My moment of clarity came after a tumble down the stairs and an ankle fracture, in 2016. I’d been distracted—again. This time, I was looking at paint chips while walking down a flight of stairs in my house and thinking about what I’d just learned about light reflectance values.

While laid up for six weeks of healing, I had plenty of time to consider what felt like my life’s failings. I had a master’s degree, but I’d made it through endless boring classes by daydreaming, doodling, and making lists of what I’d do next. My grades rarely dipped below A, but my only strategy was a combination of heavy caffeine usage, all-nighters, and make-up tests. Naturally, I’d sprained both ankles in college—after trying to read while going up a flight of stairs. As an adult, I’d had an increasingly difficult time managing my life. My keys and credit cards went MIA every week. I triple-booked myself for the doctor, the dentist, and the car mechanic, and regardless of which I showed up for, I’d be late. I attributed the tardiness to my being distracted—or possibly just dumb. After all, I couldn’t manage to follow a set of instructions unless I read them three or four times.

The pile of papers in which I put Important Things I’ll Do Tomorrow grew taller by the day, then metastasized into more piles. I’d sign up for classes on a whim and then quit going when I remembered how much sitting and listening were involved.

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As a freelance writer, I had ample access to caffeine for motivation and reward. Still, when I sat down to work, I was so sucked into my trifecta of Facebook, Internet clickbait (What Is the One Secret Trick?), or hyper-focus on a subject—such as paint colors—that hours passed without my noticing.

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I’d visited several therapists about my inability to get my life together and to get treatment for depression. Wasn’t I supposed to know how to be an adult by age 39? What had I forgotten, what would I forget, and how far could I fall?

LORA SHINN

A surprising possibility

As I sat and recovered from the ankle fracture, I remembered what a friend had told me: “You sound like me,” she’d said, “like you have ADHD.” She was intelligent, funny, talkative. So I was confused—wasn’t a diagnosis of attention deficit hyperactivity disorder for the hyper, always-in-trouble boys? No, she said, explaining that there were different types of ADHD, including a version that resulted in hyperactivity and impulsivity and another that stemmed from inattention.

Once my ankle healed enough for walking, I made an appointment with my family-practice care provider. I was hesitant to ask about ADHD, thinking she’d dismiss the idea as ridiculous. Instead, she gave me a multipage questionnaire to fill in about symptoms. By the second page, I was in tears—so much of it described me, and I’d just thought I was eternally broken. After reading through the results, she asked a few more questions, gave me a tissue, and wrote a prescription. I had to try a few medications until I found a good fit, but the one I’m on now helps me focus my attention for a full day.

Women with ADHD

It turns out many young women aren’t diagnosed due to ADHD stereotypes, according to psychotherapist Sari Solden, author of three books on ADHD, including co-authoring A Radical Guide for Women with ADHD: Embrace Neurodiversity, Live Boldly, and Break Through Barriers.

“As people-pleasers, girls internalize difficulties, especially if they’re smart or have some structure or strengths while growing up,” she says. Even with ADHD, young women rarely stand out as troublemakers or hyperactive.

In general, boys tend to exhibit more impulsive and hyperactive behaviors, says psychotherapist Terry Matlen, who specializes in women with ADHD. Girls tend to daydream, doodle, and lowkey fidget (for example, playing with hair). Hyperactivity may also be minimal or acceptable, such as chatting too much.

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“If you’re bright, you’re often not as hampered as a young person because you’re relying on your intelligence or creative thinking. You’ve developed or figured out your own accommodations, which get you through those years of schooling,” Matlen says of young women with ADHD. But college can give inklings—for example, strenuously avoiding subjects that are difficult or require focus.

Some women first realize they have ADHD issues while in college. Others hit the wall when new demands exceed their functional abilities, Solden says.

Career, family, friendships, and parenting can add new expectations, commitments and challenges. Women face unique challenges, too. “From the time we’re young girls, we’re programmed by societal expectations to take on and juggle many responsibilities—dinner, laundry, holiday plans, gifts, invitations,” Matlen says.

Women in their mid-to-late 30s often reach out for a diagnosis when they realize they just can’t keep up with the chaos, Matlen says. Others are diagnosed in their 40s during perimenopause when hormonal changes often worsen ADHD symptoms around working memory and executive function.

Finding my way

Women diagnosed with ADHD later in life can have a distorted sense of self. “You need to untangle your brain difficulties from your core sense of self,” Solden says. “While ADHD can be difficult and overwhelming, you don’t want that to color your life, and what you decide to do with your life.” Avoiding the negative narrative means understanding executive functioning, she says. As someone with ADHD, you want to understand:

• Where you operate well
• What environment you do best in
• Accommodations you might need
• How you communicate needs with your family and friends, employer and coworkers

“You’re entitled to have a life works for you, and get help,” she says. “We all have different kinds of brains, and ADHD is often misunderstood.” Strengths for those with ADHD include creativity through the ability to combine different concepts. ADHD women may be enthusiastic, interesting, funny and have a different perspective. “It’s important to see yourself as a whole, not just your strengths or difficulties, and understand your challenges while not allowing them to define your self.”

The diagnosis encouraged me to learn from books, therapists, and coaches. Over a few years, I developed a framework for understanding why organization and deadlines are such a challenge for me—and tools to make it easier on myself. Over the past three years, my lists have decreased. I don’t triple-book, I do show up on time (mostly), and I rarely lose my keys or phone (thanks to locator devices like Tile). I still struggle with tasks or projects that seem overwhelming, but I know how to break those down into smaller, more manageable steps so I can get started. Frequent breaks to stop and refocus are routine, necessary, and appreciated.

But beyond the medication and ADHD mind hacks, acknowledging my neurodiverse brain—and that I’m not lazy or stupid—dramatically boosted my self-confidence and willingness to see the positives. I remain a person who gets bored quickly, but I can appreciate now that I’m also someone who loves new experiences and challenges as well as research and learning…and I can enjoy these things without tripping on the stairs.

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Could You Have ADHD?

Women aren’t as easily diagnosed, as they don’t usually experience the hyper activity part of ADHD. If you have several of these symptoms (outside of a major trauma or a diagnosis of depression), consider investigating whether you have ADHD, says Solden:

• Chronically overwhelmed
• Severe disorganization with regard to time, money, or things
• Difficulty maintaining routines and keeping track of logistics
• Piles of paper and clutter
• Feel disorganized, but spend a lot of energy trying to get organized
• Great difficulty blocking out distractions such as a barking dog or random internal thoughts
• Tendency to hyper-focus on one subject
• Challenges with addictions such as gambling, Internet use, or shopping
• Underachieving at work or in relationships
• Trouble making decisions while getting dressed or shopping