Janine Falcon is in her 50s, but for most of her life she had no idea the things she struggled with were common symptoms for people with ADHD.
“I remember thinking once, ‘Oh, I wish I could go to the doctor and say, listen, I’m having focus problems, can you give me Ritalin? Please can I have Ritalin?'” she says.
“But I also figured: you don’t have ADHD, you’re not sitting around jittery, you’re not hyperactive in the least … they are going to laugh at you and say get out of my office, you’re wasting my time.”
ADHD – attention deficit hyperactivity disorder – is not a behavioral condition; it’s not a mental illness, or even a specific learning disability.
It’s a developmental impairment of the brain’s self-management system or executive function – your ability to stay organized, keep focused, and self-regulate.
While many people can struggle with these skills, people with ADHD can experience problems with executive function all the time.
It can manifest itself in many ways and can have a significant impact on people’s lives.
For Janine, being chronically late was a major way ADHD impacted her.
“When I worked in an office, oh my God, I never got to work on time,” she says.
“I felt it was something I couldn’t help, but deep down you think there’s something wrong with you if you can’t help being late, and so you kind of avoid that thought.”
Monash University professor of cognitive neuroscience Mark Bellgrove says it’s generally thought ADHD involves a fundamental disruption to neurotransmission.
“Principally that’s around two neurochemicals: dopamine and noradrenaline,” he says.
“These chemicals in the brain are very important for helping us regulate our alertness, our attention, but also for helping us control our behavior to make sure it’s appropriate for whatever context we might be in.
“We think in ADHD that dopamine and noradrenaline levels in the brain are probably reduced.”
There are three types of ADHD and as psychiatrist Sunnil Reddy explains, a broad range of symptoms.
“[There’s] the inattentive subtype, which is basically characterized by low focus, low attention, difficulty starting things, procrastination, things like that,” Dr Reddy says.
“Then the other complete subtype is the hyperactive subtype, which is predominated by fidgetiness, over-activeness, as if they are driven by a motor, can’t sit still.
“Then there’s a third subtype, which is the combined subtype of both inattentive and hyperactive symptoms.”
Another common symptom people with ADHD experience is an ability to hyperfocus on a subject matter they’re really interested in.
For Janine, it was writing about beauty products; she built up a successful career and was able to get by undiagnosed — until she entered perimenopause.
“I started to feel like a lighter that had that had run out of fluid — you would hit the lighter, you’d get the spark, but it would never catch the flame.
“I called my doctor and made an appointment and just told her maybe it’s depression that I couldn’t get anything done.
“You feel like there’s something wrong with you as a person — I’m always late, I can’t meet a deadline, and it’s not a nice place to be in.”
Menopause, hormones and ADHD in women
While scientific evidence is still emerging about how changing hormones can impact ADHD, Janine feels the link was undeniable.
Oestrogen helps to modulate the release of dopamine in the brain.
When Janine’s level of estrogen began to drop as she entered perimenopause, the ADHD symptoms she had been able to manage became much harder to deal with.
She initially started taking anti-depressants, but they didn’t make much of a difference.
Then her friend sent her videos of people on TikTok talking about ADHD.
“It was like, ka-bang; I just went, ‘What, woah, wait!'”
“And then I just remembered: ‘Remember that time you thought maybe you need Ritalin, remember that time?'”
“And it was like suddenly somebody had turned me the right way to look at the picture properly.”
Janine was diagnosed and prescribed Ritalin — one of the mainstay treatments for ADHD — but it hasn’t provided all the answers.
“The first time I took the first pill, once I felt it kick in, it was like somebody had cleaned a window I did not know I was standing in front of and everything was clear, it was just a little sharper,” she says .
“I will say as well though that you can’t just rely on that, or at least I can’t … just because everything is sharper, doesn’t mean I’m going to focus where I’m supposed to focus — that’s going to take some work.”
Janine has had difficulty getting the dosage of her medication correct.
Clinical psychologist Caroline Stevenson says this is a common problem for adults with ADHD.
“When people have gone through the process of being diagnosed and then they hear about the fact that they can take Ritalin or dexamphetamine, there is an idea that it might be the magic bullet and it’s going to massively change their lives,” Dr Stevenson says .
“Now, some people will describe taking medication as almost pushing the demist button on a car… it can be life changing.
“But equally there are people who are quite disappointed when they take the medication, and they don’t have that type of response.”
Dr Reddy says it is important not to squash people’s personality.
He says the stimulant medication can have a paradoxical effect on people, so rather than making them feel “hyped up”, they feel calmer and some people describe feeling sedated.
“I think it’s important not to suppress how people function, or they become more robotic,” Dr Reddy says.
Medication isn’t for everyone
Shannon, a medical doctor, was also diagnosed with ADHD later in life.
“I think the narrative for me growing up wasn’t that I had ADHD, it was that I was gifted and bored and troubled,” she says.
But she has chosen to manage her ADHD slightly differently to Janine.
“For me, it comes out more in not being able to shut up … I constantly talk, and I talk over people, and I just have no filters, so it’s more that impulsivity, just acting without thinking,” she says.
Shannon knew there was a genetic component to ADHD, and after her children were diagnosed, she recognized much of what they were experiencing and decided to trial medication with them.
“I didn’t expect that [medication] would work because I thought to myself, ‘Maybe it really is my personality and maybe I don’t have ADHD.'”
“And so I was expecting that it would just make me more talkative, but it had the effect of really slowing me down. I just couldn’t believe how quiet my brain was.
“But then I realized what I didn’t like about it was I wasn’t myself — I was quiet, I was mellow, I wasn’t bursting out of my skin with enthusiasm and great ideas, and I noticed that my performance at work got worse, not better.”
Shannon says her time management “blew out” because she was just “so chill and slow” and no longer cared about things as much.
“I was better at life skills, but [medication] took away the things that I most valued about myself.
“It’s not that it’s a disorder in all settings; sometimes it’s really an advantage in different settings, it’s more to do with the fit between your neurotype and the environment and the demands of the environment.”