ADHD Diagnosis at 48

My 7 year-old son was formally diagnosed with ADHD last year and, in that very moment on the phone with the child psychologist, I realized how terribly ignorant I was on the topic. Until then, I had only heard the term ADHD used as a self-deprecating descriptor for distracted behavior (“omg i’m like so adhd smh”) or quietly slipped into parental commentary about the coked-up chipmunk-like behavior of other peoples’ kids (“Did you see how little Timmy was acting? They really need to get him tested for ADHD.”).

Mirror, mirror

Propelled by my dadborne desire to help my son, I plunged into the rabbit hole, gobbling gobs of articles, blogs, videos, and books on the topic. Something entirely unexpected happened while smiting my ignorance: I saw myself reflected in the material I consumed.

The excerpt below from one of the books I read was part of a chapter that hit me like a ton of bricks:

“…but in less clinical terms, it helps to think of ADHD as a complex set of contradictory or paradoxical tendencies: a lack of focus combined with an ability to superfocus; a lack of direction combined with highly directed entrepreneurialism; a tendency to procrastinate combined with a knack for getting a week’s worth of work done in two hours; impulsive, wrongheaded decision making combined with inventive, out-of-the-blue problem solving; interpersonal cluelessness combined with uncanny intuition and empathy…”

Hallowell, Edward M., MD, and John J. Ratey MD. ADHD 2.0: New Science and Essential Strategies for Thriving with Distraction–from Childhood through Adulthood. Ballantine Books, 2021.

It was like my wiring schematic was rolled out on the table in front of me. How I think, process, juggle, create, and relate; the intensity of my thought life and adrenalized existence; anxiety and perfectionism; my hyper-focus and serial specialization; the paradoxical behaviors that I’d always had such difficulty rationalizing. All of my innermost traits and characteristics that I’ve spent a lifetime harnessing, corralling, and correcting, had a name: Attention Deficit/Hyperactive Disorder. Mind blown. Ka-boom.

My 0th birthday

During my research, chapter 1, page 1, paragraph 1 of my life story also came into focus. I learned that the conditions at the time of my birth significantly increased the likelihood of developing ADHD:

“Specifically, exposure to birth asphyxia was associated with a 26 percent greater risk of developing ADHD, exposure to neonatal respiratory distress syndrome was associated with a 47 percent greater risk, and exposure to preeclampsia (high blood pressure during pregnancy) was associated with a 34 percent greater risk.”

Nigg, Joel, PhD. “Prenatal and Early Life Risk Factors of ADHD: What Research Says — and What Parents Can Do.” ADDitude, December 13, 2023. https://www.additudemag.com/what-causes-adhd-prenatal-perinatal-risk-factors/.

Prior to check out from my uterine hotel, my mom was hospitalized for severe preeclampsia with insanely high blood pressure. On what became my birthday, I was in distress and ultimately delivered via emergency c-section.

Signs point to yes

I don’t own a Magic 8 Ball, but if I did, all signs to my ADHD question would have pointed to yes. With all of this supporting data, I decided to proceed with testing to get a definitive answer.

The current diagnosis process involves psychological screening and evaluation against behavioral criteria found in the DSM-5. Over the span of two months, I worked through multiple rounds of testing at a medical practice specializing in such things. The tests were weird, interesting, and challenging. I went into the testing without knowing what to expect and, since you’re reading this post, I’ll spare you the spoilers should you be considering the same path.

Scoffer no scoffing

In plumbing the depths of the Interwebs, I encountered a lot of negative sentiment about ADHD being a modern day medical hoax. Some claimed that the disorder is nothing more than a squishy catch-all diagnosis by doctors eager to push pharmaceuticals. Others pointed to bad parenting, lack of discipline, laziness, and a variety of personal and social defects to explain ADHD symptoms. The diagnostic methodology is also the target of much scoffing, due to the inherent subjectivity of psychological screening.

Recent discoveries by smart people in lab coats should squash much of this talk-track. As it turns out, the ADHD brain is structurally distinct and can be accurately identified using magnetic resonance imaging. The prefrontal cortex, cerebellum, hippocampus, and amygdala are smaller in volume, and there are differences with signaling and neurotransmitters. Because of these measurable physiological differences, biomarkers may be used for diagnosis in the future. Science, FTW!

Yep

Several weeks after completing the testing, I received a lengthy report that concluded with a diagnosis of Attention Deficit Hyperactive Disorder Combined Presentation. Suspicions confirmed. Mystery solved. Innards explained.

As G.I. Joe taught a generation of kids: “Knowing is half the battle.” I now have a gigantic data point that I can use to better understand and optimize my day-to-day existence.

Final thoughts

If you met me in real life, you probably wouldn’t walk away from our conversation thinking “Wow, that dude needs meds.” On the surface, I don’t fit the mold of the common ADHD stereotypes. Over the past few decades, I’ve worked to override my wiring in all facets of life and stay as cool as a cucumber.

Aye, there’s the rub with all things mental health. If I didn’t tell you, you wouldn’t know. You would only see the outward confidence, the successful career, the happy family, and all of the other socially-appropriate trappings of modern-day life. This was a big driver behind my decision to share my diagnosis. Not everything should land on the web or social media, of course, but I think it’s very important that we have real discussions with real people about the real challenges we face. The past few months of opening up to friends and family about my ADHD discovery has been very beneficial to me and to others.

Finally, I’m astonished that I lived 48 years on this planet with precisely zero clue that ADHD could be a factor. If nothing else, this points to a need for better education and awareness – not just for ADHD, but for mental health disorders overall.

All of that said, me and my little baby amygdala bid you adieu. Thanks for hearing me out.