How Late is Late? Being Diagnosed with ADHD in your Fifties
The phrase ‘late diagnosed’ is common to hear with ADHD and autism, and whenever I see it online, I am drawn to click through to a story or life experience. Invariably the late diagnosis involves a young women in her twenties or thirties, and I am left thinking, does that make me late-late diagnosed??
For most women, any diagnosis comes later than it should. With ADHD, men are generally diagnosed by their late teens, while women can be in their twenties or older. The gender gap in diagnosis has reduced in recent years, mostly because women are seeing themselves reflected in online posts, blogs and videos and connecting the dots. As a result, more women are getting their ADHD diagnosis at a younger age; this can be too late still, as the damage to your educational experience has usually been done, and your life chances can be impacted as a result.
But what if you are in your forties or fifties when the possibility of ADHD arises? I was diagnosed at the dizzy age of 57, after a roller coaster ride with menopause, that destroyed most of my previous coping (masking) strategies. The menopause process disrupts your hormonal balance, and can bring the usual night sweats and a short fuse. But for many of us, none of that happens, and the symptoms we do get, until now, have not been well recognised or acknowledged. I was holding down a management role at the time, and the symptoms didn’t add up to anything I could understand; I was an insomniac, became severely anxious, lived with a feeling of dread, had almost constant brain fog, and sometimes struggled to string together a meaningful sentence. One day I forgot the word for ‘grass’ in a conversation, and resorted to pointing outside to the lawn! In the worst of it all, I felt such a failure that I almost quit my job. I am not alone in this - 25% of women consider giving up work during the menopause years, and 1 in 10 women actually leave the workplace for good.
What I know now is that ADHD and peri-menopause can create an absolute storm, that can last for several years without treatment of some kind. And if you don’t know why this is happening to you, it can feel like you are going mad, or have early-onset dementia. This period of my life coincided with my twenty-something daughter getting her ADHD diagnosis - when I read the questionnaires she has completed, my first thought was ‘isn’t everyone like that?’, as her experiences were so similar to mine. I did the questionnaires to rule out ADHD, and got the result instead that I was probably ADHD too. This shouldn’t have been a surprise to me, as having a child who is neurodivergent gives you up to a 90% probability that you are too, it’s highly heritable, even if the genes haven’t been identified yet.
Still, it became an in-joke between me and my daughter, and we learned about the condition together, finding strategies that would help her, that seemed to help me too. I didn’t pursue a diagnosis at this stage, I felt like an imposter, and worried that I was reading too much into my traits. After all, I had made it into my fifties, and only crashed and burned a couple of times - my life was ok, better than most.
So what changed? I decided to train as a counsellor, and while I coped well with returning to learn at Level 2, my decision to do an MA in Counselling and Psychotherapy brought new challenges and a few ‘ghosts’ that came back to haunt me. I was suddenly in an academic setting, where coherent thought and writing was expected, with new theories to learn and practice. If my coping strategies had struggled through menopause, now the issues took a different turn:
My hyperfocus meant that researching for an essay became a rabbit hole - I would emerge after days of reading one thing after another, with no sense of how I got there, and too much information to condense into a coherent argument.
Rejection Sensitive Dysphoria (RSD) meant that constructive feedback could feel shaming, making me feel like a failure, and that I should just give up on the course. Being in personal therapy at the time really helped with this.
My inattention traits meant that I could be easily distracted, and if the subject didn’t grab me, then I could drift away in my own thoughts for half an hour. I could easily lose track of things in a lecture, and my notes, when I remembered to look at them, often made no sense whatsoever.
ADHD paralysis and perfectionism is a killer set of traits; I would struggle to get going on an essay, and would hate everything I wrote, would lose the will to live and just submit something that I couldn’t bear to wade through again.
Navigating social norms, groups and cliques can be tiring and puzzling for me. I don’t have the mental energy for the games people sometimes play, and this occasionally led me to withdraw from student life. It brought back some bad memories from school days, that I now know were down to my ADHD differences. Again, therapy helped me navigate all this.
Thankfully, my course was not just neurodivergent-accepting, it was affirming too, and my personal tutor was really validating when I explained that I suspected I had ADHD. I felt a huge weight lift once I made the decision to seek a diagnosis, and even though I had to wait months for an appointment (even privately), I began to be easier on myself, and a bit more accepting when things would go wrong or I would ‘mess up’.
While I waited for my appointment, I veered between being certain I had ADHD, and thinking I was an impostor - I think this is all a perfectly normal reaction, but a bit of a roller coaster ride. Even on the day itself, when I got my diagnosis, it was a shock, part of me had expected the psychiatrist to send me packing in the first hour. I didn’t feel elated, or sad, it was like something clicked in my head and said “Oh, I’m not just crap at being human then?”.
I spent the next year alternating between ignoring the diagnosis and accepting it, learning everything I could, and slowly building the confidence to tell people I was an official ADHD-er. I always caution anyone newly diagnosed, to go slowly with sharing the information. Not everyone needs to know, some people will change how they think about you, not always in a good way, and even some family members might feel you are ‘labelling’ yourself and looking for attention. While you are working things out for yourself, it helps if a few trusted friends or family know, and of course there is the exciting moment where you meet other people with ADHD and can do the ‘me too!’ thing. Handy hint, after diagnosis, when you look back, most of your friends will be neurodivergent too - we tend to find our tribe, even if we don’t know it at the time!
So how does being diagnosed in your forties or fifties differ from finding out in your twenties? Are we not just late, but late-late-diagnosed? I feel like we need a new term that covers diagnosis in mid life, that encapsulates the storm of peri-menopause as it hits our unwitting ADHD brains. This period of life, as our hormones are raging, can be matched by our daughters hitting puberty, and our elderly parents reaching that stage where they need physical and emotional support from us. I have seen many women crash and burn when this tsunami hits - at least if you know what you are dealing with, you can feel better about yourself, and potentially get some treatment to help you through.
For me, there is some sadness that I have found my diagnosis late in life. I am constantly looking back and remembering things, then re-writing the narrative that has played in my head for decades. That bit is helpful, my life is finally making some sense, and I no longer need to fit in, or feel obliged to do things that impact me negatively. Therapy has helped me to make sense of it all, and can be incredibly empowering for ADHD-ers, if you have the right therapist.
Our brains can sometimes be full of jumbled thoughts and noise, making it hard to think straight or make decisions. Sitting with a therapist, unpacking all the ‘stuff’ that is going on for you, can help to process confusion and noise, leaving you with a clearer head and a sense of calm.
Having a therapist who is not just ‘neurodiversity-aware’ or experienced, but who is neurodivergent themselves, can be really validating for some clients. You get some shared understanding, and we won’t try and ‘fix’ you - sometimes we just get it, and that can be a relief. If this important to you, don’t be afraid to ask about this with any therapist you approach.
Maybe I could be that therapist for you? If you are curious about working with me, click here to book a free 30-minute, no obligation discussion.
As a side note, in true ADHD fashion, I wrote this blog twice - the first time took me a couple of hours, and when I copied and pasted the sections into my website, I manged to mess it up completely, got confused and somehow managed to delete every word from both my website and my Word document. I swore a few times, may have cried a bit, then started again. This can be life with ADHD - it’s never boring!
I am hoping this second version is better, it is probably shorter, which isn’t a bad thing!