6 Surprising Signs of Adult ADHD

0:00Hey, it's your friend Mel and welcome to the Mel Robbins podcast.

0:09I got to take a big exhale because today's conversation is going to be a good one. I have been dying to share a deeply personal story with you. I was diagnosed with ADHD at the age of 47. And I wanted to talk to you about it because I'm not the only person who's been diagnosed late in life with ADHD. In fact, researchers say this is very common with women. And there's an entire generation of women. They've labeled them the lost generation who have struggled with ADHD their entire lives and never even knew it. And I was one of them. And you may be one of them too. And when I was finally diagnosed, this was just six years ago, and I'm going to tell you the whole story about how I got diagnosed because it was by mistake.

0:57But when I finally got that diagnosis, it was both a blessing and a curse. It was a blessing because I finally understood all the things that I had struggled with for my entire life. And here's why it was a curse. It was a curse because I couldn't help but reflect back on the past 47 years. I felt so much grief about the amount of struggles that I had. I wondered how things would have been different. If somebody had figured this out when I was really little, I wouldn't have struggled with anxiety or did some of the things I deeply regret. That's how big of a deal this has been in my life. And so today, you're going to learn the four key differences about how ADHD affects boys and girls.

1:39You're going to learn the reason why women go profoundly undiagnosed. You'll learn the surprising way most women find out that they have ADHD and the connection between anxiety, depression, eating disorders, and living with undiagnosed ADHD. And you will get a lot of good news because there is good news. And there's a lot that you can do to support yourself if you or someone you love have ADHD. And I'm going to focus on the impact on women, but we have fans across the entire gender spectrum. And when you hear what I'm about to explain to you, this will help you understand and empower your sister, your partner, your daughter, your girlfriend, your niece, anybody that you know.

2:24Because this conversation today is going to be full of resources that will help you empower yourself or other people in your life who have either been diagnosed or who haven't been diagnosed and are wondering, what the hell is wrong with me? Because that's basically how I felt for the first 47 years of my life. What the fuck is wrong with me? So six years ago, our son Oakley, he was in the fourth grade and I was 47 years old and he was really struggling in school. He was interrupting class. He was fidgety. He didn't pay attention, blah, bitty, blah, bitty, blah, bitty, blah. And luckily this was at a time in our life where we could afford to go outside the school and get a neuropsych exam.

3:03Huge shout out to Dr. Moldover. And sure enough, findings were very conclusive. He had profound dyslexia. He had dysgraphia, which is related to dyslexia. And the other thing he was diagnosed with is ADHD. And when I started reading the report, because when you get these assessments done, and I'm sure a ton of you have had this experience either with your kids or maybe it happened to you when you were a kid. when we got the big report telling us all about Oakley's brain, I was sitting with this pediatrician, Dr. Blumenthal, and I'd known Mark for, my God, 16 years at this point. And we're flipping through the thing and Mark's going, yeah, yeah, yeah, this makes a lot of sense, makes a lot of sense, you know, and we were going to talk options about what we could do in terms of therapy or medication or, you know, ways that we could support Oak.

3:56And I kind of looked at Mark and I said, you know, So as I'm reading this, Mark, this sounds a lot like me. Do you think that maybe I have ADHD? And Dr. Blumenthal, I just love this guy. He leans back in his chair and he looks at me with this sort of stunned look on his face. He's like, do I think you have ADHD? Mel Robbins, of course you have ADHD. In fact, you're probably the most ADHD parent I have in my entire practice. You are so successful and you are a complete bird brain. Do you realize that you will go years and not bring your kids in for their wellness appointments? In fact, every fall, we have a joke.

4:39We know that you are going to be one of those 20 parents that call in a fucking panic because you need a physical. You need a physical. Your kid's practice starts from right. You need a physical. And now it's a five alarm fire, but you've missed their wellness appointment. And you do it every year. and you'll leave every exam and you'll go, oh yeah, okay, I'll follow up. I'll call you tomorrow. I'll tell you about it. You never do. And I just looked at him because I knew he was right. I always felt so incompetent about my ability to keep up with appointments or to remember things like that or any of it.

5:11And then he goes, so do I think you have ADHD? Of course you have ADHD. And I looked him square in the eye, you guys. And you know what I said to him? Why didn't you tell me? Why didn't you tell me I had ADHD? And he goes, I'm not your doctor, Mel. I'll tell you, I was 47 years old when I realized that what I had been dealing with for my entire life may not be anxiety. It might just be fucking ADHD. And so I went to my primary care. She referred me to a specialist, sure enough, just like my son, dyslexia, ADHD. And once something happens in my life, I am like a truffle pig rooting for a truffle.

5:55I literally start digging until I find something. And I made it my mission six years ago to find out everything I could possibly discover about ADHD. Not only because I wanted to help our son Oakley and eventually our daughter Kendall and our daughter Sawyer, but also because now that I had this diagnosis, I wanted to understand what the hell was going on so I could help myself. And what I learned is incredible. I am part of a lost generation of women who were diagnosed with anxiety or depression or an eating disorder or some other condition in my teens and twenties when the underlying problem all along was that they missed the diagnosis of ADHD.

6:41And that's why I want to talk to you about it. I have wanted to have a conversation with you about this ever since we started this podcast eight months ago, but I have been reluctant to do it because I wanted to make sure I had resources to give you. Because every time I've talked about this on YouTube or on social, or I've talked about it on a talk show, we receive an avalanche of inbound stories, requests for information. And so I didn't want to unpack everything I'm going to share with you today until I knew I could point you in the right direction. And what we're going to talk about today is really important.

7:19What the research shows is that when you are not properly diagnosed with ADHD and you have it, the outcomes for girls in particular are horrendous. And the word horrendous is a word that one of the world's leading experts uses, not me. Let me just read this to you. this comes from dr ellen litman who's a clinical psychologist co-author of understanding girls with adhd and this is what she said the risk for self-harm and suicide attempts is four times higher for girls with adhd than girls without that's terrifying so the conversation that we're going to have today it goes way beyond having trouble with homework or having trouble focusing But I personally believe as I sit here and I look back on my life, I'm now 53 years old, I look back on my life and I know that I would not have struggled with anxiety the way that I did had I been properly diagnosed, medicated and treated for ADHD when I was little.

8:24Full stop. And so if you're somebody that has struggled with low self-esteem, self-loathing, anxiety, depression, eating disorders, and you can't seem to turn the corner on this, I truly want you to consider what I'm about to share with you, what I've learned in the last six years of researching this extensively, talking to the world's leading experts about this, among them, Dr. Ned Hollowell, who wrote Driven Distraction. He's like the OG of ADD research at Harvard. He's a world-renowned psychologist, Dr. Daniel Amen. The definition of ADHD, and this was new to me, ADHD is a chronic neurobiological disorder which affects the brain's structural and chemical capabilities and the way that your brain communicates.

9:11And it is also highly inheritable. And there is good news here. There's a lot of good news that you're going to learn, but here's what we're going to cover, okay? The six surprising signs that I didn't know, that I had all six of them, that could be signs that you too have adult ADHD. We're going to talk about why women were so profoundly underdiagnosed and have been for decades. We're going to talk about the mental health implication when you're not properly diagnosed and when you don't seek either therapeutic or occupational treatment for it. You're going to learn about the four key differences between how ADHD presents in boys and girls.

9:55And we're going to talk about what to do if you think this is you. And finally, we're going to get into what's actually happening in your brain when you have ADHD, because this is so fascinating. The first place to start is why are so many women underdiagnosed? Why does this go missing in girls? Well, the answer is this. When they first made ADHD a diagnosis back in the late 70s, they only studied boys. That's it. They only studied boys and boys present very differently than girls. They have totally different symptoms. And this is really important to understand because when I first heard the term ADHD, I thought of our son.

10:31Leg is jittery, hands are fidgeting, you know, raising the hand, bumping up and down, got to run to the bathroom, bopping around, do-do-do-do-do, highly distracted. But what always confused me about him is that he could also laser focus on video games. So I sort dismissed ADHD because I'm like, well, he can focus on video games, so it must be about his interest in things. No, no, no, no, no. ADHD has both physical symptoms that you see on the surface, and those are typically what's present in boys, but girls typically do not present those jittery, interrupting kind of physical chaos. Boys present four key differences with ADHD than girls do.

11:14Here they are. Number one, when a boy has ADHD, they have symptoms that appear on the surface, impulsive behavior, fidgeting, getting distracted, being very physical with their inability to concentrate. Girls, we have the opposite symptoms. Ours are all internal. We're restless, we daydream, we're hard on ourselves, we're forgetful, we're disorganized, and we start to aim it at ourselves as a character flaw. So when you're a girl with ADHD, you daydream, you're disorganized, your heart on yourself. You make careless mistakes. You might be called a tomboy or super creative. But what happens, and this is why this is so scary, and this is what happened to me, is that when you sit in a classroom and you see all your friends turning things in on time or staying organized or their lockers are clean and yours is a mess and you're running late, you start to think you have a character defect.

12:19You start to think there's something wrong with you. And it also gets missed because it's internal. We're not sitting there bouncing our leg and jumping and raising our hand. We have the opposite impact. The second key difference between boys and girls is that boys present earlier, typically around the age of seven. Girls, however, present later. On average, like around 12. The third reason why there's a big difference between girls and boys is because boys wear it on their sleeve. They have trouble controlling their physical outbursts. Whereas girls, girls are excellent at hiding this. Why? Well, because we feel the pressure to conform.

13:06We do our best to cope, look around and see what everybody else is doing and we start working harder to compensate for what we feel is a character default in us, that we are lesser than, that we're not good enough, that everybody else seems to get this but me and we hide it. And here's the big fucking difference between girls and boys with ADHD. Boys tend to get better. Girls get worse. And that is exactly what happened to me. I got way worse, way worse. What goes from daydreaming, following instructions, making careless mistakes, forgetfulness, all-nighters, not being able to stay organized, that chronic struggle turns into I'm fucked up, there's something wrong with me, and a profound correlation between anxiety, depression, eating disorders, suicidal thoughts.

14:10This is not just me, by the way. Let me pull some of the research out because this shit is scary. You can hear me flipping through my papers. Women with ADHD face the feelings of being overwhelmed and exhausted the same way that men do. However, women increasingly have psychological distress, feel inadequate, low self-esteem, chronic stress. This is extremely common. One clinical psychologist, Dr. Ellen Lippman, wrote the book Understanding Girls with ADHD. The outcomes for girls are horrendously negative compared to boys because ADHD materializes dramatically differently in girls as they get older.

14:52Anxiety and depression turn into low self-esteem and self-loathing. that happened to me, and the risk for self-harm and suicide attempts, four to five times greater for girls with ADHD. This is not about having trouble with homework. This is not about remembering birthdays. Because unlike boys, girls' symptoms veer inward. That's where the anxiety comes in. That's where the depression comes in. That's where the eating disorders come in. That's where the self-harm come in, is because you actually believe something's wrong with you. And here's what I'm here to say. There's nothing wrong with you.

15:27Absolutely nothing wrong with you. In fact, ADHD has a high correlation to being a successful entrepreneur, to being highly creative, to being a problem solver, a risk taker. There is so much beauty in this. But you also need to understand if you're dealing with a neurobiological disorder, which impacts your prefrontal cortex. Girls' symptoms are almost entirely internal, and they happen later. Most girls that have undiagnosed ADHD, you know what they start to have on the surface? Anxiety. Because, of course, if you're going to go into school every day and you're disorganized and you make careless mistakes and you're hard on yourself and you start to tell yourself there's something wrong with you, of course you're going to feel anxious about going.

16:07And it makes perfect sense, right? And that's exactly what happened to me. In fact, I was treated for decades for anxiety and I am sitting here telling you right now, I 100 % believe the issue I had all along was very simple. I had dyslexia and ADHD and nobody fucking knew it. And instead, I developed anxiety. Why? Because that's what happens when you have undiagnosed ADHD and you don't understand why your brain doesn't work the same way as everybody else. You don't understand why you're always late, why you can't get it together, why things are always a mess, why there's clutter around you, why you're constantly missing deadlines or doctor's appointments or leaving your Kleenex on the counter or you can't forget that.

16:49Like it's relentless. And so, of course, anxiety would develop. And I'm on a mission today to share absolutely everything that I have learned in my own deeply personal research to be a better mother of kids with ADHD and to be a better partner to myself as I live my life as an adult with ADHD. And what I've learned is life-changing. There are things that you can do. There are very surprising signs. And I need to say right up front, I'm not a doctor. The purpose of this episode is not meant to diagnose you at all. I am here to entertain you with my story. And I am here to educate you based on my personal experience.

17:30And I'm here to empower you to know that this is a reality for so many women in particular, so that if it rings true for you, you go seek the professional help that's out there to get a very clear answer of what's happening for you. That's what this is about, because that's how you create a better life. All right. When we come back, we're going to start with your brain and ADHD. And then what we're going to cover a little bit later are the six surprising signs of ADHD in adults, all of which I had, all of which everybody missed. Don't you dare go anywhere. We'll be right back.

18:23Welcome back. I'm Mel Robbins. And today we're talking ADHD in women in particular. And in just a second, we're going to get to the six surprising signs of adult ADHD. But first, I really want to dig into what's happening in an ADHD brain. And this comes from research from Dr. Ned Hollowell. It comes from Dr. Eamon. I know that Huberman Lab just did a bunch of podcast episodes on this, but this is how everybody talks about it. So the good thing about ADHD is it seems like the research that's been going on for decades is very conclusive about the prefrontal cortex and how ADHD impacts it. And just to remind you, because I want to make sure we invite everybody into this conversation, whether you're somebody that loves the PhD type stuff and you already understand the prefrontal cortex or you're somebody that's never even heard that term before.

19:18Everybody is included in the Mel Robbins podcast. So the prefrontal cortex is basically a part of your brain that's behind your forehead in what they call the frontal lobe. And your prefrontal cortex has the important job of switching between different neural networks that regulate your thoughts, your actions and emotions. OK, so, for example, if you've ever heard the term executive functioning, that term gets thrown around a lot when kids are getting assessed for learning style differences or for attention. Executive functioning is also used to refer to your prefrontal cortex and its ability to act like a secretary, to be able to switch gears and help you plan ahead and get organized.

20:01Here's an example. Imagine you're packing for a two day business trip. executive functioning or your prefrontal cortex, that's the secretary that kind of talks to you as you're packing that goes, okay, okay, you're going to be gone for two nights. So you probably need three pairs of underwear. Are you going to exercise while you're gone? Yeah. Okay. What's the weather like? Oh, so I should use shorts, not sweatpants. Oh, I should probably bring a pair of socks if I'm going to go for a long walk. If I want to go to Pilates, you're going to need the grippy socks. That little voice in your head, that thing that's helping you plan, you don't really notice it, do you?

20:34That secretary, that's your prefrontal cortex. That is the act of executive functioning. Pretty cool, huh? I like to think about the prefrontal cortex almost like an old fashioned phone operator switcher, you know, where you see in the movies where somebody unplugs one cord and sticks it into another hole to connect things. Another example that a lot of researchers use is an orchestra conductor or a teacher in a classroom. Somebody that's responsible for quieting down a large number of people and then calling on, you know, a certain student. So I played the flute in elementary school. And I remember the orchestra conductor was always like, tap, tap, tap at me.

21:14So the first chair of the flute could play the little stanza song thingy ma job and get everybody started. Thanks a lot, dude. And that brings me back to your prefrontal cortex and the fact that its main role is to be able to switch between different neural networks, like an orchestra conductor, that regulate your thoughts, actions, and emotions in your brain. And that's important when it comes to attention, because attention isn't just focusing on something. The skill of attention requires your prefrontal cortex, because there are two very different networks and functions in your brain that you use at the same time while you're trying to focus and pay attention.

21:56So let's talk about attention, okay? Because one mistake that people make with ADHD is they think that ADHD means you can't focus on something. That's not what it means. ADHD is the inability to direct and hold your attention in appropriate ways, in appropriate settings and situations. That's what it means. That's why you'll often see kids with ADHD that can play video games for hours. That was what our son Oakley did. I could literally be banging pots and pans behind this kid and he wouldn't even know it. He was so focused, but he had an inability to direct that attention in appropriate ways in other cases.

22:37And let me just use the example that I just gave you. It's not healthy that he was so focused on video games that he couldn't hear pots and pants. And so let's unpack what attention is. So attention is a really important skill, right? You've got to be able to pay attention if you want to be successful at work, if you want to learn new things. You need to be able to direct your attention and in relationships. I mean, just think about it. There are times where somebody's talking and your stomach hurts, or you want to get a bite to eat, or you really don't give a shit and you want to yawn, or you want to interrupt them, your ability to pay attention and suppress the urge to interrupt them or to yawn or to excuse yourself, that is the skill of attention.

23:21And it's critical for relationships. Otherwise you're going to look like a rude asshole. And so attention requires your prefrontal cortex to be able to switch between two neural networks in your brain. One of the neural networks is the part of your brain that is aware and paying attention to everything around you, okay? All the noise around you and all of your thoughts and your feelings in your body. So one neural network that your prefrontal cortex needs to control is the ability to shh. All the noise around you and all the noise within you. And I'm going to bring in an example that is used throughout the research with ADHD.

24:06And it's the example of an orchestra conductor. So your prefrontal cortex is an orchestra conductor. And I want to just bring in the sound of an orchestra warming up.

24:25You hear all the different sounds and that's, you know, like an orchestra getting ready and unpacking and warming up, that's you in the world. And one thing that your prefrontal cortex does when it comes to attention is it lifts up the little sticks and it points at the horns who are making too much noise and goes, shh. This is called a top down function. It is able to tap into a neural network to suppress, hey horns, shut the hell up, and silence the noise outside of you and silence the noise within you, your grumbling stomach, your thoughts about what you're doing tonight, so that the prefrontal cortex can then tap into the second neural network, which is the ability to raise up and focus on something specific.

25:20Hey, strings, it's time for you. Let's magnify and amplify you because now the horns are quiet. We can now amplify the string section and hear it. And so that's the network that allows you, if you crack open a book, you focus on the book itself, but you also focus on the words in your mind and what you're learning and processing as you're reading it. So your prefrontal cortex, when it comes to attention, has to do those two things, the shh of the distractions outside you and the grumbling stomach in you, so that it can turn toward what you want to focus on and direct your attention appropriately.

26:06If you can't switch between those two things of the shh and the focus, you can't pay attention. I can give you an example because I'm realizing my prefrontal cortex could not fucking do this. I went to Dartmouth College and they have this incredible library, Baker Library, and I would always go to the stacks in the library to study. And I would carry my stack of books and I would carry my notebooks and my pens and my highlighters and I would commit to being there all day. Okay, I'm going to study. I would sit down and as soon as I sit down and crack open a book, you want to know what happened?

26:48I literally would be like, oh my God, I think I'm hungry. I got to go to the bathroom. Do I feel like studying? I'm not quite sure. And then I hear somebody walking and be like, who's that? Oh, is that Emily? Hey, Emily. I was incapable of that part of attention that your prefrontal cortex needs you to do. I was incapable of suppressing the sensation in my body, suppressing the monologue in my fucking mind, and tuning out and suppressing the noises around me. I would sit there for eight hours and distract myself because this core function of my prefrontal cortex didn't work. Couldn't do it. So of course I had trouble paying attention because I couldn't suppress my internal noise because if I've got the book cracked open, I can't be paying attention to what my voice is saying.

27:40I've got to turn on the part of the brain that can now focus on the words on the page, right? My brain did not work that way. People with ADHD are missing a conductor that's working properly. And that's what the experts mean when they say that you have a neurobiological disorder that affects the brain structurally and chemically, as well as ways in which various parts of the brain communicate with one another. It takes a lot of mental fuel to quiet that network in your mind. It takes more mental fuel to activate a different network that helps you focus. And so what also happens for everybody with ADHD is you're not only spinning your wheels, you're also draining the energy tank.

28:29Dr. Amen, who's been on this podcast, one of the world's leading experts in the brain, he's done over 60 ,000 scans of brains. And when you look at anybody's brain scan who has a ADHD brain, what they find is there's not sufficient blood flow. The conductor can't work properly because it's not getting the blood flow that it needs. and he calls this a sleepy brain, that your brain is not getting the blood flow, the dopamine, the nora, epirephrine or whatever the hell it's called because we all know I can't say it. And that's why so many people with ADHD chase dopamine dumps like shopping or alcohol or any other addictive kind of behavior.