Here I am, blogging for the first time in 7 years, and this is as good a time as any to get back out there as I sit here at another scientific conference…And I’m completely overwhelmed. But at least I finally understand why.

I have “adult” ADHD.

Even though I was diagnosed 10 years ago, it’s only been the past 18 months or so that I recognized its role in my life, and even more recently how pervasive it has been throughout every aspect of life… and my career.

I’m not a psychiatrist. I still don’t know as much about it as I’d like, so this post comes from the perspective of a patient with adult ADHD. And perhaps this post will resonate with someone out there who has similar experiences with their own career.

I did fine in school. Actually I did much better than fine. ADHD didn’t have a major effect my measurable academic performance (like grades/GPA). So why would there have been any reason for concern? ADHD causes boys and young men to be continually bouncing off the walls, getting in trouble in class, and have trouble keeping up their grades, right?

Well, that’s not the only presentation of ADHD. I was able to adhere to a pathway towards specific milestones when I was in the structured environment of the first three decades of my life, through the end of my formal training. Little did I know how much I needed that structure in my life. 

However, there is another entire group of issues that lead to symptoms in ADHD, a cluster that is apparently much more common in adults, which fall under the category of impairments in “executive functions”. 

For those who may have never heard of them before, executive functions are those internal processes that help us manage more complex tasks, including those related to our ability to prioritize. To organize our day. To motivate ourselves to get started on something we don’t want to. It’s all of this, and more.

My main presentation falls within the realm of executive dysfunction. Unfortunately I wasn’t aware of any of this until… 

My therapist mentioned one episode of a podcast he had just come across. On Alie Ward’s podcast Ologies, I heard Dr. Russell Barkley describe it all in detail.

I started to cry. It validated how I’ve felt my whole life. My life finally started to make sense. 

It has taken many years since my initial diagnosis to finally come to realize that the first half-century of my life, I lived with ADHD. As the supports from the various external structures of my life (like school or training) disappeared over time, and as life got more “complicated”, I found myself falling deeper into psychologic debt without realizing what was happening. I was my own biggest disappointment in everything, including my professional life. Thus… “adult” ADHD. I’ve had the same issues all along, but their effects didn’t cause enough of a problem in my life until middle age. I look back now and understand a lot more, and I hope to be able to discuss it more in future blog posts. With a better understanding of how ADHD may affect adults, the overwhelming feelings I get at these meetings makes much more sense They play havoc with my neurodiverse brain. 

So for now, I just have to accept it and try to avoid getting overwhelmed, at least until I have a better handle my executive function impairments. 

And if this resonates with just one additional young physician, or even an older one, they might consider listening to the ADHD podcast that changed my life.

Special thanks to my mental health care team.