1168432

research-article2023
JADXXX10.1177/10870547231168432Journal of Attention DisordersMorley and Tyrrell

Research Brief
Journal of Attention Disorders

Exploring Female Students’ Experiences of

2023, Vol. 27(10) 1129­–1155
© The Author(s) 2023

ADHD and its Impact on Social, Academic, Article reuse guidelines:

sagepub.com/journals-permissions
and Psychological Functioning DOI: 10.1177/10870547231168432
https://doi.org/10.1177/10870547231168432
journals.sagepub.com/home/jad

Eden Morley1 and Aimee Tyrrell1

Abstract
Objective: The aim of research is to provide greater understanding of ADHD in adult females by exploring first-hand
experiences of female university students with ADHD in the UK, and the impact of such experiences on social, academic,
and psychological functioning.
Methods: Semi-structured interviews were conducted with eight adult women attending university in the UK—all
clinically diagnosed with ADHD during adulthood.
Results: Participants experiences were rich and insightful, identifying that many women with ADHD experience
stigmatization and social discrimination, amongst other social, academic, and psychological difficulties.
Conclusion: Overall, the research identifies the pressing need for greater understanding and appreciation of ADHD in
females, particularly amongst health professionals. (J. of Att. Dis. XXXX; XX(X) XX-XX)

Keywords
ADD/ADHD, females, gender bias, ADHD-associated problems

Introduction A potential explanation for underdiagnosed ADHD in

females is differences in core symptomatic presentation
Attention-deficit/hyperactivity disorder (ADHD) is a com- between males and females. Research suggests that females
mon neurodevelopmental disorder characterized by a persis- are more disposed to internalized symptoms, such as inat-
tent pattern of inattention and/or hyperactivity-impulsivity tentiveness and disorganization, and present with fewer
which interferes with daily functioning (American Psychiatric symptoms of hyperactivity and other disruptive external
Association, 2013). There are three subtypes of ADHD; pre- behaviours (Quinn & Madhoo, 2014). On the other hand,
dominantly inattentive, predominantly hyperactive-impul- males with ADHD are prone to more externalized hyperac-
sive, and combined, which are defined by the presentation tive-impulsive symptoms, such as motor hyperactivity,
and combination of symptoms (American Psychiatric rule-breaking and overt aggression, which results in greater
Association, 2013). In most cases, the aetiology of ADHD is likelihood of being identified and referred for clinical
an accumulation of genetic and environmental risk factors assessment (Abikoff et al., 2002; Young et al., 2020). As an
(Faraone et al., 2021). ADHD is widely recognized as a internalized symptom profile is less likely to be disruptive
childhood disorder that is most frequently diagnosed in boys, in an educational setting, females are less likely to be identi-
with estimates of the male to female sex ratio in childhood fied and referred for clinical evaluation or treatment of
and adolescence (10–18-years old) ranging from 2:1 to 10:1, ADHD. Furthermore, internalized symptoms, such as inat-
depending on a community or clinically based sample tentiveness, are harder for the individual and others around
(Mowlem et al., 2019). Though it is commonly perceived as them to identify. Symptoms such as “daydreaming,” emo-
a childhood disorder, research efforts have explored the per- tional reactivity, or hyper-talkativeness may appear stereo-
sistence of ADHD into adulthood (Waite, 2010). In adult- typical of young females with the individual accepting these
hood (over 18 years of age), prevalence of ADHD diagnosis
appears to be comparable between sexes, and, although
symptom onset typically occurs in childhood, a significantly 1
University of Nottingham, Nottingham, UK
greater proportion of women receive a diagnosis in adulthood
Corresponding Author:
(Holthe & Langvik, 2017; Quinn & Madhoo, 2014). This has
Eden Morley, University Park Campus, Psychology, Pharmacy, Life
led to recent reports of a lack of ADHD diagnoses in females Sciences, East Dr, Nottingham NG7 2RD.
during childhood and adolescence (Quinn & Madhoo, 2014). Email: [email protected]
1130 Journal of Attention Disorders 27(10)

traits as their personality. These symptoms may also be 2010). Problems at school are often the primary reason for
interpreted by others as emotional or learning difficulties, a child’s clinical referral for diagnosis of ADHD, attributed
instead of five symptoms of ADHD (Lynch & Davison, to hyperactivity, inattentiveness, organizational difficulties,
2022). and lack of motivation (Arnold et al., 2020; Sedgwick,
Within the UK, clinical research surrounding ADHD 2018). Poor educational outcomes can be a key predictor of
lays focus to males, and, as a result, current diagnostic cri- long-term functional impairments, including anti-social
teria and general understanding of ADHD is biased towards behaviour, obesity, and social function outcomes, amongst
a male presentation of the disorder (Holthe & Langvik, others (M. Shaw et al., 2012). Among university students,
2017) with ADHD in females often being overlooked. poor academic attainment has shown to have a negative
Lynch and Davison (2022) identified that the Diagnostic impact on students’ mental health and wellbeing (Sedgwick-
and Statistical Manual of Mental Disorders Fifth Edition Müller et al., 2022). There is evidence to suggest that
(DSM-V), used by clinicians to diagnose ADHD, contains a females with ADHD do not present with academic difficul-
gendered bias that does not appreciate the subtle differences ties until they reach higher education (Quinn, 2005). Quinn
in the way females experience ADHD. The DSM-V lacks (2005) identified that girls with ADHD may work harder at
guidance on gender differences in ADHD, thus likely hin- school to mask their symptoms and meet parent/teacher
dering the diagnosis of ADHD in females (Waite, 2010). In expectations. However, in higher educational settings, such
general, females with ADHD present with fewer of the as university, it becomes increasingly difficult to cope with
symptoms outlined in the DSM-V compared to males, but the struggles of ADHD amongst other lifestyle changes,
are equally as impaired by their symptoms, though it may such as moving away from home and taking on greater per-
not be as visible (Quinn & Madhoo, 2014). In a consensus sonal responsibilities (Quinn, 2005).
statement of ADHD in females, Young et al. (2020) empha- The potential absence of academic difficulties at school
sized the importance of moving away from preconceptions age may present greater challenges in recognizing ADHD
of ADHD as a disruptive behavioural disorder, and instead in young females, providing further explanation for why
focusing on internalized presentations of the disorder, many females do not receive a diagnosis of ADHD during
which are more common in girls and women. their childhood. Individuals with ADHD commonly experi-
The presence of co-morbidities in females also appears ence impaired social behaviours and interpersonal relation-
to cloud ADHD diagnosis. The overall prevalence of a ships (Sedgwick, 2018). University students with ADHD
comorbid psychiatric disorder for those with ADHD ranges often face challenges making and maintaining academic
from 40% to 80% (Shi et al., 2021). The most common psy- and social relationships, and may struggle with participat-
chiatric disorders that co-occur with ADHD include depres- ing in group work, team activities, and societies at univer-
sion, anxiety disorders, substance use disorders, bipolar sity (Sedgwick-Müller et al., 2022). Impaired social
disorder, and personality disorders (Katzman et al., 2017). functioning has a negative impact on self-esteem (Quinn &
Specifically, females with ADHD are at a much greater risk Madhoo, 2014). It is widely documented in the literature
of psychiatric comorbidities in comparison to males with that girls and women with ADHD are more likely to experi-
ADHD and non-ADHD females (Solberg et al., 2018). ence low self-esteem in comparison to males with ADHD
Co-existing internalized symptoms of depression and/or and non-ADHD females (Quinn & Madhoo, 2014).
anxiety have the potential to overshadow ADHD symp- Rucklidge and Kaplan (1997) concluded that women who
toms, resulting in missed diagnoses and therefore inappro- do not receive a diagnosis of ADHD until adulthood are at
priate treatment (Quinn, 2008). It is unclear whether greater risk of suffering with low self-esteem. Low self-
psychiatric comorbidities, such as anxiety and depression, esteem predicts negative real-world consequences, such as
occur independent of ADHD or develop due to undiagnosed unemployment, low socioeconomic status, and poor mental
and untreated ADHD. Yet, these comorbidities have the and 7 physical health (Trzesniewski et al., 2006). In a quali-
potential to complicate identification and treatment of the tative study exploring adult females’ experiences with
disorder. Furthermore, in comparison to males, females ADHD, Holthe and Langvik (2017) identified that females
with ADHD are more likely to develop effective masking with ADHD are more likely to experience psychological
strategies which hide the impact of their ADHD symptoms, distress in comparison to males and non-ADHD females,
resulting in problems being underestimated and their needs due the profound social and personal impact of the disorder.
less likely to be met (Quinn & Madhoo, 2014). Together, this highlights the severity of the impairments
Overall, ADHD is associated with significant likelihood experienced by females with ADHD, exacerbated by a
of developing psychological, social, and emotional difficul- missed or late diagnosis of the disorder.
ties, which can be amplified when left undiagnosed and Overall, the literature highlights that there is insufficient
untreated. In general, ADHD is significantly associated understanding of ADHD in females, resulting in many
with poor academic functioning across the lifespan, from females not being diagnosed with ADHD until they reach
school readiness to going to university (Daley & Birchwood, adulthood, and suffering with many of the consequences of
Morley and Tyrrell 1131

a late diagnosis. Further research studies of females with Participants were recruited via advertisements in several
ADHD are needed to improve understanding of the disorder UK-based ADHD support groups for women on Facebook
and draw attention to the subtle differences in symptom pre- and Instagram. Twenty-five women registered their interest
sentation between males and females. Lynch and Davison in taking part in the study, eight of which fully completed the
(2022) highlighted that there is a lack of qualitative research consent forms, GHQ-9 questionnaire and attended their allo-
exploring female experiences of ADHD from those directly cated interview time. Thirteen individuals did not provide
affected by the condition. Sedgwick-Müller et al. (2022) full consent, three individuals did not return the questionnaire
also underlined that there is a deficit in research exploring and one participant did not attend their interview. Eight inter-
the impact of ADHD on university students. views were conducted with intention of further interviews if
The aim of this qualitative research is to approach data did not reach saturation. Following analysis of the data,
these gaps in the literature by exploring the personal it was agreed between the researchers that no further theoreti-
experiences of adult, female university students with cal insights or themes would emerge from further interviews
ADHD in the UK, and the impact of such experiences on and that data had reached saturation (Charmaz, 2006).
their social, academic, and psychological functioning. The eight participants were adult women, aged between
This is an exploratory piece of research; therefore, the 22 and 53 years old (mean age of 31 years old). All partici-
research does not address any specific research questions pants were formally diagnosed with ADHD in adulthood,
or hypotheses. and either part-time or full-time students at a university in
the UK. Further participant demographics, such as ethnicity
or sexual orientation, were not collected, as this information
Methodology
was not relevant to the outcomes of the research.
Research Design
A qualitative approach was use, utilizing semi-structured Procedure
interviews to gain an in-depth understanding of the personal Following obtainment of informed consent, participants were
experiences of adult female students with a clinical diagno- asked to complete the GHQ 28, which consisted of 28 short
sis of ADHD attending university in the UK. Semi- questions asking participants how their general health had
structured, in-depth interviews were identified as the been over the weeks prior to the study (Goldberg & Hillier,
optimal method for collecting qualitative data about partici- 1979). Participants responded to the questions based on four
pants’ experiences of ADHD (Creswell, 2007; Hammarberg criteria: better than usual, same as usual, worse than usual,
et al., 2016). The General Health Questionnaire-28 (GHQ- and much worse than usual. Goldberg and Hillier (1979) out-
28; Goldberg & Hillier, 1979), a self-report instrument lined four subscales of the GHQ-28 using factor analysis:
widely used in assessing mental symptoms and psychologi- somatic symptoms, anxiety/insomnia, social dysfunction, and
cal wellbeing, was implemented alongside the semi-struc- severe depression. Each subscale contained seven questions.
tured interviews (Hjelle et al., 2019). The GHQ-28 was The validity and stability of this factor structure has been con-
implemented to gain additional quantitative information firmed across several different contexts (Hjelle et al., 2019).
about participant’s psychological wellbeing, and to explore Semi-structured interviews were conducted and recorded
potentially significant confounding variables, such as online via Microsoft Teams, a web-based video platform. All
symptoms of depression and anxiety, which might have interviews were performed by AT. The interviews ranged in
affected the experiences being explored. duration from 21 to 32 min, with a mean duration of 26 min.
Topics of discussion included: reasons for seeking a diag-
Participant Recruitment nosis, personal feelings after receiving a diagnosis, and the
impact of ADHD on participants’ social, academic, and psy-
A purposeful sampling method was used, recruiting partici- chological functioning. Questions asked within the interviews
pants based on a set of pre-determined criteria. The inclu- were developed and agreed among the researchers to ensure
sion criteria comprised of being an adult female (18-years the primary research question was approached and allow an
+), a student at any university within the UK with a clinical easier triangulation process. A full outline of the interview
diagnosis of ADHD—no formal confirmation of partici- questions used can be found in Appendix A. Participants were
pant’s diagnosis of ADHD was required. Exclusion criteria encouraged to elaborate on topics which they found relevant.
included participants who had a co-morbid diagnoses of Following completion of the study, participants received a £5
another serious mental health disorder, such as a depressive Amazon e-voucher as reasonable compensation for their time.
disorder or a personality disorder. These exclusion criteria
were selected as acknowledgement that diagnosis of another
Data Analysis
serious mental health disorder may present greater influ-
ence on the experiences being investigated in comparison to Participants were scored on their responses to the GHQ-28
ADHD autonomously. using a Likert scale scoring system of 0 to 3 (0 = better than
1132 Journal of Attention Disorders 27(10)

usual, 1 = same as usual, 2 = worse than usual, 3 = much worse Table 1. Mean Scores and Standard Deviations of the Subscales
than usual). Mean scores and standard deviations were calcu- of the General Health Questionnaire 28.
lated for each of the four subscales of the GHQ-28. The low- Somatic Anxiety/ Social Severe
est possible total subscale score is 0 and the highest subscale symptoms Insomnia dysfunction depression
score is 21. Lower scores indicated lower levels of psycho-
logical distress, and higher scores indicated higher levels of Mean 6.88 9.88 9.38 1.75
psychological distress amongst participants. All interviews SD 3.31 4.05 2.07 2.7
were transcribed and analysed by one author and checked by
the other. A full transcript of the interviews can be found in
Appendix B. Content of the interviews was analysed in are outlined in Table 1. Participants scored higher in domains
accordance with thematic analysis, chosen as an accessible of anxiety/insomnia, and social dysfunction, compared to
and flexible method for identifying and interpreting themes the other subscales, arguably due to the nature of ADHD and
and patterns of meaning within qualitative data (Braun & comorbid conditions. However, overall, the scores do not
Clarke, 2006; Clarke & Braun, 2017). The six steps of the- indicate high levels of psychological distress amongst par-
matic analysis include familiarizing yourself with the data, ticipants. Therefore, it is unlikely that the subscales of the
generating initial codes, searching for themes, reviewing GHQ-28 would have acted as significant confounding fac-
themes, defining, and naming themes, and producing the tors in the experiences being investigated. Thematic analysis
report (Braun & Clarke, 2006). An inductive approach was of the raw data identified three core themes and six sub-
used to analyse the data and generate codes and themes. themes. Derived from the coding framework, the themes and
sub-themes provide insight into participants’ experiences of
ADHD as a female university student in the UK. The three
Data Triangulation core themes, which guide the order of presentation of the
Both authors independently analysed the raw data and devel- findings, include “stigmatization 11 surrounding ADHD in
oped initial codes and themes. These codes and themes were females,” “journey to receiving an ADHD diagnosis” and
then compared between the researchers referring to the raw “adulthood diagnosis.” The structure of the core themes and
data to ensure validity. Any discrepancies of themes and defining subthemes are described in Table 2.
codes developed were discussed with agreement that a third
researcher would be involved if an agreement could not be Theme 1—Stigmatization Surrounding
made. There were no discrepancies between the codes and ADHD in Females
themes made.
Misconceptions, Social Discrimination, and
Prejudice
Ethical Considerations
Female adults suffering with ADHD are at a high risk of being
Ethical Approval was obtained from the University of confronted with stigmatization due to the lack of disorder-
Nottingham Research Ethics Committee (Ref: S1439R). The related understanding and male stereotypes surrounding
ethical considerations reviewed for this study centred around ADHD, amongst other factors (Mueller et al., 2012). Topics of
confidentiality, and implications of the discussion of personal stigma, public misconception, prejudice, and discrimination
memories surrounding a problem which had received clinical recurred throughout participants’ experiences. Most partici-
psychological attention. Informed 10 consent was required pants commented on the general lack of understanding and
from all research participants. Participants were informed public awareness of ADHD, particularly surrounding the dif-
that the researcher was not a clinical professional, therefore ferences between ADHD in males and females. Participants
could not provide any form of diagnosis or psychological acknowledged that ADHD is often perceived as a disorder that
care. At the end of the online interviews, participants were affects hyperactive teenage boys. One participant experienced
fully debriefed and provided links to professional support prejudice during their assessment for ADHD as their symp-
services, both within the University of Nottingham and out- toms did not align with the male stereotype of the disorder.
side the University of Nottingham, should participants have
felt affected by the nature of the interview and/or discussion “I felt like I wasn’t taken seriously during my assessment. . .
of sensitive topics. To maintain confidentiality, all identifi- because I arrived really early, which the person assessing me kept
able information was removed from the data following tran- bringing up, like, well you arrived on time so obviously that’s not
scription and names were replaced with pseudonyms. a problem for you. And they were making comments like I wasn’t
fidgeting enough, at least in their eyes. And those kind of comments
knocked my confidence and I felt like I wasn’t being believed”
Results
Mean scores and standard deviations (SD) for each of the Similarly, one participant was told that she was depressed
subscales of the General Health Questionnaire-28 (GHQ-28) during her initial ADHD assessment as she was overwhelmed
Morley and Tyrrell 1133

Table 2. Structure of Main Themes and Defining Subthemes. close friends, family, and colleagues about their diagnosis.
Participants described that they felt like they would be
Main Themes and Defining Subthemes
judged and perceived differently for having ADHD.
Stigmatization surrounding Misconceptions, social
ADHD in females discrimination, and prejudice “Even now, I don’t tell many people in my personal life
Selective disclosure about my diagnosis. I am a bit more open about it at univer-
Journey to receiving an Symptoms affecting academic, social, sity, but I am worried about what some family members and
ADHD diagnosis and psychological functioning close friends will think of me if I tell them about it” “Now,
Prompted to seek a diagnosis by like I don’t really tell people [about my diagnosis], like I tell
others my close friends and family, but for work, it’s very much a
Adulthood diagnosis Mixed emotions need to know basis, because I think, if you’re female, most
Emotional validation
people will just go right well you don’t have ADHD and
you can’t be bothered explaining yourself really, so there’s
just no point”
and visibly emotional. The participant knew that she was not
depressed, and so felt that her feelings and experiences were
being dismissed by the GP. Young et al. (2020) highlighted Theme 2—Journey to Receiving an
that it is not uncommon for adults with ADHD to be treated
ADHD Diagnosis
for depression in the first instance, as affective symptoms,
such as emotional dysregulation, are often misattributed to Symptoms Affecting Academic, Social, and
depressive disorders. One participant reported experiencing Psychological Functioning
discrimination at work, which had a serious impact on her
mental health and resulted in leaving her job. Prior to receiving a diagnosis, participants described strug-
gling with various aspects of daily life, without realizing that
“People [at work] were making comments and I was getting their struggles were consistent with symptoms of ADHD.
into trouble for things that I now realise were symptoms [of For many participants, these problems were most prevalent
ADHD] . . .and I felt like it was really unfair, and it was in an academic setting, primarily due to the inability to focus
messing with my head a little bit” and maintain concentration. It has been widely documented
in the literature that inattention, a core symptom of ADHD,
Furthermore, several participants also described experi- is associated with poor academic functioning (Sedgwick,
encing negative attitudes towards ADHD, from family 2018). Several participants remarked that, although they did
members and academic staff. Participants expressed shock not do badly at school, they struggled with motivation, par-
over the stigma surrounding ADHD that they faced. ticularly in subjects that they did not enjoy.

“I had one tutor at university who didn’t believe in ADHD and “I was great in the subjects that I was good at, which was
dyslexia and that, she just believed it was a lazy excuse for not usually the more creative ones like, you know, the more
going to school” practical subjects like PE, drama, and art, and I did really well
in those. And it’s not to say I did really badly in other subjects,
“When I told my auntie [about my diagnosis], she was really I was capable of doing it, but I just couldn’t focus to do it, so I
unsupportive, and I was really shocked. She says she knows a refused to do the work”
lot of kids with ADHD and autism and says it is brought on by
their diet and that makes them go crazy when their parents give Furthermore, most participants described having prob-
them processed food” lems with time management and procrastination, and strug-
gling to organize their thoughts, which acted as a barrier to
One participant explained that they did not wish that they performing well academically. Before receiving a diagno-
had their diagnosis sooner, as they felt that they would have sis, many participants described that they felt that these
faced even greater public misconception. Overall, partici- symptoms were part of their personality and felt that they
pants remarked that the lack of understanding and awareness were “simply just not academic.” Though, not all partici-
of ADHD in females is what led to their ADHD being undi- pants struggled with academic performance; one participant
agnosed throughout their childhood. However, some partici- described being a perfectionist and seeking a lot of self-
pants did acknowledge that awareness of ADHD in females worth and validation from her academic work, which led to
is improving, but there is still a long way to go. overworking herself at school from a young age.

Selective Disclosure “If I didn’t do well on a test at school, I would completely have
a meltdown, for me it was like the end of the world. . .I
As a result of the stigmatization and negative misconcep- remember being at a parents evening when I was 11 years old,
tions surrounding ADHD, some participants avoided telling and the teacher told my parents that I was on the verge of
1134 Journal of Attention Disorders 27(10)

burnout if I kept working as much as I was, which, you know, such as a friend, family member, or colleague, who had rec-
should not be happening to an 11 year old” ognized that they were presenting with some of the symp-
toms of ADHD. Despite acknowledging that they were
Consistent with the literature on ADHD, a recurring struggling with certain aspects of their life, most partici-
theme throughout all women’s experiences was suffering pants commented that they did not realize that this could
with low self-esteem, which had a profound impact on par- have been due to ADHD, as they were not aware of many of
ticipants’ social, academic, and psychological functioning the symptoms of ADHD, particularly in females. A couple
(Trzesniewski et al., 2006). Many participants described of participants reported that they had their suspicions that
comparing themselves to other people around them, which they might have ADHD but chose not to act on it. For 16
left them feeling like “there is something wrong with me.” several participants, ADHD had been mentioned in their
childhood, but, at the time, it was not taken seriously enough
“I really felt myself being inferior to other people, I suppose, and to seek professional help.
I always had a feeling that I wasn’t good enough. You know,
you’re thinking what is wrong with me? Why can’t I do that? Why “I’ve got a friend who has ADHD, and she noticed a lot of
can’t I be as organised as other people? How do they do it?” similarities between us, and said it seemed like something I
should follow up with. I sort of had a suspicion [that it might be
One participant described believing that “people had to ADHD], but I didn’t bother following up with it because it
put up with me, instead of enjoying my company, and I felt seemed like a lot of work, and at the time, I didn’t think it was
like I had to apologise for the way that I was,” which had a impacting my life that much”
huge impact on their self-perception. Fifteen Linked to low
self-esteem, many participants also described issues specifi- Some participants also disclosed that they had a comor-
cally related to their social functioning, including problems bid condition, including dyslexia, autism spectrum disorder,
creating and maintaining friendships. For example, one par- or anxiety, and a history of issues with self-harm and eating
ticipant described having “lots of acquaintances, but not disorders. Comorbidities were highlighted by several par-
very many close friends” as they struggled to hold onto close ticipants as a possible reason why they never realized that
friendship groups, and often found that they would neglect they also had ADHD. The presence of comorbidities in this
friendships and relationships when they were busy or sample are consistent with the literature, highlighting that
stressed. Some participants also described having problems comorbid disorders present possible overlapping symptoms
with emotional dysregulation, which had a large impact on with ADHD which can create challenges for diagnosis
their social functioning. (Katzman et al., 2017). Seven out of eight participants
referred themselves for a diagnosis after they researched
“One of the biggest things that affected me was my emotional more about ADHD and realized that they would benefit
sensitivity, and like fear of rejection, like if a friend didn’t text from seeking professional help.
me back, I thought they hated me. . .I think I would have
benefited when I was younger knowing about that emotional
side, as that really had a huge impact on my friendships and Theme 3—Adulthood diagnosis
relationships which was pretty difficult”
All participants received a diagnosis of ADHD in adult-
hood. For some participants, the diagnosis process was rela-
Emotional dysregulation is a very common symptom of tively quick and easy and lasted a matter of 3 months,
ADHD, often more severe amongst females (P. Shaw et al., however, for others, it took up to 2 years.
2014; Young et al., 2020). An aspect of emotional dysregula-
tion, called rejection sensitive dysphoria (RSD), was described
by several participants. RSD causes individuals to feel intense Mixed Emotions
emotional pain from feeling as if you have failed to meet your After receiving a diagnosis, participants reported very
own or other’s expectations (Bedrossian, 2021). RSD, though mixed emotions. Most participants described feelings of
not widely recognized, is estimated to affect 99% of adults relief and recognition. One participant described feeling
with ADHD (Bedrossian, 2021). Despite the social issues that like “a weight had been lifted off their shoulders,” as they
participants faced, most participants described having a strong felt that there was an explanation for why they had been
support network of family and friends with whom they could struggling in many areas of their life.
share their experiences and seek emotional help.
“For me, there was a lot of relief. I mean, I had spent my whole
Prompted to Seek a Diagnosis by Others adult life thinking that I just wasn’t good enough, and I kept falling
short in a lot of areas of my life, I 17 thought I was lazy, I thought
Many participants described that they were prompted to I was useless. . .so hearing that it wasn’t just me and there is
seek a diagnosis by a member of their support network, something else going on, I guess, yeah, it was a huge relief”
Morley and Tyrrell 1135

However, not all participants felt a sense of relief following highlighting the profound impact of ADHD on social, aca-
diagnosis. Despite acknowledging that diagnosis was a posi- demic, and psychological functioning.
tive thing which meant that they would be able to get support, The themes and sub-themes identified in this study over-
one participant commented that they “didn’t feel anything.” lap with previous literature surrounding females with
ADHD. Many of the symptoms which affected participants
academic functioning correspond with the literature review
Emotional Validation
of ADHD in university students presented by Sedgwick
Although there were mixed emotions initially, all partici- (2018), including inability to focus, easily distracted, bore-
pants described feelings of validation once they had time to dom, and lack of motivation. However, despite struggling
think about their diagnosis. Participants were able to under- with these symptoms and despite the wealth of literature
stand themselves better and noted that looking back, their which suggests that ADHD is associated with poor educa-
behaviour “made sense.” Validated feelings and experiences tional outcomes (Arnold et al., 2020; Daley & Birchwood,
improved participants’ self-esteem, and many participants 2010; Sedgwick-Müller et al., 2022), most participants
reported being kinder and more compassionate to them- stated that they did not perform badly when they were at
selves following diagnosis. Furthermore, many participants school (ages 5–16). As mentioned previously, one partici-
implemented appropriate management strategies, such as pant described that she was a perfectionist from a young
seeking professional support and using good organization. age, driven by the validation of receiving good grades. This
For many participants, stimulant medication had been the is in line with the research presented by Quinn (2005), high-
most useful management strategy. Likewise, having a better lighting that not all females with ADHD struggle with aca-
understanding of their strengths and weaknesses meant that demic performance at school, as they often work harder to
participants felt they had better control over their lives. compensate for their symptoms and meet parent/teacher
expectations. Greater challenges may present when an indi-
“Having a diagnosis has changed the way I approach lots of vidual goes to university, as it becomes harder to cope with
things, I plan things differently, I’m aware that I might struggle the struggles of ADHD amongst other lifestyle changes,
with certain things, and I don’t beat myself up if I can’t do things” such as moving away from home and having greater per-
sonal responsibilities (Quinn, 2005; Sedgwick-Müller et al.,
Since diagnosis, many participants returned to full- 2022). At the time of interviewing, all participants were at
time education and started university, as they were able to least 1 year into an undergraduate university degree, some
approach things differently this time round. Participants even studying at master’s or doctorate level. With appropri-
generally reported receiving lots of support from their ate recognition, support, and management for their ADHD,
university, which made the experience of returning to participants were able to perform well academically and
education much easier for them. Some participants achieve their long-term goals by going to university.
reported feeling like they needed to prove to themselves, However, participants explained that they would often
and others, that they can do it. Participants described a receive comments such as “you have a degree; you can’t
need to fulfil their potential by going to university, and have ADHD,” amongst other false claims that individuals
pursuing the career that they always wanted, but felt they with ADHD do not perform well academically. This high-
were unable to achieve prior to being diagnosed with lights that, despite the literature and common perceptions,
ADHD. which often overlooks females, ADHD is not solely charac-
terized by poor academic performance and poor educational
“I’ve spent my whole life thinking that I wasn’t capable [of outcomes.
going to university], and now I’ve finally got the belief and
Intense feelings of low self-esteem resonated throughout
motivation behind me to do it. It’s almost like I’m 18 trying to
prove something just to myself and everybody else that’s
participants’ experiences. Poor self-esteem is very common
doubted my ability” amongst females with ADHD (Holthe & Langvik, 2017;
Quinn, 2005), triggered by feelings of failure and “not being
All participants benefited from receiving a diagnosis. good enough.” Feelings of 20 inadequacy are exacerbated
However, there are still daily challenges that they face with by other’s perceptions and expectations and ultimately, by
ADHD. Participants explained that they have good and bad an absence of an ADHD diagnosis throughout childhood.
days, and with each day, they are constantly learning new Low self-esteem has a knock-on effect on an individual’s
things about themselves. social, academic, and psychological functioning.
Participants explained that having low self-esteem nega-
tively impacted many different aspects of their life, includ-
Discussion ing body image, eating habits, confidence at school,
The personal experiences of female students with ADHD romantic relationships, and close friendships. As outlined in
explored in this qualitative study are rich and insightful, the sub-theme of “emotional validation,” participants’
1136 Journal of Attention Disorders 27(10)

self-esteem improved significantly following diagnosis, as aren’t being believed” by those whom they share their diag-
participants reported understanding themselves and their nosis with. McKeague et al. (2015) investigated experi-
needs better, which allowed them to feel much more in con- ences of stigma in young people with ADHD and observed
trol of their lives. It is evident that receiving a later diagno- that stigmatization from others results in negativity towards
sis in adulthood had a profound negative impact on the self, called “self-stigma.” Self-stigma is an individual’s
participant’s wellbeing throughout their childhood. This recognition that others hold prejudice and will discriminate
emphasizes the importance of earlier recognition and diag- towards them due to their disorder, which can severely
nosis of ADHD in females. affect one’s self-esteem and psychological wellbeing
In accordance with the literature, participants also faced (Corrigan & Rao, 2012). Consequently, many participants
problems forming and maintaining friendships, particularly reported that they are selective with whom they share details
at school (Sedgwick, 2018). Despite this, most participants of their diagnosis with, in fear of being judged or perceived
described having a strong support group formed of close differently, or because they “don’t want to have to explain
friends and family members whom they could rely on for themselves.” This finding is in line with the findings of
social and emotional help. A strong support group was fur- Holthe and Langvik (2017), who also identified the theme
ther evidenced by the subtheme of “prompted to seek a of “to tell or not to tell: selective disclosure” in their the-
diagnosis by others,” in which, for most participants, the matic analysis of adult women’s experiences with ADHD.
possibility of having ADHD was first raised by someone This demonstrates that it is common amongst females with
within their support group. This further highlights the ADHD to withhold their diagnosis of ADHD from others,
importance of disorder-related understanding, as with primarily due to the stigmatization and public misconcep-
greater and more widespread understanding of ADHD in tions surrounding ADHD in females.
females comes greater recognition and diagnosis for those Overall, the women’s experiences discussed in this qual-
who need it. itative study draw attention to the complexity of ADHD.
The aim of the research was to explore the impact of The heterogeneity of symptom presentation presents many
ADHD on participants’ social, academic, and psychological challenges in recognizing and diagnosing ADHD in females.
functioning, as discussed in the themes of “journey to However, the overarching theme amongst all participant’s
receiving an ADHD diagnosis” and “adulthood diagnosis.” experiences is a clear lack of understanding of ADHD in
However, following data analysis, the theme of “stigmatiza- females. Even amongst health professionals, there is a lack
tion surrounding ADHD in females” emerged from the data of appreciation of the differences in symptom presentation
and became a highly influential element in participants’ between males and females with ADHD, and an over-
experiences of ADHD. Most participants described at least whelming existence of stigmatization. This lack of disor-
one personal experience of public misconception, social der-related knowledge, 22 alongside the presence of
discrimination, or prejudice. Stigmatizing attitudes towards comorbidities, plays a key role in females receiving a late
both children and adults with ADHD are very common diagnosis of ADHD.
(Mueller et al., 2012). As a disorder, ADHD is vulnerable to
stigmatization due to its largely unknown aetiology; there is
Limitations
not a single causal factor, nor a single diagnostic test used to
identify ADHD. As a result, there are many public miscon- This research responds to gaps in the literature by exploring
ceptions about the origins of the disorder, including myths several rich and detailed accounts of first-hand experiences
that ADHD occurs in children who eat too much sugar, or of ADHD in adult female university students in the UK.
that it is caused by poor parenting (Mueller et al., 2012). However, there are number of caveats with the sample used
These public misconceptions and stigmatizations are in this study. Firstly, given that females with ADHD are
strengthened by a lack of disorder-related knowledge. largely underdiagnosed in the general population, the sam-
There is even greater stigmatization towards females ple of formally diagnosed females used in this study may
with ADHD, in comparison to males, as it is publicly recog- not be fully representative of females with ADHD in the
nized as a disorder that predominantly affects boys. Schmitz wider population (Lynch & Davison, 2022). It is likely that
et al. (2003) observed that the stereotypical profile of an many females in the general population have ADHD that is
individual with ADHD is described as “a young, white, undiagnosed, possibly due to having less severe symptoms,
middle-class boy suffering with hyperactivity.” Due to this or have reduced access to support, in comparison to the
common misperception, participants were often told that females in this sample. Additionally, as the participants
“they can’t have ADHD” or that “they aren’t hyperactive used in this study were diagnosed during adulthood, their
enough.” Furthermore, as confirmed by several participants experiences will likely differ from those who received a
in this study, females with ADHD often experience preju- diagnosis in childhood (Lynch & Davison, 2022).
dice and social discrimination. For females, their disorder is Another caveat of the sample used in this study is the
often not taken seriously enough and they “feel like they exclusion of participants who have comorbid diagnoses of
Morley and Tyrrell 1137

another serious mental health disorder, such as a depressive receive a diagnosis and what led to you seeking a diagnosis
disorder or personality disorder. This presents a severe limi- of ADHD?)
tation to the research as there is a high incidence of depres- How did you feel after receiving a diagnosis?
sion, amongst other psychiatric disorders, in females with How has having ADHD impacted experiences related to
ADHD (Solberg et al., 2018). Therefore, the results of this your social functioning? (Prompts: such as your relation-
study are not representative of the entire population of ships/friendships/social activities).
females with ADHD. Possibly linked to the exclusion of How has having ADHD impacted your academic
participants with a serious mental health disorder, the results functioning?
of the GHQ-28 identified that the participants in this sample (Prompts: such as your performance at school/university,
were all in relatively good physical and psychological organization, meeting deadlines, did you feel supported at
health. Thus, participants’ experiences will likely differ school/university?).
from those who are suffering with their health. Overall, the How has having ADHD impacted your psychological func-
results of this study do not provide a complete picture of tioning? (Prompts: such as general wellbeing, emotional
females with ADHD and should not be generalized to all control, self-esteem etc.).
contexts. Finally, is there anything else you wish to discuss which
you feel has been relevant to your journey of ADHD?
Implications and Directions for Future Research
Appendix B
Despite the addressed limitations, this research provides
meaningful insight into the experiences of women with Full Transcript of Participant Interviews
ADHD. Today, many women with ADHD experience stig-
matization and social discrimination. Therefore, the clear Interview Participant #1. Interviewed by Aimee Tyrrell on
take-home message of this study is the need for greater pub- 10/08/2022. Interviewee pseudonym: Sophie.
lic understanding and appreciation of ADHD in females.
Twenty-three Improving public knowledge of ADHD is A: OK. So, to start with, could you tell me about your journey
important moving forwards to reduce stigmatization and to receive your ADHD diagnosis. For example, when did you
debunk stereotypes of ADHD as a disorder that predomi- receive a diagnosis and what led to you seeking a diagnosis? S:
nantly affects males. So, it wasn’t until I went to uni that I realized that I had
Furthermore, greater understanding of ADHD is particu- a lot of ADHD symptoms. I didn’t go to uni until 2020, I
larly important in allowing for earlier diagnosis of the disor- didn’t go straight after sixth form. I started to realize that I
der. Earlier diagnosis allows individuals with ADHD to had a lot of the symptoms, especially with like online learn-
develop effective management strategies, which in turn ing and when we hit the pandemic. But there was such a
improves their social, academic, and psychological function- waiting list for the NHS to get diagnosed, so I was on the
ing. Greater public understanding of ADHD in females can be waiting list for a while. I was on it for over a year and I kind
achieved through education. Moving forwards, particularly of wasn’t getting anywhere, so I went privately and only
amongst health professionals and teachers, ADHD should be got diagnosed at the end of June this year, so literally just
treated as a disorder that affects both males and females, and like really recently. But I kind of knew I had it for ages, but
attention should be drawn to potential differences in symp- obviously like I didn’t have an official diagnosis. I got diag-
tomatic presentation between males and females. nosed in June of this year and I have just started medication
However, ADHD in females should not be treated as as well. So, I have been on medication for about 6 weeks
separate to ADHD in males, as this can feed into further now, so still very early.
stereotypes. The findings of this study identify the need for
larger scale research surrounding ADHD in females, to A: How did you feel after receiving that diagnosis? S: Umm,
strengthen the validity of this research. In conclusion, the it definitely was a relief, definitely. I mean, it’s a really hard
results of this qualitative study provide significant insight thing at the moment because obviously the NHS waiting list
into the complex and challenging nature of ADHD amongst is so long, but equally privately was like horrifically expen-
female university students in the UK. sive. So, it kind of does leave you in like a really hard situa-
tion. But once I had got the diagnosis, I was so relieved that
I’d finally like, kind of been recognized, and you know me
Appendix A and my psychiatrist who diagnosed me, you know, spoke
about my childhood and, like, how I’ve been at school and it
Outline of Interview Questions kind of all made sense. And I finally realized why, like, this
Firstly, could you tell me about yourself and your journey to is why I’ve been struggling with XY and Z, like at school,
receiving an ADHD diagnosis? (Prompts: when did you because I had it all along. My psychiatrist reckons I had it
1138 Journal of Attention Disorders 27(10)

from between the ages of 6 and 12, and I’m obviously 22 At kind of school age, if I like didn’t do well on a test
now. So, that’s a long time to go without realizing I had it. that didn’t even mean anything, I would completely have a
So, it was kind of more relief than anything. meltdown, and I kind of used to think like, you know, c’mon
[Sophie], like, put it into perspective, this is one test, it’s not
A: How has having ADHD impacted any experiences related going to determine everything. But for me it was just like
to your social functioning? Do you think it was affected your the end of the world because I was like, such a perfectionist.
relationships and friendships? S: Umm, I think now that I I didn’t struggle in terms of being able to do the work, but it
have been diagnosed, I realize the way I have been socially was just like the deadlines and things like that that sent me,
makes sense. So, for example, like I’ve always tried to be a like, into meltdown. It is a really hard situation to be in, like
good friend, but I am one of those people that is like awful being a perfectionist, but then also putting stuff off until like
at replying on text and stuff, and now I realize that it’s just I have to do it.
because, you know, like the way my ADHD brain works
and like, very all over the place. And so, it doesn’t make me A: How have you found managing your academic work since
a bad friend, it’s just that’s the way I am. So, I think it kind being diagnosed and understanding your ADHD? S: As soon as
of just makes sense now. Like, the way I am with a friend I went on medication, I just started to organize myself more.
depends on how I’m feeling with myself. So, if I have got a I had energy to get things done and I think like the first
lot going on and for me that like really stresses me out, then week I was on medication I got things done that I’d literally
I will just kind of like disappear off social media and like been putting off for like months and then I got them done in
not reply to messages and stuff. Whereas if I feel like good like half an hour and I was like, oh, I could have done that
in myself and I feel like I’ve got everything under control, I six months ago. But like I said, I’ve got this extreme task
will be all into my friendships, if that makes sense. avoidance where I would put something off. And I would
like justify in my head why I put it off as well. I’m like ohh
A: How has having ADHD impacted your academic func- that doesn’t need to be done today, I’ll do it tomorrow, but
tioning? S: Yeah, I think the academic side of things is the then tomorrow comes and I just won’t. But since being on
main thing that made me realize I had it. One of the main medication I just get things done. So, it’s almost like some-
things I suffer with and one of the main things that girls thing kind of like turned as soon as I had medication, and
really suffer with is task avoidance. Like, if anything gets like I know now it is because of the dopamine hit you get
too stressful, I end up completely putting it off until like, when you go on medication, it gives you that kind of spur of
I actually cannot put it off anymore. And that has always energy to do things, and I’ve definitely found that.
been me. And at first, I thought, ohh, you know, everyone
procrastinates, things like that. But mine was really severe A: Did you feel like there was a lack of support at school/uni-
until the point where I would actually make more work for versity? S: I definitely, like I said, was struggling throughout
myself because I would like push back a deadline and ask school. I was like a huge over worker from such a young
for an extension. But then I would have so many extensions age. I remember like, being like 11 years of age and my
that I would actually be making more work for myself. And teacher saying to my parents at parents evening, like she
also, a big thing with ADHD is like making a mountain out will burn herself out if she keeps working this much. And if
of a very small task, so, say I had like an essay to do, or, you you think about it, like an 11-year-old should not be burnt
know, like when you’re at school and you have to make a out. In this case, this was not a particularly important stage
poster about something. Something that could have taken of school in terms of like A Levels and GCSE, but I was
an hour would take me like 5 hr because I would just like overworking, and I was that quiet child that didn’t really
overcomplicate it and make it so much more than it actually say much in class but was like completely having a melt-
had to be. Like, I would always leave something until the down about everything. Umm, but I mean, I don’t neces-
11th hour, even though I’ve had two weeks to do something, sarily like blame schools for not picking it up, because I
I’ll always be that person that is still doing something right generally think that, up until recently, nobody really knew
up until the deadline. Sometimes it is the other way round, what ADHD was or how it presented itself, especially in
as I avoided a task for so long, I could then do like 6 hr of females. I think the stigma about ADHD, just being that like
work in 2 hr if I had to. And that is actually like a form, now annoying boy at school that wants attention, still very much
that I actually have a diagnosis of ADHD I can understand exists and so I think when I was 11 and I was told that I was
it a bit more, and that is like a form of masking, and there on the verge of burnout, I don’t think anyone would at any
is a lot of ties between ADHD and perfectionism, and that point have thought, oh, she’s got ADHD. Like that’s her
was absolutely me. Even if the work is done, I will still be way of masking by overworking. I honestly just think that
working until the deadline because I’m like I have to use all they thought I was that student that just worked really hard,
the time that I have before I submit it, otherwise in my head but I don’t necessarily blame schools. I just think that there
I haven’t done enough. was at the time no kind of awareness of what ADHD really
Morley and Tyrrell 1139

was. But I think maybe moving forward, there definitely me they could put me to an educational psychologist and
needs to be more discussion about it in schools and stuff, essentially assess me for ADHD themselves, which is what
because so many girls that I’ve kind of connected with on I did. So, I kind of, that was in September last year, just
social media that have ADHD are very much the same. Like towards the end of first year, so, so yeah, I started uni last
nobody picked up on it. Nobody knew about it. year, I decided like it was around the same time that I was
actually looking for the ADHD diagnosis, and I thought,
A: How has having ADHD impacted your psychological you know, if I have ADHD, it will explain a lot of why I
functioning, for example, your self- esteem? S: Yeah, I think, have never had the courage to go to university before. I just
again, academically, and being that perfectionist and over- put it down to the fact that I wasn’t academic, I just had
working and then striving for academic validation. And if that, that was what I convinced myself. I just thought that I
I didn’t get that, I would completely like, lose confidence, wasn’t academic, and now knowing that there is something
self-esteem, because I’ve kind of put all of my self-worth else kind of going on that was like, well, right, if I have
into academic stuff. And now that I have been diagnosed ADHD, then maybe I can do university, maybe I can do
with ADHD, I realize that this is an ADHD trait. And I’m this, I just need to think about things a little bit different
obviously not at that point now where I think that my worth and get the support I need. So, that is what kind of pushed
is like completely academic, that was very much when I me to apply.
was like maybe 16 at GCSE age. But definitely back then,
definitely. A: How do you feel knowing you have ADHD? L: I think,
for a start, there was a lot of relief. Because I mean, I spent
A: Is there anything else that you want to talk about that is my whole adult life thinking that I just wasn’t good enough
relevant to your experiences of ADHD? S: Not that I can think and I just wasn’t, you know, like, because I kept falling
of, but I think it’s really great that you’re doing this because short in a lot of areas in my life, I thought I was lazy. I
like I said, there is like not a lot of research about ADHD thought I was useless. I just, I spent my whole life thinking
and awareness about girls with ADHD, so yeah, it’s really that, you know, why are all these other people managing to
good what you’re doing. do, to do these things? And I can’t do them, and I just put it
down to myself being really poor at life, and so hearing that
Interview Participant #2. Interviewed by Aimee Tyrrell on it wasn’t just me and that there is something else going on,
15/08/2022. Interviewee pseudonym: Lucy. was like I guess, yeah, it was just a huge relief. It was just
almost this weight had been lifted off my shoulders, just to
A: Could you please tell me a bit about yourself and your know that it’s not actually your fault, there is something else
journey to receiving an ADHD diagnosis? L: So, I guess my at play here. So yeah, massive, massive relief. It was hugely
whole kind of life I’ve kind of struggled with a lot of things, validating for me to find out from the university that it was
including focus and motivation, and it had kinda been spo- ADHD, and just, yeah, it’s taken a lot of years of self-loath-
ken about over the years, jokingly, that I might have ADHD. ing kind of away. I mean it’s not, you can’t just overcome
And I went through a really rough patch in my life, which that, you know, all of a sudden, but it’s definitely helped,
meant that my mental health declined, and so when I was and I am definitely a lot kinder to myself now because of
coming out of that, I did a lot of self-reflection and try- that.
ing to improve myself. And it was during that time of self-
reflection that I realized that I was still struggling and that A: How would you say ADHD has impacted your social func-
there was areas that didn’t improve no matter how hard I tioning? L: Yeah, I mean, I think because of the self-esteem
worked on them. I still kept falling short and not meeting issues, it has affected me socially because I’ve become a
the mark. And that is what kind of pushed me more into get- people pleaser. And so, a lot of the time, rather than just
ting an ADHD diagnosis, and then along with that, a friend being myself and sticking to my values, a lot of the time
of mine, had a friend who had also just been diagnosed and I’m trying to meet the values of others around me. And so,
when she was explaining herself, she said that essentially I find myself people pleasing a lot to make other people
it sounded like she was explaining my life, it sounded like happy, sometimes at the expense of my own happiness. But
she was talking about me. So, my friend brought that up and again, like since diagnosis that’s probably improved a little
she’s like have you ever thought maybe about doing more bit more and I’m definitely kinda, looking after myself a
research into a diagnosis, and that’s what kind of prompted little bit more and sticking to my values in life a little bit
me to go and to look further into it, which is what I did. better. I’d say, before my diagnosis, I just thought it was the
Yeah, so I’m still waiting for an official diagnosis from the way I was, I mean, my parents split up when I was young
NHS, but I have a diagnosis of such through the university I as well, so I thought there was potentially like, you know,
went to. I approached the inclusions team when I started uni a little bit of trauma there from my childhood and that had
and just told them what I was going through and they told a part to play in it, which it will be a part to play in all of
1140 Journal of Attention Disorders 27(10)

that, but yeah, I just thought it’s who I was. I’m just like, to frustrate me because I know I can do it, but I just can’t
maybe I’m just not able to excel in anything in particular, keep the momentum and the focus up. So, I didn’t do as
and you know, I’ve always seen myself as a person, that’s well second semester, I mean I got a couple of A’s and I
like, good at lots of things, but not really great at anything. think there was a B and a C in there as well, but I knew I
And I guess, through learning about ADHD, it’s just like, could have got those A’s, but I was just struggling with my
well that’s like I am good at lots of things, but the reason focus and motivation. So, and this is where it’s frustrating
that I never really get great at anything is because once it where I want my diagnosis and the help in place so that
gets difficult or I need to focus more, is when I fall kind of I can obviously get through uni cause I want to go back
by the wayside. in second year and I want to do well and like I’ve spent
my whole life thinking that I wasn’t capable of doing this
A: How would you say ADHD has impacted your academic and now I’ve finally got the belief behind me to do this
functioning? L: Well, the inability to concentrate has had a and that I can do it and, it’s almost like I’m trying to prove
massive effect on my life, because I struggled, I think I prob- something just to myself and everybody else that’s doubted
ably became a bit rebellious as well, and then I was a little me and my ability. So yeah, so like it is still a struggle, but
menace when I was at school. I was great in the subjects the uni has been really helpful in that. Obviously, I got my
that I was good at, which usually was the creative ones and diagnosis through the psychologist there, and on top of that,
like you know, the more, what’s the word, the more practi- they’ve put things in place to help me and, and I’ll get sup-
cal things, like home economics, drama, PE, art, all of those port throughout now that they know I have ADHD, they
things I did really well in. And it’s not to say that I didn’t are gonna offer me support throughout which, which feels
do well in other subjects, when went and I did my stan- good and makes me think, you know, they don’t want me to
dard grades, I was in the top class for maths. But because fail either. So, they’re gonna help to make sure that doesn’t
of the work that I had to put into it, I just wasn’t able to do happen, which is really good.
it because I just, now looking back, it was the inability to
focus. And so, I just refused to do the work because I was A: How has ADHD impacted your psychological functioning? L:
like, I can’t do it, which I could. I was capable of doing it, Yeah, well, I think that the biggest thing is definitely my self-
but I just couldn’t focus to do it, so I essentially like, pushed esteem because when you grow up, and I guess I’m older
myself down to make things easier for myself. So, I went cause I’m a mature student, but like you spend your whole life
from being the top class at maths, and I ended up coming thinking that you’re not, you’re just not good enough. You’re
down into the second class and then trying to get down into not enough in pretty much all aspects of your life, whether it’s
the third class just so I could make life a little bit easier for relationships, whether its work, whether it’s the way you look,
me. And I think that was definitely affected by my undi- and everything is just like, you see people, other people able
agnosed ADHD because I know that I was capable and I to do things and you just can’t function properly and, and it’s
guess a lot of my teachers said that and in all my reports, not for the want, like the want is always there, so you know
they said I was great when I was doing practical work, even if someone is lazy and they’re just lazy for the sake of being
in the likes of biology and stuff, I was really good when I lazy then that’s fine, but when you’re lazy, but it’s like you
was engaged and doing practical stuff, but I really struggled don’t want this, really. I’m trying to describe this, and I hope it
when we had to sit down and concentrate and write and or makes sense, but like I always want the best things for myself.
do homework. I just wasn’t able to do it. I wasn’t able to I strive and I have the ambition, it’s there, like I want to be
self-direct because I just didn’t have the ability to focus to successful, I want to do well, but it’s that inability to do it, and
do things on my own. So, I really struggled when it came to that really, really affects you when you’re trying your hard-
that stuff just because of the lack of focus. est, but you keep falling down and stumbling, and then you
look back and you’re like, but I only fell down and I stumbled
A: How is it at university now? L: When I started uni in there because of myself because I was just being lazy. I just
the first semester, I was really focused and I did really well didn’t do the things that I needed to do. And so, then that just
and I finished first semester with A’s and I was just like, goes round this self-hatred wheel because you get angry with
you know, super, super happy and really proud of what I yourself for doing silly mistakes and it’s like, well if I just
was doing. And umm, but I see that in a lot of things that worked harder, if I just stayed focused, then it would have, it
I do, it’s like I’ve been to college and stuff before in the would have been better, and I would have done well. And it’s
past and I always go in with so much enthusiasm and, don’t like that, just inability to do things is very frustrating, so you
get me wrong like the want to do well is still there just as just end up in this cycle of hate. Yeah, definitely my esteem
much as it was from the start, but it’s the ability to keep that suffered the most.
momentum and to keep that focus and motivation going that
I struggle with. So, when I went back for second semester, A: That is all of my questions, did you have anything else
I could see myself kind of declining slightly and that starts you wanted to talk about? L: Yeah, I guess, it’s just getting
Morley and Tyrrell 1141

a diagnosis, and I think that in itself is super important and, a difference to me, that’s when I sort of started to appreciate
because you will go through life with this idea of yourself the diagnosis and like the difference it was making.
that just isn’t measuring up, and getting the validation that
a diagnosis holds is integral for anybody, I think, going A: How has having ADHD impacted experiences related to
through it, and, the way things are just now for people to your social functioning, such as relationships or friendships? G:
get a diagnosis is extremely difficult and I guess that is I think I was quite like, I’m very impulsive, especially as
what we are doing with our podcast, is we are trying to raise a teenager. So, like I was always having like arguments
awareness and incite change in the way things are because it with people and like could be quite aggressive and like
really does affect people’s mental health. And having to go wouldn’t think before speaking. So, I had like very up and
through life and struggle the way they’re struggling when down friendships and relationships. I was like very much on
they could get the help that they need and recognize that it and off and like in and out of relationships and it was very
is just as important in a female as it is in a male you know. unstable, which I think just sort of causes chaos around you.
I think like once I was into my adulthood and like in my
Interview Participant #3. Interviewed by Aimee Tyrrell on 20s, it started to calm down a little bit, but part of that was
08/08/2022. Interviewee pseudonym: Georgia. like finding friends who understand me and sort of appre-
ciate it. But yeah, it was definitely turbulent when I was
A: Firstly, could you tell me about your journey to receive your growing up in primary school as well. I just didn’t quite
ADHD diagnosis? G: And yeah, so I was like 16, and my know how to maintain friendships.
mom sat me down because she works sort of in the learning Now, like, I don’t really tell people [about my diagno-
support side of things. And she’d had a presentation at work sis], like I tell my close friends and family, but for work, it
about ADHD and she was just apparently sitting there like, is very much like a need to know basis because I think if
oh, OK, that’s my daughter. So, she sat me down basically you’re female, most people will just go right well you don’t
with, like, a list of the symptoms and sort of said, look, I look like that or you don’t have that and it’s like you can’t
think you might have this. At the time, it was ADD because be bothered explaining yourself really, so there’s just no
I think it was like they had like ADHD and ADD separate, point.
and she went down the list of symptoms to me and I was
like ohh wow, yeah, that was me. But I hadn’t considered it A: Did you used to think that this behaviour was part of your
then as it wasn’t really talked about. personality growing up? G: I always used to think there was
My mum tried to get me like a referral through the GP something wrong with me, but I couldn’t really put my fin-
and the GP instantly shut me down, she didn’t even see me. ger on it, and then like I was told that I was quite aggressive
It was a family doctor, and she wouldn’t put it through. I and quite confrontational and that was what was causing it.
was fortunate enough that I got a private assessment, and at So, I would kind of question why I was like that, and I felt
the time they diagnosed me with ADD and offered me like it was sort of out of my control and yeah, I just couldn’t
Ritalin, but my parents didn’t want me to take it as I was 16. really put my finger on it. Like what was happening, and it
So that was kind of the end of that. was only like, as I have my diagnosis now, I can look back
And then when I was 24, I went back to college, and I and realize like, it does affect those areas.
realized how poor my concentration was and how much I
was struggling. I was looking at everything else in my life A: How would you say having ADHD has impacted your aca-
and like I wasn’t keeping on top of things. So, I phoned up demic functioning? G: Right. School. Bad. I skived a lot, like
my doctor and just explained everything to her and she was I was in trouble a lot. I wasn’t like a bad kid, but I was like
like, yeah, that sounds like ADHD. And she referred me. an annoyance to the teachers, like always chatting or get-
So, I was about 11 months on the waiting list and then I was ting distracted or swinging on my chair. I stopped going to
seen and diagnosed with ADHD. And I am on Ritalin now classes after a certain age. I really struggled with concentra-
and it’s made a massive difference at college because I’ve tion. I didn’t really do my homework, like I just couldn’t
gone from being like a failing student to like an A student, apply myself and I would have to like, I feel sorry for my
so it’s just like made all the difference for me. mum, because she would sit me at the table and she would
be like, just do this past paper, like she’d have to sit me
A: Following on from that, how did you feel after receiving a there and make me concentrate because I just couldn’t sit
diagnosis? G: So, I went through the NHS when I went like still. I would never sit still on a chair. I have done my work
in my adulthood, and I felt like the process was quite dif- on the floor if I had it, but like, I just, yeah, could not moti-
ficult. Like the questions they asked, and I didn’t really feel vate myself to do it.
at ease during my assessment. So, like I didn’t come out of I did manage to get myself back into school and get some
it feeling good. But then over time like once I was like on of my Highers, but it was just an uphill struggle, and I was
the right medication and I could see what it was like making resitting things. When I left school, I sort of started working
1142 Journal of Attention Disorders 27(10)

in hospitality and all that and then I moved into retail, and I group, and they found it funny, like I was the joke when it
quite liked that because it was like less academic thinking came to like intelligence and everything. So, I think when
and stuff like that, and I’ve tried to go to college a couple of you think that about yourself, you don’t really make the
times, ended up dropping out. And then during the lock- effort to like, do better as well. I’ve sort of went through
down, I was like well I have always wanted to work with my life thinking like, oh, you’re not very smart and all that
animals, so I was like, right, I’m gonna go and like, try get stuff, but actually, this year, I’ve been like, it’s been quite
this. So, I had to go and get my school subjects, by the way, eye opening because it’s the first time I’ve been like actu-
I do ramble a bit, so I hope this makes sense. ally I don’t feel that way anymore. Like I don’t see myself
And yeah, I had to go back and get my higher biology as like, less intelligent as anyone else because I have sort of
that I didn’t get in school. And I was sitting in that class, and got the capacity now to like focus on things that I am inter-
I was like, that was when I noticed, I was like, I can’t believe ested in and group my thoughts together.
I’m still struggling like this, and my teacher noticed it as I think it’s like prove them wrong kind of thing and just
well. And my teacher was just like, I thought you didn’t care like seeing my difference in college and stuff as well, like
about the subject, and I was like, no, I am actually like on a seeing my grades go up, it’s like OK, so there was actually
waiting list for ADHD now. So, that whole year was a strug- a reason that I didn’t do well in these kinds of areas.
gle and then I managed to get a C and get into my animal
care course last year. Term one was an absolute bomb, like A: Do you feel that there was a lack of support while you
it was just awful. I failed. I was like, failing everything. I were at school/in education? G: I think so because like I was
felt like I wasn’t like I was, I was missing questions and not like the bad kid or like really good, so I sort of went
wasn’t answering stuff properly, and I almost dropped out. I under the radar a little bit. I was more like distracted if other
got my diagnosis in November, and I started term 2 medi- people are doing stuff I would get involved, so I think like,
cated, and like, it just went like it was night and day. I was unless you’re really acting out, like boys tended to do more,
actually like, doing quite well and passing things, and, I like you don’t really get noticed like you’re not causing an
don’t know, it just seemed to like quiet my brain and make issue for them.
me concentrate better. It’s really weird, but it just makes I was always like drawing on my book and like swinging
such a difference. on my chair, and teachers would be like tearing their hair
out, but it wasn’t like enough for them to sort of pursue
A: Did you struggle with organization and meeting dead- anything.
lines? G: Yeah, it was like, terrible with high school work
and stuff, and I think when I started working, I got better at A: Is there anything else that you would like to talk about that
meeting deadlines. And that, like, taught me a lot about sort you feel is important? G: I don’t know how relevant this is,
of time keeping and deadlines. Time keeping is something and I know the NHS is absolutely stretched at the moment,
that like I’ve been so bad at it and now I’m like the opposite, but I think further education especially on like how it pres-
so, I’ll arrive everywhere stupid early to make sure that I’m ents in females because I did feel like I wasn’t really taken
not late. But that is also something that has definitely got seriously in my assessment. Sort of like because I arrived
better with age as well. really early to it and it kept being brought up in any question
about time keeping the person assessing was like, oh, but you
A: How has having ADHD impacted your psychological func- were on time, so that is obviously not a problem for you. That
tioning? Wellbeing & emotional control, for example. . . G: kind of knocked my confidence, so it felt hard to answer the
I’ve always had sort of issues with my mental health and rest of the questions. And they were like making comments
wellbeing, like my emotions can be quite up and down. like I wasn’t like fidgeting enough, sort of in their eyes, like I
And I’ve always been quite an anxious person. So, like now always fidget with my hands and stuff, but I’m not like stand-
finding out that they sort of like that’s common with ADHD ing up and walking around the office and that. I think those
and it coexists and stuff explains a bit more because I have kinds of comments made me close up because you feel like
noticed that like my mental state has been a lot better this you’re not being believed. So, I think there needs to be more
year, whereas it used to be a lot more up and down. I’ve education on being impartial and how it presents in different
mentioned sort of like the aggressiveness and the anger and people, and I know like it’s not that easy.
everything, I think that all just probably comes into it as I’m glad to help because it’s definitely something that I
well and looking back I’m like ohh right, that explains a lot feel like needs more research like I can see it getting. I’m
as to why I had such extreme emotions. seeing more about it now, which is nice, but it definitely has
a long way to go, I think.
A: How has your diagnosis impacted your self-esteem? G: I
was always sort of called stupid at school and like I think Interview Participant #4. Interviewed by Aimee Tyrrell on
you sort of play into stuff, so I was like the clown of my 11/08/2022. Interviewee pseudonym: Molly.
Morley and Tyrrell 1143

A: Firstly, could you tell me a bit about yourself and your myself because I’ve got a reason, it’s not that I’m stupid or
journey to receiving an ADHD diagnosis? M: Yeah, well, my that I’m lazy, I know why. And it makes me feel a whole lot
diagnosis was very late in life, in fact, it was only this year. better about myself.
It was probably, I’m trying to think how many years ago,
three or four years ago, I can’t quite remember the exact A: How would you say that ADHD has impacted your experi-
date, that I had my autism diagnosis. Umm, prior to that ences related to your social functioning? Perhaps your friend-
I’d suffered with sort of anxiety all through my life and not ships and relationships? M: Yeah, definitely, I think it has
perhaps been as successful as I should have been on paper. affected most areas of my life, but that area in particular,
You know, I didn’t sort of fulfil my potential in many ways yes. More so as I have got older, actually, even more so. I
and struggled with a lot of issues, you know, housework, suppose it was bad when I was a real small child, I couldn’t,
actually focusing on jobs, all sorts of things really. But the I struggled to make friends. I was so shy, what I thought was
anxiety was probably the worst part for me at that particular shy, and I just couldn’t, umm, deal with the whole friend
time in my life. And I went to some, umm, CBT sessions business, really. I didn’t even know what a friend was, I
and it was there it became evident that there was a possibil- don’t think, when I was really little. Teenage years onwards
ity I might have ADHD and autism, so it was from there that in my 20s, 30s, possibly even 40s, I created this person, I
she asked my GP to refer me on. I got the autism diagnosis made this mask, who was very outgoing and did a lot of
first, it has taken me ages to get and for the GP to sort out things. But I still struggled in intimate relationships, part-
my referral properly for the ADHD but got there in the end ners, or close friends. And I very often ended up in friend-
and was diagnosed with that this year. ships or relationships that were a bit abusive, really, I think
Yeah, but yeah, general struggles all my life from child- they took advantage of the fact that I was sort of trying to
hood onwards really, with work, keeping on top of things people please all the time, and made me, I think, looking
and always being late for things. Not doing homework on back, it made me quite vulnerable. Yeah, so it’s not been a
time, not turning up to work on time. You know, just so good experience in that way. Again, now I’ve had my diag-
many things really. But it never occurred to me earlier on in nosis, things are a lot better. So, I now sort of learnt to let
my life that was what it could have been. I just, you sort of certain toxic relationships go, and I’ll try and nurture the
put yourself down and think you’re just not good enough or ones best I can, the ones that aren’t. But I still feel, and it’s
that you’re lazy, or that, you know, just not as good as been a theme all through my life, is the rejection sensitive
everybody else, essentially. dysphoria, I’m very sensitive to rejection and that impacts
relationships as well. And, umm, even now, with disclosure,
A: How did you feel when you received a diagnosis? M: I don’t tell many people in my personal life about my diag-
Well, much better really, because it has helped me in a lot nosis. I am a bit more open about it at university, but I worry
of ways. I’m not currently medicated for ADHD, and I was what some family members and close friends will think of
considering it, but I’m having blood pressure issues at the me if I was to tell them about it.
moment, so it’s probably unlikely that I will end up being
medicated, which is a shame in a way because I wanted to A: So, I believe you’re a student at the moment, is that cor-
see what life might have possibly been like if I could get rect? M: Yes, that’s right.
myself organized. And you know, able to do things and yeah,
just to see things from the other side of the fence. However, A: How has ADHD impacted your academic functioning? M:
it has changed the way I approach lots of things, having the Right, yes. So, prior to diagnosis, I’ve tried to perhaps get
diagnosis, so that means now that I plan things differently, qualifications that I couldn’t get when I was at school
and I do everything a bit differently now because I’m aware because I just failed maths, I failed English. Again, I’ll put
straight away, that like, this is gonna cause me problems, or a lot of it down to I just can’t do that, that’s just too difficult
this might be difficult for me to finish, or this might be dif- for me. I’m just not good enough. And several times dur-
ficult for me to start, so I have to sort of go about things in ing the course of my life, I thought right, I need to get this
a different way and not beat myself up if I can’t do things. done. I need to do this and know I can do more. I know I can
I tend to delegate more things now, so whereas I’d try and be more; I just can’t get the paper to prove it. A few times
take on everything, knowing full well I wouldn’t be able I’ve tried to redo my English and maths and again gave up
to do it, and then making myself anxious and ill trying to because it just felt impossible. Once I had the inkling that,
do these things. I’m better now at sort of saying right, I’m yes, this is what it might be. It might be because I’m autis-
not gonna do that because that’s just not gonna work, you tic. It might be because I’ve got ADHD. Then I approach,
know, I feel like I’m better at setting boundaries a bit now. again, I approach things very differently. So, I thought,
So that’s helped me a lot, yeah, so it’s been a good experi- actually, yeah, I can do this. It’s not that I’m stupid, it’s just
ence in a way having the diagnosis with regards to my life, that I need to do things the right way for me. And so that’s
I can plan things, work things better. And I feel better about how I started my journey going to university. So, in order
1144 Journal of Attention Disorders 27(10)

to do that, I had to get my English and maths, but knowing from DSA, which again has helped, particularly the one
how I am, I found the route that was easy for me. So, umm, I that involves, it’s called Glean, so I can record lectures.
didn’t do GCSE English for instance, I did functional skills And that’s brilliant, because I can’t always remember what
because that didn’t involve poetry or anything that was too they’re saying to me, and I don’t always take everything in.
imaginative. It was basic stuff, and I did the course online. I So, I’ll find when I’ve recorded, I can play it back if I need
had to go in for an exam which was stressful. But the course to, to think, ohh, what on earth did you say, I can’t remem-
was online so that was good. And the GCSE maths I also did ber what she said, so I can just play it back. So, it’s just
online. I tried to do it in a college, but I was having panic been a case of getting all these systems in place to help me
attacks every time that I got there, I just couldn’t cope with and sort of put me on a level pegging with everybody else,
the scenario very well. I think that this was partly a build-up really. So, whereas they can take in the information, I can’t
of anxiety, maths anxiety in particular for all those years, always, it takes me longer. Umm, with regard to studying
it’s an awful subject if you’re not very good at it. And, and, at home, again that’s been challenging, umm, because then
I really struggled in that environment because it was too I’ve got to organize my time and then of course, you’ve got
sensory as well. So, when [the teacher] gave us work to do, executive dysfunction, you know, I can be sitting here, you
instead of leaving the room quietly, like letting you work know, saying I need to start. But how do I start? And then I
quietly and in silence, she’d be talking over the top of the sort of, end up sort of paralysed and not doing anything at
work, working time, so I couldn’t concentrate on my work. all. And I often find that during the day I’m tired because
All I could hear was her voice, and then she’d finish, and I’ve not slept very well at night because I can’t switch my
I wouldn’t have started. Everybody else had finished, and brain off and I’m just constantly thinking of silly things
then I’d have a panic attack, so I changed my tactics and all night. And, umm, that has an impact, sometimes what I
then did the GCSE maths online. It was fortunate because it have to do is work at night. Actually, sometimes, you know,
was during COVID so that was an option. And that worked 12 o’clock, 1 o’clock, 2 o’clock in the morning, I’m work-
so well for me because I was in my own environment and, ing away because that’s sometimes the only time where I
I could sort of have the room set-up for me, and if I got feel that I can. Because I’m exhausted in the day because
stressed, I could just walk away from the computer, play my I haven’t slept very well the night before, so it’s been dif-
ukulele for 5 min, come back again, cause I need to move ficult, but I’ve done it, you know. So, I’ve passed the first
around as well. I find that difficult when you’re sort of stuck year, passed the foundation year, I’ve learned from it, and
in a seat. I like to sort of, even though I’m not sort of run- I’ll take that forward and try and find ways to perhaps be a
ning up and down, I need to feel like I’m moving a bit, bit more sort of organized with my time somehow, I don’t
otherwise I feel, it feels like I’m in a strait jacket, it’s hard know. I’m constantly looking on the internet for methods
to explain. So, I was able to get out of my seat, move around and ideas and ways to beat this, you know? But I’m getting
a bit, and I’ve got everything sort of set-up here for me, so there, and I feel quite happy. If I’d have done this, prior to
even under the desk as I’m speaking to you, I’ve got like a my diagnosis, and not knowing that I’ve got ADHD, I think
foam roller on the floor, and I’ll roll my feet over that up it would have been incredibly difficult and I don’t think I
and down. And that makes me feel like I’m moving because would have even got past the foundation year. Well, I know
I’m getting the input you know, and that helps me if I have I wouldn’t really.
to sit somewhere for too long, I’m always rolling my feet So, yeah, having that has really enabled me to, under-
over and over on the foam roller. So, doing the GCSE maths stand, and as I said, mainly be kind to myself really, so I
online, with that sort of situation that I was controlling was don’t beat myself up if I’m struggling, if I can’t remember
brilliant. If I struggled with anything, I booked a 1 to 1 with what they said or everybody else seems to know what’s
the tutor, that really helped. So, I passed both of my English going on, I don’t worry about it anymore. I just think, uh,
and maths and then I applied to uni for the degree course, let’s sort this out.
but with the foundation year as well, rather than doing an
access course. I was advised to do that by an organization A: So, finally, would you say having ADHD has impacted
who help mature students, really, trying to get into higher your psychological functioning? Say, your self-esteem and gen-
education. And it was the best thing I did, really. I think eral wellbeing? M: Oh yeah, definitely. Umm, more so again
it was much better than choosing the access course routes before diagnosis, because I really felt myself being inferior,
because I’m sort of right there in the university. By the time I suppose, to other people. I always sort of has a feeling like
the degree course starts, I already know how the systems I wasn’t good enough. And, you know, you look around, or
work, I will know how their platforms work, and I know you go visit somebody and their house is immaculate, and
the location. I know everything about the place, and I feel everything is so tidy, they’ve got kids, and everything is so
more comfortable and confident to start, and they’ve been organized.
really helpful. So, if I’ve had a problem, they’ve always And you’re thinking how the hell do you do it? How do
sort of helped me out. I’ve had some equipment anyway you do it? What is wrong with me? Why can’t I do that?
Morley and Tyrrell 1145

Why can’t I be as organized as you? And that does leave difficult. Life is really hard. And sometimes I think ohhh, I
you feeling a bit, umm, you know, like there’s something wish this wasn’t such a struggle, I still feel like every day
not right here, like, you know, I’m not good enough. But can be a struggle, and then I just have to sit back and think
again, since diagnosis, I do view that very differently. And right, let’s make a plan and I just have to then tackle things
there’s a lot of useful resources online as well, that sort of differently, but it doesn’t stop the anxiety. It doesn’t stop,
help with those sorts of feelings and explain things and put you know, having to really push to get things done, push
things into perspective a bit. There’s a lady online, on through the barrier, it feels like you’re pushing through a
Instagram, I can’t think what it’s called, but she’s really barrier really. So yeah, that’s how I feel.
good. And it actually, sort of, teaches you to sort of separate,
when you’re trying to keep a house, for instance, the tasks Interview Participant #5 Interviewed by Aimee Tyrrell on
involved with that and you sort of separate that, it’s not a 12/08/2022. Interviewee pseudonym: Chloe.
moral thing, it’s a, umm, I can’t put the words you see, this
is another thing, you see, trying to get the words, I know A: Firstly, could you tell me a bit about yourself and your
what I wanna say but I can’t say it. Yeah, she sort of puts journey to receiving your ADHD diagnosis? C: So, umm,
things into perspective and makes you think, oh, actually, I’ve always struggled with dyslexia and like, I’ve always
yeah, and it does help me, you know. It does help also hav- struggled in school. It was around 21 when I got the dys-
ing supportive people around you, you know, and who are lexia diagnosis, but it was only the temporary one they
always sort of on your side and will push you forward and did at college. And then when I’d gone to uni, I needed
that’s helped. It’s not always been the case, particularly the full dyslexia assessment that you have to go through,
before, as I said earlier, I’d sort of be surrounded with peo- and I went and got that done in December, but then I was
ple that I don’t actually feel did want the best for me and talking to someone last September, October time, and they
they were just sort of, you know, using me, really, using and said like I do think you have ADHD. And I was like, well
abusing, but it’s not like that anymore. Umm so, moving no, because I thought generally like, it’s a bit portrayed
forward, I think I feel more in control of how I feel, you by the media as well, like you think it’s just naughty kids
know, because I can control my surroundings and my life a that have too much sugar. And then I did work with a few
little bit more. I feel like I’ve got more control over things. kids and my mindset has changed from when I’ve worked
Now I understand why, so yeah, that’s helped me. with kids, but I never saw it in myself. Umm, but I went to
Boundaries, I’m setting more boundaries now, which I my GP, and I know I’m very lucky because I was quickly
didn’t do before, I wouldn’t set any, I don’t think, and that diagnosed. Like all within 6 months, I went from submit-
has a massive effect on your wellbeing, I think. Definitely. ting to GP, had the full assessment and then started medi-
cation trials and everything. I’m very lucky. And it’s like
A: So that is all of my questions. Finally, is there anything else the more you learn about ADHD every day, it’s like ohh
that you want to talk about, anything that I haven’t touched yeah, that makes sense, or it makes sense why I do things
on? M: Umm, I think we’ve covered everything really. in a certain way.
Umm, I’m sure some people would be very, you know, feel
very differently to me and being upset when they got their A: How did you feel after receiving a diagnosis? C: It was
diagnosis, I was actually relieved, and I was very happy very mixed emotions, sometimes it doesn’t feel real still
because finally I could put things into perspective and cause it is very new, but then my biggest annoyance was
understand and feel much better about myself. Umm, you why was it not caught before and then that’s when I found
do spend a bit of time looking back on your life and look- it it’s more, it’s very hard to diagnose in females, let alone
ing back on it with a different filter on, and thinking, ohh, if teenage females, and then it’s a bit of relief because things
only this, or if only that, but that only lasts for a brief time. made sense. Like it made sense why I don’t process emo-
And then you think, well actually really this is, it wouldn’t tions sometimes, why sometimes I’m underwhelmed, or
have made much difference and I’m quite glad things have sometimes overwhelmed, why I’m just all over the place.
happened now rather than earlier. I think my age, I mean, Umm, it makes sense for pretty much everything and then
I’m 53, if I’d have been diagnosed with anything at all back it’s just a new journey of trying to find out different coping
in the 70s, what would have happened to me? strategies and mechanisms, and just how to actually deal
You know, who knows. I wouldn’t be in this position with it.
now, I don’t think. So, I’m kind of glad I had a late diagno-
sis, really. People understand it more now. There would A: How would you say that having ADHD has impacted
have been more of a stigma back then, if you know, I don’t experiences related to your social functioning? Say, your friend-
actually think, as a woman, we would have been noticed at ships and relationships? C: Relationship is sometimes hard
all really, or wouldn’t have understand what it was. Umm so especially, as like what seems like a small trivial thing to
yeah, I think that’s about it really. It’s hard. It’s really him, to me, I will just overthink it and everything, but we
1146 Journal of Attention Disorders 27(10)

just try and talk to each like, he’s like I’m gonna say some- it. And my other auntie is just, like really supportive, and
thing, but I know you’re just gonna overthink it for the next she’s like, oh you’re just crazy darling, and that we love
few hours. Or if he said something to me, like just the other you. So, it’s gone from the auntie, who you can tell every-
day we were doing the tip run, and I wanted to do a third thing to, to laughing down the phone, saying it’s all made
tip run because I had to do it to be settled in my mind, but up and it’s all lies, and saying that like she knows people
he was like I don’t wanna do it, but he did to please me, but with ADHD, and I haven’t got it. And she was very unsup-
even though he said to me three times, I don’t want to do portive, and I was really shocked as well, I was hurt, so
it, I didn’t process it, so it’s just, we’re trying to figure out our relationship has really changed, like I don’t talk to her
ways of me actually trying to register it, so it’s a learning as much anymore, and partly because I’m like what’s the
curve, umm, in my relationship and with the other half, with point in talking to her when she doesn’t understand what is
friends, a lot of my friends work in SEN schools, or they the one thing that actually makes sense in my life, but it is
are teachers, so they work in that kind of area, or some have what it is. I’m a great believer that everything happens for
ADHD themselves, and most of them thought I had ADHD a reason. My other two aunties, which I wasn’t as close to
but I just wasn’t’ medicated. Like they knew and they were before, I’ve kind of gained a better relationship with them,
like, we thought you knew and it’s just something you didn’t and I still talk to the other auntie about other stuff, but I
wanna tell us at that time. I’ve got a very good support sys- just don’t bring up the ADHD. Like, she says she knows a
tem and like a lot of them knew about it, and they were lot of kids with ADHD and autism, and it is brought on by
like, yeah, makes sense. And then we’ve discussed things their diet and that makes them crazy when their parents give
and they’ve seen the progress being on the medication and them processed food and, so yeah, she’s a bit like that. Like,
how it has helped me. My one friend, who is like not in that she’s obsessed with what the media teller her and Facebook
area, she generally knows nothing about ADHD, she’s actu- and conspiracy theories and stuff like that.
ally taking time to do research on it as well, which I really
appreciated. And it like, shows how good friends they are, A: As a student, how has ADHD impacted the academic side
because she was willing to do that. But she was like, wow, of your life? C: I did my first year at university, I did full
it’s like a checklist for you, it’s like yes, you do this, you do time because it was 2020 and I had nothing else to do. And I
this, you do this, and in her job role as well, she’s like set up was going through the dyslexia kind of process at this point,
a couple of posters in the office space and that, to help with and I had one tutor who was very supportive, and I had
awareness of ADHD. And she’s more aware of it now and another one who didn’t believe in dyslexia, ADHD, autism,
how it, like, works and stuff. Umm, so it’s kind of knowl- and everything. She just believes it was a lazy excuse for
edge and it’s just we are all kind of good together. not going to school. And then I was supposed to have her
And my mum had a bit of guilt I found. Once I was diag- for second year because of exams, and I know I don’t do
nosed, she was like, how did I miss it? It was like school well on exams. I thought I’d relieve the stress and I’d just
missed it, everyone missed my dyslexia as well, so it’s like do it part time, which I have found has been easier to cope
not her fault. Sometimes we can’t communicate properly, with, especially with time management and organizing, and
and I just end up breaking down crying because I feel like I I can just focus on like the one thing instead of having to
can’t get my point across, but it’s just a learning curve with jump between things. I was trialling on Concerta ADHD
everyone. medication, and it was very, it did not work for me. So, I
found that uni did get a bit hard at one point. I was supposed
A: Do you think that if you had someone, say a friend, who to have that old, nasty tutor, but I just put in a complaint and
wasn’t as supportive as your friends are, would you hold back said I’m not having her, please remove me, so now I’ve got
from telling them that you had ADHD, do you think? C: Yes, a really lovely tutor, who was supportive. She even sent me
so, you know that you have that one auntie that you can like ADHD links as well sometimes. And, I had an exten-
tell everything to, well I spoke to her about it and she just sion, like 2 times, and she was like you’re not submitting
kind of laughed down the phone to me and I was like, oh anything, I’ll give you a grace period, but she was like, just
OK. So, I was put off going to the doctor’s for like a month, try and get something done and everything, and it really
but then I thought, you know what, I needed answers. And worked. I found just doing it part time I was able to cope
then when we said I was going through this to get the diag- better with the ADHD and focusing on what I was learning,
nosis, she just kept really quiet of it. And when I had the and it was easier. And then I had like tutoring sessions as
official diagnosis, like when I was diagnosed, my mum told well. I had a couple sessions from the tutor where we just
one of her other sister’s and she was like oh it makes sense went through what dyslexia was and what ADHD was and
and since I’ve got a bit closer to that auntie. I’ve found that like figured out different coping strategies and mechanisms
we’ve been able to connect and bond, she’s more aware and I could do to help with uni work as well, and I’ve got that
that, she’s like, remember when you did this, it was your tutor until I graduate now. Umm, but if I have any question
ADHD, that’s you, and I can talk to her more openly about about ADHD from my tutor, or from the disability support
Morley and Tyrrell 1147

team, they will always provide information and kind of help but we know it’s the ADHD behind it. Like, a little like, I
me the best they can as well. wouldn’t realize that I would interrupt people during con-
versations, like, sometimes for me it’s like I’m gonna forget
A: How would you say having ADHD has impacted your psy- what I’m gonna say, so like that sometimes I didn’t realize.
chological functioning? C: I think, I think at the minute with And then once I was diagnosed, I would be like oh do I do
my psychological wellbeing, it’s like trying to find the right this? And they all look at me like yes, so if I do do it, I’m
medication for me and the right doses. And so, I’ve been like please tell me so I can learn. I followed this page online,
doing it since March and then Concerta didn’t work, so then and it just tells you like different things for ADHD and stuff
I had to go through withdrawal for like a month. and there was one about showering, and like sometimes I
Withdrawal was worse with the side effects than I had on didn’t want to shower for a few days when I was a teenager
the actual medication, so I felt like I was getting a bit low and when I was younger as well, and we couldn’t seem to
sometimes. With Concerta, I was emotions everywhere, figure out why. And then like, once we read about it and we
like I could drop a pen, and I would cry for like 20 min. I done some more research on it, I was like yeah that makes
was very emotional. Like my other half would have been sense why that happened, because of sensory overload.
looking at me like, what can I do for you? And then I Also, I used to be pen pals with my cousin and I kind of
dropped a plate, and you would have thought I’d just killed wanted to stop so I sent her all the letters back, and she
someone with how hysterically crying I was. I found that cried. I didn’t see, I never saw that I did something wrong.
with the medication and then my doctor was like, oh, this And later on, we were talking about it, and she was like I
might not be the medication. Then one of my friends wrote don’t think you realize how badly I was hurt over that, I just
me an email saying there was like a one in a million chance thought that’s what you do, send all the letters back. And
that I have this side effect, which was what I had. And even now looking back at things, it makes sense why I did that.
my friends noticed that I wasn’t normal [Chloe], I was very That would be the ADHD and my brain.
just like “How are you doing”? *Blunt tone*. Normally, During 2020, once the borders opened, I was in France
when I jump in the car, I always have like a story or gossip within 4 hr. Told my mum I was going to France, and then
to tell, but they said to me like something is not right with she phoned me the next day like where are you, and I was
you. I felt like, I was like, I felt physically fine, I knew I was like I’m in France. Sometimes I have compulsive spending,
a bit washed out, but I thought maybe I’m still trying to like I spent like 800 pounds in like 2 days back in October
process the diagnosis, umm, and like with uni and every- last year, and then we kind of realized then I returned the
thing and worrying about exams. But so, my friend has got stuff, like I didn’t want the stuff, I didn’t need it. But then
a toddler, and even he was like, didn’t recognize me because sometimes I would tear up the receipts so I couldn’t return
it wasn’t the same energy I usually had. I’m on Elvanse now things anyway, or I forget where I’ve put the receipts. But
and that seems to do a lot better. And it’s amazing who you yeah, like, it makes sense of why things like that happen and
speak to about it, and they’re like, this didn’t work for me, stuff, but it’s just like, little coping strategies for things.
or this worked for me, and you feel like you’re not alone on
some of the groups and some people you talk to. We do A: Finally, is there anything else you would like to add? C: I
have bad days, but we do have really good days as well and think we have covered everything. I know I am very lucky
it’s just finding the right balance. Finding and having that with the support system I have and how I was quickly diag-
support system where you can talk to people. I do find it is nosed, and I have found good tutors, good friends, and that
getting better, but if I am upset, I try and write something lot. But I know some people don’t have that. And yeah, but
down. I try and figure out what might be causing it. If there I think as well if you go in with more of an open mind and
are no obvious reasons why I might be upset, I’m like, OK, think like, OK, this is the cards you have been dealt with
maybe it’s just my ADHD brain and maybe it’s something in life, you can either go one way and you can control your
that I’m just not seeing and stuff. I have said to my friends life, or we can find ways to like to try and improve and learn
and family, like, if I said something that I might not realize and understand more about yourself.
might hurt someone and that lot, or like, if you’ve said
something to me three times, and it’s still not processing, Interview Participant #6. Interviewed by Aimee Tyrrell on
like we will try to find a way that it will process in my brain. 12/08/2022. Interviewee pseudonym: Hannah.
And like the only way I’m going to learn is if you guys tell
me and teach me. And so that’s the new strategy we’ve been A: Could you tell me a bit about yourself and your journey to
doing like the past few weeks as well. receiving an ADHD diagnosis. H: Uhh, ohhh, I was diagnosed
after my first child. And when I told my parents, they said it
A: Would you say that since having your diagnosis, you was mentioned at school, but they never bothered following
understand yourself better? C: Yes, so, before, people would up with it because they didn’t think there was any point to it,
be like “oh, that’s just [Chloe],” and we still say that now, because I already had a dyslexia diagnosis. I’ve got, uhh, an
1148 Journal of Attention Disorders 27(10)

undergraduate and just starting a masters as well. And I’ve to be really excited about it. To like finally have answers
done several jobs, I don’t work in my degree area anymore, and stuff, but I was more looking forward to the fact that
I did for a little bit then it got a bit samey and a bit boring. now there was a formal diagnosis, there was like some stuff
So, I now work [in healthcare]. I could try to see if it helped. Like, I don’t actually have any
particular feelings about the diagnosis, like, I don’t think
A: What led to you seeking a diagnosis? H: Umm, I’ve got it’s changed the way I view myself other than maybe a bit
a friend who’s got ADHD and she noticed a lot of similari- more self-compassion. But the diagnosis itself, I was just
ties between us, and I’ve also got a friend who is a clini- a bit like, OK, like, not really excited, but not really – like
cal psychiatrist who said it seems like something I should I’ve seen some people when they post stuff online and it’s
probably follow up with, because I started, I sort of had a just about how their world has shaken, now they’ve got this
suspicion for a lot longer, but didn’t bother following it up diagnosis, and that wasn’t really how it was for me. It was
because it wasn’t, it seemed like a lot of work, actually, and just, OK, cool.
it wasn’t impacting my life enough that I felt like I needed
lots of extra help. I had my own coping mechanisms, but A: How has having ADHD impacted experiences related
then after I had my first child, it was sort of, lockdown was to your social functioning? H: I think it’s always affected
imminently after sort of thing, and it was, it got a little bit my friendships, because I have had several nasty fallings
overwhelming. So, my friend that I was speaking to about out with friends and stuff, and the general theme when it
it, who had a diagnosis and was on medication, said that, happens is that I can be a little bit much sometimes and
you know, it really helped her, and it was worth going for it. they weren’t nice about it. And as I’ve got older, I think
So, I did. Going from my initial assessment to being treated, people are just a bit more understanding about differences
it was probably 3 months, which I think is pretty epic com- between people, whether or not you’ve got a diagnosis or
pared to some of the wait times that people are facing at the anything. But I always find it quite difficult to have like,
moment. Uh, and I found medication really, really helpful. friendships, and to hold onto friendship groups. I have lots
But at the time when I was struggling, I was on maternity of friends and like mates, but not like a close core friend-
leave, but still completing a qualification with work that I ship group that some people have. So, I’ve got a couple of
was doing, so I should have been using some of the mater- good friends that sort of dip in and out, but if I’m honest, I
nity leave to catch up on work that I hadn’t done when I think all of them are sort of neurodiverse, and we are just
should have done. And I didn’t, and I just found it all a bit a bit more understanding of each other, I think, but, I don’t
overwhelming, and I couldn’t deal with the distraction of have trouble being social or being in social situations other
having like a kid and more plates to spin. Finding the time to than when they get a bit overwhelming and it all becomes
sit and do it became harder, which meant I couldn’t do the, like, like a really long extended day with lots of new people
you know, leave it until the deadline makes you do it kind of and stuff, I’d probably rather go home at that point. It’s not
thing, because inevitably you’d have a child that didn’t sleep an environment that I enjoy, but I can cope with it when I
of suddenly got ill or something like that. And so, it got to need to.
the point that was pretty bad and I got referred to the educa-
tion department at work for additional support. And I sort of A: How has ADHD impacted your academic functioning? H:
thought to myself that, umm, I’m going to get in trouble with Umm, it probably made it much more stressful, because of
it. I need to sort it out, this sort of thing. So that’s really what the tendency to leave everything to the last minute or on
prompted it because it was starting to impact work and home one occasion restart a piece of work that was worth most of
life and getting things done. And I didn’t want it to get worse the module the night before it was due, because I decided
and get to a point where I did something stupid looking after it wasn’t good enough and changed my mind about what
my daughter or forgot to take her to a doctor’s appointment I wanted to write about, and so, I think, probably if I had
and things like that. So, when it was just impacting my life a better ability to forward plan and well, not even planning,
bit, it was one thing, but when it was like the prospects of I’m pretty good at planning, but just following through with
impacting my child, I was a bit like, OK, need to see this and the plan is the tough bit and it probably would have been
but then after the diagnosis I didn’t realize how much of the a bit less stressful. I can be a bit on the impulsive side, so
stuff that I’ve struggled with. Like my whole life was like for my dissertation for my undergrad, I bit off a bit,
ADHD, I just sort of assumed it was my personality. Well, I probably a little bit more than was appropriate because at
guess it is, at what point is a diagnosis a personality, I don’t the time of submitting the proposal I was full of enthusi-
know, but, yeah, so, it was good. asm and, umm, then it got quite stressful and quite a lot
because I took on quite a lot. I mean, there was a couple of
A: How did you feel after receiving a diagnosis of ADHD? H: stupid things like I missed out on a scholarship in my first
If I’m really honest, I didn’t really feel anything. I think a year because I forgot to set my morning alarm and slept and
couple of people, including my mum, thought I was going missed the exam. And the exam was only 5%, and I needed
Morley and Tyrrell 1149

90% in the module, and I already had 90% so I could have ception with sort of ADHD being only hyperactive teenage
gone to the exam and not actually written anything, and I’d boys, and oh, you can’t have ADHD because you managed
still have got the amount I needed, but the fact that I didn’t to get a degree, or you can’t have ADHD because you got
attend the exam meant I was not qualified for the scholar- A’s in those exams, you can’t have ADHD, for all sorts of
ship, so I missed out on the scholarship that way. There was stupid reasons. And oh, you haven’t been fired from every
once a time where I went on a night out the night before a job you’ve ever had, you can’t possibly have ADHD, sort
70% exam on one of my modules as well, which was really of, yeah, a lot of that sort of stuff, and obviously it is a little
stupid and I was extremely unwell the next day, during the bit more in depth than that. But, yeah, I think there is still
exam probably. Again, was not the most sensible of things. a sort of point of view that if you’re not completely burn-
I mean, luckily, it was the subject that comes quite naturally ing out and completely having a meltdown about absolutely
to me, and I quite enjoy, so actually, I managed alright in everything, then you’re not struggling, or you don’t need
the exam. It didn’t mean like, I didn’t fail my degree or any- extra support. Which is obviously not true.
thing because I’m a bit impulsive, but definitely, in some
aspects I probably haven’t done as well as I could have done A: How has ADHD impacted your psychological functioning?
in terms of grades on specific modules, and on the modules For example, your self- esteem? H: I think that is probably the
that are a bit boring. You know, the ones that you just have biggest effect it has had on me. Yeah, I think ADHD has had
to do because they’re the core modules within your degree, a massive effect psychologically. More specifically because
but like then you don’t really wanna pay much attention not being diagnosed younger has had a massive impact on
to them. There was a really marked difference between the me. I was being told things like “I don’t know how you will
grades I got in the choice modules and the ones that I felt cope in the real world” and that I must not care about things
like I had to study or didn’t enjoy. Like, my average grade if I lost or forgot about something, it made me feel like there
in the modules I liked was about 85% overall per module, was something wrong with me and that other people could
and the ones for the compulsory study or the ones I didn’t do things that I found really challenging or kept messing up.
like was probably about 60%, so I still did OK, but it was Umm, I found I believed that people had to put up with me
quite a marked difference between the two. rather than enjoying my company and I had to apologize for
things a lot that I shouldn’t have and didn’t need to.
A: Do you feel that you’ve had enough support for your The impulsive side also means that I’ve struggled a lot
ADHD throughout education? H; Umm, no, probably not. I with my weight a lot, due to bad eating habits and comfort
feel like a lot of it is lip service. In that you get a lot of, ohh, eating. I have also always exercised a lot but have found
yes, you’ve got ADHD, dyslexia, or whatever. It’s some- that I hate the gym because it is so boring and so I need fun
thing that you need support with. And then at the beginning sports and activities. The issue is when I fall out of the rou-
of the time you get a lot of, how can we support you? What tine or get bored of one activity, I find it difficult to start
would help? Ohh, you want to have notes in all of them something else or get back into routines I had. So, uhh,
or all this sort of stuff or having recordings of the lectures yeah, I haven’t always had good body image, I have often
helps you, OK great. And then actually when it comes to been called weird and that I wasn’t meeting my potential
putting those in place, it’s inconvenient and it kind of falls which led to low self- esteem. Since a diagnosis, my emo-
by the wayside. Then, then were a couple of times where tions have become a lot easier to handle, both after being
I ended up getting in trouble, well not like I was doing medicated and because I understand them more so give
something I shouldn’t have done, but I was finding it really myself more grace. I get anxious a lot too because I am
challenging because the things I’d asked to be put in place more likely to have forgotten something or mess up or get
weren’t put in place. And then I’d been told I could record lost or run late whatever when going to new places or doing
lectures, voice record lectures to redo notes, and then I’d go new things which means I find it hard to socialize outside of
to voice record them, and the lecturer would say no, even my comfort zone.
though they had said I could. And stuff like that, and some
lecturers were really great, and some teachers as well, if Interview Participant #7. Interviewed by Aimee Tyrrell on
you think all the way back to school, you get some people 18/08/2022. Interviewee pseudonym: Jessica.
that sort of try really hard to like help or support you and
then you get some that sort of go, ohh yes, well you have A: Could you please tell me a bit about yourself and your
ADHD but it doesn’t mean that you can’t study hard and journey to receiving an ADHD diagnosis? J: Basically, I always
like, yeah OK, thanks. They just don’t understand, I still thought I had a few quirks and stuff but like I majorly strug-
think in education, there are still a lot of teachers who, I gled in school, but I thought it was just, uh, you know, I
think they think maybe they think they understand it, so still performed quite well and still got good grades and stuff,
they don’t read more about it because they think they know and so, they told me I’ve got dyslexia in my first year of
what it is, but there’s a lot of the, umm, perspective, miscon- uni. This was like when I first went to uni like, when I was
1150 Journal of Attention Disorders 27(10)

like 22 or something. And I thought that answered a lot of lot more compassionate to myself now, I think instead of
questions, but then my second degree, which was in like an like taking on too many things at once, and thinking yeah, I
NHS environment, I was under quite high supervision and can cope with it, but I think that exacerbates ADHD because
like my supervisors were picking up traits and stuff which I like when you’re stressed, I think the symptoms are more
had. Initially, it was just a few traits, a few little things, and prevalent. And maybe, I think because of ADHD, I think
that. On my first placement like I used to like to click my you’re inclined to do lots of different things, uh, and it burns
pen and stuff when my supervisor was talking, not really you out. So, I guess like in knowing that I have ADHD and I
realizing and she would obviously be a bit negative towards felt like I’d been running on a motor for like, however long,
that behaviour because it might convey like, you know, not always busy, and always doing things, umm I guess it’s kind
listening or whatever. And then after a few weeks, she was of made me stop and just go, right, just work one job, just
like do you need to do that like is that something that you do one thing. You know, get things sorted and like figure out
need to do to be able to concentrate? And then as I was kind strategies that are related to ADHD so that you can better
of like piecing it together, I was kind of like, well this is manage it. It’s kind of made me think, right, well, I can’t
very like symptomatic of not being able to listen when, you function how I have been functioning because it’s not good
know, there is lots of information. So, I thought you know for me or maybe anybody else.
that might be likely to be linked to dyslexia, but then as I did
a bit more research and stuff, more behaviours were being A: How has having ADHD impacted experiences related
picked up. It was things like, interrupting someone, like to your social functioning? J: Yeah, it’s quite bad actually,
when my lecturers were speaking for example, like obvi- because like, although I’m quite a sociable person and
ously that might seem really disrespectful. I would like try whatever, sometimes I’ll get too busy with like studying
to paraphrase what lecturers were saying because what they and work and like, I kind of neglect personal relationships
were saying was too long for me to keep concentration on. at times, because I’m so busy doing whatever I’m doing.
People were making comments and I was getting into trouble A lot of the time I’ll have lots of associates, but then few
for things that I realized were symptoms of ADHD. I felt that people that actually know me like very well.
it was like unfair because they were picking up these things Umm, and I think it’s because my focus is just so bad,
which related to symptoms of ADHD, and I’d said that I was and I’m so interested in lots of different people and lots of
going through the process to get an ADHD diagnosis. It was different things, it’s difficult to just stick to one group of
kind of messing with my head a little bit that, I was thinking friends. And I think it’s made romantic relationships really
that this is discrimination arising from disability, you know, difficult because, you know, like things that I struggle with
in terms of these traits or symptoms whatever were coming on a day-to-day basis, which I thought and think are normal,
across as really annoying to the people I was working with, like probably aren’t, so it takes me a lot more focus to do
you know, like in terms of focus and stuff like that. I wasn’t simple things like organizational things and like when I’m
trying to be disrespectful, but that is kind of how it felt it doing those organizational basic things, like I don’t know,
was. And they didn’t implement my support plan, like there thinking what I need to take to work, it makes my brain
was various different failings. I had like one supervisor, who work a lot harder. So, I think in the moments when a partner
was like, you need to focus on this, it’s really important, but was around, for example, I could get quite annoyed by the
I was just thinking like this is so overwhelming, there is a lot fact that like they were even talking to me whilst I was try-
going on, there’s lots of notes to make, lots of things going ing to do something like that, which obviously doesn’t cre-
on in the wards, and I just found it really difficult to focus in ate a nice environment. I’d explain that like I can’t really do
that environment. And then I think what exacerbated it was two things at once, like I just need to get my stuff together,
not knowing how to kind of manage it or what was going on. but yeah that’s difficult and that puts strain on a relationship
So, I went to get an ADHD diagnosis and a psychiatrist diag- and stuff. I think as well what is really overlooked is some
nosed me with ADHD and confirmed that I had ADHD all of the emotional dysregulation that you have, you know,
along. This was about 4 weeks ago now. I felt constantly like when things are a bit more stressful, I think that’s where
attacked and like discriminated against, so obviously like I’ve been like more susceptible to snap. And like, feeling
that impacted my interpersonal relationships at work, and those emotions quite intensely, and I feel like that is hard for
in the end, I said, look, I feel like because of the comments anybody to understand too. Like I can’t function whilst
you’re making, like I feel this is discrimination. And then I you’re talking to me, which is really hard.
was pulled off that placement because it was impacting my
mental health and it was impacting the team, like they could A: How would you say ADHD has impacted your academic
see I was suffering. functioning? J: Yeah, I mean, to be honest, I can kind of cope
with the academic side of things, things like assignment and
A: How did you feel after receiving the diagnosis? J: It defi- stuff I tend to get quite good grades. I’d have trouble with
nitely made sense, it does make sense and I’m probably a like understanding what the assignment is and understand-
Morley and Tyrrell 1151

ing exactly what they are asking for if you know what I to miscommunication or whatever. Like I think, looking
mean. So, I guess without things being clear, whether that’s back to the start of my placement, if I could have said like
the assignment brief or whatever, like I struggle to get it on I have ADHD, this is how it affects me, things would have
the page in like an order and understand what I need to do. probably gone a lot better. Like, you know, if I’m coming
And like you could argue that is a very basic thing that a across like this it just means that I’m focusing on my work
student should have, and they weren’t always very helpful and it has nothing to do with you, so please don’t take it that
in explaining things to me either as you know, that was what way. So, yeah, if I had my diagnosis and could have gone
they were trying to assess in the assignment, but it is some- about things like that, things would have gone a lot better,
thing that I also need extra help with to get me on a level so yeah, early diagnosis is important.
playing field. I also struggled on placement with being mis-
understood, like I felt that people misunderstood my char- Interview Participant #8. Interviewed by Aimee Tyrrell on
acter quite a lot. Like, sometimes I would be super stressed 18/08/2022. Interviewee pseudonym: Grace.
and like hyperfocusing on things, but I think to some people
that comes across quite hostile, like not wanting to chat to A: Firstly, could you tell me a bit about yourself and your
people whilst I’m working and stuff. Which I found really journey to receiving an ADHD diagnosis? G: So, I’ve kind
overwhelming. of always known that I was, I was very active as a child.
My mum worked in education, so she had always kind of
A: Finally, how has ADHD impacted your psychological known, but I think because it’s like, I don’t know, the dif-
functioning? J: Yeah, like it has really affected me. I think ferent like maybe stigmas, like there’s a lot of different
it affected me when I was younger a lot more. I think in reasons why we kind of didn’t get a diagnosis as a child.
school because I think everybody gets affected in school And then when I moved away to university for my under-
anyway, but like, I think it affected me more because it was grad degree, I really, really struggled. I struggled in school
like, so up and down like a bit hyper and dysregulated. a lot, but when I moved away from my mum, I was like, oh
And I wanted to be everyone’s friend and then not under- my goodness, this is very hard. I still kind of didn’t really
standing the social norms that you can’t be everybody’s understand why, because I think my perception of ADHD
friend. Like we have cliques in school and people don’t do was just being very active. And I kind of didn’t connect
that, so I think I just didn’t understand that I was thinking everything else, and then kind of plodded on through uni
well, like why can’t I be everyone’s friend? I thought that and then I got a job as a 1-to-1 in, umm, an infant school,
was normal. But like in school, I think people are like, well, and it was the SENCO, that uh, said to me, I’d like, lost my
no, this is our clique, don’t impose or whatever. And then I gym kit that day or something and I’d come into school and
think it led to a bit of like you know self- sabotage and self- I was just like, oh my gosh, I was just absolutely have a kind
esteem stuff. Then I think when I got to like a bit more of the of, one of those things, like, another thing that I’ve lost. And
stuff that I am interested in, I think that kind of just disap- then she kind of said, have you ever thought of, you know,
peared because I was like well, I don’t really care about that. that might be this? And then she kind of showed me this
I think you become a little bit like well, this is actually who sheet of like more girl characteristics and it was just like,
I am and like I don’t really need to change for you. And if tick, tick, tick. I was like, I didn’t realize that this was all of
I’m not a bad person, like if you don’t like that, then that’s this as well. And then I went to the GP, who was not kind.
totally OK. Like you just become a little like that. But then I I was very, I was very overwhelmed because obviously it’s
think in a medical setting, like on my placement, you can’t taken a lot to go, so I kind of started crying and he was just
just say, well, if you don’t like me, that’s fine, because that very dismissive and said ohh like I think you’ve got, I think
isn’t very professional. And I think that’s why I struggled you’re depressed. And I was like, I know I’m not depressed.
more on my placement. But yeah, I think like recently it’s I kind of said, well can you refer me anyway, and he did. So,
definitely taken a toll on me just because, like, I felt like my I was on the NHS waiting list. And then the following year,
character has been like, in question. I’m like, yeah, I kinda I started my training at university, I had kind of struggled a
get what you’re saying, perhaps it’s not communicated very lot in first year, but it was that kind of realization like OK
well, but yeah I didn’t feel like my best self in that environ- like I kind of know why now. And then it was lockdown,
ment and that’s why I didn’t finish that placement. and I lost my dad at the same time as well, so it was this
kind of like all-encompassing like ohh my gosh, I’m really,
A: Is there anything else you wish to discuss? As I said earlier, really struggling working from home, and because I’d seen
I am looking at ADHD in females because it is quite underrep- quite a lot about the right to choose and stuff like that, so
resented. So, is there anything else you would like to discuss rel- in the end I thought, I’ve not heard anything from the NHS
evant to that topic? J: Well, like everything, early diagnosis for about two years, so this was last year, like February last
is better, because then you would have the coping strategies year. So, through the right to choose, then it was last August
to be able to kind of avoid these situations that kind of lead I got my diagnosis and then I, interestingly, got a letter from
1152 Journal of Attention Disorders 27(10)

the NHS because I’d moved out of the area so that knocked about that kind of emotional side and that friendship side
me off the waiting list again so, so yeah, that is kind of the of like why I’m taking things so personally and I think the
long version of how a diagnosis came about, yeah. impact that has on relationships has been pretty difficult.

A: How did you feel after receiving the diagnosis? G: Umm, A: How has ADHD impacted your academic functioning? G:
kind of like, very relieved, very validated, I think. Because Umm, again, I think I am aware of the privileges that I had
I kind of knew from like the conversations I’d always had with my mum doing her job, my dad was academic and
like with my mum as a child and then her working with that as well, so I’ve always had the impact of having pro-
children with ADHD, and I kind of, I’d kind of known, but fessional parents and, this is something that I’m kind of
then I always, always had that, like, what if I’m just being unpicking, and how it impacted what and how I achieve.
dramatic. Like, what if it’s all in my head? So, it was a mas- I was very lucky that my mum had enough awareness and
sive sense of relief to be like ohh my gosh, like OK, since patience to get me through school. I always, always needed
someone else has kind of confirmed it. Which was yeah, it a lot of support from her. In primary school like, I was kept
was really validating, and then, then it’s probably been like in a lot because I just didn’t do any work because if I wasn’t
a year on and I’m kind of going through like different stages sat next to someone that I could copy off, and it wasn’t that I
now. So, but yeah, I think relief would probably be the key didn’t, kind of, I did know what I was doing, but I also like,
word I think, yeah. I didn’t know what I was doing, so I kind of needed some-
one to kind of come and remind me and talk me through
A: How would you say ADHD has impacted experiences it again, and I found that really difficult. I found teacher
related to your social functioning? For example, your friendships relationships very difficult because of that rejection side. At
and relationships? G: Umm, I think, I’ve always kind of secondary, like as always, the things I’m interested in, I’ve
been quite privileged in that, like my friend’s always kind always excelled, and the things that don’t interest me, like,
of protected me and looked after me a lot, and I think I’ve just, I’ve not done bad at, but it’s been very hard to kind of
always been, I mean in primary school I was bullied, but in motivate myself to do it and kind of make those connections.
secondary school I kind of made strong relationships and I I think at university, I’m always kind of like a bit leave it
was kind of very well accepted there. But I think that the to the last minute or close to deadlines and things like that.
negative side of it was, and it still happens, is that I just But for like things to click it takes me a long time to kind
find it very difficult to reply to people and like following of process and apply them. So, I think with university, in
through with plans, and that kind of not being present in my undergrad degree for two years, I kind of was like ohhh
conversations a lot or just talking about what I want to talk like it’s just a big party like it’s fine, and I think because a
about, or like dotting from different things that I want to lot of the time I could just wing it almost, in certain things,
talk about. But that, something that my friends have always I would just do that. Again, my mum gave me a lot of sup-
liked about me is that every kind of story that I tell is like, port which I didn’t realize at the time, but like things like
it’s like a movie or something, which is nice. But then I proofreading, I find proofreading and like those like little
think when you become aware that you do that and that it end bit things so difficult because by the end of it, I’m just a
is kind of not considered to be typical, I guess you get kind complete burnout, and then during my undergrad, my mum
of a bit paranoid about it, so I think in terms of like meet- was like, I’ll proofread it for you, and I kind of didn’t real-
ing new friends, it’s, I think definitely as an adult that has ize the extent of how much I needed that. Maths wise and
been really difficult. Like trying to pick out which things things I’ve always had a very specific memory of my maths
you want people to see, if you get me, I’m not too sure. And teacher in Year 11, like actually screaming over me because
one of the biggest things is that kind of sensitivity, I was I just didn’t get something, I couldn’t kind of, I just couldn’t
always very, very sensitive and like that perception of oh hold it in my head. And again, kind of not knowing why
they’ve not texted me back they must absolutely hate me. was just so upsetting and I can still remember it to this day,
Umm, I think part of that as well is then not being assertive I mean me and my friend laugh about it now, but at the
with confrontation, that’s something I really struggle with time it was awful. And thinking back, I know it’s because
because of that, like fear of rejection and things that I’ve of all these reasons, and if I’d have known, I would have
definitely struggled with and that I still struggle with it now. been able to explain. Maths I always found really difficult,
It’s like when I moved to university, and my friends had like I still find it difficult now, but being an adult, I don’t need
a different group chat, and it was literally because I wasn’t to know, well, you know, I can google things. I think with
there and I never replied anyway, but like that crushed me my studying now, it’s, I’m finding that there are similar pat-
for years and I got really, really upset over it, but kind of terns of what I am finding difficult, like understanding what
knowing about it, I think that’s something that I would was specifically meant and how to kind of break it down.
have, I guess, what’s the word, sorry, I get really bad brain I’m finding prioritizing things and time management very
fog. I think I would have benefited knowing as a teenager, difficult. Like concepts and reflecting on things I am really
Morley and Tyrrell 1153

good at, I really excel at that, but then it’s kind of something other people and thinking well why can they do it, and why
I’ve always struggled with is writing and kind of, like mak- can’t I do it even though I’m trying so hard. And I think that
ing things actually make sense, if that makes sense. Like was a really big thing for my self-esteem and kind of well-
all that organizing my thoughts and then combining them being, like, why can’t I do it? Why is no one, kind of, almost
almost and linking them, that’s what I’ve always struggled like believing me that I can’t do it? Again, I have been very
with and I think, it’s just been very frustrating because, I’m, lucky with the support my parents gave me because they’ve
I have all these ideas, I know what to do, I know what I need always believed and kind of pushed me to, like say, we
to write about, but I just can’t do it, because it’s so much know you can do it. And I’ve always been really, grateful
work and there’s so much of it, it’s very all- consuming and of that, but I think the kind of impact the teachers had and
I think that’s ultimately what led to me getting a diagnosis. kind of not believing in me, and the impact of relationships
Because I’ve just returned to studying, I was off for a year, on, kind of, like not being perceived as typical, that has its
I got COVID and then I had to take time off and come back, toll on your wellbeing. And you think, well why am I not?
but I’ve also recently started medication, so that’s been very And I think it is, I’m starting to kind of go through since
interesting to kind of look at. Well, my attention and like my diagnosis, is opening up a lot of different cans of trying
concentration is like hideous, uh, yeah, and I think through- to self-heal really. I think different things kind of crop up
out school, again I didn’t realize that I was kind of very and it’s, I think I’m not sad for not having a diagnosis early
physically hyperactive as well, so that was trying to kind of or anything like that, I wouldn’t change that, but it’s kind of
squash that up and trying to pay attention to everything and just feeling really sad for that little person that didn’t under-
that was hard. Umm, but then just constantly talking and stand and they kind of took it out on herself because nobody
having those messages of like if you applied yourself then, realized how bad it was. Even as an adult, like once I’ve
you know, you’d be really clever, and the kind of impact of learned about emotional regulation and things like that, it’s
that and then since starting medication, it’s been, it’s been been so helpful for my wellbeing, like learning about rejec-
quite life changing. Like now I would say 9 times out of 10 tion sensitive dysphoria. And umm, I’ve got quite a strong
I can kind of sit down and do my work. sense of justice and realizing things like that has been help-
One of the biggest struggles I had before was, especially ful so I can kind of give myself a reason now as an adult and
with uni, was needing to sit down every day and do work, it understanding that has really impacted me. And that kind of
was like, how do I force myself to do this? And I was kind dismissal from professionals and the number of times I’ve
of just waiting for it to kick in and then running with it and been told that I’m depressed, it’s kind of like, well, no I’m
then doing like ridiculous hours because I’m trying not to not, but like I get why you’re saying that because I am very
like lose concentration and make the most of it, so that’s emotional, and I have those kinds of highs and lows of emo-
been a really big thing, that kind of consistent focus. I think tion and that does impact your wellbeing. I think, yeah,
another really big thing that I’ve noticed is being able to, I throughout school as well it is that self- esteem, like with
guess like being able to make sense of things. Like I can maths, I was just like, clearly I can’t do it, because I was
read things and it doesn’t take me 4 times to understand trying and I was listening, but I just can’t do it, and it’s kind
them, I can just read them and understand what it means. of what you carry throughout. But I also know on the other
And it’s yeah, there’s a few different little things that I kind side that I am very privileged and perhaps my parents would
of never realized how much it was impacting me until not settle because they knew that I could do it, it’s just kind
they’d been squashed. Yeah, just trying to make connec- of that impact of different teachers and I think I guess like
tions between things, I’ve kind of always described it as the strain of the curriculum and things like that. Like it just
having one thing here and one thing there, but I’ve needed wasn’t fit for me, and it’s something that I am still battling
like something in the middle to help connect the two, and with at university now, like I can’t’ demonstrate my
like medication has kind of acted as that to join it, which has strengths, and yeah, it’s quite tough knowing all this but
been incredible. So, yeah, that’s probably a very long then I can’t change anything, so it’s thinking about how I
extended answer. can move forward and that is something I am kind of trying
to battle with at the moment with my wellbeing. But yeah,
A: How has ADHD impacted your psychological function- since being diagnosed it has been really incredible, I’m very
ing? G: Umm, I think, as a teenager, I really, really strug- grateful for having a diagnosis, but it’s just kind of unpick-
gled. I had eating disorders, I struggled with self-harm, ing of years and years of feeling not great about yourself
because there was just so much emotion and I didn’t know and, yeah, kind of not knowing why.
why there was so much emotion, and I didn’t know what to
do with it. So, it was really difficult to, kind of, process it A: Is there anything else that you wish to mention? G: The
all and then I think something that I’ve realized is that I’m only other thing I did remember, was, umm, kind of how it
still realizing, like when I got a diagnosis that you know did impact my learning and something that I am finding at
not everybody feels like this and it’s that kind of looking at the moment with medication is that kind of hyperfocusing,
1154 Journal of Attention Disorders 27(10)

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The World Federation of ADHD International Consensus
Declaration of Conflicting Interests Statement: 208 Evidence-based conclusions about the disor-
The author(s) declared no potential conflicts of interest with der. Neuroscience and Biobehavioral Reviews, 128, 789–818.
respect to the research, authorship, and/or publication of this https://doi.org/10.1016/J.NEUBIOREV.2021.01.022
article. Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the
General Health Questionnaire. Psychological Medicine, 9(1),
Funding 139–145. https://doi.org/10.1017/s0033291700021644
Hammarberg, K., Kirkman, M., & de Lacey, S. (2016). Qualitative
The author(s) received no financial support for the research,
research methods: When to use them and how to judge
authorship, and/or publication of this article.
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G., & Arnold, L. E. (2012). A systematic review and analysis
Eden Morley is a teaching associate at the University of
of long-term outcomes in attention deficit hyperactivity disor-
Nottingham and obtained her PhD at the Faculty of Health and
der: Effects of treatment and non-treatment. BMC Medicine,
Life Sciences at Coventry University.
10, 99. https://doi.org/10.1186/1741-7015-10-99
Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Aimme Tyrell is a MSc Psychology student at the University of
Emotional dysregulation and attention-deficit/hyperactivity NottinghaM.