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Opinion & Analysis

Me and my ADHD

By Joelle Ladislaus

I want to share something with you and it feels almost in the nature of a confession because of the stigma of misunderstanding and prejudice that some of these things carry. I do so in the hope of debunking some myths and sharing some real issues affecting members of our community. I live with ADHD, and it is sometimes hard. But people who, like me, live with ADHD would be better off in their daily lives if there was better support available.

Let me start at the beginning. What is ADHD? The full name is Attention Deficit Hyperactivity Disorder. Put simply, it is a common neurodevelopmental disorder where a person may have trouble paying attention, controlling impulsive behaviours or being overly active. It isn’t just rambunctious, hyperactive 7-year-old boys who suffer from the effects of ADHD. This comes in many forms, and its effects vary depending on whether you fall within the inattentive type, the hyperactive type, or the more common, combined type where characteristics of both inattentiveness and hyperactivity are present (this is the type that I fall under), as well as their severity, which range from mild to severe.

I’ve always been a bag of nervous energy (“un nervio”), something that doesn’t escape anyone who knows me, no matter how calm I think I’ve been when I’m around them. I’ve always wondered why I can’t seem to keep from fidgeting, why I can talk persistently for hours on end at 100 miles an hour (a skill that my husband absolutely relishes, especially when watching the Great British Bake-Off, and that my mother enjoyed immensely at 7:00a.m. on school mornings when I was a child); why I can never be tidy; and why I always felt like I had a motor inside of me that wouldn’t switch off notwithstanding my best attempts to slow it down.

This isn’t a one-off for me, it’s my daily existence. Sometimes, I simply won’t be able to focus at all on the task at hand, and that may look or sound like laziness to some, but it’s something that is often very real to an untreated person with ADHD, and we tend to do all we can to fight against it. What I’ve found however is that my hyperactive moments will be my most creative, my most hardworking and therefore my most productive. There is a silver lining to every cloud, but we would do well to remember that clouds also carry rain.

In the November 2023 sitting of Parliament I asked the question whether the GHA has a pathway for diagnosing adults who are suspected of having ADHD, and in the midst of the lengthy answer, which by the way was a no, it does not have a pathway, I was told that there was no need for one because those with ADHD often function well within society and that in that setting it is generally not considered a severe mental illness.

The view taken was that, if you weren’t diagnosed with ADHD as a child then it isn’t having a serious enough impact on your daily life to warrant any intervention by the GHA. In the GHA, ADHD in adults is treated and assessed “only where it is co-morbid with a severe and enduring mental illness such as schizophrenia, bi-polar affective disorder, addictions, etc. The GHA does not currently offer a service for adults who are otherwise well and seeking a diagnosis of ADHD”. An interesting and rather unsatisfactory answer when undiagnosed ADHD is often the culprit for a host of other issues, such as depression and anxiety also. Seems to me that this approach is directly opposed to the primary goal of the government’s 5-year mental health strategy, which is “to improve the mental health and wellbeing of the population of Gibraltar”.

Let’s be clear, I did not seek a solution to my struggles so that I could be “awarded’ a label under which I could hide or to use as an excuse.

It’s not “trendy” to be diagnosed with ADHD. I sought help because I was suffering from brain fog; I felt overwhelmed when having to undertake the smallest of household tasks; I lost my patience sooner than I care to admit to; I struggled to focus; the motor wouldn’t switch off but I was constantly exhausted; I had persistent mood swings; organising anything from clean laundry to paperwork felt like a mountain; administrative matters like form-filling were worse than torture; I became a ninja of procrastination. The list is endless, and the reason why I have lived a relatively successful life thus far is because I, like many (women in particular), have been able to mask those symptoms to fit in with societal norms and ideals of what I should be like and how I should conduct myself outwardly. I have managed to keep up with my professional life, but it has not been without a cost, particularly to my personal life.

A year ago, precisely during neurodiversity week, I came upon an excellent video, entirely accidentally, in which a group of professionals within Gibraltar, from different backgrounds, discussed their various neurodiversities and, when it came to ADHD, it was like being described almost perfectly. Everything being said resonated with me, and suddenly the penny dropped, although I still couldn’t quite accept it. Even then, it took me another few months of difficulties before I decided that it was time to visit a professional to address my issues. You see, ADHD often goes undiagnosed in girls and women, because we don’t often present with obvious symptoms, and it is therefore much easier for our struggles to be overlooked, and even to overlook them ourselves.

At first, I admit, there was a sense of shame in going to visit a psychiatrist, a sense that I was somehow weak or misguided for even contemplating that I may need a little help to unravel what was going on in my mind; but then again, when you have an injury, when you have physical symptoms of illness, you go to a doctor. So, why then is addressing mental health so very different? What I’ve concluded after some months is that issues of the mind are not indicative of a weak mind but can be indicative of a chemical imbalance that simply needs to be addressed, much like with the rest of the body. Still, I felt like I had somehow just jumped to conclusions. Although I had my suspicions, I was still unprepared for the phone call some weeks later, after various conversations and diagnostic assessments had been carried out, confirming that I have ADHD. In fact, some probing further revealed, that I was not even borderline, there was little doubt in my doctor’s mind that this disorder forms part of who I am, always has, and always will. Even so, I do often feel like an impostor, because I don’t fit the criteria that says that those with ADHD will often struggle academically, and therefore often fall short of academic success, but then I remind myself, and others who may doubt my diagnosis and that of other people around them, that every individual out there doesn’t fit every criterion for a particular disorder that they may have, just like every individual with a physical illness doesn’t have every single symptom associated with that illness.

Some may be wondering why I have chosen to bare all in this piece. It’s taken me a good eight months post-diagnosis to feel resilient enough to speak up about this, and therein lies the issue and one of the strongest motivators for my choice to reveal that I have ADHD. The reason why I haven’t been open about this before now is that public perception of neurodiversity and anything to do with a mind that is not typical can be so cruel, while at the same time being so very wrong.

ADHD and other neurodiversities are not dirty little secrets, they are a part of who many of us are. Although immense progress has been made as to societal views on neurodiversity, there remains a dire need to continue to challenge misconceptions and stereotypes.

As for ADHD itself, in my view, and that of many others, it is not given the seriousness which is needed to make enough of a positive impact on the lives of those affected by it. Many in Gibraltar remain undiagnosed or untreated because they do not have access to the necessary medical attention and treatment for this disorder. In not providing that access through the GHA, it leaves many without answers and with worsening symptoms, because they are unable to fund private healthcare. It is contrary to the GHA’s last published constitution, under which individuals have a right to access GHA services which are appropriate to their medical needs and is a blatant breach of one of its eight key principles, namely that access to the GHA is based on clinical need and not on an individual’s ability to pay.

It has not been easy to write this article, and less so to send it in to be published, but if it has a positive impact on just one person, then it will have achieved its purpose. I have been privileged to be trusted by the electorate to be a Member of Parliament and I hope that in being honest and candid, I can help push these conversations and encourage and empower more people to speak openly should they wish. I have learned a lot about myself, and my ADHD since the General Election and I continue to learn every day.

Remember, you may not always see evidence of a neurodiversity, but that does not mean that it isn’t present. Maybe by having these conversations, we will one day, soon I hope, normalise openness and in turn empower more neurodiverse people to set aside within their own minds the barriers that society’s misconceptions often create for us.

Joelle Ladislaus is a lawyer and GSD MP who shadows the health and justice portfolios.