Visions Journal

ADHD and the challenges of seeking mental health care

Justyna Krol

Reprinted from the Intergenerational Trauma issue of Visions Journal, 2023, 18 (2), pp. 37-39

Recently, after decades of actively not thinking about the hardest period of my life—my adolescence—I decided to request my psychiatric hospitalization records from that time. I’m not sure exactly what prompted this decision. Perhaps it’s that, as my mother has gotten older, I’ve spent more time talking to her about our early years in Canada (after we immigrated from Eastern Europe) and getting curious about the way our memories match or diverge. As hard as that time was, I didn’t want to lose touch with it and how it shaped me. I was worried I would forget.

Forgetting and losing things is what I’ve always done. Friends and family have been held up while I looked for my wallet, keys, umbrella, lipstick, mask and/or hand sanitizer. Well into my thirties, I spent more than my share of the budget replacing lost purses, hats, scarves and jewellery. I once left a whole stack of library books on the shelves of a Miracle Mart grocery store in London, Ontario.
I have mostly learned to live with this, but it’s taken its toll. When I met my spouse, he did his best to help me corral the mess that always seemed to follow in my wake. Then, eight years ago, he emailed me an article published by Quartz called “ADHD is Different for Women.”¹

The subject line read, “I think this might be you?”

I read it. I cried. I googled. Then I made an appointment at the Adult Attention Deficit and Hyperactivity Disorder (ADHD) Clinic at The HOpe Center in North Vancouver and received a diagnosis of ADHD. It’s not an exaggeration to say that this changed my life. I finally had a name for the murky hole that had swallowed so much of my past—and medication to help me manage it. I was going to keep my new umbrella for longer than a month.

The relief was real, but so was the grief. As the clinical psychologist quoted in another article I read explained, “[an ADHD] diagnosis is a blessing and a curse: it’s a great relief, but [diagnosed adults] wonder what could have been different if they had only known.”²

And I did wonder. I wondered if I would have had fewer conflicts with my spouse and my family when I was younger; if the years I spent dealing with episodes of depression, which often followed periods of intense overwhelm, could have been mitigated and become something—anything—else. I wondered if I could have finished my MA faster, then followed that up with a PhD. Maybe I could have been the kind of adult who had—and met—long-term goals, instead of a person who needed every last bit of energy she had to survive the work week, just so she could eat, sleep and make her various payments.

Which leads me back to my early hospitalization and the records request.

Returning to the notes made by the doctors and nurses who treated me for a major depressive disorder in my teens was a revelation. The most common observations were that “the patient” was “unable to control her emotions,” “refused to focus and contribute in group” and was “easily overwhelmed by questions or requests.” Common consensus was that I was difficult. I could not sit still and kept bothering the nurses to find my doctor or let me out to walk the halls. These behaviours were called “manipulative.” These behaviours are also all symptoms of ADHD.  

A lot has changed in the last 30 years in how mental illnesses are treated and discussed. But it is only in the last half decade or so that we are starting to learn about interactions between types of neurodivergence, such as ADHD and autism, and mental health conditions, such as depression, anxiety, obsessive-compulsive disorder (OCD) and bipolar disorder, among others.³ If these links had been recognized when I was younger, my own hospital notes might have sounded a lot different, with the ADHD acknowledged as something that affected both my mood and behaviour.

The challenge that remains is that, at the best of times, emotional regulation is a work in progress for most adolescents. Early symptoms of a problem can sometimes be dismissed as psychological growing pains. That’s despite growing recognition of the difficulties in emotional regulation faced by those with ADHD.⁴

A friend who is a child and youth therapist recently sent me an article by Dr. Elisabeth Baerg Hall, the very psychiatrist who diagnosed my own ADHD. The article presents a series of challenges that can lead health care practitioners to miss making appropriate ADHD diagnoses. The article broke my heart a little. I see myself in so many of the lost opportunities Dr. Baerg Hall identifies. But it also gave me hope for young patients whose caregivers have access to this information.

Dr. Baerg Hall’s concerns relate to:

• poor screening among family members, even though the disorder is hereditary
• lack of awareness about how ADHD looks in adults (e.g., relationship/workplace problems rather than hyperactivity)
• misconceptions that intelligent, successful people cannot have ADHD (the opposite is true)
• poor awareness of just how often ADHD co-occurs with other mental health conditions
• overconcern about people becoming addicted to stimulants when on ADHD medication; substance misuse is more likely when ADHD is not treated⁵

I recognize how lucky I was to get my diagnosis when I did. The HOpe Centre is the only public clinic in BC to specialize in adult ADHD. I contacted them when their program was just starting and they accepted adults of all ages (I was in my early 40s). Recently, a friend sent me an article that reported on how they have closed their wait-list until further notice.⁶ This leaves a gap for people in my age group who need public help diagnosing their ADHD. I can only hope this gap closes in BC very soon.

Meanwhile, my hope for teens and young adults who suffer from undiagnosed ADHD alongside anxiety, depression or other conditions is that they can find someone who sees them for who they are and can provide them with the care they need.

As for me, these days, the list of the things I lose is much shorter. I have a hook by the door for my keys and purse, a lip balm in every bag and an automatic backup for my computer files. I work for a mental health organization, which means that in addition to doing work I enjoy, I also support others—however indirectly—who struggle with their mental health. I’ve been lucky. I do my best not to forget.