ADHD: Well known, but not well understood in women

As Em Rusciano makes headlines after opening up about her ADHD, Kerry Martin reflects on her own diagnosis of this under-acknowledged - and under-treated - condition. 

Comedian Em Rusciano’s address to the National Press Club about her life before and after her attention-deficit/hyperactivity disorder (ADHD) diagnosis is captivatingly raw, funny and insightful.

She points out how one friend described her diagnosis as a social media fad. As she retorts with nasal mimicry, "If all of you are so sick of hearing how everybody has ADHD, then imagine living with it!"

The crowd laughs. Rusciano also outlines that ADHD is not considered a disability and that treatment options are expensive and protracted. “I could have given a whole other speech about how broken our mental health system is,” she says.

I, too, dismissed my own diagnosis of ADHD, which was determined by a clinic that specialises in brain and behaviour issues during my early 20s. I just didn't seem to fit with the stereotypical picture of ADHD that we’re all used to. Instead, I focused on another condition I’d been told I might have - borderline personality disorder (BPD).

To my surprise, as a person with alleged BPD, I was treated as a volatile hedonist who could potentially commit a crime. I was labelled as unstable and unmanageable. A lot of mental health professionals weren't nice.

Out of curiosity one day, I perused a professional diagnostic criteria online. As it turned out, my symptoms didn’t correlate with BPD. They did correlate with my original diagnosis - ADHD.

The concept of female ADHD being bypassed has featured a lot in the news lately. The common theme espoused is that only stereotypical symptoms are looked for - the fidgeting, leg tapping, disruptive type. Yet as Rusciano points out, women, in particular, with ADHD experience headaches and fatigue - and often mask their behaviours related to this condition. 

ADHD affects executive function - or the brain’s command centre - and is not a mental illness. As such, while it is officially recognised as a disability under the 1992 Disability Discrimination Act - I’ve found it’s not socially recognised as one. 

My ADHD has been extremely disruptive, often causing lateness, due to my concept of time being skewed. People with ADHD can be forgetful and find planning and management virtually impossible. We can become subject to addiction, mood swings, physical symptoms and high sensitivity.

Because Rusciano is a celebrity, she can afford treatment. An ADHD diagnosis comes after specialist tests for brain imaging and the like, so the initial costs are considerable. The cheapest option I could find in Victoria costs $450. This type of testing is mandatory in order to be prescribed medication for ADHD - and ongoing costs for medication thereafter is another problem.

I envy Em. As a fellow woman diagnosed with ADHD, I feel I’ve achieved almost nothing in comparison. Then again, perfectionism is symptomatic of ADHD. If it weren't for my persistence about my diagnosis - again, a trait of my ADHD - I’m not sure I would have made it through Australia’s mental health system. 

My hope is that, by celebrities like Rusciano speaking out, women like us are heard and believed. I hope it broadens people’s perceptions of this condition - and that the process of accessing a diagnosis and appropriate treatment is made possible for all.