neurodivergence and attachment issues

I just got diagnosed in my mid 30s, about half a year ago.  

I'm in Australia, so I went to the doctors here after intense googling for supportive doctors who are also Asian, so that they understand the cultural and social contexts that I was brought up in. Prior to this, I spoke to a ex-clinician friend who is white, male, and European. He basically said that just because I "didn't live up to Asian expectations doesn't mean I have ADHD, and that there is a difference between my perceived lack of work success and psychopathology." My problem isn't that I perceive lack of success (which I do), but I was really struggling with failing to establish and maintain routines and memory failings - both of which contribute to performance issues. I noticed that I would go into meetings where I am game on and having intense discussions on projects, and then forgetting all about it the moment I left the room. I would forget what we agreed on, what I had to do, or even what I discussed. This wasn't about being Asian, this was getting into "do i have early onset dementia or just going nuts?" territory. I used to attribute this to depression and burnout during my PhD, but I was good post-PhD and I can't explain it away to burnout/demotivation. 

I must say that as a child, I greatly repressed myself to get through the tedium of life/education. I had very little emotion (big thing as ADHDs function on interest, are generally dysregulated, and can be very "rude" when unhappy) and paid very little attention to things outside of work. it started to derail at PhD where there was absolutely no structure, no clarity, fucked up social and political scene and my advisor was bipolar. but pre-PhD, I was a high achiever because I only had to "not be me" to get things done. this also mirrors insecures not being in touch with their emotions, needs and self. 

I don't have a problem reading cues when I'm not in the situation. When I'm in the situation, it can trip me up if I'm involved. These days, when I want to have a constructive conversation, I really need to center myself and be slightly detached from it so that I can navigate myself and the conversation. When I'm outside the situation, my resources are spent observing/reading the situation and I can pick up energies very easily (yay APness). but when I'm IN the situation, my resources are spent regulating myself so I don't get "too much" or "inappropriate" or "emotional", so I just get really overwhelmed when there're lots of ambiguous cues because I can't be dealing with myself AND dealing with someone else's wishy-washiness. I have very little patience for it, then and now. Now I just deal with it better and not gaslight myself ruminating over what it means. perhaps it's not so much inability to read social cues, but the difficulty with uncertainty, learned social rejection, and rejection sensitivity dysphoria. 

I think a large part of my APness also comes from the fact that over the course of my childhood, social ambiguity was very distressing but I was always told that I can't be pushy, controlling, direct. Partly because NTs know what these cues mean and how to react, but partly because as an Asian girl, I'm not supposed to be aggressive and straightforward. Combine adhd's need for stimulation and novelty, insecure attachment, typical unloving/un-affirming Asian parenting and being female, it makes for plenty of bad relationship choices. This is not to take away the seriousness of attachment styles and dynamics, but I think neurodivergence add to/interact with it. 

I self-proclaim that I'm an earned secure even before I found out about ADHD, and most certainly before being diagnosed with it. So my experiences, new skills and attitudes are all pre-ADHD. 

btw, I want to be very clear that I am NOT saying that insecure attachment styles mean you are neurodivergent, or vice versa, or that they are exclusive to each other, or that you should start excusing your partner's behavior as neurodivergent instead of focusing on yourself. I think that certain behaviors look similar and can be interpreted through either lens. I also think that they are linked through childhood experiences, personal and physical development, and having similar manifestations in the physical world. I also think that they can interact and worsen things e.g., forgetting appointments is very bad for establishing relational attachment and security. whether or not I am ADHD or AP, it doesn't really matter in the grander scheme of me working towards security and stability = the need to develop knowledge and skills to support security is the same in both situations. But understanding myself more thoroughly helps me to identify what I need to develop more accurately and efficiently.

@shiningstar
I dated someone with ASD/ADHD for a few years - and in the process was diagnosed myself with ASD.

When I read through threads on here, there are times when I suspect that a partners challenging behaviour may be rooted in one of these conditions, usually ending in an unpleasant battle as the neurotypical partner tries to get their needs met from a (usually unaware) ASD/ADHD partner.

I think that whilst the cause is very different that there are plenty of blurred areas and the behaviours can be very similar. As you said, often those affected will have had childhoods characterised by behaviour from their care givers that could trigger attachment wounds so my adulthood this is often a very mixed up and complex picture of learnt/ innate behaviours.

most definitely so! particularly if the ND is not "obvious", meaning you cannot really tell that this person is, for example, ADHD, because they are not bouncing all over the place like 6 year old boys. When the neurodivergence is not obvious, people get treated like NTs by NTs and it is an additional layer of stress.  

@shiningstar
@introvert

ADHD and ADD in females and the influence of hormones - before puberty, as a teenager, the first menstraution, childbirth, pre meno pause - menopause. (Lotta Borg Skoglund from Karolinska Institute)

"We overlook girls with ADHD because we look for symptoms that are common in boys. Girls and young women lose the opportunity to receive effective treatment because most studies of drugs and dosages have been conducted on boys and men. Both biological differences and a society that still has different social and cultural expectations for girls and boys, women and men, contribute to this.

Women's hormonal fluctuations and ADHD / ADD

ADHD symptoms do not exist in a vacuum and this is especially true for women. Unfortunately, there is not much knowledge and research on how hormonal fluctuations affect ADHD. And we know even less about how the body's own hormones can be affected by or even affect a treatment with medication. But there are exciting experiments and theories that can help us understand more about what many girls and women with ADHD describe.

Animal studies have shown that estrogen stimulates the brain's dopamine cells and is important for the production of dopamine. Natural fluctuations in the female sex hormones estrogen and progesterone during the menstrual cycle affect several of the areas of the brain involved in making decisions, in social skills and in being able to control emotions. That is, many of the features that people with ADHD have difficulty with.

The effect of stimulant drugs also seems to be affected by sex hormones, and studies suggest that the effect may be different / more pronounced in the first part of the menstrual cycle (follicular phase). Where estrogen levels rise and progesterone levels are still low compared to the last part of the cycle where the effect of estrogen is attenuated by rising progesterone levels.

Unfortunately, no major studies have examined whether ADHD symptoms vary with the hormonal fluctuations, nor anyone looking at a possible need to adjust medication or doses accordingly. Eg. it may even be the case that some women with ADHD would get better from medications that even out hormone levels during the menstrual cycle.

Thus, a large gap in our knowledge is about how natural hormonal fluctuations can change and in some cases exacerbate the underlying ADHD symptoms.

Case: A and the recurring aggressions

A was diagnosed with ADHD already in primary school. It was very unusual for girls to be diagnosed with what was then called ADHD, but A had many of the symptoms of hyperactivity and impulsivity that are usually more common among boys at the group level.

It took many years before A put two and two together and began to see a pattern in here relationships. After another failed love affair, she received a tip from a friend about downloading a 'menstrual cycle app'. A pattern of recurring periods of extra low self-esteem and pessimism, discomfort with body contact, particularly high sensitivity to impressions and an aggression that was very easily aroused, appeared one to two weeks before she was going to have her period.

The certainty that it is actually about biological phenomena has in itself helped her not to panic and impulsively make quick decisions

In hindsight, A can easily identify several relationships that were interrupted during periods when she was negatively affected. Quarrels that she bitterly regretted, and relationships that she could not save and afterwards mourned for several years. It has by no means become easier over the years, quite the contrary. At the age of twenty, it could be a few days before menstruation.

Now that she's forty-plus, it's more than two weeks, that's more than half the month.

Her ADHD symptoms are intensifying and the defense mechanisms and strategies she has developed are not adequate these weeks. For A, the solution was to keep track of her cycle using a menstrual app and, together with her doctor, tailor a treatment plan in which she adjusts her ADHD medication to the different phases of her menstrual cycle.

The certainty that it is actually about biological phenomena has in itself helped her not to panic and impulsively make quick decisions that in the long run lead to unwanted consequences, during the periods when she is more vulnerable."

www.partnersinstories.se/lottaborgskoglund

ADHD: THE JOURNEY FROM GOOD GIRL TO BURNT OUT WOMAN