Hitha Vijayakumar, 36, a media producer from Kerala, struggles with focus, attention, and organisation. In her upbringing, where gender roles played a significant part, she felt the pressure to match the conventional idea that girls should embody tidiness. This expectation fuelled her need to meticulously arrange things, obsessively prioritise the need to “be in order”, that eventually led to anxiety.
It was in her adulthood when she was diagnosed with attention deficit hyperactivity disorder (ADHD) that her behaviours and the associated anxiety started to make sense. Experts point out that many individuals with ADHD attempt to conceal such behaviours during their lifetime —a phenomenon commonly referred to as ‘masking’.
Long-term effects of masked ADHD
For Joel Godi, 53, a sociopsychologist currently working as a neurodiversity consultant and founder of Neurogifted, an endeavour to spread awareness about neurodivergence Hyderabad, ADHD created a sense of confusion and inherent self-doubt in his abilities as he always found differences in his pursuit of finding a connection. “When you grow up blind to the fact that you have ADHD, there is an intense internal emotional turmoil,” says Godi. He adds that one tends to please people, or act in ways one appears to be like everyone. He found himself in an environment not equipped to deal with his neurodivergence, which caused him severe distress, “My personality could entirely be seen as a response to a society that is inherently stressful and traumatic,” he says.
Hitha says that the health issues and stress-related challenges linked to it are the bigger concerns, given the lack of recognition of ADHD has resulted in inadequate research attention. “There are a handful of patterns that keep repeating when we discuss these issues,” she adds, whilst listing digestive disorders, low blood iron values, and hypermobility among the physical health concerns. She also highlights anxiety, depression, and even facial recognition-related disorders as mental health implications.
Most health implications of ADHD are not a part of academia and are often even dismissed. “Doctors need to take lived experience seriously,” emphasises Godi.
Work is not easy to steer
“You can give me all the perks of the office, but if my brain is not there, I will burn out,” says Godi. In traditional workspaces, there are norms of suitable behaviour that extend to meetings and interactions with bosses and co-workers. Many individuals with ADHD like to have a corporate career, he adds. However, for a person struggling with focus, workplaces bring on practical challenges requiring accommodations for neurodivergent needs.
People may also struggle with time blindness, explained as a difficulty in the subjective experience of time . Hitha explains how the lack of flexibility in time commitments, and absences of leave, require constant keeping up with the demands of the average workforce and can lead to burnout.
For people with ADHD, sustainable ways of having a career can include self-employment or entrepreneurship, say Hitha and Godi. However, there still might be some challenges. Godi has been working on a book on neurodiversity in the workplace for three years.
Unmasking ADHD
With undiagnosed ADHD, one is on a journey of understanding the self, but it is not linear at any time. “Getting a diagnosis made me realise that the person I was before was not me and added authenticity to my life,” says Godi. A diagnosis does not consider a person’s cultural and social realities, he says. Many symptoms of depression and anxiety mimic those of ADHD, and the first thing to do is have a full assessment to rule those out, says Dr Dayal Mirchandani, a Pune-based psychiatrist. “Any diagnosis only with a 10-minute interview is a red flag,” she adds.
For Hitha, connecting with fellow neurodivergent people helped validate her experiences through online communities and shared forums. She adds that the mental health system may not yet be well-equipped to dive deeper into ADHD. For her, diagnosis took five years, and multiple mental health professionals were eager to diagnose her with depression and anxiety.
Both Godi and Hitha share some pearls of wisdom that may aid the process:
- Self-assessment is the first step. One needs to be informed and collect evidence from childhood to understand how ADHD might have affected one throughout life.
- Be mindful of the diagnosis process as per DSM-5 to understand the criteria. Deny a misdiagnosis if it does not feel right.
- Talk to fellow neurodivergent people who will be able to validate your experiences.
“Try and create a life that aligns with your capabilities and not society’s expectations of you,” says Hitha. Avoid the tendency to compare the neurodivergent timelines and milestones with the neurotypical expectations of society, she adds.
