When Danielle Elliot finds herself among the many women diagnosed with ADHD during the pandemic, she gets curious. Why women? And why now? This question takes her to northern Michigan, to meet a friend’s mom.
When Danielle Elliot finds herself among the many women diagnosed with ADHD during the pandemic, she gets curious. Why women? And why now?
This question takes her to northern Michigan, to meet a friend’s mom.
For a transcript of this episode and more resources, visit the Climbing the Walls page on Understood.
Danielle: I've never been all that good at listening to instructions. When flight attendants ask passengers to put their phones on airplane mode, I don't. I usually scroll Instagram until we lose service. That's what I was doing one morning in February, 2024. I was scrolling Instagram when the little red icon appeared in the top left corner of the app, a new message. I opened it. It was a link to a video. My thumb was hovering over it as the wheels lifted off the runway. I saw the top half of the news anchor's head and the logo for Fox News. The screen froze like that.
At the time, I was working on a film about affirmative action, so I assumed that the link had something to do with that. We were in the air for about six hours, and as we landed, I opened Instagram again. I saw four more messages. Everyone was sending me the same link. As it loaded, I realized it had nothing to do with affirmative action.
News anchor: Adult women are being diagnosed with ADHD at a record pace. In just two years, diagnosis rate has nearly doubled. So, what's driving...
Danielle: Ah, yes, ADHD, attention deficit hyperactivity disorder.
News anchor: Phones could be a root cause, but ironically, it's also what's raising awareness about it.
Danielle: It was all over the news that week.
News anchor: Joining us now is Brooke Schnittman. She's an ADHD and executive function coach. It's great to have you here. So, tell us why. Why women? Why now? Why are these diagnoses going up?
Brooke: Diagnosis in ADHD is going up. People are understanding more about themselves since the pandemic. So, when we had so much downtime to really understand ourselves, that's when mental health was on the rise.
Danielle: It seemed like Brooke had more to say, but the anchor jumped in.
News anchor: But what if, you know, all of us are distracted because of our phones, right? I can be reading the Wall Street Journal editorial page at night I'm like, wait, let me check what my sister just sent me on Instagram. But where's the line between someone who feels distracted because of their phone and someone who actually has ADHD and gets a diagnosis like that.
Danielle: I knew exactly why my friends were sending me this clip. Why are so many women being diagnosed with ADHD? Do they really have it? I started asking these questions sometime in the summer of 2022, a few months after I joined the ranks of the recently diagnosed.
Listening to a news anchor question the rise in diagnosis, I realized I really do want to know, why women? Why now? For the last year or so, I've tried to answer these questions. I've talked to scientists, doctors, and I've talk to many, many women who have ADHD, some who were recently diagnosed, others who have known for decades.
This is a story about science, social expectations, stress, and the way we live. It's about who we trust. Most importantly, it's a story about women. This is "Climbing the Walls." I'm Danielle Elliot.
I had a fairly unique pandemic experience. I started dating someone in the first week. I was 35, and this was honestly my first relationship. Unless, you know, you actually wanna count the revolving door of four-month situations I've been in for the last 10 years. Anyway, everything was new and it was distracting me from everything else happening in the world. We moved in together. Things were good for a while.
I remember waking up one morning and just staring at the wall, not really moving. I laid there long enough that my partner looked at me and said, "Are you OK?" And still without moving, I said, "We used to be able to get on planes and a few hours later land in a completely different part of the world. I just miss being able to be anywhere else."
A few months later, we got vaccinated. A few months after that, we broke up. I stashed a few boxes at my parents' house, booked a flight., and left. I spent the next two months working remotely from Mexico and Belize, then went to California and Colorado for work. It was fun, but the whole time, I kept thinking about the night we broke up.
We needed to break up. We both knew this was coming. He initiated a conversation, and I exploded. I had this visceral reaction. I said things that I knew would cut deep. I couldn't look at him. I started packing, taking frames off the walls. I felt out of control. and it felt really out of character. I don't yell at people, ever. I thought I'd learn to control my emotions. But that night, I acted like a child. So, three months later, I was still beating myself up over it.
One night, I googled "extreme reactions to rejection," and this article popped up about something called rejection sensitive dysphoria, RSD. I'd never heard of it. One magazine article described it like this: It is always triggered by the perceived or real loss of approval, love, or respect. It looks like an impressive, instantaneous rage at the person or situation responsible for causing the pain. Some people use the pain of RSD to find adaptations and overachieve. They constantly work to be the best at what they do and strive for idealized perfection.
The last section of the article started with this sentence: Rejection sensitivity is part of ADHD. I remember reading that sentence and thinking, wait, do I have ADHD? I didn't really think I could because, as far as I knew, ADHD meant you couldn't focus. When I'm interested in something or I have a deadline, I focus so well that I sort of forget the rest of the world exists. I found an article on ADHD. It explained that ADHD is a spectrum of attentional issues.
The next day, I talked to my therapist. She suggested I take a self-screener. So, I took it, and it said that I have symptoms of ADHD. And I, for lack of a better word, I pouted. I didn't want to have ADHD. Everything I read said that women with ADHD struggle in relationships, careers, and as parents. I wanted to believe I'd figure these things out. And to hear I might have a condition that apparently makes it harder to do these things, it felt scary. I booked a telehealth appointment with a psychiatrist.
On a cold morning in February 2022, I sat down in front of my computer, logged into a video platform, and started talking to a psychiatrist.
Psychiatrist: Tricky, how do you make the diagnosis if it's not like so glaringly obvious to the child. Usually it's the hyperactivity symptoms that draw attention.
Danielle: There was a cop outside my window. I looked back at the screen and tried to focus on what the psychiatrist was saying. She seemed to be sitting on a bench at a kitchen table. I could see a green lawn behind her and wondered where she lived. I realized I was distracted and tried to tune back in. She was still explaining how teachers or doctors usually spot ADHD in kids.
Psychiatrist: The teacher is saying, "Oh, Billy, you're really weak," right? It's often harder when it's more of the attentional symptoms.
Danielle: I was recording on my phone because I wanted to be able to listen back to what she said about treatment. I wanted to get this right. She explained that girls with ADHD are usually not as hyperactive or disruptive as boys with ADHD, and since they're not disturbing their classmates or their teachers, their symptoms go unnoticed.
She asked me about my childhood. How did I do in school? Did I make friends? Do I have any specific memories? I told her stories from preschool, kindergarten, second grade, fifth grade, seventh grade. I asked her if ADHD is why I didn't talk or walk until a year after most kids my age. My mom says she had me tested for special education preschool, but I didn't get in.
In grad school, my advisor always said, "Danielle, I think you have shiny ball syndrome." None of us suspected an actual syndrome. I just like chasing new ideas, usually before finishing whatever I'm working on. Ten minutes into the call, the doctor said she thinks I have ADHD. I wanted this to be much more complicated. I wanted her to do a whole series of tests, but there are no definitive biological markers for ADHD. No blood test that says, "Yep, you have it."
Instead, the diagnosis is based on your experiences throughout your life and your family history. The official criteria is listed in a book called the Diagnostic and Statistical Manual of Mental Disorders, the DSM. It's published by the American Psychiatric Association. The DSM says that symptoms of ADHD develop by the time a person turns 12. If the symptoms begin after that, it's not ADHD.
Psychiatrist: It's basically our executive function, right? So, the frontal lobe is the seat of a lot of this and it's tricky our frontal lobes not fully developed into well into teenage years. So, the way, so again, this is a lot of executive function so executive function is a large part of our cognition.
Danielle: She went on like this a little bit longer, talking about something called executive function, which I'd never heard of. Then she prescribed a stimulant, which is a type of medication often used to treat ADHD. And with that, I joined the ranks of what seemed to be a rapidly emerging demographic: women diagnosed with ADHD during the pandemic.
One $500 video appointment, and I was now one of those women Fox News was talking about. My insurance didn't even cover it. I wasn't sure I wanted to be on a stimulant. I wasn' sure I want to hear any of this, honestly. But I dug into it anyway, doing my research alongside self-discovery. That's what I do after all. I should mention, I'm a science journalist. I also produce documentaries and podcasts. The more I learned about ADHD, it was clear that I have it. And I learned that it was so much more than what I had thought it was.
I thought it was about focus and attention. But it turns out it's also about emotional regulation and scheduling and your ability to stay organized and sustain interests. I read things that said people with ADHD have a constant battle between structure and stimulation and that we have strong internal voices that are often completely set on telling us that we're doing everything wrong.
On social media, there were a lot of women talking about ADHD, and honestly, they all seemed a lot like me: college-educated, mostly well-adjusted white women who apparently wanted to be more adjusted. And that started to give me doubts. I would scroll through Instagram and TikTok and think, you all seem to have partners and children and big enough careers to help you reach large audiences on social media. If you have ADHD, how do you stay organized enough to create all this content? Is there any chance you're just capitalizing on this moment when ADHD seems to be trending?
I don't like to minimize anyone else's experience. I think I was just pushing back against the idea that I had ADHD by proposing that maybe none of us women had it, that maybe we just weren't good enough, as if that's somehow better. You can't spell Danielle without denial.
My notion of who was talking about ADHD started to expand when I moved into a new apartment that summer. Great light, closet space, friendly building. I got to know three of the women on my floor. We were watching TV one night, and one of them mentioned her ADHD. Another one of the woman jumped in and said, "'Oh, I was diagnosed last year.'" Over the next few months, I started hearing this everywhere. A bartender at my favorite spot, two friends talking on the train, friends telling me about their moms being diagnosed. Unlike what I saw on social media, they weren't all white women.
Then, researchers published data that supported what I was seeing around me. Tons of women are being diagnosed with ADHD. From 2020 to 2022, the rate of diagnosis skyrocketed. Let me get inside your head for a minute. You're probably thinking, "What's the big deal? A lot of women were diagnosed with ADHD in the past few years. So what? Sounds like you made some new friends and got some helpful meds out of it. Why are you so mystified? Like, this subject needs a podcast mystified. Is this your latest shiny ball?"
It goes back to what the psychiatrist told me on the phone about why my own ADHD wasn't identified when I was a kid. Girls tend to have different symptoms, she'd said. Hyperactivity is much less common. Our brains, though no less unique than that of any rambunctious boys, slipped under the radar. For many, many years, this was the accepted wisdom. Doctors weren't diagnosing ADHD in girls because they simply didn't know they had it.
One doctor told me that in the 1970s and early 80s, he was taught the ratio of boys to girls with ADHD was 10 to 1. On top of that, the medical community also firmly believed that people outgrow ADHD in adulthood. Those two beliefs together meant that very little thought was ever given to women, grown-up adult women having ADHD.
When I was in grad school in 2013, and my advisor joked that I had shiny ball syndrome, she didn't consider that I might have ADHD. I was studying science journalism. I read so many journals and articles that year and never came across anything that would suggest such an idea. Obviously, something had changed in the last few years. Women with ADHD were now being found everywhere, from my apartment building to Fox News. I talked to dozens of women who, like me, went undiagnosed until recently. Women in their 20s, 30s, 40s, 50s, 60s. One woman in her mid-70s.
So, yeah, that's my shiny ball. My podcast-worthy question. Why women? Why now?
One day, I was at a friend's birthday party and someone said something I've never heard before. He said his mom was diagnosed with ADHD early, back in 1963. I couldn't resist. A week later, I was in Michigan, meeting his mom. If I wanted to figure out how we missed this in an entire generation of women. I felt like talking to someone who hadn't missed it was a pretty good place to start.
Emily: I was a famously active child, kinetic. This is Emily Mitchell.
Danielle: She's a graphic designer in Traverse City, Michigan. We met at her house and sat in a basement office.
Emily: So, I was famously hyperactive, kinetic, always moving. When you hit public school and you're in kindergarten, as I was, there is nap time, and I couldn't sit still, lay still on my mat. My mother made me a chain of safety pins that we attached to my mat so I would have something to do.
Danielle: That's like something to play with, somewhat quietly.
Emily: She tried things that would help me, not conform, but to participate in the structure of the day. Because I was young, I don't know how it went, but say the teacher complained, and then my mother took me to a doctor, who was a pediatrician, who was young. He was just out of med school. He was in a young crop of new pediatricians.
Danielle: And this is in Michigan?
Emily: In Michigan, in the Detroit area, Oak Park, Michigan. And he, I remember him, I was fond of him and I felt special in his office, you know? And he said to my mother, "You know, Emily likes people and the last thing she needs is to be a problem to her teacher as she starts her public education. That's not gonna be good for her. So, I have something that we should try." And it was Ritalin. And I took it and it helped. It helped.
Danielle: The first time we know of a doctor giving stimulants to kids is in 1937. About 20 years later, in 1955, the FDA approved Ritalin as a medication for adults battling depression and a handful of other conditions. Then, in 1962, the FDA improved it for use in children with attentional deficits and hyperactivity. A year later, in 1963, a young pediatrician recognized this in six-year-old Emily and he prescribed Ritalin.
Emily: I called it my silly pill. My silly pill. And it was just part of my life. So, it helped me be a good student, and we didn't realize that until I stopped taking the Ritalin.
Danielle: The American Psychiatric Association published the second edition of the DSM in 1968, when Emily was in fifth grade. This edition described a condition called hyperkinetic reaction of childhood. It's characterized by overactivity, restlessness, distractibility, and short attention span. The DSM said children outgrow this by the time they become teenagers. Emily was 11 years old, and she was starting to feel self-conscious about her silly pill.
Emily: So, when I was in fifth grade, I stopped taking it. And my grades immediately went down. And it didn't alarm my parents, you know. I think it was just the thing to do at the time. And you just, you grow out of that, you don't have to take that anymore.
Danielle: Did you feel like you had grown out of it? Like did you, as a fifth grader, did you remember then having a harder time sitting still?
Emily: Yeah. I couldn't focus on, you know, the evidence is that my grades went down. And I graduated high school undistinguished academically under 3.0.
Danielle: No one suspected that Emily's grades might somehow have been affected by this hyperkinetic energy because doctors thought kids outgrow the condition. She was in high school in 1971 when a Canadian psychologist named Virginia Douglas gave a speech that would change everyone's understanding of hyperactivity, hyperkinesis, and attentional disorders. This was at the annual meeting of the Association of Canadian Psychologists.
Dr. Douglas explained research she'd conducted at Montreal Children's Hospital, where she determined that hyperkinesis is associated with attentional deficits and impulsivity. Hyperkinetic Reaction of Childhood became known as Attention Deficit Disorder, ADD. In 1980, the third edition of the DSM updated the diagnostic criteria and officially changed the name. By then, Emily was a recent art school grad living in Toronto. She was married, building a life as a textile designer and weaver.
Emily: I wasn't even interested in the fuzzy stuff. It was the structure and the fact that you could do something with a slim piece of thread and turned it into a whole humankind's history of both art and function. It's an amazing history, and it was interesting to do.
Danielle: Emily started to gain a reputation in the art world. One of her pieces was exhibited at a museum in New York, but she and her husband were feeling the pull to move home to Michigan. They bought an old schoolhouse in Traverse City. It's a picturesque town right on the water. It's dreamy, and in many ways, so was their life. Financially, though, it was tough. Emily waitressed and continued making art, but being an artist in Traverse City, Michigan, wasn't the same as being an artist in Toronto. Her husband had started a graphic design firm.
Emily: So, I joined the company, and we've been together as creative and life partners ever since.
Danielle: What a life. She met someone and fell in love, built a creative career, moved to this beautiful place. They had two little boys. Emily absolutely loved being a mom. But a few years into joining her husband at the design firm, Emily was struggling at work.
Emily: So, I'm in a business now with deadlines. I'm business with a partner, someone who, in his case, was a champion workhorse, could get things done in a very structured way, on time reliably, and at a high level, at a higher professional standard. I am very good at generating ideas, but you have to close it up.
Danielle: Meaning you have to hit deadlines. And to hit those deadlines, you have be decisive. She would start with lots of ideas. She could whittle the ideas down to three frontrunners.
Emily: And I might get stuck on the three and say...
Danielle: Someone else will say, this is the final.
Emily: Yeah, I just see the potential in everything. I might say, "Well, I really need to run out all three. You know, I need to take these three to the next level." Or, and then while you're looking at the three, you might say, "You know, this one has led me to a variation of that," and so on.
Danielle: It was a problem because the schedules only allowed her to run through one final choice. She was doing three times the work and it wasn't working. Emily was figuring this out as it was happening. The company was successful, and the work was demanding. She was in a high-stakes environment. She loved it, most days. But when deadlines approached...
Emily: I suffered. So, I was suffering at work. Also, just the office environment. You got a list of things you have to get done every single day. So, I found myself often staying up all night. And that wasn't, in some people's lives, that's not a problem. But it was difficult for my partner. It caused a lot of anxiety for him. That was painful for me, it was painful because I don't like letting people down. which, if you remember the doctor in kindergarten, "Emily likes people, she does not like to be a problem to people" and I didn't when I was 24 or 38 either. so I started wondering, it was just...
Danielle: And you felt like you were letting him down.
Emily: Yeah, yeah, and in the meantime, we, you know, we're starting to have a family of small children and we're running this business. So, I think I spoke to a guidance counselor at the local college to double-check that I had made a good decision. You know, it wasn't the profession, it was the office work.
Danielle: A good decision as in the job that you chose?
Emily: Yeah, why am I unhappy in my job? You know, you know, why does this feel, it's just so stressful? I ended up speaking to my family doctor, annual physical, how are you? How are you doing? And he said, "You know, you, let's have a look at your brain. It might be just your brain that, the way your brain is."
Danielle: This is the mid-90s. Emily stopped to do the math. She counted on her fingers, and we laughed because this is something I do, too. Emily thinks she talked to her doctor when she was 30. So that would be 1987 or 88. They talked about her medical history, including the diagnosis in kindergarten and her silly pill. By then, doctors were starting to recognize that adults often have symptoms of ADHD. But officially, it was still considered a condition of childhood. Emily was lucky to have a doctor who was up to date on the clinical findings.
Emily: So, at 30, I was diagnosed with ADD. There's no mention of H, there's no H in there.
Danielle: A revised edition of the DSM combined ADD and hyperactivity in 1987, now officially calling it ADHD. It was a controversial update and one that didn't quite reach Emily at the time. She still thought of her childhood condition and her ADD as separate things. It would be a few more years before she connected them. Still, she had her diagnosis, and it helped.
Emily: It answered a lot of questions about my path to that point. And it did help me make a list in my day job and stick to the list and to just use my time differently. There was impulsivity. It helped with that, less interrupting. So, it was about work. The goal was to be productive.
Danielle: And it worked. Emily is my idea of the best case scenario. Each time she recognized a challenge, she sought help, and she was diagnosed according to the most advanced scientific understanding of the time. Most women didn't have this sort of luck or privilege. Emily is quick to acknowledge that she comes from a highly educated, open-minded family. She had access to great doctors, and they treated her appropriately. It helped that she had symptoms most commonly associated with boys. But still, her experience is rare. Ideally, the science would have moved faster, but it advanced quickly enough to meet most of her needs.
There was still one complication of her ADHD that she couldn't quite figure out. It wasn't about her ability to make deadlines. It had more to do with the way people treated her when she struggled with those deadlines. She grew up in a family where she was cherished and celebrated. She said she didn't really know criticism until she became an adult. Now, people, including her husband. expected her to do things in certain ways, and when she didn't, they were harsh. She struggled with this. For once, her doctors didn't have a new diagnosis. She read everything she could find on adult ADHD. She saw that someone was hosting a conference in Michigan to discuss adult ADHD, and she went.
Emily: I just was very curious about how to really thrive, to really stay with it about that brain trait, and to be in the company of people who were putting on workshops and conferences. They happen to be almost entirely by women, about women. At one of these conferences, Emily picked up a book called Women with ADD. My copy of that book is full of pencil on every page. It was about my job, it was also about my marriage and my partnership and what kind of partner I chose and how it was playing out that way.
Danielle: The book was written by a woman named Sari Solden. It was published in 1995. Emily said it helped her understand the emotional side of ADHD. For her, it was the final piece of the puzzle. But, wait, 1995? What about that common story I'd heard that women were only now being diagnosed because up until recently, no one understood how ADHD impacts girls and women? I've seen versions of this story reported in the New York Times, The Guardian, the New York Post, and all over digital media. I've heard it in newscasts. Friends say it. A psychiatrist said it to me as she diagnosed me. It's a clean story. I bought it and repeated it.
Then I read Sari Solden's book, and I realized there's a problem with this version of events in which doctors just didn't know how women experience ADHD. The problem is, it's not true.
Sari lives a few hours from Emily, so I went to see her. And that day, she helped me understand my questions. Why women? Why now? In new ways.
Sari: There was a huge fight keeping out adults and the women.
Emily: Sari was deep in this fight. She never planned to be a pioneer, but she became one when she wrote about what it's like for women with ADHD.
Sari: You don't usually get to be there at the birth of a whole new way of looking at human beings. And that was what it was. That was why it was an eye-opener. It was like, "Wow, we can look at these people and ourselves through this new lens."
Danielle: That's next time on "Climbing the Walls."
"Climbing the Walls" was written and reported by me, Danielle Elliot. It was edited by Neil Drumming. Sound design by Cody Nelson. Briana Berry was our production director. Ash Beecher was our supervising producer. And Diana White was our associate producer. Fact-checking by Mary Mathis. Research by Karen Watanabe. Our music was composed by Kwame Brant Pierce, with additional music provided by Blue Dot Sessions, and our mixing was done by Justin D. Wright.
The series was brought to you by Understood.org, a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia.
From Understood.org, our executive directors are Laura Key, Scott Cocchiere, and Seth Melnick. A very special thanks to Rae Jacobson, Julie Zeitz, Jordan Davidson, Sarah Greenberg, and Kathleen Nadeau. If you want to help Understood continue this work, consider making a donation at Understood.org/give.