When High Ability Meets ADHD: Delayed Diagnosis and Midlife Transformation

G: I remember the day like it was yesterday, and it was actually over 20 years ago, and I was sitting with a client. My client population was mostly very high achieving, public facing individuals, and oftentimes they had some sort of addiction, whether it was chemical, whether it was work, whether it was sexual compulsivity, but they were very high functioning. And so it was hard for them to get to the place of even understanding that I can't manage this. And so I was working with this client, and I'd been working with him for a little bit, and we were really kind of breaking through some things and making some connections.

And I kept hearing among all of this success, there were all of these patterns of stops and starts. There were all of these patterns of taking on more than he actually could deliver and not being able to tell the difference. There was definitely the anxiety and the depression presentation. There was a very low attention span. And in every area of his life, his bells would ring for the excitement and chasing the next excitement. And he would say to me, can you keep up with me? And I said, oh, yeah, I can keep up fine. And I said, I'm tracking it, I'm good at this. And so towards the end of the session, I asked him, you know, had anyone ever mentioned the possibility of adhd? And he's like, no and I was like, well, why do you say it like that?

Because he had an expression on his face. And he also had a very narrow idea of what ADHD looked like. So we talked about that so I recommended the book to him, and he was my last client that day. And as he walked out, I realized, damn, I have never read that book from cover to cover. And then it made me think about, I know, all these books on my bookshelf. Something about them. And none of them have, I read cover to cover. And as a matter of fact, even when I was in school, I didn't read things cover to cover. And so I said, I need to read this book.

And man, I finished that book in two days. And I was so grateful because it answered this big question mark that I'd had all of my life. And I went shortly after that to get a professional assessment. Sure enough, ADHD and, you know, it was nothing I was ever ashamed of, it was a relief. Every single report card I had as a kid, my mom saved all of them. It had some form of, if Lisa would pay attention, fill in the blank. And, and my, you know, I'm in my 60s and at that time they weren't diagnosing ADHD and I wasn't a problematic kid. So it wasn't, they couldn't label it behavioral, but there was always this potential that people would see that I didn't seem to be leveling up to.

H: Yep. And I think you and I are part of a group of folks with ADHD who tend to be women who tend to be diagnosed well into adult life, who tend to figure it out for themselves and then seek diagnosis as confirmation. And the group I'm talking about are individuals who are high ability. They may have a high IQ or they may have particular skills, they may be gifted. And so they've been able to work around and work through a lot of the challenges that stop many other people with ADHD. And I think if you're a high ability individual and not surprising at all that you specialized in working with high ability individuals and why you were attracted to them, why they were attracted to you, why you were able to do excellent work with them, and the number of them that also turned out to be ADHD.

I don't think before you and I connected, Lisa, I don't think I had met another individual who had been working as a therapist identifying ADHD in their clients, who had seen other people before us who had not identified it, and then sort of fell backwards into our own diagnosis because we sort of connected those dots. And I have to ask you, you mentioned a minute ago it was a sense of relief and it answered a question you've had for a long time. What was the question?

G: The question was in various forms, I've been able to do this, whatever this is. It could be professional, it could be personal. And it seems like there's more that I can't quite get to. I can see it, I can taste it, I can feel it. And there's this barrier and, you know, kind of like a bullet point under that question was, I know this stuff like the back of my hand, like, you know, and why am I not able to articulate it as clearly as it is in my brain?

H: In an earlier conversation, I was talking about, and we were giggling about it like two schoolgirls about situations that we would go into in life, and our brains would instantly recognize the gap, what I call the gap. It's how things were and then in our imagination, how we think they could be. And I think that gap is that more it's that recognizing. I may be achieving. I may be achieving at normal levels, I may be able to achieve at superior levels, but I know that there's something I'm not able to access. There's something that with this level of ability, I should be able to reach.

It's not effort. It's not mindset. It's not will, it's not skill. There's some sort of invisible obstacle. And the term that I would hear and you probably saw this in your report cards as well, because I had the same thing. Like, Diann's never going to learn anything unless you tie her to a chair. Or, Diann has many abilities but will not succeed unless she could narrow her focus.

G: Yes, yes.

H: That's classic high ability with adhd, the ADHD is sort of the missing piece. And so it completely makes sense why there's a sense of relief. And when I've shared my own story, which is pretty similar to yours, I mean, I wrote my master's thesis on whether ADHD persists into adulthood, because at the time I was in grad school at UCLA. The thinking was, this only affects a small percentage of children, and they're all boys, and they outgrow it. They outgrow it by adolescence. So I thought, well, how could this be me? But I did the research, and my conclusion was, oh, this absolutely is a lifelong condition. Ten years later, it made it into the adult side of the DSM. But I had people say to me, how could you be a therapist.

And actually think of yourself as a skilled clinician, a skilled diagnostician, and not see your own ADHD when you were so good at seeing it in others? And I'd love to hear your thoughts on that I think for me, it kind of became a game to see. Kind of like I sort of felt like I was kind of beating the system because I knew I had some sort of handicap. But if I could figure out a way to Work around it. I thought I was winning, and I almost wonder now if that didn't delay me figuring it out sooner.

G: Yes. So it's interesting because two of my kids were diagnosed with adhd, and in one of them, you know, at the time, I thought the same. It's like you're just paying attention to the hyperactivity. The other one, the hyperactivity wasn't external, was internal. The mind was just going, going, going, like a superhighway and so I still didn't notice it. And I think the reason that I missed it for myself is, is because it just was a way of life. I couldn't do things before the last minute, but the outcome was great.

And I just thought that was the norm. I thought it was the norm to have to really struggle and grind and have so many ideas, but then condense it into something that was linear, pain, and understandable. So I just thought that was something that I had to live with. Like, it was just. It was just me. You know, I didn't know that there was another way for me. I knew that other people didn't seem to have the same struggle, but I didn't. I just this is me, and this is how I have to. I got two master's degrees, I mean, did well, all that stuff. And so I just thought, I have to, I can accomplish things, and I have to struggle to accomplish it.

H: And for me, Lisa, isn't that wasn't it, like, a point of pride in a way that even though, I mean, nobody really wants to struggle, but in a way, if that's what you're used to. If everything you've ever accomplished has come with a significant amount of struggle. For me, anyway, it became almost a point of pride that, well, you know, this wasn't easy. And so I really feel like I accomplished something. And we're going to talk in a couple minutes about what happens when women like us reach the ripe midlife stage of recognizing. Okay, I've spent all this time being who I thought I was supposed to be and who everyone told me I was supposed to be. And now I feel called to figure out a new way. But I think when you've just figured out you have ADHD and then you have your midlife awakening, those things can kind of all get mushed up together.

G: And I you know, one more thing on that is, my struggle wasn't to understand. It was to communicate what I understood. And my struggle was being able to slow down and take my time. Not so much, like, externally it didn't look like that, but internally, because it was so easy, some things for me. And so I would start there and think that everybody wanted to know, you know, the ins and outs and depths and circles around whatever we were talking about. And so that's the thing that was hardest for me, is not understanding. But how do I put this in a format where others can understand? Never a problem in therapy right Because I only had one person to focus on.

H: Yes, ma’am.

G: Yes. And one thing and no matter what was going on, even the hour before, it was out of my head, we're here, we're present.

H: It's really funny that the way we are wired, for lack of a better term, as women with adhd, who really do care a lot about people who are curious, fascinated, and really drawn to use our gifts and abilities to help others, that I really didn't like doing family therapy. I didn't really like doing group therapy. I didn't really like doing couples therapy because there were too many people to pay attention to. But put me in a room with one human being, regardless of what they're dealing with, and it was an endless source of fascination for me and a compulsion to really do everything I could to help. Once there were multiple people in the room, it really was difficult for me to feel like I could keep up with and give equal attention to all of them. And it's so interesting to hear you say that.

G: But I love working with couples and groups, because what I'm paying attention to there is.

H: It's a dynamic. Yeah.

G: Yes. And these common threads and patterns And so, yeah, I love that and it's interesting, right? So it is something that we're not interested in, girl, forget it.

H: And that the point of understanding is like, I think in order to be able to communicate who we are and how we are to others, we do need to understand it. And that's one of the things that people oftentimes need some help kind of coming to terms with, is if we're interested, we're fascinated. If we're fascinated, we're obsessed. If we're obsessed, we literally can't stop thinking about it, reading about it, listening about it, and talking about it. And it can take a minute to realize, you know, not everybody is wired this way. And sometimes, you know, we're going off on side quests and we're talking about our latest obsession, and people are just shaking their heads like, oh, my God, this is exhausting.

But for us, it's like, you know and when we're interested, there's no limit to how well we can pay attention. I think if there's one thing people can understand about those with ADHD and about themselves, is that we need to be interested. For all of the so-called superpowers, we have to come online and be activated and utilized. If we're not interested, that is when we are most symptomatic and when we are struggling the hardest.

G: Yes, yes.

H: But you and I are interested in a lot of the same things. And one of the things that we are also interested in, being women of a certain age, both of us are in our 60s now, is what women go through. Not just women with adhd, but all women to some degree in and around the time of menopause. You know, in our mother's generation, it was referred to as the change, the change of life. And before I got there, I thought, so change of hormones. Why are you making the change of life is so dramatic? Well, it turns out it was true. And one of the things that happened for me is that I didn't want to be, I won't say just a therapist because just sort of minimizes what a wonderful role, what a privilege it's been to be a therapist and I wanted something more.

It's like we're coming back to that, more that Coming back to, okay, I'm doing this and I love it and I want to continue doing it, but I want more. And I think menopause and all the things that get ushered into our life around that time, not just the change of our hormones and the change of our focus, but everything that's changing in our lives around that time as well, changing in our bodies and our relationships. It kind of brings an awareness of, is this enough and is this it and is it too late for me to lean into other things? And that's a big part of the work that you do now.

G: Yes, yes. And in order for me to talk about menopause, I have to talk about perimenopause, because that was the biggest shift for me and mine went on And I'm just thinking about this right now. That was also around the time I got diagnosed and I didn't know I was in perimenopause until sometime later, but I was in perimenopause for 10 years.

H: Oh, damn.

G: Yeah, 10 years. And I kept telling my mom, why didn't you tell me? Why did you tell me and…

H: Would it have helped, I mean, would it have helped if you would have worn through it?

G: Yeah. But I would have been able to expect some things like, yeah, I didn't know what was happening. And for me, it was a time when I had no other choice but to humble myself and realize that I was not firing on all the cylinders that I had been before and that it was a change of life. It wasn't something bad or negative. Now, it took me a while to grow into that, but I had the great fortune of working with a medical doctor, and she's also a naturopathic, and she worked out of her home. And I would be at her home you know, I'd call her and I'd say, oh, my gosh.

And so she really, really helped walk me through that. But at the beginning of that, I was still trying to prove myself and still trying to push myself and I don't even know. Some of them may have been my goals, but, you know, like the other, probably the vast majority was what I thought I should be doing. And I would say sometime around my 50s, I started to, like, care less. Absolutely, care less.

H: This is one of my favorite topics. Bring it. Bring it. Bring it.

G: Yeah. And, you know, I didn't have to be all fixed up to step out the door. I could admit when I made a mistake and not think I was horrible for it. I could differentiate between what I liked and what I didn't like. I could consider it was okay for me to take care of myself with boundaries, I could pivot if something no longer felt right. It didn't mean that it was a failure. It means there's a continuum. And so during COVID that's when it kind of, like, really peaked for me for so many reasons. You know, the world was and still is but I'll talk about that. But, you know, with COVID and George Floyd, that were, yes, it just changed my life.

H: Inflection points for some.

G: Yes, yes, yes. And so what I really knew that I was to do more of was to build community and to what I'd always done and had known that was help people either come back to themselves or come to themselves for the first time and to understand that home was inside.

H: Yes.

G: Now, easier said than done, but really looking at not just behavioral tendencies, but, like, who am I? What are my values? What do I need to reevaluate what fulfills me? And not in a selfish way, but where makes me not only better for myself, but better for my relationships and my purpose for being here. And I've always been a spiritual person, but my spirituality even grew more during that time because it was such more of an internal journey. And it was a reckoning of, wait a minute. Like, you've stayed beyond the expiration date in a lot of areas of your life, mainly because of fear and even the shoulds were rooted in fear.

And so, you know, through my own personal journey, whether that was spirituality, studying, meditation, therapy, coaching, whatever that was. And I've always been that kind of person that I want to look at me and accept. And I think that this was like, how we talk about that second knowing. I think this was it's like, first of all, yes, you do a lot of things, and guess what? You're not good at all of them. And second, you've got to learn to trust the things that you can't control.

You gotta let go, sister of some things. You're holding on too tight to this perception of who you are rather than accepting who you are. And so there were just so much healing around that. And relationships for me, deepened some relationships fell away, just how I saw myself. Yeah and I mean, that continues, hopefully right. But that's where the height of that was for me, during that time where it just whoa.

H: There were so many intersections. So, like, almost like a perfect storm, because you were dealing with the upheaval of perimenopause and menopause. And it does take a lot longer than we realize and thank goodness we're talking about it. We're talking to the younger generations about it, because our mother's generation, it was a big stigma.

G: Yes.

H: They did not tell their daughter. I wasn't prepared, you weren't prepared. It just wasn't talked about. Doctors didn't even ask about it. Your gynecologist didn't ask about it because it was stigmatized, just like mental health was more stigmatized. So it's not all surprising that we figured things out for ourself. And also the beauty of just the timing and the convergence that your hormonal balance. And we now know that hormones changing during perimenopause and menopause do make ADHD symptoms worse in women. It's one of the reasons why so many women who have been achieving and struggling for decades finally get themselves evaluated and diagnosed and treated in those years between 45 and 55.

But all the backdrop of COVID and the isolation and the quarantine and George Floyd and just seeing the culture around us changing so rapidly, it was an opportunity for those who are introspective to look deeper and so just the timing of midlife adhd diagnosis. The COVID pandemic coming together and saying, you know, it is time. It is my time to look within, to look deeper, to go beyond the well, this is what I've been doing and yeah, but why am I still doing it? It's not a quit, it's not a fail. It may be a completion that I've been doing this thing.

I've been in this hobby, I've been in this lifestyle, I've been in this relationship, I've been in this career path, I've been in this friend group, whatever. Some of it, all of it kind of is, like, up for reconsideration. I almost think of it as, like, renegotiating the contract we have with our own life and going line by line by line, what's my relationship with my body? What's my relationship with my soul? What's my relationship with the divine? What's my relationship to work and to relationships, into community and all that? It all comes up for grabs. And some people, some women are absolutely terrified by that, because when they start to go down that list.

They say, I have literally constructed an entire life in my 20s before I even really knew who I was. And I've been living that life for now, decades. I don't know who I am. I've never asked mice, and no one else has asked me either. But now those questions are front and center and demand to be addressed. That's either welcomed and embraced, but not without pain, or it's overwhelming and terrifying. But it's an opportunity and it was one that you leaned into. It was one that I leaned into.

And as you did, that coupled with your desire to create community, it's led to speaking. It's led to developing an entire program that invites women to. Instead of looking out outside to see who we're supposed to be, it's looking inside. I love the term that you use, the second knowing. Because I think for many women, it's not the second knowing, it's the first knowing, because they've never known and they've never been asked, and it never even occurred to them, that they should ask before. Do you encounter women like that in your program? That they're like, I literally have no idea who I am, and no one's ever asked me before you.

G: Absolutely. And these are women that you know their personal and professional resumes are impeccable by anybody's standards. They've done well. They're also exhausted. They're also insecure. They're also just feeling like whirling dervishes in their own life. Many of them are still the only one in the area that they are in, in terms of their professional progression. Absolutely. But to me, the first knowing is what we think we know. So what I thought I knew was I graduate from college, I get a corporate job, I make a certain amount of money, I have this, that, and the other. I get married, I have children like this is …

H: Check off the boxes.

G: Yes, yes. And so at that time, I thought I knew that and that's what I wanted. And to your point, because there weren't enough people around me saying, well, what do you want? Let's tap into that. How do you know what you want? And so it's kind of mechanical at least it was for me. I remember looking at my house one day, and I was thinking, why do I have that there? And it's like, well, because my mother had it there and that's where it's supposed to be.

You're supposed to have this here and this there, and that's supposed to match and all that stuff. And it's like, no, you know, life is too short. What do I find joy doing? What do people access me for? What is for me when I feel closest to my higher power is when I'm doing this, that the other. And they all have a common thread. And so, first of all, I said, I can't do that for me in the box of therapy. I need to do this in a broader way. So coaching, speaking, facilitating, and I don't want to work with someone's diagnoses. Therapists can do that.

I want to leverage what they have and encourage them that there's still another journey and that our life is evolving and all of it is catching up to this point. And now we get to refine and we get to pick out and we get to sort. And I think that that is something that so many of us women haven't been given permission to do. Even when we've been given permission to succeed, it's by these metrics.

H: Yep. And it's the story of how to succeed was not written for us. It was not written for women. It certainly wasn't written for women of color.

G: Absolutely not. Absolutely not.

H: So, not surprisingly, we ended up somewhere that we didn't necessarily intend to be. We were just following the path. And because of our, I think, the drive, you know, we've talked about in other conversations, the drive that women with ADHD have, especially women who are high ability, we Just feel like as long as I feel like I'm moving forward, that I'm doing the right thing. But you could be moving forward according to values and metrics and parameters that really don't have anything to do with who you are and your highest and best expression of yourself. And I think even though a lot of people, they say, oh, you know, you're so such and such age, you're literally standing at the intersection of ageism and sexism.

And while that is true for someone with ADHD who's always, like, you talked about your client earlier, always taken on more than you can handle, always pushing yourself to the next thing, to the next thing, to the next thing, to be able to have your body tell you, yo, bitch, I do have an expiration date. Even though you still have all these ideas. And my kids have always joked, I'm going to be, like, climbing up out of the grave at my own funeral and saying, but I had plans, you know?

And it's like, I think maybe we have to be in this body, in this life, on this earth, long enough to realize this is not going on forever. It's undeniable that this flesh suit is falling apart and I need to focus on what's most important. What is my contribution? What am I here for? What do I want people to talk about when I'm gone? And if I'm not doing that yet, I need to clear all the shit out of the way that is interfering with me doing that and only that.

And while it is kind of daunting in a way, because there's a lot we have to let go of, and you talk a lot about that. It's the weight of the things we let go of that is hard. But I think it's how we create lift, too, because those things weigh us down. And we're not going to fulfill that legacy, that legacy period of our life that we're both in. We're not going to be able to do that if we're scattering our energy or if we're doing things simply because of habit or obligation. We have to put that.

G: Absolutely. And I think about in particular ways, for black women, we're trained early to hold everything. The pain, the pressure, people's projections, and still perform. And so burnout for many of us is not just about running too hard. It's about carrying generations of emotional labor.

H: Yes, ma'am.

G: Suffering, survival codes, what's been inherited. And so in that second knowing we're also doing legacy work, we're healing so that some things our daughters, whether they're our biological daughters, or our younger women, don't have to carry it, our stuff. They'll have their stuff to carry, but they don't have to put our stuff in their backpack as well. And wonderful anything by Bell Hooks really speaks to black women and self recovery because we've lost parts of ourselves, all of us, but in different ways. Black women never could own it ourselves until you come to a place where it's like, wait a minute, wait a minute. What I can do, I can do. And the most important thing that I can do is to learn how to take care of myself, to learn how to value myself not in the way that the world has projected.

H: And that's fundamentally a spiritual journey. Because society, society is not going to give you that permission. You have to give it to yourself and realize, you know, Black women have always done, well, more than their share well, more than their share. And to reach a point where you say, okay, this I can do, and this I'm going to let go, and this I'm going to let someone else take from me and carry it forward and that's very, very deep work.

G: Yes.

H: So what's next for you, my friend? As you and I both walk on this path of continuous personal evolution, you've called out for community, you've called out for bringing women together and giving them permission to reach that second knowing, to let go of the obligations and the habits and the performative practices that our culture calls success and winning and create new definitions for themselves. What is next for you? What are you leaning into? What are you expanding? What are you embracing?

G: So what I'm leaning into is creating spaces, whether those are groups, whether those are retreats, whether that is keynote speaking, those kind of things, to remind women what's deep inside of us, that perhaps we've never tapped into. That it's not about we can have it all. It's about what is it that this life that I'm living is purposed for? Where are the pieces in my life that I have scattered? Where do I need to go back, return and see what I need to bring forward? There's this term Sankofa, and the image is a mythical bird, and the bird has its feet going forward and its head turned back with an egg in its mouth.

And what Sankofa means is, in general, to go back and get what you've forgotten. A lot of therapy, we're telling people to let go of these negative things. But there's a lot of jewels that we've forgotten about, because in that first knowing, we couldn't figure out how they fit. So we became a role and helping women to de roll and express who I am. And it doesn't mean, like, there's this thing, you're gonna have to leave your job or leave your husband or this, that, and the other or maybe you will.

H: Although sometimes that happens.

G: Yeah. But all of it is in support of integrity and integrating who I really am versus who I became out of necessity. Honoring both, but giving yourself permission to continue the journey. So I just, you know, that's what I do. And I do coaching with individuals, with groups and teach. I'm working on doing some curriculum for my second knowing. Having our first retreat in the spring. So just because I just know that, and maybe I do mean it this dramatic that in some ways we have to save ourselves and each other.

H: It might be dramatic, friend, but I'm with you on that. I'm absolutely with you on that. You know, we didn't talk about this before, and so I'm sorry if I'm putting you on the spot, but it's like, how do you see, or do you see your coming to the awareness that you're a neurodivergent person. You have adhd, you've always had it, and now you know what its name is and how it looks. How does that knowing help you facilitate the work that you're doing now?

G: Oh, boy. So there are absolutely days where I wish neurodivergency wasn't who I am and what I had to work through. But mostly I celebrate the creativity and the ability to see beyond the surface.

H: Yes.

G: An ability to have compassion. An ability to tap much more into my intuition and not just using my intellect and ability to have, what is the saying? It's progress, not perfection.

H: Yes.

G: And so and celebrating the progress instead of always looking to okay, but I'm not there yet. I'm not there yet. Where am I? And is it different from where I was before? And so that ADHD has helped me to celebrate not just the big bang, but the little things along the way.

H: I love everything about that.

G: And have fun.

H: Yes, ma'am. I was wondering if you were going to get through this entire interview without mentioning the other F word.

G: Yes.

H: That was fun.

G: Yes. Yes. And we get to teach people, don't outsource your identity. You know, don't outsource it. And I think that as more and more women do that, we're going to see bigger changes faster.

H: I agree. It's an accelerant.

G: Not that we're different, we're just made different.

H: No, it's an accelerant. I think when women understand who they are and radically accept who they are and join with one another, that is going to create the best kind of progress.

G: Yes.

H: Not checking off the boxes, not dress for success or…

G: Right.

H: You know, but I think it's going to be women, and I know you, you believe this too, Lisa. I think it's going to be women that are going to lead us into the much, much needed healing.

G:That's what Gandhi said.

H: And he knew a thing or two.

G: Yes, he did.