This morning I woke up with a mission: to drop off two parcels that needed to be returned and get my shoes re-heeled.
Yet this eminently achievable and unambitious plan was derailed by my inability to prioritise before I’d even left my bedroom.
Between waking up, coffee in bed, answering emails, deciding my socks needed pairing, reading an article about the legalities surrounding the Epstein scandal, and other distractions too numerous to mention, I finally had to jog to the Post Office in the five minutes I had left before my first meeting. The shoes would have to wait.
Until my late-50s, I blamed myself for this sort of procrastination. Now, a late-life ADHD diagnosis – three years ago – has finally made sense of my constantly whirring, utterly exhausting brain.
I once had outer space described to me as being not the great, deep silence I’d always imagined, but a cacophony of noisy activity as stars burn, space junk whizzes by and asteroids explode. On most days I feel this echoes the activity inside my head.
My attention span is so short and my patience so easily challenged, my brain drifts off even as someone is speaking to me.
Neither do I ever switch off. If you gave me a Pulitzer Prize, as I gave my acceptance speech, I’d be thinking about taking the dog out and upcoming deadlines. There’s no respite.
It is, frankly, a miracle that I have co-written a number of books and am about to start touring a new stage show, Cracking The Menopause, which I hope will be informative, thought-provoking and funny.
At least now I can work with a better understanding of how my brain works – and how menopause exacerbated the condition.
‘ADHD is a neurodevelopmental condition, where the brain has low levels of two key neurotransmitters: dopamine and noradrenaline,’ says Dr Deepali Misra-Sharp, a British Menopause Society-recognised NHS GP with a speciality in ADHD.
‘It’s not new, it’s just that these days we are far better at recognising it.’
For decades, it was thought that ADHD affected far more boys and men than girls and women, but that’s because the diagnostic criteria were – and to a large extent still are – shaped around traits that manifest primarily in boys and men.
In other words, hyperactive, disruptive behaviour.
By contrast, says Dr Misra-Sharp, ‘girls and women with ADHD tend to be inattentive, often high-achieving but exhausted, with internalised distress’. Their struggle is quieter and often characterised by ‘masking’, to hide symptoms and fit in socially.
Unfortunately, these different symptoms don’t trigger a medical referral which means, on average, women are diagnosed four years later than men. Around 75 per cent of women are initially misdiagnosed with anxiety or depression.
And for women, hormonal changes have a huge impact.
When women have pre-menopausal oestrogen levels, they are better at this masking, albeit at a psychological cost to them. Oestrogen is good for concentration and for boosting dopamine, which plays a critical role in ADHD.
With peri and menopause, when oestrogen fluctuates and falls and the protective layer it provides is ripped away, symptoms become more evident and harder to control.
‘Women compensate for years with perfectionism, overwork and white-knuckle organisation,’ says Dr Misra-Sharp, ‘and then the scaffolding collapses.’
That’s why we’ve seen a swathe of middle-aged women seeking a diagnosis.
With hindsight, I realise that my own ‘unmasking’ began in perimenopause more than a decade ago, when my anxiety levels rose to code red without any good reason at all.
It was as though the omission of tomatoes from the Tesco order created the same threat level in my brain as a possible nuclear attack.
I only discovered my ADHD via my son Dan’s diagnosis during his GCSEs. He’d just had a dyslexia diagnosis and his school suggested we investigate ADHD as well.
I’m afraid I huffed a bit. Then Dan showed me the list of symptoms. It was less a revelation than a mirror: difficulty concentrating, poor time-management, restlessness, easily distracted… I wondered whether what I thought of as character flaws – my own – actually added up to a clinical diagnosis.
Some of you reading this will be rolling your eyes, saying: ‘Those things happen to everyone. We all procrastinate and get distracted!’ But there is a difference when it impacts your entire life and every decision or task feels like herding butterflies.
Now I take the medication dexamphetamine, which is short-lasting, but does offer some relief if, for example, I have to write something.
And a diagnosis does mean that I can say: ‘I’m sorry, if I’m leaping up and down every five minutes, it’s because I’ve got ADHD.’ I am more able to forgive myself, too, because I know there’s a rationale.
Although it’s now thought girls experience ADHD as much as boys, the rate of diagnosis still heavily skews male, with different studies citing ratios from 3:1 in favour of boys to 9:1.
Not having our symptoms recognised still shocks me. I try not to dwell on this but I wonder how different my life might have been had I not had it.
ADHD has been a big part of who I am and what I’ve done, and I’m grateful for the varied nature of my career – but it’s also why I go from one thing to another.
The irony about this story is that I started writing it a week ago. But then I got distracted by other work, an interview and our puppy, as well as the faint but ever-present suspicion I’d forgotten something vital…
Cracking The Menopause premieres at the London Hippodrome on March 16, with Mariella Frostrup and Meera Syal, fane.co.uk/mariella-frostrup
