GEMMA STYLES OPENS UP ABOUT HER ADHD DIAGNOSIS: 'IT’S BEEN UTTERLY TRANSFORMATIVE'
In 2019 I sat in my therapist’s office and told her i was frustrated. Something was lingering in my depression, a feeling I couldn’t shake. I’d been on and off various antidepressants for the majority of my twenties. But having always resisted therapy, after a bad depressive episode, this time I’d leaned into the talking. It helped. As well as the big stuff, we spoke about the day-to-day things that I didn’t like about myself; why could I never keep on top of housework? Why did I make to-do lists and never complete them? Why did I spend all day feeling guilty? I thought I was stuck with low-level depression; all the symptoms seemed right: zero motivation, feeling guilt-ridden, finding it difficult to make decisions... Even now, listing them here, I can understand why nobody saw what was really going on.
Fast forward a couple of years and I’d started to get wind of a conversation rising in public consciousness: late-diagnosis ADHD in women. I’d read articles about it, but it wasn’t until an influencer shared on Instagram that she’d been struggling for a long time, and my best friend Chloe forwarded it with a gentle suggestion that the things this woman had experienced sounded a lot like, well, me, that I began to take notice. Over the next few months, I went down a rabbit hole – which I would now describe as hyper focus (an extended period of highly focused attention or fixation that’s very common in ADHDers) – all about ADHD in women.
I read about how so many adult women go undiagnosed and the social conditioning that causes them to fly under the radar for so long. How girls may thrive at school and then crash hard when transitioning to adulthood. The low self-esteem and mental-health issues that can so often accompany undiagnosed neurodivergence. I was reading about my own life.
And yet, for the next year, I wondered about it privately. Was this my light-bulb moment, or had I just stumbled upon an excuse I could make for some of the most frustrating parts of my personality? I’d been a typically ‘good’ school pupil. I did pretty well in exams. Because people love to downplay anything that suddenly swells in mainstream conversation as ‘jumping on the bandwagon’, I had to wonder whether was I guilty of the same thing.
One of the trickiest parts of communicating the ADHD experience is that it’s so relatable. Because so many of the symptoms are things that most people probably experience on occasion it can be hard to grasp the impact that experiencing them constantly can have. Sure, everyone might put off tasks sometimes, or have a day where they make zero progress on their to-do list, but when that’s your default setting it’s very easy for the wheels to fall off. Another issue is that it’s been misunderstood for a long time. A lot of what we’ve ‘known’ about ADHD has been based on the stereotypical image of a young, energetic boy who struggles to sit still at a school desk – and this is what our research and diagnostic criteria were based on for a long time too (the National Institute for Health and Care Excellence guidelines – which inform the NHS – didn’t even recognise that ADHD existed in adults until 2008). Now we’re really playing catch-up in our overall understanding of the condition.
When we talk about adult women, the picture is different: disorganisation, feeling overwhelmed, a history of anxiety and depression. (Big tick over here.) This could well be because, research suggests, women and girls are more likely to experience the inattentive presentation of ADHD, as opposed to the hyperactive-impulsive presentation (although, of course, this isn’t always the case). Even when we do experience hyperactivity, it’s commonly described as ‘internal’ – the classic image of the serene swan frantically kicking under the water. Our emotional dysregulation can result in rejection sensitivity, obsessiveness and low frustration tolerance. I really struggle with decision-making or analysis paralysis. I get so tangled up in trying to evaluate every possible option and outcome that it feels completely overwhelming. This applies to big, serious decisions but, day to day, it often becomes an issue in supermarkets. Alone and at my own pace I’m usually alright, but shopping with someone else and making decisions at speed is almost painful. To find such a ‘simple’ thing so difficult makes me feel silly and incapable.
In October 2021, my GP agreed my concerns merited a proper assessment. I waited, and chased, and waited again, and eventually got my referral through: a psychiatrist’s assessment would take 14 months. If you’ve seen ADHD in the news recently, then that waiting-list figure may not surprise you. In many parts of the UK, the backlog of people on NHS waiting-lists for an adult assessment would take eight years to clear. Estimates suggest upwards of 196,000 adults are currently waiting. I’m very aware of how lucky I am that I was able to choose to seek private care.
Once the decision was made, getting the actual diagnosis was one of the simpler parts of the process: I spoke with the psychiatrist, then filled out questionnaires and surveys all about my life, behaviour and things I struggled with. My mum filled out some paperwork too, as the current diagnostic criteria for ADHD means that you can only be formally diagnosed if there is an identifiable history in childhood too. Then I undertook a lengthy structured interview known as the DIVA and soon after got my report. ‘Diagnosis: Attention Deficit Hyperactivity Disorder – Predominantly Inattentive Type.’ The piece of the puzzle I didn’t know was missing had been found.
Being diagnosed has validated how I’ve felt my entire adult life. It’s been utterly transformative. Living with undiagnosed neurodivergence had fundamentally eroded my self-esteem, and having this explanation has given me a platform to start building some of it back. Knowledge of the condition doesn’t make it go away, but the voice in my head that always told me I wasn’t good enough is a bit quieter.
When I was first diagnosed, I did try medication, but as someone who struggles with anxiety even on caffeine, I didn’t love taking stimulants. The dose I needed to have a positive impact on my ADHD symptoms made me feel jittery and nauseous, and I needed a break from the trial and error. Since then, I have either been pregnant or breastfeeding so, medication has been on the back burner. I may revisit it in the future, as I know how life-changing it can be. In certain ways, trying to balance new motherhood with work has helped my productivity – often people with ADHD are only spurred into action through urgency, and knowing that I only have the length of my baby’s nap to get work doneis a motivator. The encouragement of other mothers with ADHD and the support in my DMs has also been invaluable.
There’s a lot of eye-rolling at the role social media can play in someone identifying their ADHD. But when the waiting-lists and/or private costs can be so prohibitive, sometimes using a self-diagnosis to start implementing lifestyle changes or simply begin a journey of acceptance is all a person has. I get messages every day from women and girls asking me about ADHD, or indeed thanking me for sharing about it as my experience was, in turn, their light-bulb moment. Some of them are 15; some are 55 and have struggled in these hidden ways for longer than I did. These are women who have often felt less than, who’ve beaten themselves up over and over for not managing what ‘everyone else’ seemed to find easy. Who feel, in that typically female way, that they’ve been letting other people down by struggling themselves.
Writing and promoting my book Why Am I Like This? about mental health was hard because, throughout it all, I am still a neurodiverse person who deals with mental-health issues myself. I am constantly trying to make sure I’m saying the right thing, but also that press about the book does justice to the issues I’m attempting to shed light on. And while some people choose to describe ADHD as a superpower that allows them to be more creative, that isn’t how I feel. For me, it’s about understanding my ‘why’ and I really hope that I can offer some of that relief to my readers. Because knowing we’re not alone is something we all deserve.
‘Why Am I Like This?: My Brain Isn’t Broken (And Neither Is Yours)’ by Gemma Styles (£20, Bantam) is out now. For more information about ADHD, visit mind.org.uk.
This article appears in the November issue of ELLE UK, out October.
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