I am a Black Caribbean woman with ADHD. No one believes me.
Receiving an ADHD diagnosis at 24 and dealing with the wave of emotions that come along with that is one obstacle — the other obstacle is hearing from your family “you don’t have ADHD, you just need to get it together.”
In Caribbean households, things oscillate between “something is seriously wrong with you” and “there is absolutely nothing wrong with you” — constantly shifting from you are lazy and unfocused (this is what is wrong) to you do not have that (a disability/disorder).
I sat after my assessment with a psychiatrist who told me that I have Attention Deficit Hyperactive Disorder Primarily Inattentive (ADHD-PI) in utter disbelief.
In the United States, Black and Latino children are significantly less likely to receive an ADHD diagnosis than their white peers, even though they show symptoms at the same rate. I could not find any statistics for ADHD diagnoses in the Caribbean. Anecdotally, everyone I knew growing up with ADHD was a boy, including my younger brother. My understanding of ADHD was a hyperactive young boy who could not sit still and was incredibly loud and misbehaved.
How could I have ADHD?
I told the psychiatrist that I was a “good kid”. I was quiet, listened to adults, and received excellent grades at school. My parents said I never misbehaved as a child. A large chunk of the ADHD assessment is recounting your childhood experiences. Once we started digging deeper, it was clear to me that I had been struggling with ADHD for my entire life.
ADHD is a common neurodevelopment disorder that interferes with the functioning and development of an individual. It can present as the stereotypical hyperactive type, inattentive, or a combination of the two. ADHD is neurological and there is no “cure” — though treatment is possible. Undiagnosed ADHD can lead to mental health issues such as self-harm, anxiety, depression, and other serious disorders.
As I listened to the common traits of people with ADHD Inattentive, I felt as though the psychiatrist knew me better than I knew myself. I was chronically disorganized, unable to commit to extracurricular activities, had an inability to maintain friendships, struggled with emotional dysregulation, was constantly overstimulated, and more. My parents saw this as “laziness” that I needed to just get over. I needed to stop daydreaming and start focusing. Lazy. Selfish. Spaced out. Mindless. All of these were things adults described me as. I internalized this all throughout my life, constantly looking for ways to “get it together”.
Looking back, my ADHD was masked entirely by being “good at school”. I was what my Caribbean parents would call a bright child. I learned to read at three years old and skipped two class grades. I did struggle with math and science, but overall I received good grades. At the same time, I struggled to focus in class and stay on task and always forgot my homework. I just learned to be a bullshitter. In high school and college, I just made it look like
I was paying attention. There were periods in high school where I completely failed classes, even the ones I was good at like art or history, simply because I did not do the assignments or skipped the tests. I did terribly in my first semester of college simply because I skipped class and participation was a large portion of my grades. I could never finish tests because there was never enough time. I started and quickly quit tennis, swimming, soccer, violin, piano, Spanish club, and every other hobby I picked up.
While I was struggling to stay afloat with my school work, I watched my mother advocate for my younger brother. He was also struggling with ADHD, but he was getting in trouble in school for being disruptive, not listening to teachers, and failing tests. I watched her take him to doctors for more assessments and push for him to get more time on his assignments. I look back and feel an immense sadness that what I was going through was overlooked. But this experience is common among girls. ADHD traits in girls are consistently overlooked.
My hyperactivity is internal, not external in the way it presents for other people with ADHD. My brain and my emotions are all over the place, even if I am sitting quietly in a room. Sometimes in social settings I shut down, which comes across as rude. When there is too much going on in my environment, I experience sensory overload and basically go mute.
While in college, I started therapy for my anxiety and depression. After I lost my step-brother to suicide, I was starting to unravel. I was having anxiety attacks weekly and mostly suffering through this alone. I was embarrassed about breaking down. If I am honest, I am still working through my shame around going to therapy. Caribbean families tend to view therapy as a sign of weakness, or “telling somebody else yuh business”. I was deep in a mental health crisis and kept it from my parents. I wanted to keep up the image of an overachiever.
When I was diagnosed with general anxiety disorder I started trying to understand the root of my anxiety. In March 2020, I felt like I was finally developing good habits, then the pandemic hit and I started spiraling again. I finished up my Master’s online, from my partner’s apartment. I could not sit still in three hour Zoom classes. I had to take my camera off constantly and pace around the house. When professors demanded we keep our cameras on, I struggled. I kept asking for extensions. I was incredibly close to dropping out of my master’s program. I stuck with it out of fear of letting my family down. Then, I got a work from home job and felt like I was struggling more with my tasks, coupled with adult responsibilities like groceries, cooking, cleaning, etc. And that’s when I decided to seek out a psychiatrist to get an ADHD screening. I realize now that so much of my anxiety is tied to not being able to meet expectations — from myself and others.
My medication I was on for a few months.
My doctor prescribed a low dosage of Adderall, which I was already hesitant to take because of the stigma of meds, especially methamphetamines. The first day I took my meds, I cried. My mind constantly felt like I had 87 tabs open on my web browser and on my meds it felt like I had three neatly organized tabs open. My mind no longer felt like a jumbled mess. I could focus calmly on one task and seamlessly move onto another.
Having a psychiatrist who is a woman of color was incredibly important to me. I read stories about doctors not believing women, especially women of color, because they did well in school or never got fired from a job. Standards like this are typically based on boys and men. ADHD presents differently in girls and women.
My medication was helpful initially. I am not medicated right now but I am exploring alternative methods for treating my ADHD. Medication is a helpful tool for many people with ADHD, and the stigma around it is incredibly harmful.
Right now, I am focusing on exercise which is incredibly helpful in managing some of my symptoms around lack of focus and motivation. I picked up bouldering — a form of rock climbing without ropes and harnesses — which is one of the best forms of exercise for my brain. It challenges me in novel ways every session, and allows me to focus on a problem until it’s solved.
Following my diagnosis, I focused my energy on getting people to believe me, especially my parents. There is a little girl inside me literally begging my parents and teachers to just see me and help me. I have an image in my head of me just physically shaking my parents into believing me. I sent my parents memes, scientific articles, lists of what I have been experiencing and keeping from them. I received:
Everybody deals with those things. You do not have that.
You are successful and very intelligent. You don’t look like you have ADHD.
This quick dismissal is not necessarily surprising. In the Caribbean, we have a way of dismissing mental health struggles. They’re not real nor serious. We rather people suffer in silence than admit that they have a very real disorder. Some parents may view their children’s disabilities as a parenting failure. And this is why I don’t blame my parents for not noticing nor believing. Our broader cultural and societal dynamics re-inforce negative ideas about people with disabilities or mental health disorders. Of course I am still frustrated with them. I still wish they would believe me, but I’ve moved onto a different stage of processing — getting myself to believe and accept.
After 24 years of molding myself to fit neurotypical standards, I’ve started shaping my life in ways to meet my own needs. Coming to terms that I cannot perform average tasks like cleaning and work tasks in the same time that a neurotypical person may be able to. Understanding how my executive dysfunction — a common symptom of ADHD that makes it difficult to structure and complete tasks — impacts my daily life has allowed me to make those accommodations for myself. I have different capacities and abilities and I am on a journey to accepting and honoring that.
My life makes sense now.
I am grieving for the younger me. The little girl who could have had extra time for assignments and tests. The little girl who suffered with sensory issues and forced herself to be “normal”. The little girl who cried trying to finish her math homework every night.
I am frustrated that no one noticed that I was struggling. Still, no one in my family believes me. I am frustrated that I can’t show or describe to people exactly how it feels to have my brain. I am frustrated that I could not commit to any activities or hobbies for longer than a few months. I am frustrated that getting the prescription for my medication required me to see a doctor every month.
I am angry that my brother was diagnosed and given support and I wasn’t. I am angry that still many doctors believe girls can’t have ADHD. I am angry that there is so much misinformation about ADHD — it not being real, being a conspiracy to push drugs onto children. I am angry that as a Black woman I had to advocate so hard for myself in the medical system just to get care.
But, I am also grateful. I am grateful that I was able to push past so many barriers and receive access to a psychiatrist. I am grateful that I can now adjust my own expectations of what I can achieve. I am grateful that I have the ability to go to therapy and develop my coping skills. I am grateful that I understand myself better than ever before.
My ADHD diagnosis has been life-changing. I finally understand why my brain works the way it does. I am being more gentle with myself when I don’t live up to neurotypical standards. I’m working through a lot of internalized ableism. And I’m over trying to convince people to believe me.
