#Also I gamify it which I think rly helps idk

[stuckinapril]

im also a pre med student and i HAVE to tell you . i am literally so jealous that you enjoy studying im literally fighting for my life here

Studying is soooo nice when I’m acing all the concepts and sooooo infuriating when it takes me a little longer to understand something. Overall I like how it makes my brain feel . And the fun facts

[adhd-asd]

(Pt 1) I know it's not possible to develop ADHD later in life but... I did?? Now at age 21 I easily meet ALL the other diagnostic criteria for ADHD-PI, but the symptoms didn't start appearing til I was 12-13. Before that, every teacher said I was super focused, I had above average executive functioning ability, I even got the "self-discipline award" in grade 3. I've done tons of research--I don't have symptoms of a mood/anxiety disorder, I do have undx'ed ASD for sure

(Pt 2) but it doesn’t account for all my symptoms as well as both diagnoses would. I have an assessment in Feb for ADHD and ASD and idk what to say. If I’m honest that the ADHD symptoms didn’t start before age 12 they probably won’t diagnose me even tho I’m on stimulant meds that rly help me; and they might just call me subclinically ASD because of my particular presentation. But financially I can’t afford an assessment that I don’t get anything out of. Idk what to do :/

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     I have a lot of different thoughts on the subject, so forgive me if this gets a little long. To start, the number I was given as far as the age that symptoms need to be present by was 12, so if yours started becoming noticeable around 12 and that’s also the number your diagnostician uses, this could very well be a non-issue. They’re more commonly noticed around 8-9, but I was never under the impression that that was the cut-off point, personally.

     But, just to be prepared, let’s assume that whoever’s in charge of your evaluation expects them earlier. The thing about ADHD-PI is that it’s pretty common for people to fly under the radar because the symptoms are largely internal, and therefore more difficult to notice. Whereas hyperactivity isn’t very hard to spot most of the time, someone quietly spacing out won’t draw nearly as much attention, and probably won’t stand out as much in your own memories of your childhood, either.

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     Then there’s the fact that the rate at which we lag behind our neurotypical peers becomes more pronounced and obvious as we get older. The flip side of that is that it may not be at all obvious when we’re young. All grade school children are still in the process of developing their executive functions, and the workload and responsibilities we’re dealing with at that age tend to be fairly simple and straightforward, so executive dysfunction may have been far less impactful at that time.

     Once our peers have started maturing in a way that we haven’t is when problems tend to arise. Personally, I was at the top of my class and sent to an enrichment program for gifted students when I was very young, but as time went on and the workload, responsibilities, and complexity of the later grades became more demanding and complicated, I began to slip more and more each year. Even the additional challenge of the enrichment program was a bit much for me and I procrastinated on my homework and made obvious mistakes because of it.

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     Something else to keep in mind is that a lot of ADHDers work very hard to compensate for their symptoms, sometimes without even realising it, so symptoms being obvious on the outside isn’t always the best metric by which to judge your situation. I personally had a disastrous work ethic in high school but managed to cram assignments in at the last minute and still get an A, so none of my teachers knew how much I was really struggling. I also didn’t exhibit any obvious impulsive behaviours to my diagnostician until I explained just how often I have to consciously make an effort to keep those impulses in check.

     There’s also the fact that it’s possible for your symptoms to actually contribute to your success. If someone with ADHD and ASD is a people-pleaser, the desire to live up to these academic expectations can sometimes be the external motivation we need to thrive in a school environment. Alternatively (or perhaps additionally), you could have felt competitive and wanted to “beat” your peers. “Gamifying” our responsibilities intentionally is even suggested as a way to make difficult work more bearable.

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     I also think it’s important to consider your life outside of the school environment as a child, because a lack of focus on school wouldn’t be an issue if you actually enjoyed school. I personally excelled in school as a kid because I genuinely enjoyed it (and was a people-pleaser and competitive), but I could never apply the same level of engagement to chores and simultaneously got easily distracted and frustrated while cleaning my room.

     I talked more about my own experiences with undiagnosed ADHD and how I believe it affected my school life here, which may or may not ring true for you as well, but the bottom line is that it’s possible to excel in school while still having ADHD, and a strong academic performance isn’t necessarily indicative of a lack of symptoms. The symptoms themselves can be both what hinders you and what motivates you, depending on how they manifest.

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     I’m not trying to argue that you’re definitely wrong about not having symptoms of ADHD before 12-13, but with all of the reasons I’ve outlined for why they may have been missed, I would encourage you to look back and think very carefully about whether the symptoms weren’t there, or if they just didn’t register as symptoms at the time.

     A big one for me personally was my inability to take criticism, also known as Rejection Sensitive Dysphoria (RSD), which resulted in a lot of deeply hurt feelings, held grudges, and lashing out defensively. While initially written off as growing pains and an attitude problem, I now know that these experiences are a symptom of ADHD, but I initially didn’t remember just how far back they went.

     It can be very difficult to objectively analyze our own behaviour and experiences as children, especially if the memories are old and unclear. If possible, consider speaking with people who knew you when you were younger and sharing the symptoms you’re looking for to get their perspective and see if they might remember things you don’t. But remember to also think back to how you experienced various events internally, rather than whatever the external results were.

     I’ve linked to this article a million times before but I still think it does a really good job of exploring common ADHD experiences in a more human way, not overly-sterilised with medical language and diagnostic criteria. It’s the article that made everything click into place for me personally, and it may help you as well to get out of the overly strict diagnostic mindset.

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     Finally, I would encourage you to consider if there are any ways in which ASD symptoms may have altered, masked, or compounded upon certain ADHD symptoms. For example, while ADHDers may notoriously struggle with focusing on reading large amounts of text at once, an ASD special interest in a certain series could override that completely. ADHD can then build on that by kicking us into hyperfocus and the next thing we know it’s 4am and we’re still reading Artemis Fowl and our arms may have fallen asleep but our mind sure hasn’t.

     In essence, while I believe it’s possible your symptoms may not have become noticeable until you were 12-13, that doesn’t necessarily mean they didn’t exist until then. Our brains are complicated and the ways in which our symptoms present can depend on so many factors in our environments, upbringing, additional disorders, natural coping mechanisms, and aptitudes and interests. Anxiety especially significantly impacted the way in which my ADHD manifested in my teens, similar to how it’s outlined here, for example.

     Once you’ve considered all of this, if you still firmly believe that your symptoms did not exist at an earlier age, I would probably still encourage you to be honest about that. Ultimately your experiences are your own and if nothing I said here hit home, then that just means hey were different from mine. I do hope that this was helpful, though, and good luck with your evaluation!