Welcome to my screaming brain

How ADHD looks different in women and is often underdiagnosed

Here are some places I’ve lost my keys in the past week: my refrigerator, my underwear drawer, my bathtub.

I have ADHD, a disorder marked by inattention, hyperactivity and impulsivity.

So does my brother, but he was diagnosed at 5 years old. I was not diagnosed until I was 21. That’s because ADHD presents very differently in women. As a kid, my brother was a hyperactive troublemaker who frequently found himself in the principal’s office. His grades were poor, and ADHD was brought up early.

But I was quiet and well-behaved. I got mostly As, except in math, which I always had to repeat in summer school. I was chronically disorganized and often running late.

None of these behaviors severely disrupted my life until I got to college. This is when the worst ADHD symptoms tend to show up for young women with the disorder. Without a parent to remind me to take the 12 moldy mugs out of my bedroom or hang my key on a hook, my symptoms went unchecked. As I took on more and more responsibility, they quickly spiraled out of control.

I just got distracted by Facebook. Where was I?

Oh, yeah –– I spent a lot of time beating myself up for my symptoms. I thought I was just lazy and disorganized, and couldn’t understand why I couldn’t get myself together no matter how hard I tried. I would sit in bed, clothes and dishes strewn across my bedroom floor, feeling paralyzed and overwhelmed. I would clean up the mess through frustrated tears, only to have it look just as bad a few days later.

I would fill out my planner with all my appointments, exams, meetings and work schedule only to find myself still forgetting to write down important events, forgetting to check the planner in the first place or losing it altogether.

My professors always seemed confused to discover someone so smart, motivated and conscientious was really such a mess. Finally, one day I showed up at my therapist’s office in tears because I didn’t know what was wrong with me, why I was a grown woman and still unable to take care of myself and be a responsible, functioning adult.

It wasn’t that I was lazy or that I didn’t care. It was that my brain always felt so mixed up, so unclear, like it was always screaming and no matter how much I tried to snap it into submission, nothing changed. It made me hate myself, I told my therapist.

That’s when she said it sounded like I had ADHD.

I was shocked. I never brought up these symptoms in therapy before because I didn’t see them as symptoms, and there was always more pressing problems to discuss anyway. I thought they were just the byproduct of a lazy, useless personality. I knew my brother had it, but we couldn’t be more opposite, so it was never a possibility I even considered.

After being evaluated for ADHD, I was officially diagnosed. Just knowing my difficulties were the result of a mixed-up brain chemistry –– not some character flaw –– was huge. I constantly have to remind myself that my inability to stay organized, be on time, keep my apartment clean and stay on top of appointments and homework are not character flaws but symptoms of a mental illness. Sometimes the way I beat myself up over it can be even more debilitating than the disorder itself.

Once I got the diagnosis, I quickly learned my experience was not uncommon. For high-IQ young women with ADHD, particularly those undiagnosed, there is a huge emotional toll.

“Confused and ashamed by their struggles, girls will internalize their inability to meet social expectations,” Sari Solden, a therapist and author of “Women and Attention Deficit Disorder,” said in an interview with The Atlantic.“For a long time, these girls see their trouble prioritizing, organizing, coordinating, and paying attention as character flaws. No one told them it’s neurobiological.”

Getting the diagnosis didn’t make my ADHD go away, but it helped me learn how to manage it. I now get extended time and a separate location for exams, and I’ve seen my grades improve as a result. I now know my organizational problems are a symptom, one that tends to get worse when I am feeling particularly stressed. I can plan for it, and also work with my therapist to come up with specific strategies to cope with it. Medication also helps keep my brain a little clearer, and these days it doesn’t feel like it’s screaming as much.

But the biggest benefit of having the diagnosis is knowing there is an explanation for why I can be such a mess. Now when I can’t find my keys, instead of crying and thinking I’m so stupid or disorganized, I laugh to myself when I find them in a box of cereal. Or when my Lyft driver calls me to say he found my key in his backseat, but he is in Canada so it will be a while until he can return them.

Once I find my keys, I’ll hang them on the hook I always forget to use, despite the big red sign I have above it that says “HANG UP YOUR KEYS, MADDY.” But I’ll probably find them at the bottom of my laundry basket later this week. And you know what? I’ve made my peace with that.

Maddy Fowler is the editorial editor and can be reached at maddy.fowler@ubspectrum.com and @mmfowler13.