The hidden struggle of being a woman with combined type ADHD

Overwhelmed, stressed, feeling like you can never keep up with everything, or like there’s always something you haven’t done? Being late for work, again! Procrastinating when assignments are due. Sitting or lying down with that sinking feeling as you know you are supposed to be doing something, but for some reason, you just can’t do it. Not because you’re not capable or because you’re lazy, but because you feel paralysed.

Going from procrastinating to doing a million things at once. Feeling driven by a motor, but never quite getting things right. Living in a messy home because you can’t keep on top of the cleaning and tidying, but not quite understanding why that is. Spending a ridiculously long time in the shower, completely losing all sense of time. Feeling so hurt and upset at the slightest criticism or whenever you experience rejection. Impulsively spending money like it’s going out of fashion and regretting it when the credit card bills start coming in.

Looking and acting like everyone else, but never feeling like you “fit in”. Getting decent grades, progressing at work, and socialising with friends. Trying your best to keep up with life like everyone else, but never being as “put together” as everyone else...

No one would know that you feel and are different. No one sees your struggle and how exhausted you are because it’s so hidden.

After years of thinking you’re just a bit rubbish at everything and not knowing how other people manage to get everything done, you stumble across a social media post. It has the heading “ADHD” and lists all of the things you’ve been struggling with all these years.

A lightbulb goes on in your head. You do some research. Of course you do, you’re brilliant at researching stuff!

You start to realise you meet a lot of the symptoms for ADHD. You learn that your chronic tardiness and ability to lose track of time (all the time) are called “time blindness” and "executive dysfunction". Experiencing intense emotions when you feel rejected or criticised is called “rejection-sensitive dysphoria”. There are words to describe all of these things you go through each day. You’re not going mad, it’s not just you being you. You come to the conclusion that you almost certainly have ADHD. 

Your life starts to make sense. You go to the GP and learn all about NHS waiting lists, Right to Choose, and private options. It’s a minefield knowing which route to take. You have a stack of forms to fill in. The forms feel impossible to fill in, and you nearly give up several times. But something within you manages to push through and get them completed. You know you’ve made a right mess of the forms, but you’ve tried your best and you reluctantly submit them anyway.

You continue your research as you wait for an ADHD assessment. You discover podcasts for women like you, by women like you. You buy books on ADHD that you’re never going to read – well, you’ll start reading them, but you can’t finish the books because your ADHD symptoms make it difficult to focus and concentrate enough to get through a full book. Oh, the irony!

You join an online support group where you all share the things you’ve been finding difficult. You start to feel a little less alone in the world.

Eventually, you have your ADHD assessment. The psychiatrist asks you about your childhood and what you were like at school. You were great at school, always did as you were told. You found it difficult to concentrate, but you were bright, so you managed to get by without teachers having any cause for concern. You were quite quiet at school; you tended to stare out of the window rather than run around the classroom causing havoc.

Your stomach drops. You worry that you might have got it wrong and that you don’t have ADHD after all. Maybe you were over-exaggerating. Maybe having the assessment was a mistake and a waste of the psychiatrist’s time. You feel guilty for making a fuss when it’s clearly just you making things up, hoping you’ll get a diagnosis to make you feel better about yourself. You feel ashamed.

The psychiatrist asks a few more questions about school. Yes, you were always late for school despite getting up two hours before school started. Yes, you did hand in your GCSE Graphic Products coursework right at the last minute, unfinished, even though you knew you’d had plenty of time to complete it. Yes, you didn’t revise for your GCSE exams because you couldn’t concentrate enough to retain much of the information. You’d read one line and forget what it said before you finished reading the sentence. Yes, you didn’t do as well in your exams as you know you could have done. Yes, since school, you’ve avoided any course with an exam because you know you can’t focus enough to perform to the best of your ability. OK, maybe you weren’t over-exaggerating, and the symptoms of ADHD have negatively impacted your life.

You’re asked questions about your life as an adult. You talk about your difficulties doing all of the things! Juggling work, family, friendships, relationships, fitness, health, and hobbies. You give examples. There are more questions. It’s quite intense!

At the end, the psychiatrist gives you the diagnosis of combined type ADHD and recommends medication that can help. This is a relief, you haven’t been making it up, it’s a real thing!

You start researching combined type ADHD and discover it’s where people experience both “inattentive” and “hyperactive” symptoms. The more you read, the more things start to make sense. The “inattentive” symptoms explain why you struggle to follow detailed instructions, why you struggle to finish tasks, and why you struggle to maintain friendships. The “hyperactive” symptoms explain why you find it difficult to sit still without tapping your foot or twirling your hair, why you find it hard not to interrupt people when they’re speaking, and why you feel impatient and restless a lot of the time.

You experience a kind of euphoria at finally having an explanation and now being able to better understand yourself. However, this is quickly followed by grief and sadness as you start to mourn the life you could have had if you had been diagnosed as a child. Life has been such a struggle, as you’ve given yourself a hard time for not being able to fit into a neurotypical world. You reflect on all of the shame you have felt over the years. The messy bedroom, the failed degree, and feeling so low and depressed.

You talk about this with your ADHD support group. Grieving the life you could have had is yet another thing you all have in common. It helps to talk about it. It doesn’t make it go away, but it helps you to process all of those difficult, pent-up emotions.

You can’t go back in time, but you can start living your life now with a fresh understanding of yourself.

You focus on learning about the good things about ADHD and what that means for you. You notice you’re passionate, driven in your career, you’re quick-witted, intuitive, empathetic, and able to connect with others on a deeper level.

Navigating your ADHD is a lifelong journey. There are ups and downs along the way, but you know there is help available. Therapy helps. Peer support groups help. Podcasts help. But the best thing you can do is to be kinder to yourself.

For the first time in your life, you feel like you’re finally getting there and starting to feel more in control of your life.

What is combined type ADHD?

There are three types of ADHD:

• Hyperactive/impulsive – this is the type most people think of when they're asked about ADHD. It's where you are restless, fidgety and might struggle to keep still. You might interrupt people when they are talking, talk a lot, and get impatient when waiting for your turn to speak during a conversation.
• Inattentive – this is where you struggle to concentrate and get distracted easily. You might be forgetful or lose things like your keys or your phone. You may find it hard to follow instructions that have more than one step. Being disorganised is also a big symptom of inattentive ADHD.
• Combined type – This is a bit of both hyperactive/impulsive and inattentive. You get the double whammy of having symptoms of both of them! It's the most common type of ADHD.

How can therapy help women navigate a diagnosis of combined-type ADHD?

Counselling can be an important step in your ADHD journey; you don't have to struggle with this on your own. It can help to have therapy when you first suspect you may have ADHD, whilst you are awaiting an assessment, and post-diagnosis, too.

Therapy can provide a space for you to explore the range of emotions you are experiencing and how you can manage symptoms like emotional dysregulation. You might find that your ADHD symptoms get worse a few days before you start your period; this is very common. In therapy, you can figure out what you can do about it.

It can help you to understand yourself and your identity through a neurodivergent lens. In counselling sessions, you can look at what ADHD means for you and how it affects your life.

Research shows that women with ADHD are more likely to experience anxiety, depression, and low self-esteem. With the support of a trained therapist, you can develop practical coping strategies that work for you and work on your relationship with yourself and others.