Making peace with who I might’ve been
We need to do better for girls’ and women’s mental health
To be relevant in the context of mental health awareness, this discussion requires an accurate depiction of certain events, and can therefore at times get pretty fucking dark, in ways that might not benefit people whose mental state is vulnerable. If this is you, please prioritise self-care.
TW: suicide, inappropriate language around intellectual disability
So, I’ve quite recently received a correct diagnosis for my lifelong mental struggles, which has made my entire life make sense. Major spoiler alert for anyone wondering what 30 years of living in the dark were like: it’s ADHD, predominantly inattentive. To what, in a perfect world, should’ve been absolutely no one’s fucking surprise.
The signs were blatantly obvious. Yet it took around 3 decades of struggle, over half of which were marked by active despair, for me to actually be awarded this definitive, thorough conclusion by a medical professional. Which, in the years since reaching adulthood, wasn’t for lack of trying on my part.
This shit has been a dangerously long, harrowing, winding, alienating journey, wrought with self-hatred and self-abuse.
But it needn’t have been.
What was always there, but never seen
When did it all start, my psychiatrist would inevitably ask.
Pffft. Always. Never. It was always there, it never started. I haven’t a single memory of things ever being ‘not-off’ — and what might have seemed natural to me at the time through mere lack of any basis of comparison, is most definitely ‘off’ in hindsight. But I guess the real trouble started when I was forced to exist amongst peers in an environment that’s centred around measuring performance.
I neither wanted to be around this many people, nor did I want to have my performance measured. I especially did not want to have my performance measured.
Wanting to be amongst people would come later, much later, as I would discover that I was fundamentally, irreparably, inevitably broken, and that other people wielded the godlike power of acceptance, of reassuring me that I was okay even though I was the way I was, that, despite everything I painfully wasn’t and could never hope to be, I was still, mercifully, worthy of love — and that with it came their power to deny me any validity through rejection, to refuse me any sense of worthiness. I will never judge people who gamble, because I’m a recovering people-pleasing-addict. Though I had yet to find the definitive answer to the lifelong riddle that is my brain, I knew I had made progress in my mental health journey when I started not particularly wanting to be amongst groups of people and needing my alone time again, the way I had when I was a really young child.
Wanting to have my performance measured came never; outside inevitable work-related metrics, you can keep that shit in its entirety, there isn’t a single competitive bone within my body, I hate all of it, from that insufferable Activity party game to toxic overly competitive corporate environments to relationships driven by an ever present dick measuring contest energy. My only beef is with myself. I have no competition with you whatsoever, whoever you might be.
Alas, though I had no desire to compete and could be neither coerced, motivated, nor threatened into doing so, I was forced to compare.
See, the first five years of my life, I had no real benchmark through which to perceive myself. Adults are alien to a four-year-old anyway, so I was simply content just living in my own universe, playing with model trucks and building sand structures, forging my naive make-believe worlds, creating characters and role playing them. Other kids my age had to at first be shoved down my throat, before I could develop any tangible desire to interact with them. My parents describe this phase of my upbringing before the educational system as easy, because, so long as you didn’t forcefully remove me from my self-induced parallel universe, I pretty much just sat wherever and played with whatever, for hours on end, talking out loud to imaginary people from imaginary worlds. They took me with them to pubs, rock concerts, barbecues, tax payment obligations — didn’t matter, I did the same thing.
Things would become complicated for my parents a bit later, as I would discover that, despite every caregiver’s insistence that I could stop being flawed if I just wanted to and really decided to try, I was fundamentally, irreparably, inevitably broken, and that being worthy of occupying a space in this world would forever be denied me unless I somehow managed to persuade the people who cared for me, the adults I looked up to, and if not them then persuade absolutely literally anyone really, that, despite everything I painfully wasn’t and could never hope to be, I was still, mercifully, worthy of love.
If you’re looking to ease the emotional load of this story with a well-timed daddy issues joke, this would be the perfect time to go for the joke in question.
Love me, daddy.
My first clues that I was broken came when I was about five, when my parents tried to have me enrolled in one of those preschool situations. No kids wanted to play with me and no adults wanted much beyond the bare minimum to do with my oddly serious piercing gaze, my inability to care about things on command, or my aversion to being removed from my imaginary bubble. This is how I first became aware of being different. I suspected it wasn’t a good thing, being different, but I only came to be sure of it once the performance indicators started rolling in.
In first grade, my parents were summoned to school: ‘She is retarded’, came my educator’s conclusion, a phrasing I have no more desire to quote than you have desire to read, which was nonetheless the word-for-word verdict that my parents were presented with. ‘She doesn’t pay attention to classes and just keeps staring out the window. She can’t follow along with the other students. She needs to be taken in for an IQ assessment’.
Now, if at this point you’re hearing deafening alarm bells because many adults with an internet connection have since come to suspect that this might be a symptom of Inattentive ADHD, well, you’re alone on that in the context of this story. I was facing this journey in 30-years-ago-but-might-as-well-have-been-60-from-a-mental-health-awareness-point-of-view Romania.
So, taken in for an IQ assessment I was.
A psychiatrist, mind you, heard the entire not-paying-attention-to-the-point-where-she-can’t-keep-up ordeal — and proceeded to test my intelligence level without further questions. She concluded that I was, in fact — there’s that word I don’t wanna quote again but need to for accuracy’s sake — ‘not retarded’. She did not stop to wonder whether any other avenues needed to be entertained or investigated here. Shit you not. She provided my parents with the conclusion that I was ‘above average intelligence’, an assessment which would come to do me considerably more harm than good along the way as it provided my parents with a licence to blame every symptom I was experiencing on me, and sent us all on our merry way.
From then on, the possibility that I needed any sort of help from a mental health perspective would never again occur to my parents for as long as I would live under their roof until the age of 18. I would go on to seek psychiatric help as an adult, after having sunk so low into self-hatred and crippling anxiety that I spent a few hours in the bathtub, pondering the illustrious plan of getting black out drunk so that I might drown in said basin.
Deciding that my partner deserved better than to come home to this scene, I instead called my mother and asked her for help getting to a psychiatrist asap. This was around 10 years ago. Since that time, before finally starting on a correct path less than a year ago, I have seen multiple mental health specialists, tried dozens of types of treatment, some of which did absolutely nothing, some of which made things worse — or, worst of all, some which seemed to make things better only to soon make them much much worse.
Turns out, you can actually make someone with ADHD exhibit Bipolar Disorder symptoms if you feed them enough SSRIs, even as the unfortunate brain owner repeatedly brings up what isn’t working. As a result of these adverse interactions with experts in the field of psychiatry, for a while, I just refused to try any more and resigned myself to a life of mental suffering and debilitating lack of motivation. For a few years, I stopped taking any medication (I can now see how attempting various ways of messing with serotonin levels in one doctor or another’s pursuit of a flawed clinical conclusion could have never hoped to regulate the way my neurons respond to dopamine) and I stopped going to any form of therapy (if one more benevolently clueless psychologist tries to talk me out of being neuroatypical, I am not responsible for my actions).
Eventually, the despair caught up with me again. Fortunately, this time round, sans dangerous bathtub contemplations. Instead, I allowed myself to fall down the rabbit hole of what I now understand to be a bout of ADHD hyperfocus and researched basically all of the psychiatrists in Bucharest, Romania. I picked the one who seemed to be the most up to date on his scientific literature and the smartest, a decision I would come to both applaud and regret. During a session that cost me the equivalent of a black-market-acquired viable human kidney, this well read smart man, with an ego so big it threatened to flatten you into a corner and an empathic bedside manner reminiscent of the character Patrick Bateman in the film American Psycho, took 30 minutes to decide that I had Inattentive ADHD.
I went home, read the diagnostic criteria myself, and spent the subsequent half an hour crying in the bathroom over a list of clinical symptoms. I might have also been crying about having the same person who pointed me in the correct direction invalidate my struggle during the exact same session. There was a lot to unpack here, people.
It would take almost another year for me to finally get over my disdain for those working in the psychiatric field and see yet another specialist for a full evaluation. 2 hours of testing and a considerably less empathy-bereaved psychiatrist later, the ADHD verdict was officially confirmed.
My mum recommended my current psychiatrist, insisting I would not want to shoot him on sight after the session if I only gave him a chance, so in that I consider we’ve come full circle: from insistently, relentlessly driving it into me that all my symptoms were in fact characters flaws that I could overcome through mere willingness to do so, to directing me towards the medical professional that would finally start helping me along the journey of healing a lifetime of self-blame, as I learn to embrace my neuroatypical brain.
The treatment plan itself helps, of course, but it’s the validating-over-30-years-of-struggles that’s doing the heavy lifting here.
What could have been there, but never will
In the early days of what was finally my path towards correctly-informed mental coping tools, I found myself mourning something I’d never expected: the brain I will never have and the life it could’ve allowed me to live. Don’t get me wrong, I don’t mean to say that I wish I had a neurotypical brain. I mean to say I wish I had the ADHD brain I could’ve had if I had been diagnosed back when I was first sent in for that IQ assessment. An ADHD brain shaped into adulthood by compassion from my teachers and caregivers, accurate coping strategies, and, yes, probably some well prescribed medication. Instead, I’m stuck with this battered brain, abused by years of toxic self-talk, debilitating anxiety, all manners of self-abuse, and failure-to-thrive-induced depression.
In the year since my diagnosis, my internal discourse is greatly improved, I’m exhibiting a modest-yet-life-changing degree of motivation, I’m finding it easier to focus through my work tasks and experiencing way less burnout as a result of having to do so, my anxiety is less disruptive to my daily life, and at my worst I feel considerably less inclined to engage in suicidal ideation.
It also helps that, in the last 5 years, I’ve been privileged enough to work for a company whose claims of diversity really are reflected in the people being hired and those being chosen for promotions — but I’ve clearly been doing better at my job in the past year, to a point that’s allowed me to take on responsibilities beyond ‘just writing’, which had previously, throughout my entire life, been the single thing I could ever do reliably and consistently, in intense bursts followed by episodes of debilitating burnout.
And still, despite these major improvements, the vague sense of regret lingers. A yearning for a version of myself that I could never come to know.
No matter how hard I work on myself today, I cannot give back to the 20-year-old me who abandoned her movie directing pursuits her chance at going down that path.
I could go down that path today, you will argue, and sure, in theory, I’m sure I could.
But I don’t want to anymore.
That version of me who wanted to do so is dead — some of her died by my own hand in order to spare myself suffering, some of her died at the hands of a society that has lightyears to travel before neuroatypical people are treated fairly — and no amount of work I could do on myself today will ever bring her back, because I’ve long since lost any desire to be her. She is forever a thing of the past, replaced by someone else, someone whose dream is to never again attempt to pursue anything ‘artsy’ in exchange for currency. I would sooner abandon all of civilisation and raise goats in an internet-deprived hut than embark on a quest towards that dream today. The idealistic self-expression-driven individual who could’ve made this dream a reality had she met with favourable circumstances, no longer exists.
So, then, if I don’t want to do it anymore, what is there to regret?
Fair question, kind observant reader, fair question.
I regret lacking the desire to ever be her again. I regret the years she wasted hating herself, believing herself less-than and punishing herself for it.
What should be there — and totally can be
At this point, those of you who go to therapy (a practice that I enthusiastically encourage despite my present rant) or who are otherwise CBT inclined, will note that I have absolutely no way of knowing how I or how things in general would have turned out, and whether that would’ve been preferable to my current self or circumstances. To which I say:
**sigh** I know. I bloody know, ok? Rationally, I am fully aware of the obvious futility in mourning the might have been.
However, I dare suggest something better that could be offered in response to my need for a period of mourning:
Society needs to do better for women and girls.
Not all ADHD brains live inside the skulls of hyperactive-presenting white boys. Yet, the standard case profile remains a young white boy who can’t sit still and talks to excess, just as the standard case profile for ASD remains a white boy who’s really into trains.
Even though, in childhood, the ratio of boys to girls with ADHD is roughly 3:1, in adulthood, the ratio is close to 1:1. Since ADHD is not an acquired condition, this suggests that girls go undiagnosed in childhood. Sure, some boys grow out of their symptoms, but that alone fails to account for the entirety of this gap. As our undiagnosed struggles threaten to overwhelm us completely, we end up desperately seeking answers as adults, closing the gap that should’ve never been there by means of our own persistence and resilience.
There are many reasons why this gap in correct diagnosis exists, but, if you want the abridged version, here it is: it’s the patriarchy.
Yes, I said ‘the patriarchy’ unironically and I’m standing by it so long as the default average human remains assumed to be a white male, even in fields as unbiased and secular as medical research.
ADHD presents differently in women and girls — and the only reason why these differences are not common knowledge amongst medical professionals is we, as a society, didn’t have enough fucks to give about women and girls. We didn’t conduct enough studies using gender-disaggregated data even when we started suspecting that presentation might be different, we didn’t work to create the needed awareness even once we knew this to be the case, we simply didn’t care enough to be bothered.
Likely due at least in part to the way in which we’re socialised as young girls, we’re more likely to be better at masking, which doesn’t mean we don’t suffer the same negative consequences as boys if we go without adequate treatment. Our care has simply been deemed inconsequential enough in relation to that of our male counterparts to not be worth the hassle of a gender-disaggregated study. That’s, like, twice the data to parse y’all, which is inconvenient. I can’t even begin to imagine how well we’re doing when it comes to offering specialised care to gender minorities or to minorities in general.
With the IQ test episode and many, countless others in my upbringing, the symptoms and signs were all there. Towards my lamentable entry into adolescence, the signs became desperate cries for help. At the end of my rope as an adult, I must’ve seen a depressing total of around 10 specialists before finally being offered a correct diagnosis.
The obvious was consistently overlooked, because we didn’t matter enough as a gender to be worth the trouble of more complicated methodology.
Despite my abiding, unshakable belief in the ways of science, regardless of my love for and gratitude towards the enormous advancements made possible by the ever-updating scientific consensus, the scientific community still needs to step up and do better for women and, by extension, definitely better for gender and racial minorities.
What remains — and what is to come
Of course, other than doing my best to contribute to awareness around mental health, with an emphasis on equal access to care for all genders, races, and income levels, there is nothing to do but move forward. Allowing yourself to mourn when and what you need to is healthy, but so is learning to let go. I can’t say I’m 100% there yet, but I am getting there, every day.
To my incredibly resilient, immensely intelligent, ever invested in self-betterment mother:
I hold towards you no resentment, only love and compassion. I hope that, rather than feeling guilty for having not seen what society had denied you the information to see 30 years ago, you can take pride in having since worked your way into an empathy and understanding towards neuroatypical people that I can only hope every mental health professional on the planet will soon share.
To my witty, grit-driven father, whose stubbornness and unyielding perfectionism-fuelled professional ethic I’ve been lucky to inherit without our sharing actual DNA:
I hope that, despite it being positively illegal for you to voice any such thoughts aloud in my presence, you might come to feel proud of me not in spite of who I am, but because of.
To that wide-eyed, disarmingly naive young Moody that I once was:
I am sorry you were failed by the medical community. I forgive you your transgressions and missed opportunities as you fought hard to navigate a world not designed to accommodate you, without any of the vital adequate coping tools to aid you in this challenge. I’m humbled by how far you’ve come. Through all that has been and all that is to happen: you are enough.
To anyone facing a difficult, seemingly helpless mental health journey:
You are worthy of adequate care. You should not have to advocate for yourself in order to receive it, but you do deserve to have it. Please do not give up. Reach out for help, read about other people’s experience, be the voice society tried to deny you through its carelessness. It can and does get better.
Thank you for joining me on this emotional journey, kind reader. I truly appreciate your time here. I also welcome your input and experiences, so please do share in the comments — or feel free to slide in my DMs, so long as you’re not there to send dick pics.
Until next time — stay safe, fellow nerds.
