Attention to inattention, an advice heard since elementary school, but which I would never have put down to a developmental atypicality – a phrase that intimidates and prevents the acceptance of an obvious reality: at least 1 in 10 people is diagnosed with Attention Deficit Hyperactivity Disorder, ADHD, formerly publicized by American society as ADD [*]. I say ‘at least’ because, despite the high number of ADHD diagnoses made in North America, the global tendency is to deny the existence of symptoms altogether, or to overlook the importance of a correct diagnosis.
For me, as for many others, ADHD was an urban myth. I probably wouldn’t have heard of the term ‘hyperactivity’ if my parents didn’t know some friends whose daughter had a diagnosis. She ticked off all the symptoms well before the age of 6, the age at which a child is officially diagnosed. She could never sit still and had great difficulty at school. After her mother, a psychologist, exhausted all alternative treatments, she turned to medication. I remember my parents at the time constantly bringing up how ‘mushy’ the little girl had become later, or how grateful they were for not having such problems with me.
That’s how the image of attention deficit (which implies much more than the name suggests!) was ingrained in me: a form of mental retardation, even disability. Movies and TV shows were silent on the subject, and the doctors I went to for various reasons had never suggested there was anything wrong with me.
It wasn’t even a question – from a young age I was quiet, I watched films and theatre plays with maximum interest, and I didn’t care much for running around or climbing trees. Furthermore, according to some, I had a developed vocabulary and rarely had problems with learning.
It was just that I talked quite a lot. And I almost always found it hard to stop myself from interrupting adult conversations. I asked a lot of questions. Most likely I inherited this from my father, because he also talked non-stop, jumping from one subject to another. A nagging habit, among many others he had, and hard to correct – that was how his nature was perceived.
The decision to enrol me in school after I turned 7 was made by my mother, after she drew up a table with several arguments in favour of an extra year of ‘childhood’. I was too disorganised, inattentive and constantly chatting with friends. Even in the teacher’s view, I was far behind the other children in the group.
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They expected that with age I would also get rid of childhood stubbornness, the time spent ‘in my head’ and the fits of rage. At school, however, I hit an even more rigid framework where I had to excel in all subjects, supported by my parents’ encouragement. How could I explore novelty – something I have always sought – if I was not allowed to ‘waste time’ under any circumstances?
From secondary school, I encountered difficulties in the exact sciences. In the evenings, my father took on the role of maths tutor, without much success. I made mistakes (and I still do!) in calculations all the time. I couldn’t hide the boredom caused by abstract explanations: it was written all over my face that my mind was elsewhere. I would procrastinate on my extra homework, looking for a way out – either I found excuses that I didn’t know how to approach the exercises, or I boldly copied the results from the back of the workbook, ignoring the risk of being discovered by my father, who was exasperated by my behaviour. He knew that I was ‘intellectually capable of more’. And yet, sometimes I did well at maths. I had so-called ‘flashes of brilliance’, somewhat unusual ideas that led to the solution in a convoluted way.
Between the ballet and guitar lessons suggested by my parents, I engaged in my own projects. Just like Barbie, I was in turn an interior designer, writer, athlete, actress, photographer, and programmer (until I discovered that maths is indispensable here too).
The only common point of my hobbies is that I have never finished any of them.
I wanted to fight against the current dictated from home – I liked to talk loudly and make all sorts of jokes, to stay after school in the little park without worrying about homework. In my small group of friends, I felt best because I knew I was appreciated for the natural effervescence of my personality.
I had realised that my parents didn’t like my ‘noisy’ side and didn’t listen to my interests and desires. And why would they, if everything seemed to end in abandonment? From their point of view, I was acting out to attract attention and to shock. In reality, I was looking for balance, for improvement, and to suppress what everyone, including myself, thought were bad habits.
High school didn’t offer me the much-coveted freedom either: I suddenly found myself lacking the well-established structure of my parents. They were finally offering me what I had wanted so much – the opportunity to organise myself as I wished. Paradoxically, designing a schedule to my own liking seemed impossible to achieve. In my mid-teens, I felt more restricted than ever. I hadn’t managed to get into the high school I wanted. Of course, I hadn’t worked hard enough, something I was constantly reminded of.
Without the obligation of an exam, I had been tempted to stop studying. However, I didn’t do that. Although the struggle with a lack of motivation was to become recurrent, I gave myself a chance to prove the opposite – maybe I could still overcome the difficulties.
The high school profile focuses on subjects I haven’t mastered. While my classmates’ physics homework took them only an hour, I needed three times as much time. I didn’t concentrate enough even in the absence of distractions. I knew that, once sat at my desk, whether I entered concentration mode or not, I was doomed to ‘wasting time’. Even tests or being called on in class no longer caused me pangs of conscience as they once did.
How can I function in a society with a rhythm I cannot conform to, where age is a deadline and imposes a certain threshold of achievements on me?
Suddenly, the mental buzz of ideas and plans had disappeared. I had given up looking for the next experience to spark my enthusiasm. I had somehow decided that I would be better off alone. From skipping classes, I moved to refusing invitations to go out with friends. I would never have guessed that a person who normally recharged with the energy of others would ignore messages and calls. Weekends spent staring at the ceiling became entire weeks of holiday. I was physically and mentally exhausted. My back constantly ached from the hours spent lying in bed. This state was worse than any boredom, which in the past was one of my great personal fears.
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In the evenings, during the long hours when I couldn’t sleep, I had started looking for answers. On the internet. I was familiar with the possibility of having entered a depressive episode. At one point I had also found information about attention deficit, but, reading it, I was only amused by my past attempts to justify my inattention in maths through an imaginary dyscalculia**. I desperately wanted a label to prove I wasn’t pretending, anything but ADHD, which then seemed to me just an eligible excuse for someone lazy. I had never been hyperactive and I couldn’t call the lack of ease with calculations a real learning difficulty. I didn’t have the ‘serious characteristics’ that I considered the basis of ADHD.
It took more than a year before I started treatment for what I didn’t want to admit was major depression. Based on a series of evaluations and questionnaires, but also on my mother’s notes and observations, many months later I received confirmation on a yellow prescription: I was starting treatment for Attention Deficit Hyperactivity Disorder (or ADHD). The association with depression would not be a first.
In many girls, depression sets in against a background of ADHD that remains undiagnosed due to the lack of hyperactive manifestations, which are more common in boys.
Although I officially obtained the diagnosis, the fact that I can sit still in a chair (still feeling the need to fidget with my leg) still raises suspicions for the doctors and psychologists I consult. I have been told that I don’t look or talk like someone with hyperactivity and attention deficit would talk. In the opinion of some, everyone has moments when they might seem to have ‘ADHD’.
I constantly continue the ‘struggle’ of self-defence: in front of my mother, who denies the diagnosis, in front of my father (for whom the fact that he keeps forgetting medical appointments or business meetings doesn’t raise any questions) and every 6 months for the re-evaluation of the diagnosis. It’s as if every consultation seeks to verify the truth of my story, just in case I omit some symptoms. Or, eventually, to conclude that I am cured!
There are moments when I think it was all a mistake. That, out of a lack of willpower, I resorted to medication for something intangible and, at first glance, invisible to those on the outside. And the medication, although it works, doesn’t always do so. I end up wondering if it’s acceptable to ask for a medicinal alternative, or if I risk being labelled as someone who tries pills like sweets?
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In Romania, as in most European countries, obtaining an ADHD diagnosis in adulthood is very difficult. After 18, I will no longer be entitled to subsidised treatment, which can by no means be considered affordable for everyone. Although those who are neuroatypical with ADHD detest structure, they cannot live without one, and precisely where there is the greatest need, in the medical system, not many possibilities are offered to us.
This whole process, extremely long and costly, makes me wonder if it’s worth the effort. Is it, perhaps, cost-effective to wait dozens of weeks for appointments and reimbursed investigations? Would it be better to turn to the private system, where a consultation costs as much as I would spend for a single month of treatment – received only if I come across a doctor who validates my symptoms and, implicitly, my suffering?
If psychiatry does not yet allow for a diagnosis based on objective measurements (biological markers identifiable through laboratory tests or imaging), how much longer will the speculation continue that ADHD is ‘an invented disease’, from which only pharmaceutical companies benefit?
As I am a proponent of more integrated approaches, preferring to resort to medicinal treatment only as a last resort, I have reflected on the problem many times. And each time I answer myself with another question: who would really be willing to make their life harder every day, deliberately, by claiming false symptoms?
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[*] Thomas R., Sanders S., Doust J., Beller E., Glasziou P. (2015). Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics, 135(4), e994-e1001.
** dyscalculia = specific learning disorder (SLD) based on a neuro-biological dysfunction that affects the development of the brain’s ability to work with numbers
For more details on how ADHD manifests and is treated, see our factsheet.
