Welcome back to another episode in the Entrepreneurs with ADHD series!

Today, I’ll explore the legitimate reasons why many people decide against getting an official diagnosis, the challenges involved in obtaining one, and what you can expect if you're considering it. 

I’ll also share why I’m embracing the term "ADHD-ish" and advocating for a world where everyone, diagnosed or not, can feel supported and informed.

Stick around for an episode packed with insight, empathy, and a call for broader acceptance and understanding within the ADHD community.

Whether you’ve been diagnosed, suspect you might have ADHD, or are just plain curious, this episode is filled with insights you cannot miss.

What to expect in this episode:

• The rigorous and often frustrating process of getting an official ADHD diagnosis as an adult.
• Why many people, despite recognizing ADHD traits, choose not to get diagnosed 
• Alternative labels like "fast-brained," "creative," or even the trendy "neurospicy."
• How past experiences and societal misconceptions keep many from seeking an ADHD diagnosis and treatment.
• Why I’ve started using terms like ADHD-ish to create more inclusivity 

If you have been diagnosed with ADHD, one of the decisions you’ll need to make is whether to share it with others, especially people you work with.

Join fellow ADHD coach Cathy Rashidian and I on July 19th for a LinkedIn Live discussion on if, when and how to disclose your diagnosis in the workplace or in your own business. 

🚀 Register Now for the next LinkedIn Live on July 19th 

💬 What did you think about this episode and the term ADHD-ish? Opinions? Thoughts? Harsh Words? I can handle it all. Share your feedback with me.

Email - Voice note -  DM on LinkedIn or Instagram

Well, hey, friend, and welcome back to another episode in the Entrepreneurs with ADHD series on the Driven Woman Entrepreneur podcast. Today, I am going to be talking about the topic of ADHD and ADHD-ish. The legitimate reasons why many people decide not to get a diagnosis, the difficulties with getting a diagnosis, and what to expect if you are gearing up for this process. And my personal thoughts about being more inclusive with this term instead of using it to exclude others. I personally believe we are in the age of identity right now, whether we are talking about our ethnic and cultural identity, our gender and sexual orientation identity, or increasingly where we identify in terms of our neurobiology whether we identify as being neurotypical or neurodivergent. So let's get right to it, starting with what is involved with getting an official diagnosis. This is something that many people really don't know.

And for starters, first and foremost, ADHD is diagnosed on the basis of behavioral observation and history. So if you are an adult and you do not have a history of being diagnosed in childhood, there's a whole lot of forms and a whole lot of other people's opinions that are gonna be sought out. Now I have heard of abbreviated, diagnostic experiences, they are by no means the norm. What is typical when you can even get to see someone for an ADHD diagnosis as an adult and we'll talk about the difficulty of that in a couple of minutes. Here's the process, a qualified mental health professional or physician, typically a psychiatrist, because of course a psychologist or psychotherapist is able to diagnose you if they have the training and the experience to do so, but they can never prescribe medication. So sooner or later, you're gonna end up with a psychiatrist if medication is going to be part of your treatment plan. They are going to gather information from multiple sources, whether that be your parents, your children, your partner, people you work with and, of course, that's with, you know, your permission, of course.

There will be behavioral rating scales to complete, ADHD symptom checklists. Some places require you to have a complete psychological evaluation. You will be recounting your past and current history of functioning in a variety of different domains and information will be sought from significant others. But because adults with ADHD tend to be impatient and have a very low tolerance for bureaucracy, paperwork, and anything that we find boring, tedious, or arbitrary. The number of hoops that a person actually has to get through to complete the diagnostic process means many people who want a diagnosis and legitimately deserve one are not going to get all the way through the steps because they've just made it so difficult. Now we all know the reason why it's so difficult and that is because these stimulant medications which are so helpful for people with ADHD can be diverted and used by those they are not prescribed for.

This is a huge problem and so they've really made it extremely difficult for people to legitimately get diagnosed and treated. But, you know, in my opinion, having been a licensed therapist for many years and been a coach working with adults with ADHD for the last 10 years, I think there are many legitimate reasons for choosing to opt out of getting diagnosed while still completely accepting and embracing the fact that you have ADHD. For example, some people just have other labels that feel more aligned with them. I mean, if you're gonna have a label, it might as well be one that you choose. And many people who would absolutely meet diagnostic criteria for ADHD just simply prefer to call themselves fast brained, they may prefer to call themselves creatives. Some people totally own being disorganized, but they don't like the label ADHD. Some people even prefer to think of themselves as hyper.

Those who don't particularly like the ADHD label, but don't mind being called or thought of or think of themselves as neurodivergent or the increasingly popular neurospicy, they just like that better. And there's plenty of people who still refer to themselves as ADD or ADD without the h, even though it's not technically or clinically accurate. What would be accurate is, oh, I'm ADHD inattentive distractible subtype. That's way too many words, we like to cut corners. Some people don't even mind being called hyper, and they call themselves hyper. But here's the thing, this is not a private club. You don't have to apply to get in. Other members don't have to accept you. They don't have to identify with you. There's no secret handshake. And while there are several industries that have way more people with ADHD than others, I'm thinking tech. I'm thinking first responders. I'm thinking sales.

I have yet to see any job description that has must have ADHD listed under the qualifications for the position. Could happen in the future, I don't see it happening anytime soon. And guess what, there are legitimate challenges in accessing a diagnosis for so many people. If you wanted a diagnosis, you were able to get all the way through the process of getting a diagnosis, you can consider yourself fortunate because this is not the case for many, many people. There are so many barriers to accessing mental health care for so many of us. And we just don't have anything even close to parity for mental health care as we do for other types of health care and there are difficulties with other types of health care too.

I think we should also talk about the costs associated with getting diagnosed and getting treated. I mean, actual stimulant medication, unless you go for one of the newer sexier ones, that's not the expensive part. It's that there's now a greater demand for an evaluation and unfortunately, there are some opportunistic individuals that are taking full advantage of it and jacking the prices way up. We also simply do not have nearly enough psychiatrist and at least in the US or Canada, there's a great number of psychiatrists who've aged out, retired, left the profession. They have not been replaced by an equal number of folks coming in from the other end. There are also not enough psychiatrists who actually are competent in diagnosing an adult, especially an adult woman, even though they may be perfectly competent in other areas of psychiatry.

And it's because we are lagging several decades behind in our understanding of how ADHD presents in women. There are huge geographic disparities and don't even get me started talking about how almost impossible it is to get diagnosed in many countries of the world who have just as many people with ADHD as we have here in the West. Another huge problem that causes many people to say, you know what, on second thought, I'm gonna pass on the whole thing, is the frequent lengthy shortages of medication. Now I still don't completely understand why they haven't been able to sort this out, but can you imagine? And if this has happened to you, I am so, so sorry. But after jumping through all the hoops to get the diagnosis and getting the prescription and getting started on the prescription and finding some benefit along with making lifestyle changes and maybe working with an ADHD coach or an organizer, only to 2 or 3 months in go to fill your prescription and you're told they're out. In fact, there's a nationwide shortage, and they have no idea when they're going to have it available again. This has not just happened one time, this has happened repeatedly.

And some of these shortages have lasted months and months and months. I have personally known individuals who nearly had a breakdown and were barely functioning at their job after 7, 8, 9 months where they were unable to get their medication. I honestly cannot believe we have not figured out how to prevent this from happening again. There's also the inconvenience of the fact that this is a controlled substance because it can be diverted, and we've got plenty of people who are buying it off label, meaning on the street. So it has to be controlled, which means you cannot get a 3 month supply through the mail. You have to get a 1 month supply and I know when I moved from California to Oregon, simply because of the differences in state legislation around certain types of substances, my insurance company would no longer pay. There's just so many of these surprises and let's face it.

We are people who by nature, by our ADHD nature, have issues with regulating our emotions and keeping them regulated. I mean, how much frustration do you want people to go through? Another really, really valid area is personal choice and concerns about stigma and confidentiality. I mean, let's face it, if you manage to get through childhood with ADHD and you got through adulthood, maybe even did well in school, maybe even got an advanced degree, many of the women I work with have multiple advanced degrees. And then you finally reached a point where you were not able to function so well. You started dropping the ball, you started making mistakes, started slipping through the cracks, and you finally, at long last, got a diagnosis.

There are many people who are still really reluctant to go that route because they had a sibling who was diagnosed in the eighties or nineties when the dosages of stimulant medication that were given at that time, exclusively to little boys, were so high that kids would go from, quote, unquote, bouncing off the wall. Man, if I heard that once, I heard it 10,000 times. Kids would go from bouncing off the wall to zombie like. So these zombie horror stories have been both personally witnessed by family members, and they have certainly been circulated, and a lot of them are still in circulation. I know some very intelligent and, you know, certainly not ignorant people.

When I've asked them, have you ever thought about getting officially diagnosed or would you ever consider a trial of medication? Say, aren't you gonna turn me into a zombie, so I'm like, oh, well, okay, so these stories are alive and well. People have traumatic childhood memories, not even of their own family member, but of being in a public school classroom at a quarter to 12 when all of the kids who were on Ritalin at that time, because that's all there was, were all escorted from the room down the hall, past all the open doorways so everybody could just gawk at them to the nurse's office where they would line up to get their second dosage of the day.

Now we've taken care of this problem because now we have long acting. But those memories cling to people and the hurt and the shame and the stigma and the fear and not wanting to stand out really does mean a lot of people, even in these times, say, I'm not I'm not going there. I'm not going to do that. There are many people who choose not to be diagnosed because they compare themselves to others with ADHD that they think is more severe than theirs. And either think, well, I'm not like him or, oh, I, you know, I've got a really mild case. I have a lot of people tell me that. I have really mild ADD, okay, of course you do. It's a spectrum. And over time, we can go up and down on the spectrum. Some days, some weeks, some months, some seasons of our life were mild, sometimes moderate, sometimes severe. And there are many in the ADHD family who are doing the same thing but for some of us, we don't wanna be included in that club.

We don't wanna be lumped in. We don't want to identify with or associate with people whose ADHD feels shameful or stigmatizing to us. There are some people I know who they know they have ADHD. They know but they consider it a point of pride that they've never had it officially diagnosed or treated. It goes along the lines of, I have to work so freaking hard to get even the most basic stuff done. That makes me a badass and resilient AF also, sounds like it also makes you pretty fucking exhausted. I know it did me before I finally decided to do something about it. But, hey, you do you, boo. This is what I consider a point of pride and for some people, just knowing how hard it is for them to do a lot of things because they don't have any sort of support or assistance, chemical or otherwise, but it has become their identity that they struggle and they overcome. That's a choice they're allowed to make. That's not up to you or I to take away from them. Then there is the very legitimate concern about confidentiality and the possibility that once this information, should you get diagnosed, will be a common become part of your permanent health information. You're not gonna be able to get it out of there once it's in there. And there are people who believe that at some point in time, that information could and will be used against them.

Now I know there are some professions where if you have any kind of a mental health diagnosis, any kind of diagnosis, you have to disclose it. If you don't and they find out, you're gone. And there are people that don't particularly want folks with ADHD working for them because there are folks that still think that we are a liability. So they choose not to get diagnosed so enter ADHD-ish. Now I know there's probably gonna be some confusion. There might be controversy. People might get triggered. They might find this offensive. They might think, how dare you, Diann? Or who are you to throw around a term like that when you know how much some of us suffer. I don't think that we need to distance ourself as people who are formally diagnosed from those who identify with this term. Like I said, it's not a private club and I mean no disrespect to anyone by using this term. I do not wish to offend anyone who has gone through the rigorous process of getting diagnosed or anyone whose lived experience is really tough.

It is one of the reasons why I frequently speak out against this whole rhetoric of ADHD as a superpower. Because I think while it may legitimately be for a few very privileged people who have zero trauma history and zero other co-occurring diagnoses and who happened to grow up wealthy and, you know, had every convenience and creature comfort. It may be a superpower for those people, but those are not most people. And you cannot tell me that even the people who say it is their superpower don't have some very dark, very disorganized, and dysregulated days. Because if they don't, they really don't have this diagnosis. So can we be more inclusive? Can we choose to be more inclusive? And can we choose to accept people who identify as ADHD and identify with ADHD? Even those who don't have a diagnosis, don't choose to be treated or medicated because they identify with the strengths and struggles of ADHD. I don't have a problem with it, personally. I do understand that my attitude, my philosophy, might be triggering and if you are so angry with me right now, I legitimately invite you to dialogue with me about it.

I'm gonna leave several links in the show notes, so you have a variety of different ways to get in touch with me according to your communication preference and I mean that with all sincerity. But why I am starting to use the term on my socials, why I even grabbed the URL. I haven't figured out exactly how I'm gonna use it yet. But I believe that being more inclusive and acknowledging the diverse experiences of people who have mild, moderate, severe, complicated, uncomplicated ADHD like traits, I prefer to be more inclusive. I hope that by using terms like ADHD-ish, people who identify with the strengths and struggles of ADHD will be inclined to learn more about it. Will be inclined to feel less shame. Will be inclined to feel less stigma. And in learning more about it, some of them may realize, you know what, I think I'm actually more ADHD than I thought.

And they will follow that road to learning even more and getting whatever level of help and support and assistance that they believe they need. I'd like to think that we can find common ground. I would like to think that we can balance the perspectives of those with a formal ADHD diagnosis with those who identify as ADHD-ish. My emphasis always is on empathy, understanding, and respectful communication. I would love any listener who wants to share their experience and their perspectives with me to do so. And my goal is for there to be more people who feel and function well, whether they meet the diagnostic criteria or don't, whether they choose to get diagnosed or not, whether they prefer to take medication or not. I also want to help spread awareness that while there are differences between those who have ADHD and those who do not, I wanna live in a world where people who are struggling can get information and can get support that is appropriate to their struggles.

Hey, I am fully aware that I am very idealistic, but I really want to advocate for a world where everybody has a legitimate shot at being mentally healthy and feeling and functioning the best that they possibly can, as well as having the access and the means to do so. I'd like to think that it's possible that we can embrace others who are different as well as those who are like us, but differ from us philosophically and a place where neither ADHD nor neurotypical is considered an insult. So I encourage you to take advantage of the links in the show notes to communicate with me, to dialogue with me, to tell me off if that's what you feel inclined to do. Trust me, I can handle it. And if you are officially diagnosed and one of the things that you are considering is, do I wanna tell other people about this, especially people at work? I have a special invitation for you. My good friend and fellow ADHD coach, Cathy Rashidian and I are doing a series of monthly live streams on LinkedIn and YouTube. And the next one is coming up on July 19th.

I will include a link so you can register for that or watch the replay. We are gonna be talking about the topic of disclosure. Should I or shouldn't I? Who do I tell? How much do I tell? When do I tell? Under what conditions do I tell? And we're also gonna be talking about if you are the boss with ADHD, if you are the business owner with ADHD, do you tell your team members and why? So I hope that you will choose to join us there. That's it for now, and I hope that this has been a helpful, inspiring, and eye-opening episode for you. Meet me here again next week, we'll be back with another guest.