Skye 0:05

Hi, we are the ADHD skills lab podcast. My name is Skye,

Sarah 0:10

and my name is Sarah.

Skye 0:11

And we will be your hosts chatting to you about practical ADHD strategies. You can use the research behind some of these strategies as well as interviewing other professionals with ADHD, about how they've developed skills and working through struggles in their lives.

Sarah 0:25

You might know us from unconventional organization where we talk about this kind of stuff all day long. So we're super excited to have you along and we're gonna chat through it together.

Skye 0:39

Okay, well, welcome to this week's research recap. Today, we're going to be talking about two really awesome papers, two of them, we both enjoyed. One focusing on the idea of self motivation, what motivates you if you have ADHD, and we'll talk a little bit more about that, because it's not always what people think. And then the second thing we're going to be talking about is woman's experiences with being diagnosed. And there was a wonderful qualitative research analysis that looked into what it was like to be a woman who was late diagnosed, and will definitely speak to that, both in the academic sense, but also probably in terms of our own experiences as well, because I know, Sarah, you definitely related to this. And so did I.

Sarah 1:27

Yeah, I'm really excited to get into that study, in particular, because I've never actually seen anything in the research literature like that.

Retrospective Report of Academic Motivation Among College Students With Elevated ADHD Symptoms

Skye 1:35

Yeah, it was very, very cool. And I know, because I said that which was amazing. Some people who actually did this study had ADHD themselves, which was awesome. So we're gonna start with the first one, the first paper is from the Journal of attention disorders. 2023, as all of these papers are, in this paper, looked at the idea of whether being motivated by the acquisition of knowledge or skill, or whether it be motivated by something else, like good grades, was associated with higher academic achievement among students who had ADHD symptoms. And I'll say right at the beginning, ADHD symptoms, nobody in this study was, as far as they know, diagnosed with ADHD, they didn't actually check that. So yeah, that was kind of the overall focus on the study. So what was the kind of research questions, Sarah? Yeah, so

Sarah 2:30

in this study, as Skye just said, the main purpose of this was to look at two different motivation theories or theories of motivation as it relates to academic performance. So those were Achievement Goal theory, which basically just states that people sort of acquire knowledge so that they can achieve either to develop competence compared to others. So like, basically meet or exceed their peers knowledge, or just for the sake of learning, which I related to pretty heavily.

Skye 3:07

And then expectancy value theory basically, is a theory of motivation that states that it's a function of a student's belief or expectancy, that they can be successful, and the value that they place on engaging in those tasks required to be successful. So it's kind of like when I read this, it kind of reminded me of like a cost benefit analysis. It really did. Yeah, as it relates to motivation. Yeah, 100 was, there's like, two different main theories. And really, they're looking at whether people are going to learn and do something academically, because it's something that they really enjoy, they want to get better at, or whether it's something where they, they need a certain number of points to meet a goal. And so they're going to put the amount of work into it that they need to meet those goals. So that's kind of the the two differences there. Yeah. One of the things that came out of this conversation was that I in psychology, we learned a little bit about these different reasons that people learn. But you'd said that this was kind of the first time that you'd actually looked into this and learned that there was different theories for this topic.

Sarah 4:17

Yeah, that's right. I never really considered that there would be separate theories of motivation

Skye 4:23

is the theory for everything. Yeah, there really is.

Sarah 4:27

It's hard to keep track of everything. But if you're interested, you can ask a question and find that somebody else has already postulated something. Yeah, I mean, so this reminded me a lot of the intrinsic extrinsic motivation, conversation, which sort of brought me down a little bit of a rabbit hole. We shouldn't go down that

Skye 4:46

No, no, but I think it is important to stay, because I'm sure there's a lot of other people who who've never thought about why they do what they do, and that there might be different theories of that. And it's kind of a fun thing to do. Just think about for yourself, like for those of you who are listening, who don't yet know what happens, you know what they actually found for ADHD, I just want you to take a minute, think about your own experiences of studying or meeting some kind of goal. And think to yourself, are you somebody who cared more about always motivated more by achieving a goal. So achieving kind of a, well, I'd like to get a certain grade point average, because that's going to give me like some kind of benefit, or I'm going to reach some kind of project goal, because then I'm going to get some kind of performance review, you know, that's gonna be good, or whether you're more motivated by wanting to learn and figure something out. Because I think this is something we can just kind of think about for ourselves. And then we'll talk about what they found. And I'd love to know if anybody wants to tell us whether it was the same as what you got. So let's talk about the methodology. So basically, there were 461, first year undergrads at a university in the Midwest, and they were doing retrospective surveys. So they were doing a survey of people's past experiences. It's not like they were doing a test where they then saw how well they were going to do with the future. And I think that's really important, because what we tell ourselves about the past is not necessarily what happens when we actually have to do something. And it's worth mentioning that that was case.

Sarah 6:32

Yeah, this study was pretty much all self report, there were several different self report scales, including the one that accounted for the ADHD symptoms. And then even the high school GPA that they were measuring was also self report

Skye 6:48

actually didn't pick up on that. That's so interesting. Yeah. So it was it was all sort

Sarah 6:53

of self report, and then possibly memory bias.

Skye 6:56

Yeah. So this is what students thought about themselves, like in the years past, essentially, right?

Sarah 7:05

Well, it's really interesting, too, that they looked at just GPA to measure academic achievement, as if that is the end goal of academia is to get a GPA. I'm sorry,

Skye 7:17

have you not looked at the expectancy value theory? That is the end goal? No, definitely, definitely. So what they found was that for students who had more elevated symptoms of ADHD, what tended to motivate them was their mastery aspect. That was the thing that got them. That Higher Achievement people who said that they were more interested in mastering something and understanding something for its intrinsic value, to become a better scientist, or to become a better writer, for example, they were more likely to have a higher GPA than people who were doing it, because they needed to get their GPA to a certain number, or they needed to hit some kind of other cost benefit analysis goal. And that really rang true.

Sarah 8:11

It's really sort of that drive to find the answer. It's sort of like hunting for the answer. You know, if something is actually interesting to me, and I would imagine to others, you cannot rest until you find that answer. And so that's why it was really important to me that I do a major, I guess, that did satisfy that need for me.

Skye 8:31

Yeah, no, totally, I feel the exact same way. When I first started university many, many years ago, I started with the expectation that I was going to do law, and they talked a lot about your GPA, it was really, really important to the super competitive thing to get into. But then once they actually got to the topic for me, anyway, they tell this interesting story about this person that things had happened to, and then they'd stop the story halfway through and be okay, what's the rule of law here? And for me, personally, I was like, the rule of law, like what happened to them? Are they okay? And then when I was doing psychology, which was my other, you know, thing that I was potentially going to major in, they did tell me that stuff. And I was I did feel like I was mastering and understanding of human behavior, which was something I had always wanted to learn about. And so when it came time to decide between the two, it was a no brainer. I was not only was I more interested in psychology, I was I was much better at it. I'll tell you that right now.

Sarah 9:32

That's really funny. I have a similar experience when I took economics courses. Really? Yeah. Just the way that you interpret the graphs. In the research. It's opposite. Yeah. Because one is people focused and one is not. Yeah,

Skye 9:48

no. 100%. And I think this is a also a kind of a bigger question, because sometimes you have to learn something. And you're sitting there going, how do I make this interesting to me? And I've definitely had to do this. There's been a lot of papers I've had to take that had been less fun than others. And often without even really thinking about it, and something that I've really just thought of Now, often what I've done is I've gone okay, well, what am I going to master from this? And tried to add an element of mastery to say, Okay, well, this requires me to learn a particular tool, that tool might be useful in the future in a different way. So if I can master that tool and see that as what I'm doing, that can help me back in to this very boring thing that I'm studying right now. Basically,

Sarah 10:37

that's a really good point, just sort of harnessing the harnessing the motivation for use elsewhere, because that's really what we're trying to do as ADHD people all the time, just either harness the motivation or manufacture it. If you can't make your own store bought is fine.

Skye 10:56

Yeah, 100 percent, and it is interesting, you know, what they found with this idea of mastery, this might be something that's worthwhile for you to think about in your own, whether it's work or academic life, to think about what you can master and what you can see yourself as improving in and learning more about, and maybe spend a bit less time focusing on the while I want to get a good performance review, because I want to hit these metrics. Because even though that might work for other people, and it did, according to this research work for other people, it didn't work so well with ADHD. So in terms of the impact, I mean, there was no conflict of interest, there was no funding that I could see, it was all self reported retrospective, and it was one study. And as we always say, with that, take that as what it is, this is one study, it may be that if we did a meta analysis of this, we would find slightly different results. So it's more in the interesting category, then, and then in the category of I would change my whole life around this

Sarah 12:01

basically, definitely, and also sort of in like, the pondering category, because, yeah, what the researchers were thinking is that this study adds to the literature on ADHD and motivation of which there's not a super big amount, which is surprising. Yeah, it's all sort of related to like I said, the external factors, sort of like how does this impact your GPA? Like, how does this increase graduation rates and things like that? So it sort of starts to add to that literature, but then it calls for more research to be done to evaluate the relationship between motivation and achievement in ADHD, because they're hoping that if we can better understand how motivation can be better harnessed by the ADHD population, that they could have better academic outcomes.

Skye 12:48

Yeah, definitely. And so the practical takeaway for this is that it's so important for yourself, you know, with whatever you're doing, whether it's work, or you know, being a student, to think to yourself, What am I doing this intrinsically for? What is my intrinsic motivation, I have my external motivations, we all know about those. But on those really rough days, it can be helpful to have some kind of additional intrinsic motivation, something that you want to learn that you want to grow and that you want to be like, it's okay, if I fail at this thing. Or if I make mistakes, because I'm just I'm just figuring out how to be the best. Whatever it is, I'm trying to figure out how to be a really good Excel spreadsheet designer, like that's a really fun thing for me. And that's my intrinsic motivation for this slightly boring report writing job.

Sarah 13:38

Mental tricks? Yeah. Well, it's

Skye 13:40

all about those elaborate traps we set for ourselves, basically. Yeah,

Sarah 13:46

I mean, this is definitely not do what you love. And you'll never work a day in your life, because that is not true.

Skye 13:54

But it is about can you make what you're doing? Because often, you know, we're like, I'm not off to do another thing. This is what I'm doing. It's like, can we make it closer to something that you might love? A little bit?

Sarah 14:07

Right? Yeah, it's sort of like, what do you do all the time? And how can you make it useful in other areas of your life? Sort of how can this skill be interchangeable?

Skye 14:18

Yeah, exactly. So yeah, very cool research. And we hope to see more on this idea of, of motivational theories of ADHD because we talk a lot about ADHD and motivation. We talk about why we're not motivated, why we should be more motivated. What we can do to get us more motivated in terms of medications and other things like that. But we don't often talk about the research and the intrinsic motivation, and that deeper stuff as well.

Miss. Diagnosis: A Systematic Review of ADHD in Adult Women

Sarah 14:44

Yeah, it's usually more focused around the dopamine. Yeah, the relationship between ADHD and dopamine. Yeah, definitely. All right, so the next article that we're going to talk about today is also from 2023. Except this one is um, Data Analysis. It was published in the Journal of attention disorders and its name is Miss diagnosis, systematic review of ADHD and adult women, which I thought was so cute.

Skye 15:12

Yeah, it's very, very qualitative review, which is something that I've spent a lot of time doing in my academic career. Sorry, I appreciate this. They often have really fun titles.

Sarah 15:24

You know, I love the fun articles, or the fun titles for the research articles that is becoming more prevalent nowadays. It's just adds an element of entertainment to what can otherwise be quite draining. Anyway. So Skye, do you want to tell us a little bit more about this study?

Skye 15:41

Yeah. So this was a systematic review of qualitative research. And what that basically means is that all of the papers, yeah, I think all the papers we've talked about so far have all been quantitative. So there's some kind of number involved, whether it is a survey, and this is the percentage of people who found this or whether it is a experiment, you know, and they did some kind of analysis. This was still an analysis, they looked at a number of different papers, I think they ended up looking at eight different articles when they did the test. But it is looking more at themes using something called thematic analysis, which I actually was taught by one of the professors who developed that system. So it was cool to see them develop some themes. And basically what they did this around was the experiences as Sarah said, adult woman who had ADHD and experienced ADHD later in life. So they were particularly looking at studies that were published after 1997 that were in English, that focused on woman over the age of 18, who received a diagnosis of ADHD in adulthood, which I thought was really interesting, because they specifically spoke about the difficulty of ADHD in adulthood. But it's not like they had a control group of people who were diagnosed in childhood. But again, because they're doing a thematic analysis and qualitative research, that's not what that kind of research is about. So there's a bit of a different flavor to it. It's not meant to be control group style research, it's more meant to generate a body of knowledge that can then be turned into potentially that kind of more detailed research that will be like, I'm just listening in my head, I can hear all the qualitative analysis, people will be like, No, it's best on its own. And I agree, it is good, but I'm not gonna get into that. Also, all the papers they looked at were peer reviewed, and they had available full text, obviously,

Sarah 17:46

kind of crazy that there were only eight articles left.

Skye 17:49

I also found that crazy, I can't remember how many they started with. But I wasn't sure if eight articles is a lot, because I've done thematic analysis before, but it's been on interviews with people and usually want to have like 20 interviews with people. So eight articles is quite a small number. But I I'd love to know if anybody knows, is this small for a thematic analysis, systematic review? Because I actually don't know the answer to that question. So from what I can tell, they were looking for studies on a number of different platforms, obviously. So they searched on Google Scholar, Site Info, PubMed, and then a few other sources. So they started with 484 articles. Wow, that's a lot and got down to eight. Yeah, no, I'm looking at their workflow now. So they started with quite a few articles. And then yeah, they removed 27, duplicates. They removed a lot of articles and the titles and abstracts stage. So I'm imagining that they would have found that a lot of articles didn't meet their criteria, once they really looked into it. I would be curious, and I will, I'd love to have one of the people from this paper on our podcast to talk in more detail about what it was about these articles. That meant that they ended up with so few, because it would be interesting to give us a sense of maybe a focus, maybe a lot of the articles were about men, or people who didn't buy this man, they weren't a lot of woman articles, you know, maybe that was the factor in it. I think there's probably something there and that they were looking at something that hasn't been hasn't been highly studied, which, again, is a really common thing in a qualitative analysis. Like often you are looking in depth at something that hasn't been highly studied. That's one of the reasons you're doing this. Yeah,

Sarah 19:48

that is actually one of the quotes in the study is just how under research to this whole topic is What did they call it? I think they called the research scant. Or scarce. Where is it? Yeah. As the paper goes on to call the available literature scarce, yeah,

Skye 20:05

yeah, exactly. If you'd like what you hear, don't forget to subscribe, you can get weekly updates. When we launch a new podcast episode, we have lots of interviews, practical strategies, as well as research recaps with Sarah and I go through the latest research. So the other thing just to note, one of the things that people tend to do in these kinds of papers is they'll actually talk about their assumptions, they'll say, sort of this is my perspective. So there's a sense that because it's qualitative research, you don't want to talk about yourself as being non biased, because everybody has a bias. And one of the biases that were identified by one of these authors is that she was a woman with ADHD herself. And so she might have prior assumptions, which I can totally relate to about experiences of women with ADHD diagnosed in adulthood, but very, very, very cool to have a paper where the person in the paper identifies himself as having ADHD. Really awesome.

Sarah 21:02

Yes, very much. So I understand why someone might call this out as a bias. And I do appreciate that they disclose this. However, you could just say that she had the intrinsic motivation to get to the bottom of this. Because it doesn't seem like there's a lot of other people who are like trying to, yeah, no, 100%, you know, sort of like she's curious, she's has the means. I'm gonna do the work.

Skye 21:30

Definitely no. Very cool. As is common with thematic analysis, there was four themes. So basically, there were four main areas that they found something in. And then within that there were other things. So I'm just going to outline what those themes were. So what they found, the first theme was impacts on social and emotional well being. So they found that having undiagnosed ADHD was something that was having a big negative impact on people's lives. The second one was difficult relationships, they found that people tended to talk about how difficult it was to have family and romantic relationships. For example, divorce, unsatisfactory relationships was something that they talked about, again, with that undiagnosed ADHD, feeling a lack of control, feeling like they have no control over their well being and satisfaction. And then the last theme was self acceptance, and coming back into self acceptance after diagnosis. So that's kind of a rundown of the main themes, but I want to delve into these in more depth, talking about them. And then also maybe chatting a little bit about our own experiences with this because we could have been in this study, yes, we could, we both, you know, meet the criteria of late diagnosis. So the first one was that impact on social and emotional well being Sarah, do you want to talk a little bit to that? Yeah. So

Sarah 22:57

basically, the main themes that fell under that category were things like low self esteem, struggling with identity formation, which pretty much just means that when you're in a group with other people, you always feel like the outsider or the other, just general struggles with emotional regulation, which we know why sort of developing maladaptive coping behaviors, you know, so things like drinking smoking, just what psychologists would call risky behavior, sort of that unchecked impulsivity at work. And then just in general, a desire for having their diagnosis earlier in life. I think it was something like 38% wishes Yeah, that they could have gone back and changed the typecasting criteria to fit them at the time. Yeah. And actually, it's really sad. I don't know if you took a look at Appendix B. But it was the theme. And then the codes for the theme. And in this case, the codes mean, sort of like keywords. So if one of the study said something like shame or feeling different, that would be coded as impact on social emotional well being, and I just, I found those kind of hard to get through. Did you have

Skye 24:11

a look, I didn't have a look at the appendices. But I can imagine I'm just having a look at them now. Like it's really tough. I mean, partially because it, it hits home, like none of these things feel like oh, I had no idea. They talked about this idea of shame, feeling lazy or stupid. These are some of the codes social anxiety, difficulty relating to others isolation, comparison to others. And it's tough. I think we've all had that experience prior to diagnosis specifically, where it's just what is wrong, what is going on? And it might not even be something that we've necessarily said out loud or said to other people, but it's definitely there.

Sarah 24:56

They go on to talk about sort of the ramifications of it. All of those beliefs, you know, self beliefs and sort of what that can do to you, as one would expect, it just generally leads to an adult who struggles with their mental health and their sense of self worth, then.

Skye 25:13

Yeah, yeah,

Sarah 25:14

it's rough. So that first one was like, Oh,

Skye 25:18

it definitely was. It also made me think a little bit about, you know, we talked about this idea of, it's been talked about, especially in the UK at the moment, there's a documentary that came out that talked about ADHD diagnosis and misdiagnosis. And although misdiagnosis makes a lot of sense, it's really important that you get the right diagnosis. A lot of people have been there where they were misdiagnosed with something that wasn't ADHD, and then would have liked to have known that it was, in fact, ADHD. It's also really important to get diagnosed if you can, because the alternatives, particularly when looking at this research, is to feel shame, feel different feel lazy or stupid. Feel social anxiety and difficulty relating to others and have no concept that it may be ADHD.

Sarah 26:05

Yeah, just assume that it's a moral failing of some kind.

Skye 26:08

Yeah, that's awful. Yeah. And that's one of the reasons why everybody talked about wanting to go back. I've definitely had that experience of going like, maybe I didn't want to get diagnosed at the end of my academic career when I was already done. Basically,

Sarah 26:25

yeah, that's something that we see with a lot of clients who are sort of late diagnosed, especially as sort of the older they get worse those feelings can be.

Skye 26:33

Yeah, so definitely, yeah, it's important to get diagnosed if you can, but it's also very hard. I know that one of the quotes in this article was actually they said, for many women, ADHD falls under the category of illnesses you have to fight to get. And that's a quote from Steiner. And I definitely related to that idea of having to fight to get it, you know, it's expensive, it's hard to access. It's hard to find somebody who would take a woman diagnosis is very different, in many ways. So, yeah, it's just brought all of that back up to the surface and brought that all home for me. I'm sure it was the same for you, Sarah. I had

Sarah 27:14

to convince my psychologist to even screen me because he was not convinced that it was ADHD. And I was like, let's just do it for fun. Definitely.

Skye 27:25

Yeah. Yeah. And I know a lot of our coaches he read their bios is like, they asked for a diagnosis after ABC. Haven't Yeah, yes. Experience. Yeah.

Sarah 27:38

This is why we talked about self advocacy so much in coaching, and really just mental health in general.

Skye 27:44

Yeah, definitely. So let's go on to theme two difficult relationships. And we will get to theme four, which is self acceptance, so it does get better gets better. Yeah. In this paper and in life when you're diagnosed, hopefully. So the second part is, yeah, that idea of difficulty in your romantic relationships, how to get into and maintain romantic relationships, having difficult childhoods difficulty with your relating to other people who don't understand you, or feeling like somebody said, they felt like they were living in the wrong family, which is interesting experience. Definitely very tough. So yeah, both of those relationships, that was a theme as well.

Sarah 28:29

Yeah, really sad family romantic relationships with teachers, pretty much everyone. And it's not hard to understand why, given what we just discussed in theme, one, sort of when all of that becomes your internal sort of self talk, it just changes who you are as a person and how you can relate to other people.

Skye 28:47

Yeah, definitely. Definitely, it makes a huge difference, especially as we said, for the first one, you don't know at this point that this is ADHD. So this is just you not doing things correctly, and feeling out of place, essentially too loud. I definitely relate to the to loud part. I will say as somebody who has combined type ADHD, I'm not a quiet person. I don't know if you know this, I have a podcast. But you know, I remember distinctly as a young person, always worrying about interrupts, which, as it turns out, is a marker for ADHD. But I didn't know that at the time. I just knew I was a person who accidentally interrupts sometimes, it's so easy to just constantly have that feeling of just being too loud or not paying attention enough, all those kinds of things. So theme three was the lack of control, which I thought was really interesting, because wanting control is definitely something that I've experienced and understood, but I always thought of that more as a mental health thing. Not so much as an ADHD thing, and I found that this was probably the thing that I was the most surprised to read about, what did you think, Sarah?

Sarah 30:03

So I think it's important to note that this is not talking about a lack of control, like in an impulsivity way. It's sort of talking about just feeling out of control of your life, sort of like somebody else is reaching in and like pulling the strings and making you do the things, or things are happening to you, instead of like you are doing the things. It's obviously something that leads to a lot of distress, psychologically, it's bodily autonomy is just one of those like basic needs. Yeah. Fair enough that they sort of talk about, yeah, motivation framework as well. Yeah. So I definitely also can relate to sort of feeling like I was out of control of my life, like it was just happening around me. And I was just hanging on and trying to make sure that I kept going with it.

Skye 30:53

Yeah, I think I had a mantra, which was like, just keep going, you know, that was kind of my mantra was just like, keep stepping on the rocks, you know, over the beach. Some of them are wobbly, but just keep moving. And you'll get to the other side. And now looking at this, I'm like, Oh, that makes sense. Because nothing felt as very much in control. It was all just kind of like, good day, bad day. Good paper, bad paper kind of stuff. Yeah, I do think it is interesting. One woman talked about in grad school, if she got an A plus, or an A, she felt like, oh, it's an easy class. But if she didn't do well, she think I'm supposed to be able to do this, but I still can't do this. And there was also a little bit of a feeling of powerlessness and your ability to cope with life. So life would sometimes be great. And then sometimes it would be overwhelming. And there was sort of a lack of an understanding of why what was going on. And, and I feel like a lot of that comes down to if you have no idea you have ADHD, you also have no idea that you struggle with time blindness, the timeline, find this is even a thing, that working memory from memory. Yeah, that, you know, you might have impulsivity, or maybe that that next decision you're about to make is not a decision you're making 100%. Because of you it might be because you're bored. It will dopamine, there's just so many underlying factors that we are not taught at all.

Sarah 32:19

Yeah, so just sort of building off of what Skye just said, you know, that feeling that lack of control, sort of not knowing why, you know, obviously, it relates back to some of the negative feelings that you have about yourself, because you have undiagnosed ADHD, but it sort of all clears up. Once you get that explanation, all of those things you're able to sort of point to and say, Oh, I understand why this happened.

Skye 32:44

Yeah, no, I agree. I agree. I mean, I would say, maybe not immediately when you get the diagnosis. But hopefully, after a while, when you work with somebody who can teach you a little bit more about your ADHD. It's a lot of what we do in coaching as people like I was diagnosed, and I was given some advice, but it's limited, and I need help to figure out the rest of it. And that's often the first thing we do is actually just explain some of these things. But that does bring us on to theme four, which is self acceptance after diagnosis. And this was also very related and more of a positive was the feelings of relief, the ability to gain control over your life, the self acceptance that people discussed experiencing after they were diagnosed, which I think again, speaks really, really well to the idea of diagnosis and the importance of knowing who you are and what's going on in your life.

Sarah 33:40

Yeah, it can be a bit of a rocky road, when you first get that diagnosis, you'll probably go through I always say like, what stage of grief, are we in over this? Because you know, you do you sort of you might have that initial reaction where it's like, Oh, my goodness, this explains everything I do. And I knew it wasn't me this whole time, or just me, I should say, but then naturally, that'll sort of lead to a period of self reflection, where you're sort of taking stock over however many decades, and sort of going, oh my goodness, what if and that's just sort of like a call back to the last one where you genuinely were sort of lacking in control because you were not in control of your symptoms, I guess. But then once you make it through that, once you sort of let yourself do that thing, that self reflective thing, then you can start sort of gaining new coping skills and say, Okay, well, I know I struggle here. So let's do this about it. It just clears a lot of that blame and that shame. Yeah,

Skye 34:43

it externalizes that as well. Like, even the way you just said it. It's like this is working. This isn't working. This is a thing that I'm struggling with. It's not about me and a moral failing that I'm having.

Sarah 34:55

That's so interesting, because that kind of ties into Act, which is that acceptance to come It meant therapy that we were talking about in the past. It's a really good therapy for people with ADHD, particularly people who are late diagnosed, because it sort of teaches you to instead of say, I'm anxious, I feel anxious. Yeah, take the time and the effort to externalize that emotion because then you're more, you know, in control of it, then it's not you.

Skye 35:22

Yeah, and as they mentioned here, gaining control. You know, they said many women reported it was only after diagnosis, they were able to feel more in control of their symptoms. It allows them to see things through different perspectives. So people said, I'm not lazy, my control really improved. What I thought was weaknesses in character are actually adjustable things that are just differences in the way we're working. And it did have a positive effect on on their life and ultimately lead to self acceptance. Beautiful. Yeah, there's so many great quotes in here, just people's experiences. If you want to read some, you know, definitely check out the paper, it's actually open access. Yeah, it's open access. So it's, you can go and read read the paper for yourself as well. It was really nice, as tough as it was to read all the other parts reading about that self acceptance, honestly, maybe a little bit emotional. You know,

Sarah 36:17

I definitely got emotional reading this study, mine came more towards the well like all throughout, but that's only because I I read the study out of order as I tend to do, but the last sentence actually really got me. Yeah, it just says, um, women and girls are too often suffering in silence being left out of the ADHD narrative, it is imperative that these women are not forgotten. I can't even say it,

Skye 36:43

ya know, 100 percent, it is so important. And they talked a lot in this paper about how women with ADHD do not necessarily get to get a diagnosis in the classroom, which is where most of our ADHD support systems are based. Especially historically,

Sarah 36:50

the statistic was 40% of teachers were unable to recognize ADHD symptoms and girls.

Skye 37:04

So a lot. And a lot of the papers we've been looking at with ADHD, they test based on symptoms teachers found in the classroom. And sometimes if you want to get diagnosed with ADHD at all, some people won't give you a diagnosis unless you have proof from your childhood, from what was written down by your teacher of your ADHD. And so again, this is just harder to get if you have ADHD, and you're a woman because maybe you've masked super, super well. And they referenced that the idea that women with ADHD can really struggle with burnouts can really struggle with masking. And you know, it can be so frustrating to be like, Oh, I'm sorry, did I do a really good job of being normal? And now I don't get to have my diagnosis. Good. Yeah, I'm sorry. I did I did. I try really hard to sit still, even though it was impossible. And I wasn't actually paying attention, because all I was doing was focusing on sitting still, like, I'm sorry that I did not, you know, have enough ways in which my life was annoying you and therefore you notice that this was happening. So that's kind of the thing. It's a bit of a diatribe. Sorry.

Sarah 38:31

Yeah. No, yeah. You're not the only one, though. Yeah, so relatable.

Skye 38:36

So just to go through some of the limitations as well, there were a few. The study included relied on subjective measures. So self reports, interviews, they also relied on self reports of childhood, which similar to the previous paper we talked about, there could be a memory bias, especially since it's very far in the past. And also, they mentioned the small sample sizes. So generalizability might be limited. I mean, papers that are qualitative and never expected to be widely generalizable. That's kind of one of the limitations of all of these kinds of papers, but they did mention it as well, specifically, I think a small number of papers and a small sample size makes us a very limited experience kind of paper overall. But there were no funding, no competing interests, nothing like that, except for the interest of somebody wanted, as they pointed out, to better understand ADHD, their own experiences.

Sarah 39:36

I think that's so cool. I still do. Yeah,

Skye 39:39

no, definitely. So yeah, I think overall, this was an amazing study. I really want to talk to some of the people who did this. I'm definitely going to be reaching out to them. If you wrote the study, expect to get an email from me because I really want to talk to you. I think that the practical takeaway of this is You're not the only one. A lot of other people have experienced this. A lot of women have experienced late diagnosis. It's an emotional roller coaster. It's emotional to read, as we've just experienced, it's emotional to live. And yeah, you're not you're not alone. There's a lot of other people experiencing this. And it's so important for this reason to be more of an advocate for ADHD diagnosis for the people who want it, because this is what happens. This is the shift that it can have.

Sarah 40:32

Yeah, and, you know, just to add to that, one person's experience with ADHD is just that, you know, we all sort of have our own experiences with ADHD, we might have a different sort of combination of symptoms than someone else with ADHD, maybe we, you know, we all kind of cope differently with different mechanisms and things like that. So if you sort of know someone who has ADHD and go, Oh, they don't really don't really seem like me, that doesn't actually mean that you don't have it just means that like you're an individual who may or may not have ADHD.

Skye 41:06

Yeah, exactly. And we were adults, you know, we're gonna have developed our own coping mechanisms, good and bad, complicated. Law and have that's going to play a lot into how we experience it as well. So yeah, so we've we had basically today, we've talked about two really interesting papers, both of which I think, have been really good and really big in terms of the way that they, even though they are subjective papers. And I think that's important. And they rely a lot on self reporting, which is an important limitation. Again, they do both really look at moving forward or trying to move forward. A little bit of what ADHD is, and what ADHD can be both in terms of pupils experiences of diagnosis, but then also pupils experiences of intrinsic motivation and how they get themselves to do things, basically.

Sarah 41:57

Yeah, I thought it was really cool to take a sort of inside look at, you know, motivational theories, that yeah, that was a new field for me, when that I will probably be spending some more time looking into and then, you know, the last one was just really validating, it's like, oh, I had that experience, and that one and that one, and it's, you know, it really just adds to that whole feeling of community, you know, not only just finding people who also have ADHD and can sort of share some of your experiences, but also finding people who have experience with late diagnosed G because they're going to have a slightly different experience.

Skye 42:34

100% I mean, on a personal note, this was the first time I've seen somebody write an article and say that they have ADHD in the article. So in terms of finding a community, it was nice to just have somebody else be like, me, too. I really appreciated that. Yeah, long, long. may it continue. May we all acknowledge and feel safe to do so. Yeah. Well, that's it for this week. And we'll see you guys in two weeks with another interesting research recap. Thanks for listening. If you'd like to reach out or connect with us, you can leave us a message and admin at unconventional organization.com.

Sarah 43:15

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Skye 43:29

If you'd like to learn more about what we discussed here today, or you want to read the transcript, you can find that on our show notes page at unconventional organization.com.

Sarah 43:38

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Skye 43:55

Thanks so much for listening. And we'll see you back in the ADHD lab next week.