Note: the following post was authored by a special guest, Imani Bentham. to provide some context for this piece, we have included a brief bio for Imani below.
Imani (she/her) joined the Unconventional Minds Coaching team as Operations Manager in July 2021. Imani helps service-minded and social change entrepreneurs with the back-end work so they can focus on what they do best - serving their clients. It is her belief that personal transformation is the heart of sustainable social impact and she enjoys working with organizations who share similar values. As a neurodivergent African-American woman and mental health advocate, Imani is passionate about providing the opportunity and creating environments where all can live at optimal wellness. She is a New York native and graduated with a B.A. in International Affairs from The George Washington University in Washington, D.C. She currently lives in Atlanta, Georgia, with her pup, Simi.
Who I Was Before ADHD Diagnosis
My mother called me “Mayhem”. That was my nickname. It's literally how she would greet me when I walked in the door. “Uh oh, Mayhem is here. Let me move my things before she breaks them.” It happened for years. Ever since a series of unfortunate events in school, my family, and quite frankly everyone I knew, could not shake the idea that I was unbelievably cursed. Blame it on the religious background or the mountain of evidence that lay in my wake, probably both. But the point is, they deemed me disruptive and destructive.
For years, people would say to me, “if my head wasn’t attached to my body, I’d probably lose that too”. I’d spend my time packing and unpacking across all of my homes and losing everything in between. My keys, my belts, my shoes, jewelry, phones, you name it. In college, it was so common for me to lose a phone that by the time I’d graduated, I’d had 4 different telephone numbers. In addition to the forgetfulness, I had horrendous attendance and trouble with keeping commitments. I’d always been a highly-intelligent and engaged student in class and teachers loved me…when I would attend. My impulses were constantly out of whack; it wreaked absolute havoc on my finances. But rather than view my perpetual tardiness, impulsivity, and forgetfulness as symptoms of a larger problem, I was told I was lazy, undisciplined, and unproductive.
I spent years burdened with shame and guilt for not living up to my potential.
An Unsurprising Late Diagnosis
ADHD (attention deficit hyperactivity disorder) affects 2.6 million adults in the US and is one of the most common behavioral disorders in the country. The gender health gap is at play here, too: just 3.2% of women will be diagnosed with ADHD in their lifetime, compared with 5.4% of men. In recent years, researchers have discovered ADHD diagnosis may be underreported for women largely because ADHD had largely been associated with hyperactivity in young (often white) boys. Now, we see that women and girls tend to receive diagnosis later in life than boys. We are socialized to assimilate and mask symptoms in order to conform to societal pressures and expectations. As Dr. Ellen Littman describes in her 2012 publication “The Secret Lives of Girls with ADHD”, “society still supports the feminine obligations to accommodate others' needs, be passively compliant, work cooperatively and be neat and organized. Consumed with shame, we are likely to judge ourselves much more harshly in comparison to our male counterparts.
As the Atlantic reported in 2013, “It’s difficult for girls to be diagnosed unless they behave like hyperactive boys.” Research in recent years has also revealed ADHD symptoms develop in dramatically different ways in females than males. According to the 5th edition of The Diagnostic and Statistical Manual of Mental Disorders, ADHD symptoms can fall into three subtypes: predominantly hyperactive, predominantly inattentive, and combined type. The inattentive ADHD symptoms are still largely misinterpreted by medical professionals who mistake them for mood disorders, anxiety, or co-occurring disorders. It is reported that inattentive ADHD is also more common in girls and women than it is in boys and men.
Typically, ADHD in women ADHD presents in forgetfulness, impulsivity, procrastination, and trouble with emotional regulation. A 2012 research study also showed that ADHD manifests in women more commonly as low self-esteem and self-loathing. In Understanding Girls with ADHD, Littman shares that the pressure to perform means many girls internalize their symptoms—disorganization or carelessness—as personal flaws rather than medical issues to be treated through medicine and therapy. Often, if girls are smart or in supportive homes, symptoms are masked,” author and psychotherapist Sari Solden shares in The Atlantic article, ADHD is Different for Women. “Because they’re not hyperactive or causing trouble for other people, they’re usually not diagnosed until they hit a wall, often at college, marriage, or pregnancy. A lot of things that are simple and routine to other people—like buying groceries, making dinner, keeping track of possessions, and responding to emails—do not become automatic to these women, which can be embarrassing and exhausting.”
Double Burden of Black & Woman
The ADHD stereotype of young, white hyperactive boys is doubly damaging for Black women in particular who find it impossible to see themselves in the narrative. Failing to see themselves represented, black women hesitate to seek out adequate support. Battling ADHD stigma in the BIPOC community is nothing new, but evidence shows that people of color are much less likely to be diagnosed with ADHD, even though they show symptoms at the same rate as white people. And if they are diagnosed, they aren’t as likely to receive treatment — even though many studies show that it can dramatically help kids and adults manage symptoms.
Inequities in health care — particularly mental health care — also aren’t new. In 2002, the Institute of Medicine released a report entitled “Unequal Treatment”, which found similar racial and ethnic disparities across the entire healthcare spectrum. Studies show that implicit biases in white Americans are at about the same level as they were in the 1950s — and that they’re still affecting how clinicians diagnose and treat patients.
Though I felt relieved by my diagnosis, for many Black women, a late diagnosis comes with a mixture of despair and relief. It’s disheartening to know that the challenges faced without a diagnosis and without support. In seeking a community for my new diagnosis, I discovered that the pandemic lockdown served as a catalyst for several black women to examine their ADHD tendencies and to seek out support.
Stopping the Spiral
Like many Black women, I was taught “you have to work twice as hard for half as much”. My parents and school administrators reminded me regularly when I was a child. I was expected to be exceptional. I considered my messiness, forgetfulness, and trouble concentrating to be embarrassing personal failures.
In 2010, feeling that it was becoming harder to stay afloat, I was diagnosed and treated for bipolar depression. I started treatment to receive treatment but that’s the thing about navigating mental health challenges in black families, particularly Afro-Caribbean families. My family struggled to understand my mental health choices. My dad adamantly disagreed with my doctor’s diagnosis and encouraged me to reject medication. Owing to my upbringing, I had long attributed perfectionism and personal achievement to my own understanding of my worthiness and self-esteem. That love, attention, and affection was only given to those who were able to achieve at high levels. That mental health was a vulnerability that made you less able to produce than others. The thought burdened me…And that is when I fell.
I fell into such a dark hole of depression. I felt unworthy, I felt crazy and despite my personal best efforts, I couldn’t turn the ship around. Eventually, I landed in inpatient therapy in a women’s center where I felt supported by others who helped validate my experiences. It helped me quiet the noise and hear those parts of me that weren’t getting their needs met. In this women’s center is where I found the courage to begin again.
After leaving the women’s center, I felt a deeper sense of self and connection to others who shared in my experiences. I thought life would be different. I assumed I’d be healed. But, that wasn’t quite how it went. I began to understand the journey of healing and growth is almost always non-linear.
In the years that followed, though I developed better tools to cope with the stress and self-loathing, my ADHD quirks (losing my keys, irritability, overspending, absences) persisted. I was frustrated because I knew I was better than this. I knew I was not reaching my potential. And for a recovering perfectionist like myself even with better self-esteem, my diminished performance and seemingly stagnant growth was troubling.
After scouring the internet and self-help books on how to replace bad habits and how to become a highly effective person, I recognized myself and my symptoms in much of the ADHD literature I came across. Prior to the pandemic, I’d sought support in receiving an ADHD diagnosis however, I found that it was more difficult than I’d ever expected. Despite my history with mental health professionals, doctors did not take my concerns about a potential ADHD diagnosis seriously citing my concerns as symptoms of my previously diagnosed and co-occurring disorders of anxiety, PTSD, and bipolar disorder. I remember speaking to doctors about my thoughts (almost all of them white in the years prior to 2019) watching them eye me with wariness and skepticism about my difficulties. One even said to me, “I know an addictive personality when I see one.”
My family said that I was “putting things on myself.” That I’d made such significant progress in so many other areas of my life that I was looking for something else to explain why I was not perfect. Family members said that getting an ADHD diagnosis was simply taking the “easy way out” of hard work. Feeling embarrassed and invalidated once again, I put my head down and kept trying to manage without the help I knew desperately needed.
But, at the start of the COVID-19 pandemic, a likely period of introspection for many of us, I decided I was tired of feeling unworthy, insecure, and unfulfilled. I didn’t just want to do or perform better. I wanted to just BE. Be comfortable in my own skin. I wanted to understand the why behind my choices and why sometimes it feels as if I’m fighting in quicksand. So, despite my previous obstacles, I pushed forward and found a doctor to help me with my diagnosis.
Embracing My Unique Way of Being
My ADHD diagnosis, simply the awareness of the disorder and neurodivergence has done wonders for my self-esteem, confidence and sense of belonging.
The most important thing to remember is that this embracing of myself did not happen overnight. Nor did it happen in isolation. Learning to embrace myself has been work. It required surrounding myself with people who were willing to work with me, to give me the chance to grow into myself and who did so in a non-judgmental way. In the process, I had to learn to challenge the stories I’d told myself and challenged myself to create new stories. I had to be open to learning how to love myself so fiercely.
I sought self understanding. I developed self-compassion. I showed myself grace, care, and love. I found a way to stop critiquing myself for all that I was not and started to appreciate myself for all that I am. As Coach Samantha said to me recently, “We are not perfect and there’s nothing wrong with us.”
Here are some resources that have helped me this year:
Black Girls Breathing
Unicorn Squad, For Black people of Marginalized Genders with ADHD
It’s been a process. A process of trial and error. A process of learning and unlearning. Of beginning and beginning again. It’s been messy and difficult and the biggest test of patience. But I’ve fallen in love with the messiness.