Late Diagnosed ADHD: How To Heal After Years Of Pretending (5 Steps) | Dr Judith Mohring

1. 0:00 – 3:33

   Trailer

   1. SPSpeaker0:00

      People with ADHD are very emotionally sensitive. That can be a superpower 'cause it means we can be super tuned in, and it can also be a difficulty. That emotional sensitivity is such a key issue in a late diagnosis of ADHD because not only do you often feel things quite deeply, but you're gonna be going through a bit of a storm.

   2. APAlex Partridge0:16

      Dr Judith Mohring is a Cambridge-educated psychiatrist who specializes in ADHD.

   3. SPSpeaker0:21

      She's here to guide you through the 5 stages of processing a late ADHD diagnosis. ADHD used to be thought of as a condition that was present in kids and then got better with age. Recently, we've realized that actually it doesn't. Not all adults with ADHD will become distressed or need a diagnosis, but for lots of adults, it causes very predictable difficulties. We don't do enough therapy, education, and coaching that's really based on the neuroscience and the evidence base for ADHD, and it's actually quite complicated to get it right.

   4. APAlex Partridge0:47

      Do you think there is a risk that somebody could get a diagnosis so late in life that they just feel completely lost, they don't know what to do, they feel so scared about stepping into the unknown?

   5. SPSpeaker0:55

      I've seen-

   6. APAlex Partridge0:57

      Can I have just a second of your time? If this podcast has helped you understand your brain or made you feel less alone, can you do me one favor? Can you hit the subscribe button? And I'll repay the favor by continuing to book the best and most exclusive conversations on this topic. Please enjoy the episode and always remember, you're not broken, just different, and you have always been enough. Judith, welcome back.

   7. SPSpeaker1:22

      Thank you, Alex. It's so lovely to be back.

   8. APAlex Partridge1:25

      We're gonna cover a big topic today, how to process a late diagnosis.

   9. SPSpeaker1:30

      Mm-hmm.

   10. APAlex Partridge1:30

       And if someone's watching or listening and they're trying to understand how to process a late diagnosis, they've clicked on this video, and they might not be convinced yet whether to stick around, how would you convince that person? What would they learn if they stuck around for 45 minutes or so?

   11. SPSpeaker1:47

       Um, I'm late diagnosed myself. I'm an expert in ADHD and a, a psychiatrist who has taught doctors about ADHD, has diagnosed and treated ADHD, and I've also developed coaching programs for late diagnosed adults. So this is kind of my bread and butter, and I think it's just taking... picking it apart, uh, creating a sequence that people can follow so that you understand if your immediate diagnosis doesn't bring relief or brings feelings of anger, that's okay. So I hope that people will come away from this session knowing it's okay. Whatever comes up is okay, and, and there are reasons for, for all those steps along the way.

   12. APAlex Partridge2:22

       There's gonna be a huge amount of emotions, I imagine, that we go through in this conversation that perhaps might come with a diagnosis later in life. How does the topic of late diagnosis tie into your general ADHD mission? What would you say that is?

   13. SPSpeaker2:38

       So, I guess the ADHD mission is, um, you know, ADHD used to be thought of as a condition that was largely sort of present in kids and then got better with age. And then recently we've realized that actually it doesn't go away, and it causes very specific, uh, problems and difficulties for some adults. Not all adults with ADHD will, will become distressed or need a diagnosis, but for lots of adults, it causes very predictable difficulties. Um, and that's my mission, is to say to people, "If you are late diagnosed, there's lots that you can do as well as medication." Um, I, in the past, have treated, diagnosed, and prescribed, and I teach people how to prescribe for ADHD. But what we don't do enough of, in my view, we don't do enough therapy, education, and coaching that's really based on the neuroscience and the evidence base for ADHD, and it's actually quite complicated to get it right. So that's my real mission, is trying to get it right for adults with ADHD and their clients and therapists so they can, they can follow that stepwise process.

2. 3:33 – 4:34

   The hardest part of a late ADHD diagnosis

   1. APAlex Partridge3:33

      What would you say is the hardest part of processing a late diagnosis?

   2. SPSpeaker3:39

      So, should we go straight to emotion? Um-

   3. APAlex Partridge3:41

      Let's do it

   4. SPSpeaker3:41

      ... let's do it. Let's go straight to emotion. So this is a hypothesis of mine, but one of my hypotheses about ADHD is that people with ADHD are very emotionally sensitive, and actually that can be a superpower 'cause it means we can be super tuned in and empathic and great communicators and really kind and warm. And it can also be a difficulty, because you feel all the emotion in the world, and then you end up responding to it. And I talked the first time I was on here about pretzeling, this idea that when there are big emotions in the room, you pick up on them and think, "I must change. I must adapt." So that emotional sensitivity is such a key issue in a, a late diagnosis of ADHD because not only do you often feel things quite deeply, but you're gonna be going through a bit of a storm of emotion where lots of the kinds of emotions that we see in grief are gonna be coming up. Um, and those are big things to process, and they're particularly tricky if, if you are very emotionally sensitive.

3. 4:34 – 6:44

   Grief

   1. APAlex Partridge4:35

      Grief comes up a lot on this podcast, particularly when we are talking about late diagnosis. If someone gets a diagnosis later and they are grieving, what do you think they are grieving?

   2. SPSpeaker4:47

      Oh. Grief, grief is a really, really... It's a really helpful topic as a therapist to think about and to hold in mind because essentially it means processing loss, and I've talked about grief in all sorts of situations with my clients over the years, you know, grieving a change of job, grieving a change in health, grieving a marriage. It's not just about people passing away. It can be all sorts of things. And, and grief brings with it very characteristic emotions. So often there's a sense of shock. Um, there may be de- denial. There may be anger. Um, and there's also periods of time where you feel basically okay, and then other times when you suddenly don't and it suddenly comes back. The outcome of that painful process is at the end you hopefully have processed the experience, and there's more space in your life to bring something new in. That's the purpose of grief, is to allow us to process and create space for something new.

   3. APAlex Partridge5:39

      Can you grieve what could have been different had you known that you were ADHD or, or neurodivergent sooner? Because I suppose you can grieve things that you've lost, but if you look back on a... perhaps you've lost a life that could have been so much different had you not masked so much or had you not taken that job that m-Probably wasn't a good fit or not got into that relationship that wasn't right for you, but because you were trying to fit in so much and masked so heavily, you kind of made decisions that weren't in a- alignment of who you really are. So can you get that grieving piece? Can that be a grief of what could have been?

   4. SPSpeaker6:18

      Totally. That's probably, I think, the biggest, the biggest grief piece for people is going back and going, "If I had known then what I know now, I might have made a different decision. I might have been better supported. I might... If you're taking medication, I might have been on medication. I might not have done that thing." And it's, it's like repeated sliding doors moments where you go, "Oh, there was another path back then. I, I didn't take it for what, you know, because of that ADHD related reason." So...

4. 6:44 – 13:38

   Resentment

   1. APAlex Partridge6:44

      Can some of the resentment that perhaps someone could feel after a diagnosis of ADHD, can that be spun into a positive?

   2. SPSpeaker6:53

      Um, so resentment. Okay, we... [laughs] I love that you're using... Yeah, we're, we're talking emotions. So resentment we would put probably somewhere in the anger family of emotions. Uh, there might be a, a hint of envy in there as well, so digging into the flavor of that emotion. Um, when we understand the purpose of emotions, what they're there to help us do, it helps us work out how we can put them to work for us. 'Cause emotions, they can be really painful. They're called feelings because they hurt, unsurprisingly. They can be really, really painful, but they have a survival function. So that resentment may have been something that was holding you back from doing something dangerous, like it might have held you back from shouting at your boss. So you were resentful every day, but at least you didn't shout at him. Or it might be a resentment over things, opportunities other people got that you weren't able to pursue. So I think it's understanding what the purpose of the emotion is. And when we understand that our emotions are there to help us, they're not bad, they're painful, but they're there to help us, we can then work out how to turn them to our advantage.

   3. APAlex Partridge7:51

      With envy, I think that's an interesting one. Can you be envious of somebody that seems to be living their life on much freer terms than you are?

   4. SPSpeaker7:59

      [coughs]

   5. APAlex Partridge7:59

      Because you're also terrified of letting people down, you don't wanna expose yourself to a criticism, so you don't put yourself out there. You don't apply for that promotion. You don't start that business. Can you be envious of other people who seem to be able to do the things that you want to do, but your, your fear of criticism is holding you back?

   6. SPSpeaker8:15

      Totally. I remember not long after my own diagnosis, watching a friend doing things in order, the kind of getting shit done, and she just did a load of not particularly interesting things in order, and then she stopped doing those, and then she switched to do a whole load of other not very interesting things. And I'm like, "How do you do that?" I was astonished that you could do all these not very interesting things in order and then finish them and then not be exhausted. I was like, I was really envious of, of that aspect. Um, for me, there's often... And I see this in many of my ADHD adult clients, so I do a lot of kind of group coaching and a little bit of one-to-one coaching as well. I see some really, really successful people who are almost the opposite of narcissists. There's, um, a real taking on of responsibility, a fear of upsetting others and, uh, really thinking about the impact on other people of what you're doing. Um, and I wouldn't ever say that I envy that, that, you know, that some people can be quite... They don't really mind what other people think or how things land. But I do think it can be quite, I'm gonna say crippling, which might m- sound too strong, but it can really hold you back where you're always thinking about the impact of your actions on others. It stops you sometimes from just being free. So I think there is an envy piece there.

   7. APAlex Partridge9:29

      I think so much damage can be done when you're living your life. Perhaps you are, are ADHD, and because of your differences, it does expose you to lots of bad messaging from the outside world, and that can start really young. So is there a, a sort of wish sometimes when you get a diagnosis that you could travel back in time and put your arms around the younger version of yourself, that, that, the little kid, the little boy or little girl who had that realization that they were different and abandoned their true self, and from that point kind of lived this life not really in tune with, with who they really were? Do you see that wish, that fantasy about being able to travel back and, and sort of whispering in, in your younger self and saying just, "You're not broken, you're just different"?

   8. SPSpeaker10:18

      Very much so, and I think it's also quite a, a beautifully described ADHD experience. The imagination, the rumination, the ability to, to bring to mind other possibilities is a, can be a very ADHD strength for some people 'cause it's a default mode network piece, that going back in, in time and, you know, time traveling back to the younger self. Um, and I talk about kind of multiple light bulb moments for people as they process a late diagnosis. You go through the multiple, "Oh, that was why I could never stay employed. That was why I kept leaving relationships, kept moving house. What have I, what have I lost? What have I missed out on?" So there's this real piece around kind of re- reflecting on, on past losses, and it goes on for quite a long time. You also mentioned something else which I think is really important about the loss of the true self, and, um, a sense of self-awareness is an executive function, the ability to kind of integrate oneself into a whole, and that can be quite difficult sometimes for adults with ADHD and also with other neurodiversities. And holding onto that sense of self as a whole takes practice, which is why, you know, I talk to people about therapeutic journeys with ADHD, who to see, what the right process is, you know, um, because it's really coming to know yourself as you are, accept yourself as you are, and, and be really kind of compassionate and celebratory towards whatever the how- however you are in the world, I think is really important.

   9. APAlex Partridge11:40

      I think the general concept of abandoning your true self and sort of shape-shifting and putting on this version of yourself that, that is accepted, like-

   10. SPSpeaker11:51

       Mm-hmm

   11. APAlex Partridge11:51

       ... will be so relatable to the viewers and, and the listeners. Have you got any stories of, of people that you've met, patients perhaps, who have their own late diagnosis story and maybe some epiphanies they've had?

   12. SPSpeaker12:04

       So many epiphanies, and obviously I can't share individual client stories 'cause they're confidential, but, um, I often say that working with clients is like reading books, and you read, you- somebody brings you this very precious text, and you kind of, you're allowed to, to read the text. And, um, and there are a number of, I would say, universal stories, and we come back again and again to the universal story, stories in this library of all these books. And, um, one of the universal stories is about the kind of the young person who was really misunderstood at school, didn't fit in, and has a real sense of loss. Um, and I remember, you know, I've, I've seen people who've come in and said to me, "I think I must have borderline personality because people find me so difficult, or I'm too much." And it's like being able to review that diagnosis, say, "No, that's not it, actually. You are emotionally sensitive, and, um, you are trying to please people here, and it's at times causing you to really feel really, really caught up in that." Um, so yeah, I think so many stories of, of people over the years coming in with, with reflections and suddenly going, "Oh, it's that. That's what it is."

   13. APAlex Partridge13:07

       I remember meeting a, an amazing woman at an event, I think it was about a year ago. She was, she was 78 years old, and she recently had a ADHD diagnosis, and she had some incredible self-reflection [laughs] to do, and she did. Um, and she described the feeling as relief. And she, I remember she said it felt like she had unknowingly spent her whole life underwater, and then she got the diagnosis, and it was like just coming up to the surface and suddenly [gasps] getting that gasp of air in.

5. 13:38 – 15:08

   Relief

   1. APAlex Partridge13:38

      Relief. Is that, is that a common description that you hear from people who get a late diagnosis?

   2. SPSpeaker13:44

      Massively, because it's the difference between thinking that you're lazy or stupid or disorganized, and you're just not trying hard enough, versus there's a reason. And it's, it's, again, it's that light... I'm sure you've had the same thing, the light bulb moments. Like years after a diagnosis, you suddenly go, "That's why I have six sets of keys."

   3. APAlex Partridge14:02

      [laughs]

   4. SPSpeaker14:03

      "That's why I have-

   5. APAlex Partridge14:04

      "That's why I've lost my car in the big car park again." [laughs]

   6. SPSpeaker14:06

      Yes. Yeah, that, that's why. Oh, it's that. Yeah. It's, you know, the light bulb moments-

   7. APAlex Partridge14:12

      Mm

   8. SPSpeaker14:12

      ... just, they never stop, do they?

   9. APAlex Partridge14:13

      There's so many brilliant things too. You know, I've got a, a cupboard full of reusable shopping bags, unpaid parking tickets. I forget to empty my washing machine. That's all a daily struggle, and I put systems in place to manage them. But we're so creative as well. Like so many, so many of us are pattern recognition people, entrepreneurs. Um, not everyone, but I'm saying there's so many, once you do unmask and you do find your true self and you, you kind of stop putting the effort into the wrong places and you, and you position it and direct it to self-awareness, and then you can really begin to realize what you're actually interested in-

   10. SPSpeaker14:49

       Yes

   11. APAlex Partridge14:49

       ... and lean into those, perhaps after years and years of pretending or doing something that doesn't really light your soul on fire. Perhaps you've been in a marriage that wasn't right for you, a whole career that wasn't right for you, and you get this diagnosis and you think, "Oh my gosh, my marriage was a mask," or, "My whole profession was a mask." Do you see that kind of

6. 15:08 – 18:49

   Unmasking realisations

   1. APAlex Partridge15:08

      pattern? How big can the, the sort of unmasking realisations be?

   2. SPSpeaker15:13

      Huge. It's really interesting you saying that, actually, because, um, I think so much effort goes into being neurotypical and, like doing it the way you're supposed to do it, and I always knew I wanted to be, uh, you know, I wanted to write and I wanted to run a business, and then there I was as a doctor, and I had this successful practice on Harley Street, and I'd look in the, in the mirror and go, "I don't know who you are." And it's a real anguish. It's really painful when you're like, "I am apparently really successful, but I don't feel it because I don't know who I am." And it's lo- that loss of connection with the self because there's a sense that you had to pretend because you knew, I knew what was expected of me, and it wasn't going off and running a business and doing the things that I really enjoy doing, which is teaching. I just love teaching. People are a joy, and I learn so much from them.

   3. APAlex Partridge16:00

      Can getting a diagnosis later in life be quite risky? Because I think of the film Shawshank Redemption. Have you seen that?

   4. SPSpeaker16:07

      Yeah.

   5. APAlex Partridge16:07

      You know when they've been institutionalized for so many years and then they get out.

   6. SPSpeaker16:11

      Yeah.

   7. APAlex Partridge16:12

      Some of them get out really, really old, and they get their freedom, but they don't know what to do because they're so used to their old way of life that's been that way for so long, and the outcomes are, in that film, not good. Do you think there is a risk that somebody could get a diagnosis so late in life that they just feel completely lost? They don't know what to do. They feel so scared about stepping into the unknown. Is that a risky position for someone to be in?

   8. SPSpeaker16:35

      I, I guess it varies from person to person. I haven't seen it that much. I've seen one pattern is for people to be really furious, like absolutely furious. "How could this, this have been missed for so long? How could it have been missed?" Um, and also the anger at all the things that may have happened along the way. But you touched earlier, Alex, on the strengths of ADHD. Now, obviously strengths vary, and neurodiversity's different in everybody, but many people with ADHD will have as a strength a- adaptability and creativity, and I think that often comes to the fore. So when you can turn the shame down, increase the self-acceptance, very often you'll be like, "Oh, well, I could create some ways around this." The difficulty then is actually not creating different techniques every six weeks.

   9. APAlex Partridge17:16

      Yes. [laughs] Yeah, yeah, yeah.

   10. SPSpeaker17:17

       A new process.

   11. APAlex Partridge17:18

       Yeah.

   12. SPSpeaker17:18

       Yay.

   13. APAlex Partridge17:18

       [laughs] I mean, I was, I was relatively young. I was 34 when I got my diagnosis. Again, I, I mentioned I, I spoke to that lady who, who was late 70s, and it's, you know, it's very common for people to get diagnosed in their 50s, 60s, 70s. I think 94 was... I didn't meet her, but I saw a story on-

   14. SPSpeaker17:36

       94

   15. APAlex Partridge17:36

       ... Instagram, and she got a diagnosis. Do you think the, the emotions, the big emotions that people feel correlates to the stage of life they're in when they get their diagnosis? In other words, do you think the older you are, the bigger the emotions?

   16. SPSpeaker17:51

       Well, interesting. Sorry, I'm, I'm distracted by thinking about asking for the 94-year-old's school reports.

   17. APAlex Partridge17:56

       Yeah, yeah. [laughs]

   18. SPSpeaker17:57

       Do they exist? [laughs]

   19. APAlex Partridge17:59

       Yeah.

   20. SPSpeaker18:00

       Um-

   21. APAlex Partridge18:00

       That would be like going down a family tree and some archive job. Be, be impressed if they found them.

   22. SPSpeaker18:04

       It would be amazing, wouldn't it? "And here are the school reports written on vellum."

   23. APAlex Partridge18:08

       Yeah. [laughs] Yeah

   24. SPSpeaker18:09

       Sorry, you asked me something else. I've forgotten what it was. Um

   25. APAlex Partridge18:12

       Um, so do you think the scale of the emotions that come in response to the diagnosis, do you think they get bigger the older you are when you get your diagnosis?

   26. SPSpeaker18:23

       Um, they tend not to generally. Um, and the reason for that is that older people are better at emotion regulation generally, and it's to do with changes in the brain that older people are better at dealing with difficult things, which is kind of quite handy 'cause often as we get older in life, more difficult things happen. But, um, it, it does also depend 'cause sometimes when ha- somebody has a history of trauma, um, lots of, you know, lots of things might come up that are related to their ADH- ADHD diagnosis

7. 18:49 – 20:27

   Complex diagnosis emotions

   1. SPSpeaker18:49

      as well.

   2. APAlex Partridge18:49

      What other complex emotions do you think might crop up when somebody gets a late diagnosis?

   3. SPSpeaker18:55

      So, uh, [laughs] um, one of the commonest ADHD emotions is, um, irritability and frustration and impatience. So that's a real common one that we talk about a lot. So in the groups I run for adults, um, we often talk about kind of the power of the pause and learning to create a little bit of space, and then what comes into that space is a sense of, "Don't make me stop." And, and working out what the function of that is, that itchy, scratchy, irritable, "For goodness sake, let's get on." Um, and it-- the, the function of that, I suspect, is that it, in the past, or perhaps as part of our neurobiology, it keeps us going, it keeps us busy, it keeps us active and engaged. Because if you don't have a certain amount of kind of active engagement, your brain will disengage. So I think there's a function to that emotion, and it's understanding that you don't always have to be on edge. Um, another complex emotion is anxiety. Many, many ADHDers are very anxious. We talked about this before.

   4. APAlex Partridge19:53

      Mm.

   5. SPSpeaker19:54

      Um, and its, its function there is to turn the, the heater up, as it were, to turn the burners up. So it's like i- if the anxiety's there, if I'm worrying enough, then stuff might happen and, you know, rumination, so often we've got the washing machine. Whoa. Rumination so often is, is a, an emotional, a sort of cognitive response to that emotion which, which comes from the anxiety that we're just worrying. Because if I worry enough, I might remember all the things I have to remember. So it's unpicking the function of those emotions. What are they doing? They're protecting us.

   6. APAlex Partridge20:25

      Mm.

   7. SPSpeaker20:25

      How can we use them more adaptively?

8. 20:27 – 21:29

   Tiimo advert

   1. APAlex Partridge20:27

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9. 21:29 – 23:53

   Late diagnosis regression

   1. APAlex Partridge21:29

      Do you think it's possible for your ADHD traits to get worse in the immediate aftermath, post a late diagnosis? Because you could almost regress in a way, 'cause you're, you're, you're so sort of set in your ways, so to speak. Then you get a diagnosis, and you might suddenly realize that actually you don't like playing squash or you don't like cooking or that friend isn't good for you, and, and you might sort of fall into this void of not having anything to do, and therefore that irritability could go up in the short term.

   2. SPSpeaker22:01

      I think you've named something really important, Alex, about, um, how people process anything difficult, which is if you have a way of being in the world and you've kind of learned to cope, and maybe you've learned to cope by always being on the edge of burnout, by being so busy, so manic, so frantic, so worried that you're getting everything done, and then you get a diagnosis, maybe you get given some medicine, maybe you get diagnosed with anxiety, you get given some, an SSRI or something, which obviously is not, not the ideal thing, but y- you get to that point where you're so, you're so burned out and, and then you get a diagnosis of ADHD, and then you think, "I've got to change things." You have to unlearn, and unlearning means unpicking your previous ways of managing. So that takes time, and it's like learning-- I can't swim front crawl, can't do it, can only swim breaststroke. Whenever I try and swim front crawl, I can't do it 'cause I have to unlearn, and I think I'm gonna drown.

   3. APAlex Partridge22:53

      Mm.

   4. SPSpeaker22:54

      And I think it's that unlearning piece. You have to unlearn the rushing. You have to... I was late today 'cause I've tried to unlearn rushing, not always successfully.

   5. APAlex Partridge23:01

      [laughs]

   6. SPSpeaker23:01

      You've gotta unlearn, and that's hard. So I think, yeah, giving yourself time to, to practice new ways of doing stuff and going, "That's not gonna be perfect. Well, that was a fail. Oh, that was a success," is really, really important when we're kind of... I don't know. Did you have experience of doing things differently?

   7. APAlex Partridge23:17

      Yes. Drinking. [laughs]

   8. SPSpeaker23:20

      [laughs] Yes.

   9. APAlex Partridge23:20

      Yeah. So that was a-

   10. SPSpeaker23:20

       Yeah

   11. APAlex Partridge23:20

       ... 'cause of-- I mean, I knew for many years that I had an issue with drinking, and then I got my diagnosis and made the connection between addiction and ADHD. It was very clear that-

   12. SPSpeaker23:29

       Yes

   13. APAlex Partridge23:29

       ... if I didn't unlearn that I can't drink, [laughs] then that-

   14. SPSpeaker23:33

       Yeah

   15. APAlex Partridge23:33

       ... that, you know, wouldn't have ended well.

   16. SPSpeaker23:35

       So that was your kind of baseline. If I've unlearned that, then I can go from there.

   17. APAlex Partridge23:38

       Yeah. I mean, my sobriety is 100% the foundation of everything, my relationship, my work, looking after my dog. If I have a drink, then everything falls down, and that was, for me, the one of the biggest realizations of, of my diagnosis.

   18. SPSpeaker23:52

       Mm-hmm.

10. 23:53 – 37:21

    How to unlearn ‘normal’

    1. APAlex Partridge23:53

       So if someone has just got a late diagnosis, how does one go about unlearning a version of themselves that perhaps doesn't serve them anymore?

    2. SPSpeaker24:03

       Um, it's a, that's a really lovely question 'cause actually it's sort of something I've become more aware of in the last year or two, is that often that emotion of irritation and frustration is, is recognizing that you're, you're nudging against unlearning, that you're having to do something differently and maybe you don't want to. Maybe rushing works really well 'cause it gets you focused. Maybe over-scheduling works really well because it means that you've got a lot to do, so you, you always get something done, even if it's not the thing that you hoped to get done. Um, and it's that irritation that arises is so healthy, 'cause it's like, "I know what I'm doing. I've learned to manage this way. Don't make me unlearn." And it really is just about being conscious of it and going, "Ah, okay, maybe this is how I've learned to manage, but I guess I might have a choice here. I could choose to do it differently, um, if I wanted to adapt that." And then making a, a conscious decision, "I might try that differently. I might not." So time management for me, massive piece of unlearning.

    3. APAlex Partridge24:56

       Mm-hmm.

    4. SPSpeaker24:56

       I've had to s- work really, really hard to make time visible. Even today, I was half an hour late 'cause it wasn't in my diary the right color.

    5. APAlex Partridge25:04

       [laughs]

    6. SPSpeaker25:04

       So, so, and there's a lot of kind of you can't do it the way you used to 'cause you keep tripping up, and it's upsetting.

    7. APAlex Partridge25:11

       Mm.

    8. SPSpeaker25:11

       It's costing me. So it's like if it costs us as individuals, then I think it's valid to say, "I'll try it differently." But don't change on behalf of other people.

    9. APAlex Partridge25:18

       And I suppose as-

    10. SPSpeaker25:19

        Unless they're your boss.

    11. APAlex Partridge25:20

        Yes. Yeah, yeah, yeah. [laughs]

    12. SPSpeaker25:21

        Maybe then change. Yeah.

    13. APAlex Partridge25:23

        And I suppose as well as unlearning, you can learn new stuff, right? You can learn new hobbies, perhaps new careers. Have you met anyone who's got a diagnosis and they've completely abandoned maybe a career and s- started a whole new one?

    14. SPSpeaker25:38

        Loads of people. It's a really, really common thing to do. So, uh, um, Ned Halliwell, who I think you've had on the podcast-

    15. APAlex Partridge25:42

        Mm

    16. SPSpeaker25:42

        ... haven't you, um, he, um, talks about right career, right job, right partner, and I think that's so true. A, a partner who accepts you and loves you just as you are, um, and a, a job that, that suits your strengths and your skills and works with who you are. Um, yeah, I remember somebody, uh, once who became a tree surgeon after their diagnosis, and that was like a big, big change. Lots and lots of lawyers who've gone from being external, working for external clients, to going in-house, um, and maybe doing HR law. I've had people go and retrain as therapists. Um, I've had people go and retrain, um, do... just go off and do completely different things. Maybe becoming a yoga teacher, having previously been an ordinary teacher. Very often it's about taking your previous skill set and saying, "How can I segue that into something that allows me to move more or introduces more variety or more human contact?" So that, I mean, the career change piece is huge for, for ADHDers, I think. Yeah, definitely.

    17. APAlex Partridge26:38

        What I see a lot of, uh, it seems like a bit of a risk, and I don't know if you agree. If people get a diagnosis of ADHD, and then they might talk about it, they might share it with their friends or family, and then because of unhelpful narratives in the media and on social media sometimes, they could get comments like, "Oh, you're just making it up." Is that a risk to someone's self-esteem at that point?

    18. SPSpeaker27:05

        I- it's not just a risk to self-esteem, but it's also a reflection of internalized stigma. So in the one-to-one work I do, people will often... This is a very... This is, this happens again and again in the first year or two. It's like, "No, no, no, I'm, I'm just making... This is... I, I can't have ADHD because I have this successful career," or else, or this, this, this. And it's, it's sort of saying, "Well, you, you managed, but it was costing you, which is why you came to chat and talk about it. Um, and now what we're doing is a bit of unlearning and going, 'Actually, no, it do- it is real. It does cost you, and these are the things that are causing you difficulty, so let's work on those.'" So it's, I think we internalize the idea that we, we, it must all be fine. We're just, we're just making it up. We just need to try harder, so... And then obviously there are plenty of people in the world outside who will tell us that if we could just do it the way they do it, it would all be fine.

    19. APAlex Partridge27:51

        Mm.

    20. SPSpeaker27:51

        If you could just learn to be organized, it would all be fine.

    21. APAlex Partridge27:55

        Is there a risk there that somebody could be gaslit by friends or family? They get the diagnosis late, they go to their family and, and, uh, and they don't believe it, or they kind of make excuses on behalf of the person who's just been diagnosed, and then the person who's just been diagnosed starts to doubt or question the diagnosis because of messages from their family saying, "Oh, then that's normal," or, "You don't have ADHD. It, it's not a real thing." Can the person who gets the late diagnosis be gaslit by their nearest and dearest over the diagnosis?

    22. SPSpeaker28:26

        Yeah, I mean, I guess so, yeah. And I also talk about not gaslighting yourself-

    23. APAlex Partridge28:30

        Mm

    24. SPSpeaker28:30

        ... that it's easy for you to doubt it and think, "No, no, no. No, I'm really just, I'm making this up." And that's one of the joys of group work, is in a group, if you've got eight or 10 ADHD adults together and we talk about something called the empty PEZ task, what boring things can you not do, everybody comes up with the same boring things. And we- it's like normal things that normal people appear to be able to do without, like finding your keys, doing the laundry, cooking a meal, getting showered, brushing your teeth-

    25. APAlex Partridge28:53

        Mm

    26. SPSpeaker28:53

        ... putting the bins out. The, the, the empty PEZ task is so universal across all the ADHD adults. Everybody goes, "Oh, it is real. It really is me. Ah, okay." And that, I think, is really helpful, is to find other people. So we can gaslit ourselves, we can be gaslit, and I don't think... It, it's difficult if you don't experience the world this way to understand how other people experience the world. So it could be gaslighting, which has a toxic element, or it could just not being, not having the imagination to know what it's like to be time-blind.

    27. APAlex Partridge29:25

        Mm, yeah, and can you, when you get that realization and you suddenly realize that the old cliché, you know, you've been living life on hard mode, but you just didn't know it, you didn't have the instruction manual. Can you be angry at that point when you realize that fact? Can you look back at your past and think of specific examples where perhaps things weren't fair because you didn't know? For example, you could be doing an ex- an exam at school, and you should've been given extra time, but you weren't because you were masking your struggles. Can you look back as a late diagnosed person with anger at things that were unjust?

    28. SPSpeaker30:02

        TotallyYeah. I mean, I sort of don't [laughs] don't wanna quote Oasis, Don't Look Back in Anger, but I think-

    29. APAlex Partridge30:08

        [laughs] Yeah, yeah

    30. SPSpeaker30:08

        ... we often do look back in anger and go-
11. 37:21 – 39:19

    Personal growth after a diagnosis

    1. APAlex Partridge37:21

       realization, is there a growth piece that comes post-diagnosis?

    2. SPSpeaker37:25

       So there's a whole piece of research around something called post-traumatic growth, um, and I've done, you know, done a little bit of work in, uh, working with trauma one-to-one, and also teaching people about trauma, and I've got experience of, of PTSD, and, and the ex- experience of going through that is extremely unpleasant. Um, and when you're able to process it and work through it, um, and integrate it, we know from the research, actually, it builds, people develop extraordinary resilience and connectedness, um, and can often come out the other side with a sense of, of growth and a sense of possibility, where, having worked through something difficult, you develop new skills, new ways. It's that learning piece, new ways of, of managing and adapting. And I think that's, that... I can see that in spades in many of the people I work with, ADHD people who've been able to pull on different resources, take their time, 'cause it does take time, um, but really come out the other side with a new sense of awareness and of, of their strengths and when to deploy them and when to ask for help. So I think it is very possible to grow through this, yeah.

    3. APAlex Partridge38:29

       Truly fascinating, Judith. Um, I'm really excited about the next section. In the last interview that I did on late diagnosis, I went through the comments, and the three top questions on the topic of late diagnosis, I want to ask you now-

    4. SPSpeaker38:44

       Okay

    5. APAlex Partridge38:44

       ... if that's okay.

    6. SPSpeaker38:45

       No pressure.

    7. APAlex Partridge38:45

       Uh, [laughs] yeah. So I'm gonna reach-

    8. SPSpeaker38:47

       I feel like I'm having an exam. [laughs]

    9. APAlex Partridge38:49

       [laughs] No, no pressure. There's a lo- the, the most in-demand questions for-

    10. SPSpeaker38:53

        Okay

    11. APAlex Partridge38:54

        ... for... But don't worry. It's all, we're, we're all friendly.

    12. SPSpeaker38:55

        I've been helping my son with his h- math homework.

    13. APAlex Partridge38:57

        Yeah. [laughs]

    14. SPSpeaker38:57

        So as long as it's not like this, to, diameter of a circle or something.

    15. APAlex Partridge39:00

        [laughs]

    16. SPSpeaker39:00

        Fine.

    17. APAlex Partridge39:00

        Yeah. They're in the washing machine of woes, which regular viewers will know is a representation of my memory loss, because I always forget the washing machine in the machine, like I mentioned earlier. But the Tiimo app has helped me. The first question is, "I've been diagnosed with ADHD, and I swear as soon as I did, my symptoms

12. 39:19 – 42:49

    Most popular audience questions

    1. APAlex Partridge39:19

       got worse. Is this normal?"

    2. SPSpeaker39:21

       Yes, it is, and it's to do with selective attention, that when we suddenly become aware of something... So let's say you've been diagnosed with ADHD, so you've gone and you've spent time working with someone to go through your symptoms or difficulties or areas that are problematic. And obviously to get the diagnosis, you have to be experiencing distress or difficulty, then you have to provide evidence of them. You have to say, "Oh, yes, I forget things all the time. Yes, I lose my car keys. Yes, it's very difficult to get organized. Yes, time management is a problem. I struggle to finish things. I struggle to listen. I'm fidgety. I'm restless. Um, it's really hard for me not to over-talk. I'm impulsive. I'm impatient." You know, you, you list all these things, or you go through and you suddenly... Your awareness has just shot up. So because y- it's salient, suddenly this is really salient, you just notice it more. So yeah, and it feels like it's got worse, um, but I don't think necessarily it has got worse, it's just that you're much more aware early stages post-diagnosis. So.

    3. APAlex Partridge40:17

       Fascinating, Judith. And in a quick-fire fashion, onto the next most in-demand question. Someone has asked, "When I got diagnosed, I was so angry at the world, and I still am. It's made me a bit more depressed. I lost years to confusion. How can I overcome this?"

    4. SPSpeaker40:36

       Okay. Brilliant, brilliant question. Yeah. Um, this is also very common. It's called an adjustment reaction. Even has its own diagnostic name, which is when something changes in our kind of mental model of the world. Like, oh, there's something everybody missed about me, then we have to adapt, and we have to process that, and very commonly, that's experienced as a period of low mood. I'd really recommend to that person that they find a group of adults with ADHD to talk with, or perhaps a one-to-one therapist or a, a good friend. This will pass. This too shall pass, but it probably needs a little bit of time and, and ther- and, and space, and that might be a therapeutic space.

    5. APAlex Partridge41:09

       Fascinating, Judith. And onto the final question. I feel like some kind of melancholy drum roll is needed. [laughs]

    6. SPSpeaker41:16

       [laughs] Let's hope it's a good one.

    7. APAlex Partridge41:16

       For the washing machine of woes. [laughs] It's too upbeat. And finally, the last question, Judith. "My wife is 55, and I think she's ADHD. She knows, too, but won't admit it. She doesn't think a diagnosis will change her life. Do you think she should get one? Is an ADHD diagnosis worth it?"

    8. SPSpeaker41:35

       Oh, that's a really, that's a really nuanced question. Yeah, I always struggle with "My wife is," 'cause, like, ooh, okay, [laughs] let's be thoughtful here about, about the relationship for these two people. Um, so I think it, uh, a good diagnosis can be really therapeutic, because a good diagnosis involves spending time with someone and going through life history and making links, and that's therapeutic whatever the outcome is, hopefully. Um, so I think it is worth it. Uh, but it's about finding someone who you trust and you feel able to open up to. Um, we know that ADHD medicines can work. Many people find them very, very beneficial, so that can be really useful for some people. For other people who choose not to take medication, actually just knowing about difference is helpful. How you broach the question is, is subtle, and it might involve talking, you know, with her consent, talking to friends or family members, or sharing that you've got colleagues maybe who've, who've experienced this and, and found it useful. And telling her, obviously tell her that you, you love her as she is, but you'd love to see her, you know, making even more of her strengths and, and, and overcoming certain struggles more effectively.

    9. APAlex Partridge42:40

       Fantastic. Thank you so, so much, Judith. And if anyone watching or listening would like to submit a question for the washing machine, uh, there will be an email in the description. And just finally,

13. 42:49 – 45:05

    Judith’s ADHD item

    1. APAlex Partridge42:49

       Judith, we're gonna reveal your ADHD item. Your ADHD item is patiently waiting underneath this cloth in front of us, and I'm going to reveal it now. There we go. [laughs]

    2. SPSpeaker43:00

       It's very small, isn't it? It's a bit disappointing. I should've got a bigger one.

    3. APAlex Partridge43:04

       Yes. Well, no, it's fine. I think an explanation. What, what is that?

    4. SPSpeaker43:08

       Okay, so this is a very small representation of what's known as a feelings wheel, um, which I use it a lot personally and also in kind of the groups. And what we do with the feelings wheel, you know we were saying feelings are called feelings 'cause they hurt.

    5. APAlex Partridge43:23

       Yes.

    6. SPSpeaker43:24

       And very often we'll have, because we're sensitive, we'll have lots of emotions. Being able to kind of name something, and there's a whole technique called Name It To Tame It from Dr. Dan Siegel, but just being able to name, go, "Oh, I think it's envy," or, "Actually, I'm really irritable," just immediately reduces some of the temperature of that emotion because the prefrontal cortex, the language centers, are linking to the amygdala and the emotion centers and calming us down. So really simple technique is to use a feelings wheel. I have these all round the house. I use them myself, with the kids, with colleagues, in businesses, in therapeutic settings. Uh, obviously bigger than this. [laughs]

    7. APAlex Partridge44:04

       Yes. [laughs]

    8. SPSpeaker44:07

       'Cause obviously nobody has feelings that... And you'd have to squint at it and go, "Oh, I'm feeling, uh, hmm, I'm not sure." So there-

    9. APAlex Partridge44:13

       And if someone wants to buy one, are they quite easy to find online?

    10. SPSpeaker44:16

        So there's, there's, um, some from a company called Junto. They have the copyright ones, Junto Feelings Wheels, which I love, and then you can also get just representations of feelings wheels in all sorts. I've got big metal ones and all sorts. It's also attached to my house key. This is one of the many, many house keys I have. I'm not giving you my house key.

    11. APAlex Partridge44:31

        [laughs]

    12. SPSpeaker44:32

        Um, but I have to have lots-

    13. APAlex Partridge44:33

        [laughs]

    14. SPSpeaker44:33

        ... of house keys for every different handbag or coat, otherwise I get locked out. So I'm gonna take my house key off in a minute and then give this to you.

    15. APAlex Partridge44:41

        Incredible. Thank you very much. I will probably keep that one and get a bigger one for the s- podcast set-

    16. SPSpeaker44:48

        Yeah

    17. APAlex Partridge44:48

        ... so it's more visual. But this one will stay with me, so thank you very much.

    18. SPSpeaker44:51

        Over to you, Alex. Enjoy your feelings.

    19. APAlex Partridge44:53

        Incredible. Thank you so much. Judith, on behalf of everyone grappling to understand their brain after a late diagnosis, thank you so much.

    20. SPSpeaker45:02

        Thank you very much. [outro music]

Episode duration: 45:06