I’m seeing a lot of this too. Ive been most interested in the increase of middle aged women who are identifying with the diagnosis. I work with a lot of mothers. I try to validate everyone’s internal experience while also highlighting how our life experiences (in this case parenthood) can cause a sizable burden on our executive functioning. But your words here also remind me of the fact that parents in the US are trying to parent within a completely unreasonable and unsupportive culture. So much so that our Surgeon General put out an advisory stating that parent mental health is a major public health concern! The stress could certainly be a factor in why so many women are noticing symptoms that look similar to ADHD. I know you aren’t in the US but it’s just an example that makes sense given your hypothesis. Thank you for this perspective!
Yes, absolutely. I also see it a lot in that demographic, as well as women transitioning through peri-menopause. Stress seems to be so key, and so many people are living lifestyles that are unsustainable. Thanks for naming that Amber, and I'm glad to hear it resonated with you.
Thank you for this important perspective Vicki, and Amber. I can't comment much for two reasons, notably I am not a mental health professional so have no idea what I'm talking about. However, as a bystander in the field of NMSK health a zillion of my patients now have ADHD. Sadly the majority of them seem to be middle age women and this makes me think perhaps they are struggling with life and perimenopause or menopause but getting diagnosed with ADHD. It seems to be the trend that we are unable to talk about because if we (me) say anything I am downplaying their struggles with mental health which is not my intention yet I think there may be more to the story.
Yes, I think you're spot on Donna - there is more to the story. It's a fine line to walk, validating their experience, while also exploring what else is going on. But it offers the hope of change if we can identify what's out of balance in people's lives. Of course, the imbalance doesn't just sit with individuals, it is a societal issue as Amber points out. Tricky territory, but can be empowering when you start to disentangle these threads... Thanks for commenting.
As a midlife woman who has gone through menopause and sexual betrayal, I have a theory that among those of us with marital problems living with narcissistic cheaters, the psychological abuse messes up your cognitive cohesiveness. I've listened to the stories of hundreds of women who have been cheated on, and being gaslighted and blamed for things we were not responsible for is hugely crazy-making. I hope the mental health profession starts to really take sexual betrayal seriously as an underlying factor behind a lot of the female midlife symptoms.
Yes absolutely Lily. That would certainly fall under the category of trauma and would undoubtedly affect your capacity to function on many levels. I'm sorry to hear that has been your experience and hope you're finding the right supports to navigate this ❤️
Thanks for bringing this to my attention Lily. I had not considered this but now that you mention it I fully agree. It stands to reason that someone who had been through this kind of trauma would be very scattered and uncertain to say the least. I am so sorry this happened to you.
Thank you, Dr. Vicki and Donna, for your empathy and validation. Having gone through this kind of trauma, which I would never wish upon anyone, I am trying to raise awareness of the psychological damage that the betrayed has gone through. For those who haven't experienced this, their exposure often is through the media, which trivialize and minimize the trauma and abuse, and turn it into materials of scandals and gossip for people to consume with a bag of popcorn. We deserve a more serious mental health discourse.
I agree. I have an adhd diagnosis and I believe that in my case it is really just a description of a way of processing the world having been deeply traumatised as a child and young adult. My brain does not always work properly, I struggle with memory, and i struggle with emotional regulation. It can be helpful to tell people I have adhd because it's a reasonably well known condition that does explain some of my difficulties. But I also feel like a bit of a fraud because in my view my brain works this way because of trauma, technology, and a natural artistic/imaginative/creative drive.
Oh thank you for sharing that Georgina. I think we are only just beginning to fully understand how interlinked all these patterns are. I think the label can be useful if it helps you and others to understand you better, and I'm glad to hear you're also digging into those questions of where the patterns come from, as I think there is so much gold there.
Some of the strategies for dealing with adhd work well for me, so there is that element, too; it can be helpful to have those strategies and tactics for e.g. emotional regulation or organisation or communication. Even to just have the framework of "this is how my brain works, it's not because I'm weak/lazy/bad," is so helpful. It's not about abdication responsibility for yourself, but taking away that self-hatred and shame which can be so damaging. I guess I feel that I agree, adhd is over-diagnosed. But also it can be a helpful framework for supporting ourselves. So maybe what's needed is a wider conversation about the long term effects of trauma on the brain, and how we can support ourselves with non-medical interventions, such as diet, exercise, judicious use of technology, emotional regulation skills and so on.
Yes well said Georgina. I very much agree. Diagnosis can be very useful. I'm keen to see more conversation around all of this. Thanks for sharing your thoughts.
Thank you so much for writing this, Vicki. I love how, instead of highlighting just one factor (such as technology and the obvious impact that has on our brains, attention, and patterns), you look at several - including the impact of trauma. When we consider how these myriad factors interact with each other...and create a whole new dynamic and momentum, just...
How could that NOT have a tremendous, mind-and-life-altering impact? How could we imagine that slapping a label on it, prescribing some meds, and cementing an identity is the only or the holistic solution?
Yes, exactly. We are complex beings and undoubtedly shaped by our environments. We need much more nuanced conversations about all of this I believe. Thanks for your comments Dana.
I see this in my psychotherapy practice too Vicki, the increase in self-, or medical diagnosis of ADHD where there's clearly a history of trauma and ongoing hypervigilance and nervous system dysregulation. I appreciate the clarity of your discussion, and your walking of the middle path, staying open to both the possibility of an ADH disorder and the likelihood of a subtle, or not so subtle, traumatic nervous system response. The intricacies of our neurology and embodied experience are truly amazing and we now have so many wonderful ways of calming and supporting wired nervous systems. I especially like your comment about the effect of technology. We are electromagnetic beings who run on bioelectricity. I'm sure our energy and cell functioning are affected by our increasing exposure to screens and electromagnetic fields.
Thank you Violet, it's good to hear that this resonates with your clinical experience too. I feel we are lumping a lot of different experiences under one umbrella here, and need to be much more thoughtful about what's presenting.
Agreed. It's great to have so much more trauma aware therapy available now too. My hunch is these disorders often present from such early developmental and relational trauma they are normalised.
This is such a great post… and such a great analysis. I feel it is everywhere (a bit like everyone and their dog has now gone out with a narcissist!). I think your analysis is really clear and the last important point being that this is about being nuanced and so everyone gets the right approach. 👏
Oh thank you Alana. I was a bit hesitant about putting it out, I don't want to invalidate anyone's experience. But I do think we need to think a bit deeper about what's going on. I'm glad it resonated with you 😊
As always, your post so beautifully articulates how powerful "lifestyle medicine" is....and how forgotten and underutilized is. At a time when we are constantly bombarded and "on" -- overwhelm, stress and an hyperactive-response to life is easy to confuse with how one can feel with the diagnosis of ADHD. I do agree, the medical diagnosis of ADHD deserves proper medical attention. But also agree that if the diagnosis is more "self-diagnosis" in nature, it's helpful to also reflect on lifestyle choices, boundaries and habits as getting intentional around those can equally be powerful medicine in today's hyper-speed world. ❤️
It's so important to have these conversations, and look at all the complex factors that may lead someone to have ADHD symptoms. I often think our culture is so quick to label and diagnose people with something wrong with them and prescribe medication, rather than seeing the ways our bodies adapt to our experiences as making total sense - and then looking at how we can support our bodies to feel safe again in a gentle, compassionate, holistic way.
Thanks Alana. Your post has a lot to say to us in the schooling sector and I really appreciated that while acknowledging the place of medication and diagnosis, there are wider contextual factors that are creating barriers to wellbeing - particularly for our adolescents (e.g. screentime/social media, peer pressure and intense academic expectations).
Thank you Vicki for articulating my concerns, this is a topic I feel needs a lot of attention because as you say, many people are self diagnosing from online tests.
I have friends who have done this and not only identified as having ADHD but are also claiming their children do as well.
There has always been stigma attached to mental health diagnoses but now we seem to see and hear an almost badge of honour approach from some people- as if they're proud to say they have ADHD. Particularly when there has been no trauma- this seems to be a new way of life for some people.
Inattention in the form of trying to constantly multitask, emotional detachment, high expectations of self and others, addictive behaviour, not understanding or managing high stress levels, poor rest and too little sleep, excessive exercise or no exercise, excessive use of social media, lack of knowledge about nutrition and therefore poor diet; all these things contribute to our inability to focus on one thing at a time.
As a Well- Being Therapist my approach is an holistic one with a focus on developing self awareness and mindfulness. Several of my clients have been coming to me in the "waiting to get tested for ADHD" phase, and we are having great success working with all these important lifestyle choices as well as relaxation and meditation, self regulation and identifying triggers and reconnecting the heart, body and mind.
In a world of uncertainty, divisiveness and separation, I think it is essential we focus on what we all share rather than what sets us apart. What if the rise in neurodivergence and ADHD is simply a symptom of our world in crisis?
Thanks for sharing your thoughts Sally, and yes, I agree those lifestyle factors can make an enormous difference for many people. It seems from the comments here that a lot of therapists are seeing the same patterns. Whilst increased awareness is very helpful, the rise of self-diagnosis is a troubling phenomenon.
You made some really good points here. I totally agree that environmental context must be considered. The use of devices and multitasking have changed how we deploy our attention. I think these affect almost everyone, unless you're a luddite or hermit. Trauma is an interesting factor. I have experienced many deep and repetitive complex traumas. But I feel that my attention isn't too affected by this. I wonder if the diagnostic procedure for ADHD is akin to taking a snapshot of a moment in time. If so, could it be that a person may have attention issues temporarily instead of chronically?
Clinical diagnosis would usually take account of the longer-term picture and require evidence of the problems being present in childhood. However, I think so many people are self-diagnosing these days and missing this. Plus, the problems may have been present in childhood if trauma was present in childhood, so even this doesn't necessarily indicate that the problem is irreversible. It's complex and deserves a lot more thought than just slapping a label on, in my opinion. Thanks for your thoughtful comments Lily.
Diagnoses like ADHD and, previously hysteria (or “nerves” as it was called in my family history) tend to proliferate when a sizeable proportion of the population are being exposed to unrealistic expectations in society whilst their lived reality is being silenced and denied. I’m particularly horrified by the proliferation of “zero tolerance” schools here in the UK where children are persecuted (and I don’t use that word lightly) for sometimes very trivial failures to conform. It’s led to a terrifying explosion in the number of Autism and ADHD diagnoses. I’ve noticed my own ADHD like symptoms ever since I began therapy for childhood trauma and strongly suspect there is a connection between the two. I refuse to pathologise what is likely to be a normal and natural response. But I have the luxury of not having to earn a living in a rigid late capitalist society that attempts to internalise everything that prevents people from healthy social functioning.
Well said Miranda. Yes it is often an adaptive response to an unsustainable lifestyle. It really calls for a much bigger conversation, rather than pathologising individuals. Thanks so much for adding this.
I’m seeing a lot of this too. Ive been most interested in the increase of middle aged women who are identifying with the diagnosis. I work with a lot of mothers. I try to validate everyone’s internal experience while also highlighting how our life experiences (in this case parenthood) can cause a sizable burden on our executive functioning. But your words here also remind me of the fact that parents in the US are trying to parent within a completely unreasonable and unsupportive culture. So much so that our Surgeon General put out an advisory stating that parent mental health is a major public health concern! The stress could certainly be a factor in why so many women are noticing symptoms that look similar to ADHD. I know you aren’t in the US but it’s just an example that makes sense given your hypothesis. Thank you for this perspective!
Yes, absolutely. I also see it a lot in that demographic, as well as women transitioning through peri-menopause. Stress seems to be so key, and so many people are living lifestyles that are unsustainable. Thanks for naming that Amber, and I'm glad to hear it resonated with you.
Thank you for this important perspective Vicki, and Amber. I can't comment much for two reasons, notably I am not a mental health professional so have no idea what I'm talking about. However, as a bystander in the field of NMSK health a zillion of my patients now have ADHD. Sadly the majority of them seem to be middle age women and this makes me think perhaps they are struggling with life and perimenopause or menopause but getting diagnosed with ADHD. It seems to be the trend that we are unable to talk about because if we (me) say anything I am downplaying their struggles with mental health which is not my intention yet I think there may be more to the story.
Yes, I think you're spot on Donna - there is more to the story. It's a fine line to walk, validating their experience, while also exploring what else is going on. But it offers the hope of change if we can identify what's out of balance in people's lives. Of course, the imbalance doesn't just sit with individuals, it is a societal issue as Amber points out. Tricky territory, but can be empowering when you start to disentangle these threads... Thanks for commenting.
As a midlife woman who has gone through menopause and sexual betrayal, I have a theory that among those of us with marital problems living with narcissistic cheaters, the psychological abuse messes up your cognitive cohesiveness. I've listened to the stories of hundreds of women who have been cheated on, and being gaslighted and blamed for things we were not responsible for is hugely crazy-making. I hope the mental health profession starts to really take sexual betrayal seriously as an underlying factor behind a lot of the female midlife symptoms.
Yes absolutely Lily. That would certainly fall under the category of trauma and would undoubtedly affect your capacity to function on many levels. I'm sorry to hear that has been your experience and hope you're finding the right supports to navigate this ❤️
Thanks for bringing this to my attention Lily. I had not considered this but now that you mention it I fully agree. It stands to reason that someone who had been through this kind of trauma would be very scattered and uncertain to say the least. I am so sorry this happened to you.
Thank you, Dr. Vicki and Donna, for your empathy and validation. Having gone through this kind of trauma, which I would never wish upon anyone, I am trying to raise awareness of the psychological damage that the betrayed has gone through. For those who haven't experienced this, their exposure often is through the media, which trivialize and minimize the trauma and abuse, and turn it into materials of scandals and gossip for people to consume with a bag of popcorn. We deserve a more serious mental health discourse.
Yes, absolutely.
Absolutely.
I agree. I have an adhd diagnosis and I believe that in my case it is really just a description of a way of processing the world having been deeply traumatised as a child and young adult. My brain does not always work properly, I struggle with memory, and i struggle with emotional regulation. It can be helpful to tell people I have adhd because it's a reasonably well known condition that does explain some of my difficulties. But I also feel like a bit of a fraud because in my view my brain works this way because of trauma, technology, and a natural artistic/imaginative/creative drive.
Oh thank you for sharing that Georgina. I think we are only just beginning to fully understand how interlinked all these patterns are. I think the label can be useful if it helps you and others to understand you better, and I'm glad to hear you're also digging into those questions of where the patterns come from, as I think there is so much gold there.
Some of the strategies for dealing with adhd work well for me, so there is that element, too; it can be helpful to have those strategies and tactics for e.g. emotional regulation or organisation or communication. Even to just have the framework of "this is how my brain works, it's not because I'm weak/lazy/bad," is so helpful. It's not about abdication responsibility for yourself, but taking away that self-hatred and shame which can be so damaging. I guess I feel that I agree, adhd is over-diagnosed. But also it can be a helpful framework for supporting ourselves. So maybe what's needed is a wider conversation about the long term effects of trauma on the brain, and how we can support ourselves with non-medical interventions, such as diet, exercise, judicious use of technology, emotional regulation skills and so on.
Yes well said Georgina. I very much agree. Diagnosis can be very useful. I'm keen to see more conversation around all of this. Thanks for sharing your thoughts.
Thank you so much for writing this, Vicki. I love how, instead of highlighting just one factor (such as technology and the obvious impact that has on our brains, attention, and patterns), you look at several - including the impact of trauma. When we consider how these myriad factors interact with each other...and create a whole new dynamic and momentum, just...
How could that NOT have a tremendous, mind-and-life-altering impact? How could we imagine that slapping a label on it, prescribing some meds, and cementing an identity is the only or the holistic solution?
Yes, exactly. We are complex beings and undoubtedly shaped by our environments. We need much more nuanced conversations about all of this I believe. Thanks for your comments Dana.
I see this in my psychotherapy practice too Vicki, the increase in self-, or medical diagnosis of ADHD where there's clearly a history of trauma and ongoing hypervigilance and nervous system dysregulation. I appreciate the clarity of your discussion, and your walking of the middle path, staying open to both the possibility of an ADH disorder and the likelihood of a subtle, or not so subtle, traumatic nervous system response. The intricacies of our neurology and embodied experience are truly amazing and we now have so many wonderful ways of calming and supporting wired nervous systems. I especially like your comment about the effect of technology. We are electromagnetic beings who run on bioelectricity. I'm sure our energy and cell functioning are affected by our increasing exposure to screens and electromagnetic fields.
Thank you Violet, it's good to hear that this resonates with your clinical experience too. I feel we are lumping a lot of different experiences under one umbrella here, and need to be much more thoughtful about what's presenting.
Agreed. It's great to have so much more trauma aware therapy available now too. My hunch is these disorders often present from such early developmental and relational trauma they are normalised.
Yes, I tend to think the same. And it can look genetic/inherited, because trauma is passed on down family lines.
This is such a great post… and such a great analysis. I feel it is everywhere (a bit like everyone and their dog has now gone out with a narcissist!). I think your analysis is really clear and the last important point being that this is about being nuanced and so everyone gets the right approach. 👏
Oh thank you Alana. I was a bit hesitant about putting it out, I don't want to invalidate anyone's experience. But I do think we need to think a bit deeper about what's going on. I'm glad it resonated with you 😊
Alana, well stated. I agree.
As always, your post so beautifully articulates how powerful "lifestyle medicine" is....and how forgotten and underutilized is. At a time when we are constantly bombarded and "on" -- overwhelm, stress and an hyperactive-response to life is easy to confuse with how one can feel with the diagnosis of ADHD. I do agree, the medical diagnosis of ADHD deserves proper medical attention. But also agree that if the diagnosis is more "self-diagnosis" in nature, it's helpful to also reflect on lifestyle choices, boundaries and habits as getting intentional around those can equally be powerful medicine in today's hyper-speed world. ❤️
Yes, well said Kajal. I'm glad to hear it resonated with you.
It's so important to have these conversations, and look at all the complex factors that may lead someone to have ADHD symptoms. I often think our culture is so quick to label and diagnose people with something wrong with them and prescribe medication, rather than seeing the ways our bodies adapt to our experiences as making total sense - and then looking at how we can support our bodies to feel safe again in a gentle, compassionate, holistic way.
Yes absolutely Ellie. It's amazing how much symptoms tend to make some sense when you have enough of the back story
Thanks Alana. Your post has a lot to say to us in the schooling sector and I really appreciated that while acknowledging the place of medication and diagnosis, there are wider contextual factors that are creating barriers to wellbeing - particularly for our adolescents (e.g. screentime/social media, peer pressure and intense academic expectations).
Glad to hear it was useful Mark. And yes, so important to hold in mind the complex context of adolescents' lives.
Thank you Vicki for articulating my concerns, this is a topic I feel needs a lot of attention because as you say, many people are self diagnosing from online tests.
I have friends who have done this and not only identified as having ADHD but are also claiming their children do as well.
There has always been stigma attached to mental health diagnoses but now we seem to see and hear an almost badge of honour approach from some people- as if they're proud to say they have ADHD. Particularly when there has been no trauma- this seems to be a new way of life for some people.
Inattention in the form of trying to constantly multitask, emotional detachment, high expectations of self and others, addictive behaviour, not understanding or managing high stress levels, poor rest and too little sleep, excessive exercise or no exercise, excessive use of social media, lack of knowledge about nutrition and therefore poor diet; all these things contribute to our inability to focus on one thing at a time.
As a Well- Being Therapist my approach is an holistic one with a focus on developing self awareness and mindfulness. Several of my clients have been coming to me in the "waiting to get tested for ADHD" phase, and we are having great success working with all these important lifestyle choices as well as relaxation and meditation, self regulation and identifying triggers and reconnecting the heart, body and mind.
In a world of uncertainty, divisiveness and separation, I think it is essential we focus on what we all share rather than what sets us apart. What if the rise in neurodivergence and ADHD is simply a symptom of our world in crisis?
Thanks for sharing your thoughts Sally, and yes, I agree those lifestyle factors can make an enormous difference for many people. It seems from the comments here that a lot of therapists are seeing the same patterns. Whilst increased awareness is very helpful, the rise of self-diagnosis is a troubling phenomenon.
You made some really good points here. I totally agree that environmental context must be considered. The use of devices and multitasking have changed how we deploy our attention. I think these affect almost everyone, unless you're a luddite or hermit. Trauma is an interesting factor. I have experienced many deep and repetitive complex traumas. But I feel that my attention isn't too affected by this. I wonder if the diagnostic procedure for ADHD is akin to taking a snapshot of a moment in time. If so, could it be that a person may have attention issues temporarily instead of chronically?
Clinical diagnosis would usually take account of the longer-term picture and require evidence of the problems being present in childhood. However, I think so many people are self-diagnosing these days and missing this. Plus, the problems may have been present in childhood if trauma was present in childhood, so even this doesn't necessarily indicate that the problem is irreversible. It's complex and deserves a lot more thought than just slapping a label on, in my opinion. Thanks for your thoughtful comments Lily.
Thank you for your explanation of the diagnostic procedure and the complexity of it. Extra care must be taken with complex, trauma-based conditions.
Yes I agree, it can very easily look the same on the surface level
Diagnoses like ADHD and, previously hysteria (or “nerves” as it was called in my family history) tend to proliferate when a sizeable proportion of the population are being exposed to unrealistic expectations in society whilst their lived reality is being silenced and denied. I’m particularly horrified by the proliferation of “zero tolerance” schools here in the UK where children are persecuted (and I don’t use that word lightly) for sometimes very trivial failures to conform. It’s led to a terrifying explosion in the number of Autism and ADHD diagnoses. I’ve noticed my own ADHD like symptoms ever since I began therapy for childhood trauma and strongly suspect there is a connection between the two. I refuse to pathologise what is likely to be a normal and natural response. But I have the luxury of not having to earn a living in a rigid late capitalist society that attempts to internalise everything that prevents people from healthy social functioning.
Well said Miranda. Yes it is often an adaptive response to an unsustainable lifestyle. It really calls for a much bigger conversation, rather than pathologising individuals. Thanks so much for adding this.