(ADHD) is a condition that is known to affect young people. More it is being recognised that this also affects adults as well. In this article Lisa Davies, parenting professional, and Mark Williams, Director, Perinatal Mental Health training, share their experiences of ADHD and how this may impact parenting.
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If I mention ADHD (Attention Deficit Hyperactivity Disorder), you might think of a hyperactive little boy, bouncing off the walls or those amusing TikTok videos that have helped to normalise some of the behaviours, especially in adults, but also, at times, made us devalue this crippling and sometimes life destroying condition.
Lisa
I was diagnosed with ADHD over four years ago at the age of 41. That’s not to say it hadn’t always been there. It lurked like a shadow I couldn’t shake off or identify, which loomed darker and more menacing at some times more than others. It wasn’t until my son received his ADHD diagnosis that things started to add up.
When I look back at my traits and challenges, a time in my life which was most difficult was becoming a mum. As a student, I could always pull out the assignment or study for the exam at the last minute, once fear and adrenaline kicked in. Doing something I enjoyed in the fast-paced world of work, I thrived. My cognitive restlessness was fed, sparking interest, imagination, and an intense drive to succeed. Problem solving, thinking outside the box and tight deadlines were my forte. It had got me this far, so why did having a much wanted baby and staying at home during maternity leave, feel so hard.
Many people don’t realise that ADHD presents differently in women compared to men. This is one of the reasons why so many women go undiagnosed until they are much older. Until a big life event, or increased awareness, causes the scales to fall away. Until then, many ADHD adults may have been diagnosed as anxious, depressed, or some other mental health condition. Many times, these can develop and become comorbid conditions due to untreated and misunderstood ADHD -throughout childhood, teens and beyond. Studies show ADHD females may have fewer external symptoms compared to males, such as hyperactivity or aggression, however they are more likely to experience higher levels of depression and anxiety. They are more likely to be called, even playfully or with affection by family and friends, names like lazy, dramatic, overly emotional, flaky, a day dreamer, forgetful, air head, chatterbox. Always late, always losing things or making careless mistakes.
This leads to higher levels of emotional distress and chronic stress, low self-esteem and negative self-image, all because of the struggle to complete daily, and sometimes boring tasks. Add feeling overwhelmed, living with chaotic thoughts, and feeling out of control.
Now let’s throw in a hormonal rollercoaster and a baby into the mix and see what happens.
We know, being a mum is challenging for everyone. As a parenting professional, running groups and carrying out 1:1 bespoke intervention for families, I was well aware how significant this role was; the importance to focus on parental wellbeing and promoting long term best outcomes for children. I had done all the courses, read all the books, I even delivered parenting programmes. Step aside world, smug super mum coming through.
I had it all figured out, or so I thought. Imagine my surprise when the wheels came off and all I knew and believed came tumbling down. That’s because, the so called “normal” parenting guidelines were not written by or for neurodivergent people.
Mark
I was only diagnosed with ADHD after struggling with my issues after having our son. I found it hard being a new father and I had self-managed without knowing that I had ADHD until I was diagnosed at forty years of age. In the years of working in perinatal mental health, I now feel that this was also a contributing factor why I was depressed during the postnatal period. Mental health we know is so complex and of course seeing my wife go through her labour and thinking both mum and baby would die affected me.
After years of speaking with parents, I have come across many mothers and some fathers who have been diagnosed with ADHD after going through depression during the perinatal period. It is important that we understand how people with ADHD understand the information and support that is given to them. Some people with sensory processing disorder underreact to sense stimuli, which can cause them to seek out more intense forms of stimulation. But more commonly, particularly in people with ADHD, this disorder causes hyper-sensitivity to sensory information.
As a father in the labour ward, it became overwhelming and had my first ever panic attack due to words, “Emergency-c section”, doctors coming into the room at once, midwives looking concerned and how the room changed in that split second. Then, not knowing what was going on and told I was to go into theatre with my wife, found it hard to process; it all happened suddenly.
Having ADHD, you are more likely to lack focus, poor time management skills, disorganisation, impulsivity, fits of rage, forgetfulness, restlessness and anxiety, fatigue, relationship issues. Now when the baby comes along, there is little sleep and you are not just trying to look after yourself, you have a new baby to take care of which can become even more overwhelming without outside support.
There are biological or chemical links between ADHD and depression, too. It is said that ADHD is associated with dopamine dysregulation. Dopamine is the neurotransmitter, the driver for motivation, and happiness. When I became a father, the things that kept me well took a backseat, like good sleep, fitness and motivation for myself.
We know that there can be a higher risk of anxiety and depression during the perinatal period, if you have any disorder like bipolar, schizophrenia, mood disorders and post-traumatic stress disorders.
ADHD was first recognised as a valid condition in the UK in 2000 but was not officially recognized as an adult condition until 2008. ADHD affects 5% of children and 3% of adults (1.5 million) in the UK, making it the most common behavioural disorder in the country. So many parents are often never diagnosed and the diagnosis can take years, in the meantime they are preparing for parenthood.
What we can do better
- Provide Parenting Group Facilitator and 1:1 Parenting Practitioner with experience of working with neurodivergent children aged 0-18 years and their families.
- Consider attitudes and stereotypes – guilt, shame and self-esteem. Not just for kids, adults have it too!
- Differences and inclusion – why are we still getting it so wrong?
- Parenting and the effects on executive functioning – increase in demands, organisation and routines, which ADHD folks already find difficult. How lack of sleep or exercise, irregular mealtimes and hormones can make ADHD symptoms so much worse.
- Family Dynamics. Our own experiences of childhood and how we bring this to our own parenting. Triggers. Recognising ourselves in our children. ADHD parents and how they manage their ADHD kids.
- ADHD burnout, overwhelm and managing emotions – impact on mental health. What support is available – Currently only on managing medications which not the right choice for everyone. No behavioural support or counselling recommendations for expectant or new mothers and fathers. More research and understanding on the role hormones play on ADHD women and young people.
- How well informed are the helping professionals – lack of neurodiversity training and awareness. ADHD comorbidities when it’s not understood and left untreated – anxiety, depression, increased sensory sensitivity, mood disorders, OCD, ODD ….
- What might help – Tackling stigmas and stereotypes. Raising awareness and early identification. Increase in behavioural and therapeutic support services. Reframing traits and thinking styles using a strength-based approach. Understanding yourself better. How you help your mind work with you instead of against you.
Becoming a parent requires routine, organisation, time management, inconsistent stimulation and sensory input, memory recall and prioritising. All these processes require us to call upon our executive function skills, which is something us ADHD folks find difficult. Thanks brain!
We already know that the rise and fall of oestrogen plays a huge role on female mood, emotions and cognitive function. It impacts during the menstruation cycle, menopause, while pregnant and especially after birth.
Aumatma Shah, N.D. fertility specialist and author of Fertility Secrets: What Your Doctor Didn’t Tell You About Baby-Making explains the dramatic rise in oestrogen and progesterone, “These two steroidal hormones are key to creating dopamine and serotonin, two neurotransmitters in the brain that are important to feeling calm and happy” and why many of us can feel invincible during pregnant. However, what goes up must come down. “Unfortunately, immediately postpartum, oestrogen and progesterone will both plummet. Simultaneously, there will be a surge in prolactin and oxytocin”.
A new baby, may bring lack of sleep, poor nutrition and increased sensory sensitivity, which all heighten and increase ADHD symptoms. It’s a one-way ticket to emotional and cognitive dysregulation, increased anxiety and depression, possible mood disorders and a steep decline in mental health and wellbeing. As stated by Sari Solden M.S., LMFT, psychotherapist and adult ADHD counsellor, “Managing the home is one of the most unfriendly lines of work that anyone with attention deficit disorder (ADHD OR ADD) could undertake…. The multiple-task coordination required to keep a household functioning smoothly bumps directly against the executive-function difficulties inherent in ADHD”.
Lisa
My crash and burnout didn’t happen straight away. I had spent a lifetime becoming a master of masking, in front of family, friends and work colleagues. No one must know how useless and inadequate I really was. However, due to my studies and vocational career in Early Childhood and parenting, I was also acutely aware that my mental health was deteriorating and the detrimental effect this could have on myself and my family. Therefore, I bravely shared my feelings and emotions with health professionals. After all, this is their job, they’ve seen it all before, they’ll know what to do. 3 years of weekly weeping sessions at baby clinic, going to my GP and finally asking for a mental health assessment came to nothing. Because my presentation did not score high enough on the Edinburgh Postnatal Depression Scale and I displayed a strong attachment with my 2 beautiful and well cared for babies, (by now aged 3 and 1), I received a letter in the post stating, ‘Anxiety state unspecific’. Advice given was to rest more, phone a friend or make myself a nice cup of tea. As the guilt and shame mounted, I told myself, to get a grip! Try harder. Work harder. Find the magic key to motherhood and all will be well.
Having a baby and becoming a parent is one of the biggest changes and challenges in any person’s life. So, let’s look at the job description “Personal assistant for at least one other person under the age of 18 years and possible other adults in the household. 24 hours a day, 7 days a week. Limited or disrupted sleep and mealtimes. Cleaning, laundry and healthy eating meals must be provided daily at scheduled intervals. Excellent organisational, memory and time management skills, for yourself and others. Tutor, nurse, emotional and behavioural coach. Personal shopper, taxi driver and mediator when required. No sick leave, annual leave or payment. Possible part time position or retirement when your children leave home. Due to historic societal expectations, this role is part of the female ideal. Desirable requirements, to maintain your appearance and home to be at presentable and attractive standard. Paid employment in an economic role to cover usual household bills and finances”.
Kathleen Nadeau, Ph. D and co-author of ADD-Friendly Ways to Organized Your Life explains, “Women with ADHD, no matter how successful in other areas of life, struggle on the household front”. They may question themselves as a parent, compare themselves to others and left feeling inadequate and unworthy.
In an attempt to combat this critical thinking and poor self-esteem, many adults (and young people) with ADHD will fall into destructive patterns of behaviour – rigid thinking, obsessive behaviours, and ruminating thoughts. Break down in relationships or substance dependent. Also ,becoming perfectionists or workaholics to compensate for feeling that they don’t measure up. This can lead to ADHD burnout; not attending to your own needs and self-care and becoming physically and mentally unwell can effect us during the perinatal period.
I place no judgement or blame for this dark and difficult time. Everyone I encountered did their best with the resources and knowledge they had at that time, including myself. Thankfully, after my maternity leave, I was able to access counselling and CBT through my employer, which led to a referral for an ADHD assessment. Taking off the mask and sharing how I felt was the most vulnerable and best thing I ever did. It took just one knowledgeable and compassionate professional to notice the root cause of my perinatal anxiety and sporadic waves of depression. I still look back with shame and regret for the precious time wasted; feeling so lost, confused and alone, all because ADHD is misunderstood. Now I have the knowledge and tools to avoid anxiety and depression creeping up on me again, by telling my story, hope to help others too.
What might help:
- Acknowledge ADHD and how it impacts you, your family and other relationships.
- Talking to a professional who gets it; trained and knowledgeable in understanding ADHD and differing presentation in men and women.
- You may not be the best personal assistant, but you can be a great project manager. Delegate tasks to other members of the family to seek professional support. You can’t do it all alone.
- Problem solve as a family and work as a team.
- Respect your own feelings and how hard it can be. Notice when you are starting to feel frustrated, agitated or restless. Overwhelmed, fatigued and when everything just feels too much. Consider what and who can help before emotions bubble over. If an emotional tidal wave does take hold, how can you ride it out safely, without causing harm to yourself or others.
- Focus on the strengths, in yourself and others. Acknowledge that everyone is doing the best they can in that moment.
- Putting on your own oxygen mask first. Plan in advance how best to avoid burnout, becoming emotionally overwhelmed, drained or unwell. Prioritise your own needs and make self-care and downtime part of your daily life and routines.
- Create Golden Time every day. Even if it’s just 15 to 20 minutes, stop on your path to enjoy the scenery. Regularly create space with no schedules, responsibilities or tasks to complete. Enjoy the freedom of just being in the moment. Alone and also as a family. Laugh, joke, play and have fun!!
- Know your own boundaries and when to say No!
- Look at and identify your individual values and beliefs. Follow your own path without comparing yourself to others. Find what works for you and live a life that makes you and your family feel good.
- Don’t sweat the small stuff – choose your battles and only do what you can manage in that moment. Celebrate the small everyday achievements as well as the big ones.
Resources
ADHD https://www.lanc.org.uk/about-us-adhd-asd-assessment/our-history
ADHD foundation https://www.adhdfoundation.org.uk/
Lane SJ, Reynolds S. 2019 Sensory over-responsivity as an added dimension in ADHD. Front Integr Neurosci. 2019; 13:40. doi:10.3389/fnint.2019.00040
Littman E 2022 Survival strategies for ADHD moms podcast episode #97 https://www.additudemag.com/adhd-moms-podcast-97/
Perry C 2023 What to Expect with Postpartum Hormone Changes. www.parents.com
Sherma C 2019 Is it ADHD, depression, or both? https://www.additudemag.com/adhd-and-depression-symptoms-treatment/
Solden S. 2021 Overwhelmed Mom Syndrome — It’s a Real Thing www.additudemag.com/overwhelmedmomsyndrome
Sreenivas S 2023 ADHD in women https://www.webmd.com/add-adhd/adhd-in-women
Lisa Davies, parenting professional, and Mark Williams, Director, Perinatal Mental Health training