHD was traditionally seen through the lens of boys bouncing off the walls of a school classroom. But girls, more likely to express their symptoms through daydreaming, fidgeting or chatting, have long gone uncaptured in the diagnostic criteria.
In fact, symptoms for women were not formally classified in psychiatry’s handbook the Diagnostic and Statistical Manual until 2013. The rise in diagnosis we’re seeing is due in part to this broadening definition of ADHD. Rather than an ‘epidemic’ of the disorder, we are seeing something closer to a balancing of the scales.
ADHD is a neuro-developmental issue that hampers the operation of neurotransmitters in the prefrontal cortex. There are a number of neuroscientific theories exploring the complex ways that ADHD operates in the brain – and it expresses itself differently in every person – but commonly, ADHD symptoms include impulsiveness, distractedness, poor memory and emotional dysregulation.
It can be utterly transformational for women to learn in midlife that the issues they have struggled with for decades are biomechanical, rather than personal failings. It’s not me, I long to get printed on a t-shirt. It’s my underactive left inferior orbital prefrontal cortex! But wait, there was more: there is an extremely effective stimulant medication that could balance out my underperforming chemistry. Shut up and take my money!
But isn’t everybody ‘a bit ADHD’?
There is pushback. ‘Everybody is a bit ADHD,’ people say. ‘Nobody can focus anymore! It’s all hysterical Instagram social contagion!’
There are elements of truth to all of this. Social media has brought increased awareness (along with a spoonful of misinformation) to the masses, and we do all function within a hyper-stimulating environment that is hard for the brain to manage. But the important distinction is the degree to which behaviour causes difficulties in day-to-day functioning, self-regulation and wellbeing.
It’s like the person with the pristine pantry who claims to be ‘a little OCD.’ They may exhibit obsessive traits, but their behaviour doesn’t profoundly impact their happiness; as opposed to a person with true OCD, whose compulsions cause enormous distress. A diagnosis of ADHD requires a gruelling assessment to determine traits that track back to childhood and impact on the patient’s quality of life.
Paying the ADHD tax
The cost of living with a distractable and impulsive brain, sometimes referred to as the ‘ADHD tax’, can be very high. The risk of elevated harms related to ADHD include eating disorders, accidents and injuries, unplanned pregnancies, chronic stress disorders and even shorter life expectancy.
Diagnosis for me was like cleaning a cloudy window to the past. It allowed me grace and self-compassion; an explanation, not an excuse. Meds have helped me enormously, and I feel like I am beginning to truly understand myself.
Still, I remain the same essential person. Recently, for instance, I spent a sleepless night worrying that I had offended a friend by saying her baby looked like Winston Churchill.
I’m also proud of my neurodivergent brain. Impulsiveness gets a bad rap, but it’s a close relative of bravery and initiative, and an ADHD brain has sharp pattern-recognition and compassion borne from our many mistakes.
Plus, we’re fun at parties.
A valid neurotype
I’ve come to regard ADHD as a different and valid ‘neurotype’ as well as an invisible disability, and I’ve developed a boundary against those who want to tell me whether or not my ADHD is ‘real’. (The people who push back the hardest, I find, are those who see neurodivergent traits as ‘normal’ because they share them, like the man who says that in his day nobody was autistic, they just got on with life and then goes off to re-catalogue his rock collection).
Diagnosis was like finally receiving the right operating manual for my brain. It’s like I’ve been trying to start my car with a potato for 5 decades, and I’ve finally been handed a key. The road ahead looks both steadier and brighter.
The information in this article is general in nature and should not be used to diagnose or treat a health problem or disease. Do not use the information found on this page as a substitute for professional health care advice. Any information you find on this page or on external sites linked in this article should be verified with your professional health care provider.
Feature image: iStock/Doucefleur
Discover more about wellbeing: