Thread by @AdhdAngsty

For an ADHD diagnosis, the DSM requires "clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning."

Medical professionals define what this looks like, not ADHDers. Here are some issues with this approach (thread, 1/11)

When doctors look for evidence of symptoms that interfere with functioning, they're looking for external evidence of this e.g. bad grades, poor work history, risk taking behaviour, and so forth. It's a tickbox approach- and one that has a myriad of limitations.

First, the requirement of "clear evidence" ignores the fact that many undiagnosed ADHDers experience a great deal of shame. We are often told from a young age that our symptoms are actually moral failings, and so use coping mechanisms to HIDE our ADHD behaviors.

This is why so many ADHDers who make it into adulthood without a diagnosis have anxiety. Anxiety gives us the motivation and energy to overcome executive dysfunction, at a cost. Unfortunately some doctors will see anxiety and not consider that ADHD is the cause underneath it.

Some doctors also require parental "evidence". Not only does this again miss that many ADHDs hide our symptoms, but it relies on our parents RECOGNISING these symptoms- when they likely don't really understand what ADHD is (or have it themselves, so think it's "normal").

Next, "interfere" is subjective. Factors like culture, language, class, and gender influence how people experience life and what they aspire to. Being unable to meet your world's expectations bc of ADHD is still interference, regardless of how a doctor interprets your behaviour.

Because of this, the "quality of school, social life, and work" as a evidence base is limited. The external "quality" might be good, but require lots of internal angst to keep it up. Plus, someone may be succeeding in these spaces, but failing at other things they care about.

Personally, I also don't like that ADHD needs to get "bad" in order to get a diagnosis. In high-school, I had all of my admin needs taken care of, and thrived. I was still just as much of an ADHDer then as I am as an adult, it just wasn't disrupting my life in a visible way.

Treatment, support, and accommodations still would have been useful to me back then. Instead, I made it to uni, and essentially developed anxiety to keep up my work/school/social life, and had no framework to understand why things were so hard.

Ultimately, we need to place more value on how it FEELS to be an ADHDer, so professionals and those who are undiagnosed can recognise it. We especially need to amplify POC voices, and build a better understanding of how gender socialisation influences ADHD presentation.

ADHD has been defined by how much we annoy others around us, whether that be our parents, teachers, or workmates. Screw that. Let's keep sharing our stories on here, and build a better repository of what ADHD feels like, so more of us can get the support they deserve.