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Psychotherapeutic counsellor Bev Woolmer helps us to understand that ADHD doesn’t just happen in a vacuum. An ADHDer’s comorbid conditions can impact and/or mask symptoms of the condition.

(5 minute read)

Awareness, information and debate about ADHD have increased significantly. ADHD has become part of our social discourse and the increase of people seeking diagnosis and support is rising. It is likely that within our circles we know people with ADHD or we may be neurodiverse ourselves.

Data from the NHS Business Services Authority show that in 2022–2023, more adults were prescribed medication for ADHD than children – a rise of 32% in adult prescriptions (NHSBSA, 2023). In March 2024, the National Institute for Health and Care Excellence (NICE) estimated that 3 to 4% (roughly 1.9 million adults) and 708,000 children in the UK have a diagnosis of ADHD.

Statistics aren’t, generally speaking, my thing, but what resonates here for me, and something that is maybe less discussed, is ADHD and comorbidity (AADD UK; Plos One; The Understood Team). Comorbidity means the tendency for one condition to co-exist with another. What I recognise both personally and professionally is how anxiety and depression are often diagnosed, and what can often be missed are conditions within the umbrella of neurodiversity.

Recognising in later life that my brain is neuro-spicy, that there is a reason why numbers, “clumsiness”, not knowing my left or right, being a “daydreamer” (a firm favourite in school reports) all started to fall into place. I began to piece together the things that had challenged me and began to see all this was unique.

It is no surprise this is also a large feature within my work as a counsellor with clients. The privilege in holding space for others, where the mask they’ve worn can be explored with compassion and curiosity. A supportive ally on the journey of self-discovery, the reflecting back, seeing the signs and missed opportunities, often a grieving process, recognising the loss and the re-building.

This piecing together often brings into view co-morbidity and how the presence of these can affect ADHD symptoms as well as mask ADHD.

How anxiety and depression mask ADHD

Anxiety: this can impact the ability to concentrate, the racing of thoughts, constant worry and fear. It can exist as a generalised anxiety disorder and be experienced in relation to health or social anxiety. Perfectionism, and comparing oneself to others who seem to function and manage, are often internalised. About 50% of adults with ADHD will also have an anxiety disorder.

Depression: adults with ADHD are three times more likely to experience depression; they are more likely to be significantly affected by their symptoms than those with either disorder alone. Low mood and low self-esteem can impact self-image and can result in a sense of failure in not meeting expectations or goals. This can impact both personal and professional relationships, struggles with communication, reading body language and “fitting in”.

 

How specific learning differences mask ADHD

Specific learning differences are neurological conditions that can impact how a person learns. These are not related to intelligence, and those with one or more of these conditions are more likely to have ADHD or ASD than people who do not have a specific learning difference.

Dysgraphia: this can cause challenges with written expression, handwriting, spelling, grammar and putting thoughts onto paper as well as fine motor skills – for example, holding a pen.

Dyspraxia: challenges with movement and co-ordination, including poor hand-to-eye co-ordination, manual dexterity and poor balance. It can also affect language, perception and organising thoughts.

Dyscalculia: affects the ability to acquire arithmetic skills – for example, in performing mathematical calculations, understanding place value, reading timetables, telling and tracking of time, and challenges with distinguishing left and right.

Dyslexia: causes difficulties with reading, writing and spelling. It can cause confusion over the order of letters, which may be written the wrong way round. It can also cause challenges with following directions, perception, planning and organisation.

Empowering ourselves

Being able to understand ourselves, to name what challenges us, can enable and empower us. It can provide an opportunity to learn strategies, to reframe our story and to find a sense of self of who we are. As poet Maya Angelou says: “If you’re always trying to be normal, you will never know how amazing you can be.”

 

References

AADD UK. No date. Accessed 3 December 2024: https://aadduk.org/symptoms-diagnosis-treatment/comorbidities/

National Institute for Health and Care Excellence. 2024. Accessed 3 December 2024: https://cks.nice.org.uk/topics/attention-deficit-hyperactivity-disorder/background-information/prevalence/

NHS Business Services Authority. 2023. Accessed 3 December 2024: https://media.nhsbsa.nhs.uk/news/nhs-releases-mental-health-medicines-statistics-for-20222023-in-england

Plos One. No date. Accessed 3 December 2024. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0277175

The Understood Team. No date. Accessed 3 December 2024:https://www.understood.org/en/articles/adhd-comorbidity

 

In “ADHD, ME …”, sister poem of “ADHD? ME?”, poet Jackie Fernandez illuminates the work struggles she endured around her initial diagnosis just before the Covid-19 pandemic. Full of Jackie’s usual wit and charm, “ADHD, ME …” continues to allow readers into the thoughts and journey of one woman with a late diagnosis of ADHD.

 

I was diagnosed as we were going into lockdown

Covid taking over our lives

Boris acting like a clown

As we got used to living day and night in our dressing gowns.

 

It was only a week or so from getting this bombshell

I was assessed by a psychiatrist

Asking me loads of questions

About my childhood

About school

About the jobs I had and lost

With little notice

But at a great cost

To my confidence

Unsure of my skills

My experience

Was I any good at it?

Did I try my best?

Why couldn’t I fit in?

RSD wanting to put me in the bin

 

I worked for a charity

That supported people with disabilities

Providing stability

To folk who struggled with mobility

Or folk who were neurodivergent

Some very observant

Some obsessed with detergent

Some talking like a machine gun

Because in their head it was urgent.

 

I thought I was in the right place

To share my diagnosis with grace

And not hide my face.

 

I told my manager

I have ADHD

Could you share this with the board

It will shed light on how I work

And understand how ADHD can be a positive quirk

 

I didn’t get the response I expected

Words that would’ve been a warm embrace

But  in reality,

I’ve never felt so rejected.

 

She explained how now was not the right time

We had to focus on Covid-19

I had to look after my staff team

Steady the boat

Keep it afloat

 

A Secret

Like it was something so bad

So awful

So earth-shattering for them

 

I felt unimportant

But took it on the chin

I had to focus on my job

Put my feelings in the bin

 

The news was shared eventually

To all the board members

Who’d known me for years

But things did not look like they appeared

 

An email was sent out to all

Telling them of my ADHD

I was expecting to be bombarded with responses

Telling me its ok

We will support you

How have you managed for so long?

We are right behind you

You’ve done nothing wrong.

 

I was bombarded by silence

It   was    deafening

Soundless

So, so quiet

So, so still

Nobody said anything to me

It gave me quite a chill.

 

I had no support

They didn’t want a CEO to have ADHD

What an embarrassment I was to them

To have a disability

To not be neurotypical

“Normal”

A role model

To not be abnormal

 

I felt I let them down

I had taken a step down

I had lost my crown

 

Visit Jackie’s poetry site

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Published 6 December 2024

 

All rights reserved © Copyright Jackie Fernandez 2024. Unauthorised use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. Author contact via website Contact page.

Website version and image © Copyright Attention Allies 2024.

Counsellor, psychotherapist and supervisor Claire Wirsig invites readers inside some of the thought processes that a network and community of therapists (focused on neurodivergence) must also consider.

(5 minute read)

This blog post has been inspired by my deep care for people and reflecting on the many ways in which we can be “othered”. I also take inspiration from Eugene Ellis’ book The Race Conversation (2021), as well as other authors. I’m hoping to begin a useful “race conversation” within Attention Allies, and perhaps, beyond.

As therapists, we do a lot of reflecting on identity. The therapists within Attention Allies (myself included) support clients who have ADHD. We facilitate our clients to understand ADHD as a neurotype that lends itself to certain experiences, as well as supporting our clients to explore their own unique and individual identities within ADHD. The way ADHD presents and feels for one person will be entirely different for someone else.

Prior to doing this work with clients, we will have gone through our own respective therapy trainings and personal therapy, and reflected on our own identities. For me, a large part of these reflections had been about my gender and my culture. Even with all of this introspection, some pieces of the puzzle remained hidden. I remember with crystal clarity the moment it dawned on me: Never do I ever feel white. This is white privilege.

Anti-racist activist Peggy McIntosh’s famous article “White Privilege” (1989) describes white privilege as “an invisible package of unearned assets that I can count on cashing in each day, but about which I was ‘meant’ to remain oblivious”. McIntosh goes on to list 26 of these unearned assets. I’m sure there are many more.

In my journey to better understanding white privilege, I read Reni Eddo-Lodge’s book Why I’m No Longer Talking to White People About Race (2018). In this book, Eddo-Lodge states: “Racism’s legacy … brings with it not just a disempowerment for those affected by it, but an empowerment for those who are not. That is white privilege. Racism bolsters white people’s life chances … it is designed to maintain a quiet dominance.”

Alongside examining my own experience of white privilege and reflections on how it affects my therapeutic work, I am curious about the subject of racism within the field of therapy, and how it shows up in different spaces. But before we delve into the matter further, let’s pause for a moment to think about how we engage with this subject.

Bringing up the subject of race/racism can give rise to strong bodily sensations and/or feelings. Some responses might include noticing an increased heartbeat, feeling defensive or shutting down. Ellis (2021) calls this phenomenon “race construct arousal”. In The Race Conversation, he explains that “when race is the focus, dissociation, confusion, anger and blame are the central experiences, along with dysregulation … and feeling psychologically unsafe”.

Ellis invites the reader to “be with” this arousal without “being” the arousal. “It involves staying at the contact boundary of our discomfort and, at the same time, compassionately meeting our implicit responses and biases.” I invite you, reader, to notice what you’re feeling now having read this far, and I invite you to stay at the contact boundary of what responses are aroused in you as you read this article.

On the homepage of our website it reads: “Attention Allies. Therapists for ADHD in Bristol”. Scrolling down, we have a group picture of what appears to be nine white-skinned faces (of which I am one). In relation to this image, I wonder whether Attention Allies is unconsciously bolstering the chances of therapeutic support for white people with ADHD and, as a consequence, neglecting and/or disempowering people of colour with ADHD?

Of course, Attention Allies is not alone in being a predominantly white therapy organisation. The therapy profession itself is aware of whiteness in the mental health professions. An online search revealed that 80% of NHS talking therapy staff are white and female (AI overview, 2024). According to the HCPC survey (Kanceljak and Calia), “90% of registered practitioner psychologists in the UK identify as White, followed by 4.3% Asian, 1.7% Black and 3.6% Other”.

During our last meeting of the Attention Allies, I had a discussion with some colleagues about whiteness in our group. We asked a number of questions of ourselves including inquiring if we were colluding with white privilege and if we were consciously or unconsciously sending out any messages the we are only here to support white people with ADHD. Are these experiences being seen and heard? Does our group seem like a community where those intersectional experiences can be seen and heard?

I don’t know and I can’t know the answers to these questions. But I feel strongly that we need to be asking questions like these – in our group, in the therapy profession, and as people living in this world.

Although this discussion will be ongoing, I will end this piece with another quotation from Eddo-Lodge:

Anti-racist work … needs to be led by the people at the sharp end of injustice. But I also believe that white people who recognise racism have an incredibly important part to play … Support looks like white advocacy for anti-racist causes in all-white spaces. White people, you need to talk to other white about race. Yes, you may be written off as a radical, but you have much less to lose (2018, pp.215–216).

 

References

AI overview on Google. Accessed 30 October 2024.

Eddo-Lodge, Reni. 2018. Why I’m No Longer Talking to White People About Race.

Ellis, Eugene. 2021. The Race Conversation: An Essential Guide to Creating Life-Changing Dialogue.

Kanceljak, Dan and Clara Calia. No date. “Diversity and Inclusion in UK Psychology: A Nationwide Survey”, The British Psychological Society. Accessed 30 October 2024: https://explore.bps.org.uk/content/bpscpf/1/369/15#:~:text=According%20to%20the%20HCPC%20survey,Black%20and%206.7%25%20as%20others

McIntosh, Peggy. 1989. “White Privilege: The Invisible Knapsack”, Peace and Freedom, July/August, 10–12. Accessed: www.nationalseedproject.org/key-seed-texts/white-privilege-unpacking-the-invisible-knapsack

 

Click the links if you’d like to visit Claire’s therapy website or her directory entry on Attention Allies.

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Published 6 December 2024

 

All rights reserved © Copyright Claire Wirsig 2024. Unauthorised use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. Author contact via website Contact page.

Website version and image © Copyright Attention Allies 2024.

Founder, psychotherapist and coach Duncan E. Stafford is worrying about ADHDers and celebratory times. On the other side of the pond, in the US, my British–American family are preparing to commemorate Thanksgiving (with awareness of indigenous sovereignty). It’s one of those times when people come together, eat, drink and celebrate. Of course, there are, for many people in the UK, other celebratory occasions coming up …

(5 minute read)

As a neurodivergent adult or child, celebrations like birthdays, weddings, Christmas, Bar/Bat Mitzvahs, Eid and Diwali – to name just a few – can become very challenging times. They are also about enjoying occasions with other people and can bring excitement and joy. However, these sorts of shared events, as ADHDers know, may also trigger overwhelm and stress, and encourage emotional outbursts of one kind or another.

Challenges for ADHDers

Celebratory events can bring sensory overload. Think, for instance, of the bright lights and loud music or noise from tightly packed spaces. These sorts of factors can make for difficulties with “filtering” and thereby lead to overwhelm, exhaustion and, of course, irritation.

Celebratory events, while being enjoyable for many, also bring disruption to routines – something that can be particularly difficult for ADHDers who rely on routine for self-care management. One late night out of routine can lead to irregular patterns and disrupted schedules, which quickly escalate to fatigue and becoming unable to manage your emotional responses.

Social expectation

Socialising can bring considerable demands on ADHDers; continuing polite conversations beyond your own limits or feeling the need to conform to social conventions can really “up the pressure” on the individual. Yes, sitting at a table for extended periods while conforming to social norms such as listening without constantly interrupting others, keeping track of themes or staying on topic can be remarkably tiring and create internal stress of all sorts.

The good side?

Of course, such events are also full of novelty, stimulation, relatedness and, if fully engaged with, ADHDers might even get involved in a bit of pleasurable hyperfocus and positively become the life and soul of the party.

What can ADHDers do to survive celebrations?

Planning and preparation can be very helpful at times of celebration. Simplify preparations into small tasks like buying presents over a defined period, rather than expecting yourself to do it all in one mammoth, dopamine-absent shopping trip.

When it comes to the event itself, create your own timeline. Arrival and exit times – the book ends of an occasion – can often be within your own control. Also, plan your downtimes and escapes within an event. Trips to the bathroom, e.g., can be a saving grace. Taking a few moments to be on your own or reasonably silent are often a possibility – even if only when you are waiting at the bar or buffet. If you are someone who finds events difficult, spread out these “downtime moments” to get you through the entire event – allowing you to see the whole as a series of short stages.

The closer you are to the action the more stimulating it is likely to be, so take breaks from the noise, light and energy of others from time to time. Don’t forget fidget gadgets, but go careful on the things that stimulate and exacerbate hyperactivity and emotions.

If occasions and cultural demands allow it, say “no” when you need to and let the people closest to you know your needs. What’s fun for some is a challenge for others and it is often okay to skip part of an event if people know why you are doing so.

Embrace self-compassion and acknowledge your feelings, as this can help to minimise feeling judged and reduce self-imposed stress. Finally, prioritise and look forward to the bits of celebrations that you like – dance if you want to, but check that’s what other people will be doing, too!

The end of the year?

Members of Attention Allies come from, and work with, a wide variety of backgrounds, ethnicities and cultures. During 2024 we have heard in sessions about ADHDers’ celebrations – some of which were just as they had hoped for, while others became a challenge. Towards the end of this calendar year and into the beginning of the next, they will be heading towards, for example, Christmas, Hanukkah, Bodhi Day, Shōgatsu, Kwanzaa and Pancha Ganapati hopefully with new skill sets and tools to be successful in their celebrations. For me? I will be sitting down to a feast with my nearest and dearest on the longest night of the year to celebrate the start of Yule (one of the oldest events in December) warming my way to 2025. While I’m glad to celebrate, it’s also something I enjoy doing relatively quietly. Good cheer!

 

Click the links if you’d like to visit Duncan’s therapy website or her directory entry on Attention Allies.

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Published 25 November 2024

 

All rights reserved © Copyright Duncan E. Stafford 2024. Unauthorised use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. Author contact via website Contact page.

Website version and image © Copyright Attention Allies 2024.

Intriguingly, anger is noticeably missing from the formal diagnostic criteria for ADHD. While there is research to support the idea of emotional dysregulation being part of the story, there are perhaps other ways to look at your anger and ADHD. Here, transactional analysis-trained therapist Hayley Watkins takes us through some interesting thoughts on how to understand your anger and its part in your self-protection system.

(4 minute read)

Anger is energetic, it’s forceful, and it can feel good – really bloody good. Anger says, “That person’s being unfair and I won’t stand for it!” That’s why we sometimes get angry when we feel powerless: it’s more reassuring to feel angry than to give up and feel defeated.

It’s empowering. Or at least, it can be.

But you wouldn’t be reading this if you were entirely satisfied with your relationship with anger. So, rather than labelling your experience with anger as “anger issues” and looking at “anger management techniques”, let’s explore what anger means, starting with paying due respect to what it does for us.

The bodyguard emotion

Problems can start to arise when we get angry at ourselves: “I didn’t do my best, so I should be punished for that.” That’s a part of how RSD (Rejection Sensitive Dysphoria) works, and it can make our anger self-destructive, which isn’t helpful for us if we already feel like other people treat us badly for having ADHD.

Anger can also become a problem when we get angry at someone who didn’t cause the problem in the first place. Perhaps we’re angry at Person A but only feel safe to get angry at Person B, or perhaps nobody’s at fault at all. But it still feels “better” to get angry, so we do.

So, how do we make sure we’re not hurting ourselves or the people who care about us?

Protective or destructive?

I could talk here about how you could take a step back, be logical and decide whether you’re being fair to yourself or the other person. If you can do that, then fantastic – go for it! But that’s not the whole story.

Whether we’re angry for the “right” reasons or not, we still feel it. It’s still one of the range of emotions that people feel, and we need to let ourselves process it rather than denying it or pretending it doesn’t exist.

How can we do that? Having a friend who understands that we all get angry sometimes can help. If you and your friend both know that you get angry sometimes, and can talk about it after you’ve cooled down, then that may well be all you need.

With that said, friends who stay around us if we’re often angry can be hard to come by, because they may feel shamed or even scared by anger. If you don’t have anyone in your life to do that, then a therapist might be a good option.

Getting angry at your therapist

So, now you have a therapist. Now things should start getting easier … right? Perhaps, or perhaps not. At some point, you might feel angry at your therapist. But if you feel angry at your therapist, then doesn’t that mean they’re no good? Well, not quite.

“Feeling better” might be your long-term goal, but before we get there, you might need to work on what happens when you get angry – and sooner or later, you almost certainly will get angry at your therapist. The key here is, what do they do when you get angry? A good therapist will usually invite you to talk with them so you can both understand how the anger became part of your relationship, what it’s protecting and how else you might approach the situation.

This is called “processing”. It’s a major part of therapy, and well worth hanging around to do.

Finishing up

This blog post isn’t about discouraging you from ever feeling anger. Anger’s a part of your self-protection system. I wrote this to draw attention to the way we can develop an unhealthy relationship with our anger, and explore what we can do about it. Exploring this is worthwhile because when you have a good relationship with anger, you’ll have a good relationship with your vulnerability. When you have a good relationship with vulnerability, you’ll have closer, more meaningful, more loving relationships.

So, wherever you are on your journey to understanding and processing your own anger, good luck!

 

Click the links if you’d like to visit Hayley’s therapy website or her directory entry on Attention Allies.

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Published 17 November 2024

 

All rights reserved © Copyright Hayley Watkins 2024. Unauthorised use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. Author contact via website Contact page.

Website version and image © Copyright Attention Allies 2024.

At Attention Allies we know that RSD (Rejection Sensitive Dysphoria) is an overwhelming challenge for many ADHDers. However, our founder Duncan E. Stafford suggests that by focusing on autonomy, competence and relatedness (the three basic psychological needs outlined in self-determination theory (SDT)) we can begin to build resilience against the intense emotional pain of RSD.

(6 minute read)

If you live with ADHD, you may have experienced the intense, sometimes overwhelming, set of emotions known as RSD (Rejection Sensitive Dysphoria). Although RSD doesn’t yet constitute a formal diagnosis, it’s a term that resonates deeply within the ADHD community.

RSD is generally understood as an extremely intense emotional reaction to perceived or actual rejection, criticism or failure. The emotional pain can be overwhelming, leading people to avoid social situations, withdraw from relationships or, in some cases, express explosive anger. These reactions can deeply affect an individual’s psychological needs, leaving life feeling like a series of high-stakes emotional hurdles.

Sam’s rejections

Sam, who was diagnosed with ADHD aged 38, describes her past experience with RSD as feeling like an “internal ticking bomb”. In her words:

I was hypersensitive to anything that might feel like rejection. When I was in that headspace, neutral or sometimes even supportive comments would feel like attacks.

This hypersensitivity undermined her sense of competence and her belief in her own ability to handle life’s ups and downs effectively. During times of real and perceived rejection, Sam’s confidence would plummet – being replaced by self-doubt and a sense of deep failure.

Before Sam entered coaching and therapy (where she developed skills that helped her to “step back from herself”) she strongly believed the classical thinking about ADHD: that she lacked control because of impaired executive function. Coaching and therapy that used SDT principles began to support and develop her sense of autonomy (our ability to regulate our own responses and manage the emotional world), helping her to become engaged and invested in personal change that no longer felt out of reach:

I went from feeling like my reactions had a life of their own to having a stepped framework to understand I could be autonomous and competent. The intense RSD feelings – the after effects of which could last for a few days – became something I began to deal with as soon as I was aware I’d been triggered.

Therapy helped Sam to recognise specific triggers that tended to precede these emotional surges, gradually supporting and developing her sense of autonomy. By becoming more aware of these triggers, she could manage her emotions before they spiralled out of control.

Connection amid emotional pain

RSD often chips away at our sense of connection to others (relatedness). When minor misunderstandings or perceived slights can feel like intense rejection it’s easy to question whether we’re genuinely accepted or valued by others. For Sam, this played out in her relationships with friends, family and colleagues. A seemingly casual comment, for example, could be misinterpreted as criticism, threatening her sense of security and belonging.

Our need for relatedness runs deep, but when RSD undermines our connections it can lead to social withdrawal or frustrated outbursts. Sam found that coaching and therapy helped to strengthen her communication skills so she could be clearer about her needs, feelings and boundaries, in turn easing the impact of RSD in her relationships.

Feeling with meaning

Many ADHD researchers suggest that emotional regulation issues stem partly from impulsivity and challenges with executive functioning. Yet for those with ADHD, emotional control often aligns with how competent, related and autonomous they feel. For example, when a task feels meaningful and we feel capable, emotional regulation is easier. When an ADHDer feels disconnected or the task lacks value and interest, managing emotions becomes considerably harder.

Ali, another person with ADHD, describes how, “when I’m feeling overwhelmed, it doesn’t take much to set me off. A crowded store or a car cutting me up in a queue would feel very personal, like an attack.” Ali found that his RSD was often connected to previous experiences of times when he’d felt invisible or unimportant leading him to spiral into feelings of rejection – even when he logically knew that wasn’t the case. Through therapy, Ali worked on recognising his emotional triggers and particularly developing his sense of competence. He additionally developed greater autonomy in handling his emotions, further reducing the power of RSD episodes over his life.

Recognition

Being able to recognise situations and people who challenge our fundamental experience of autonomy, competence and relatedness can help us to begin to gain control over RSD. Recognising triggers can begin the process of developing our autonomy, empowering us to manage our emotional responses. Techniques learned through therapy or coaching can help us to release pent-up emotions, fostering a sense of competence and self-efficacy. By nurturing supportive relationships, we can reinforce our relatedness, creating a safety net for times when RSD feels especially intense.

Sam’s journey through therapy highlighted the importance of strengthening all three of these psychological needs. When she learned how to identify her triggers, she gained autonomy; when she practised emotional regulation techniques, she built her competence and when she improved her communication with friends and family, she was able to see and develop her relatedness. Each of these shifts contributed to her ability to better manage RSD, improving her emotional health and overall wellbeing.

Understanding how RSD impacts our core needs of autonomy, competence and relatedness can offer those with ADHD a new way to navigate life’s challenges, build stronger connections and feel more secure within themself.

Read Bruised/RSD – a connected blog article by poet Jackie Fernandez who lets us take a full-force glimpse at the inner world and emotional volcano of rejection, low self-esteem and shame of a person full in the flow of RSD

 

Click the links if you’d like to visit Duncan’s therapy website or her directory entry on Attention Allies.

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Published 4 November 2024

All rights reserved © Copyright Duncan E. Stafford 2024. Unauthorised use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. Author contact via website Contact page.

Website version and image © Copyright Attention Allies 2024.

Relational counsellor Becky Gant brings a personal voice to the discovery that lurking under a presenting story of addiction there might well be an ADHD diagnosis.

(5 minute read)

About a year before I stopped drinking, a friend of mine suggested I look into ADHD. I’d been sharing honestly about my struggles to keep on top of housework. Not just getting a little bit behind… but what felt like the really bad, shameful stuff. The kind that filled me with horror when someone unexpectedly knocked at my front door.

When my friend sent across a few articles for me to read about ADHD and executive functioning, I was completely blown away. I had no idea the things I’d found so hard my whole life could be linked to ADHD! As I looked into it further, I realised there were many other aspects of my experience that seemed to be connected. How frequently I lost important items. That growing pile of unfinished projects. Time blindness. ADHD paralysis. The constant internal chatter that made it impossible for me to sleep without the TV on….

For the first time, I saw these things spelled out in professional-sounding terms and given official names. Excitedly, I called my mum and told her all about my discovery; but although she validated my identification, she had some scepticism too.

“Couldn’t those things be because of your drinking?” she asked.

I had to admit, her question was a fair one. After all, I was usually drunk or hungover when these sorts of things happened. I mean… I was pretty much always drunk or hungover. How could I really know whether I had ADHD until I’d sorted out my relationship with booze?

My dance with alcohol

Alcohol and I had been doing a dance of power for many years at that point. I’d been drinking from a young age. At first it had seemed to be my friend – it gave me the courage to speak where I had previously been, as I described myself, “painfully shy”. With alcohol’s help, I became more confident, and whenever a big scary life event happened, it was there to see me through.

Then it started to betray me.

I found myself waking up after only going “for a quick pint”, and having no memory of getting home. I was dealing with increasingly frightening consequences of my drinking, and repeatedly wondering how it had “happened again”. My attempts to analyse the data of each drunken experience, to somehow control and manage my drinking, would each time inevitably fail. Once I picked up a drink, I simply never knew where it was going to take me.

What am I giving up?

Eventually, about a year after that conversation with my mum, I accepted I wasn’t going to be able to be friends with alcohol anymore. I was tired of battling to gain the upper hand over alcohol… but I was also scared of what I was going to lose.

Even before I had any knowledge of ADHD, I knew I’d been using alcohol as a way to self-medicate. I believed it helped me manage my anxiety. That it was my only way of relaxing enough to connect with people. I thought it was the source of all the joy and fun in my life, because it made that ever-present feeling of restlessness and irritability go away for a while. I couldn’t live with alcohol… but I couldn’t live without it either, could I?

What came first? The ADHD or the booze?

Still, I decided to give sobriety a try, and as I fumbled my way through those first few years, I was very happy to discover I was wrong. That the confidence I thought I needed alcohol to access was already in me, being squashed down by all the shame and regret. That I could have experiences of joy and fun, without any substance creating an artificial high. That I didn’t need it to cope with life after all.

Even many of those ADHD symptoms improved; but after four years, I felt confident in the conclusion that ADHD wasn’t going away. Alcohol had certainly made my symptoms worse… but it hadn’t caused them.

The more I learned about ADHD, the more I understood how intertwined these two parts of me were. In fact, it wasn’t just me! Articles I read told me that children with ADHD are two to three times more likely to develop a substance abuse problem.* That correlation started to seem obvious. Of course our struggles with impulsivity might make us more prone to risk-taking behaviours! Of course shame and remorse following drinking binges would be increased by RSD! And those constant hangover cycles were bound to make facing up to mountains of washing up next to impossible!

It all made sense to me, in a way that I referred to at the time as “the great unshaming of my life”.

Working with ADHD and addiction

Within my work as a counsellor, I come up against this connection frequently. There are many clients who come for therapy looking to process their ADHD diagnosis or manage their symptoms more effectively, who later acknowledge a difficult relationship with alcohol or other substances. There are also many clients who come for therapy looking to manage their addictions, who discover there may be undiagnosed ADHD hiding beneath the surface. As I tell my clients, whatever your experience is, only you can really know the way in which ADHD and addiction are connected in your life. All a therapist can do is be there to support you, to help you navigate through those memories and experiences, if you choose to explore them.

If your journey is anything like mine, that exploration might just be the key to lasting change.

If you’d like to find out more about working with Becky you can visit her website here

Reference

* Lee, S.S., Humphreys, K.L., Flory, K., Liu, R., Glass, K. “Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review.” Clinical Psychology Review, 2011, April 31(3):328–341.

 

Click the links if you’d like to visit Beky’s therapy website or her directory entry on Attention Allies.

 

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Published 28 October 2024

 

All rights reserved © Copyright Becky Gant 2024. Unauthorised use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. Author contact via website Contact page.

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Relational and integrative counsellor Cat Chappell argues that it’s not ADHDers that need fixing but a variety of aspects of society and its provisions that should alter to enable those with ADHD to thrive. 

(5 minute read)

As more information and understanding of what ADHD is, and what it means to have it becomes available, we are increasingly able to understand how it shows up in people internally and externally, and (for some) that ADHD is part of who they are and what they may have been living with for years.

In tandem with this, I’ve noticed an increased supply of therapists, coaches, Instagram healers and mobile phone apps that offer therapies and “solutions” for ADHD.

I am glad there is so much more support for those with ADHD, but what I do worry about are the offers of support that claim and allegedly provide the “fixing” and “curing” of ADHD, as if it is a disease or condition to overcome.

I feel that ADHD is a neutral term – not a superpower, nor a hindrance that stops life happening (but, within that, I fully acknowledge how it can make life much more difficult – more on that later). For me, ADHD is a way that some human minds function. For some circumstances it can be useful. An example may include when working under pressure or with things that need an emergency response. Another example is using a novel approach and/or streamlining (getting something done quickly) with minimum effort.

For others, especially when faced with a generally neurotypical and capitalist approach to living and working, it can prove particularly tough and exhausting to navigate. A lot of that exhaustion comes from pushing through the painful task of engaging with something that provides no interest, and quite a bit can come from masking.

As a therapist and a human being I believe there should never be a “one-size fits all” approach to how to work with anyone – including those with ADHD – because we are all different, as people, as sets of experiences. We vary in how our brains work and what being a human in the world is like, the societal privileges you do and don’t have, and how those experiences have impacted, or continue to impact, on you as a person.

For those with ADHD there are many similarities, shared experiences and ways of being. Each has their own (what I would call) “flavour” of ADHD – especially those with dual diagnoses (e.g. Autism and ADHD). For example, some experience the hyperactivity externally in their physicality (and how they move will be different also), and for some the hyperactivity is internal, in the mind and thought. Some experience it in both and, for all, the “volume” of the hyperactivity varies from person to person and will change throughout time.

One sad commonality I do find for those with ADHD is shame – often given typically in work, education and family – especially when they are in neurotypical institutions and circles with little understanding or tolerance for those who are different.

The ADHD doesn’t need fixing – the system does. But in lieu of that, as a therapist, I aim to help “de-shame” the client from those previous and future experiences. One term I enjoy and use often is that of tasks being “morally neutral”. I first came across this term in the helpful (especially as it is brief) book called How to Keep House While Drowning by K.C. Davis. In it, Davis lists all care tasks as morally neutral – they need doing, but how they’re done is up to you. For example, we all need to eat – but how you get the food and what it consists of is morally neutral. It doesn’t matter if you cooked it all by scratch, or microwaved a meal or ordered takeaway: all of these options are morally neutral. The goal is to eat, and the point is making that happen. The shame comes from having to “do it right”, which is a combination of neurotypical thinking and internalised capitalism. Women can be subject to this further, as there is more judgement on how they keep their households, regardless of the others who live in it with them. So rather than a fix, allowing simple self-compassion and permission to do tasks in any form (or ditch those that aren’t vital), and do them in the easiest and most pain-free way, can be liberating for anyone, let alone someone with ADHD. Having financial privilege helps, as many experience what is known colloquially as “ADHD tax”. This is accumulated by paying for convenience, buying multiple items, missing returns windows, or replacing items that have been dropped or lost.

The only “fix” needed is that within society. Give more understanding and provision to those with ADHD from childhood through to adulthood, and you will see many more ADHDers thrive rather than drag themselves through society’s needless hoops in this “one-size-fits-only-the-really-privileged” way of being.

 

 

Click the links if you’d like to visit Cat’s therapy website or her directory entry on Attention Allies.

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Published 25 October 2024

 

All rights reserved © Copyright Cat Chappell  2024. Unauthorised use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. Author contact via website Contact page.

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Although Rejection Sensitive Dysphoria (RSD) is yet to be formally recognised as a diagnosis by the medical professions, many people who have ADHD – or know an ADHDer – will have some awareness of the difficulties RSD can bring to a person’s life and relationships. In her gut-punching verse, poet Jackie Fernandez lets us take a full-force glimpse at the inner world and emotional volcano of rejection, low self-esteem and shame of a person full in the flow of RSD.

(Please be aware, this poem contains expletives.)

 

Rejection

Sensitive

Dysphoria

RSD

A by-product of ADHD

That’s me!

 

It sneaks up on you when you least expect it

Anywhere

Anyplace

Any     fucking      how

 

At

 

Any

 

Fucking

 

Time.

 

It’s like a tidal wave

Smashing into my body and soul

Knocking me off my feet

Punching me beyond defeat

 

My RSD becomes my inner voice

When I’ve forgotten deadlines

Forgotten appointments

Or I haven’t tried my best

Putting me to the test.

When my body can’t keep up

It will pour shit on me

From the shittiest cup

 

And then it starts saying

You’re rubbish at …

Running – you will never run fast

You’re too fat

You’re shit at that!

You’re shit at football

You run out of puff

You stupid fucking Chuff!

You can’t kick a ball

You let in goals

People are just putting up with you

You don’t deserve any of these roles!

 

You’re slack with your work

You got pulled up on a report

For not spell-checking

Or checking the grammar

You always come up short!

Shame on you!

You     fat      fucking    scammer!

 

You’re a crap parent

The kids know that

They put up with you

Until they can leave

Shut the door behind them

And feel so relieved.

 

You deserve nothing!

You’re crap at everything!

You’re old grey and fat

Nobody will ever love that!

 

Pause …

 

And then the wave recedes

The black clouds move away

 

I open my eyes

And see the bruises

That RSD left …

I felt every punch

The fists pummelling me

Beyond recognition

But now, I am free

 

It’s gone for now

To return once more

My spiteful friend RSD

Will knock me to the floor

And pound me once again

To my very core.

 

Jackie Fernandez

Visit Jackie’s poetry site

 

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Published 7 October 2024

All rights reserved © Copyright Jackie Fernandez 2024. Unauthorised use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. Author contact via website Contact page.

Website version and image © Copyright Attention Allies 2024.

Our founder, psychotherapist, counsellor and ADHD coach Duncan E. Stafford brings you the first of our ADHD express reads series in which he highlights the fascinating connection that can be drawn between the Sputnik panic of 1957 and Methylphenidate.

(2 minute read)

From the early to mid-20th century, educators, doctors and politicians were, according to historian Matthew Smith,* more likely to be worried by shy, nervous and retiring children than those who displayed what we now consider typical ADHD characteristics – namely hyperactivity, impulsivity and inattention.

The so-called Sputnik panic of 1957 (when the Soviet Union launched its Sputnik 1 satellite into space orbit) altered views towards hyperkinetic (what we now call ADHD) children bringing concerns that the American educational system – with its progressive views and person-centred teaching methods – wasn’t facilitating children to attain as highly as their Soviet counterparts, who reportedly trained two to three times more scientists each year than the USA.

From historical writings and analysis, it seems that the post-Sputnik view of hyperactive, impulsive and inattentive children became pathologised creating an attitude of “neurological dysfunction”, in turn inviting pharmaceutical preparations such as Ritalin (Methylphenidate) as the only possible treatments for this dysfunction.

Attitudes in the UK differed to some degree, especially around medicating school-aged youngsters. Ironically, though, the progressive teaching methods probably offered some of the best options of progress and development for those we now call ADHDers. Makes you think …

Footnotes

*See Hyperactive: The Controversial History of ADHD.

 

Click the links if you’d like to visit Duncan’s therapy website or her directory entry on Attention Allies.

 

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Published 24 September 2024

 

All rights reserved © Copyright Duncan E. Stafford 2024. Unauthorised use and/or duplication of this material without express and written permission from the author of this post is strictly prohibited. Author contact via website Contact page.

Website version and image © Copyright Attention Allies 2024.