Sarah's Story: Multiple ADHD Diagnoses

By Sarah Goncalves

I will never forget when the developmental pediatrician sat with me and my husband and told us our four year old had been diagnosed with ADHD. Her next question sent a million emotions through me at once. "So, which one of you has ADHD?" She sat expectantly as we both looked at each other, confused. I considered for a minute and replied "neither of us." She patiently explained that ADHD is an inherited condition, and it was likely one of us had passed this down to our child.

Over the next several days, we made many follow up appointments. We met with the pediatrician to discuss initiation of therapies and medications, school accommodations, and strategies for behavior modifications at home. As any parent knows, making medical decisions for your child is one of the hardest things you can do. It was a constant battle of good and bad communication, time management, coordination of appointments, and constantly questioning if we were doing the right things and all we could for our son and our family.

(Above: Our son at age 4 during ADHD testing)

The gold standard treatment for ADHD is stimulant medication combined with cognitive behavioral therapy, and started him on both soon after the diagnosis. We read many conflicting recommendations, reviews, and comments regarding medication. In our experience, we got our son's real self back. It was evident from the first few weeks that the symptoms of this disorder were controlling his life in many ways, and with the addition of stimulant medication, we were able to improve our connection with him and ultimately help him grow and thrive.

As we began these initial therapy meetings, I began to have flashbacks to my own struggles in adolescence and adulthood. In middle school, I exceled at math, and soon was moved into the accelerated program midway through the semester. I struggled to fill in the gaps I missed in those months, and ultimately thrived after a few tears.

In college, I couldn't help but notice how my study habits differed from my roommates. While their programs were project- and presentation-based (marketing, business), mine (pre-medical) was heavy on memorization and preparing for graduate school. I assumed many of my classmates also were studying as hard as I was to achieve the required grades to be admitted to our respective medical programs. I met with a few counselors during my undergrad, all of whom were dismissive of my concerns, stating "you would not have made it through high school and this program if you had ADHD."

In graduate school, surrounded by my peers and classmates studying the same subject, I quickly realized I was spending much more time memorizing and understanding the material. I met with another counselor who assured me "I would have never made it through undergrad without a diagnosis." And I settled for envy that my classmates could learn the material so quickly and wondered what I was doing wrong to have to work so much harder to earn slightly lower grades.

As I entered into my PhD program, I hit a wall I didn't think I could make it through. It was the first time I'd been in a program that didn't incorporate the movement and lab hours that better met my learning style. I couldn't read the research, I couldn't sit for 3 hours and listen to a lecture, and I was ready to quit. Looking back, I wonder how many children arrived at this place much sooner in their educational journey? Thinking they're just not smart enough to go on.

I relayed this history, once again, to a neuropsychiatrist at the age of 31. He smiled politely across the desk as I shared my concerns, a look I distinctly remember so many offering me prior to this visit. I had the energy for one more try before I conceded that life was just going to be a bit harder for me than it was for everyone else, it seemed. There was a palpable change in the atmosphere of the room when I added that my child was recently diagnosed with ADHD, and that led me to seek out this evaluation based on the recommendation of the developmental psychologist. I felt like all of a sudden, I was being heard.

As I progressed through the four hour testing, I was discouraged as I breezed through many of the exams. Abstract thinking, mathematics, and word associations. I was sure they were going to again wonder why I was even there, wasting their time. Until I got to the attention task. I won’t compromise the validity and reliability of the standardized test here, but I had flashbacks of struggling with an extremely simple task that my brain just couldn't complete. The follow-up appointment began with a solemn-looking physician explaining how extremely poorly I had performed in the area of sustained attention, while excelling in all the rest. He illustrated how I'd been able to compensate for the low attention with elevated intelligence, outwardly appearing as if I was "average" and therefore unlikely to be considered to have a disability. I remember feeling relieved and anxious all at the same time.

Having seen how well my son responded to medication, I was eager to see if I would have the same benefits. Initially, I was extremely angry. Not as a side effect of the medication, but the healing. I couldn't believe how much easier everything was. I could concentrate on my patients, could complete my daily therapy notes on time, and could pay attention during a conversation with my family. While I struggled with the correct brand and dosage of medication, I knew it was going to be invaluable to me in my daily life.

Soon after, we began to see similar signs of ADHD in our daughter. While our son displayed some classic signs of ADHD (difficulty at school, sitting still, and waiting his turn), our daughter struggled with anxiety, emotional regulation, and following directions. I saw myself in some of her struggles, and she was also diagnosed at the age of four with ADHD. Even having had previous experience with the diagnosis, the struggle of balancing two children with special needs introduced an elevated workload to our family. Understanding their shared and separate needs, the dynamic of the relationships between themselves and us, and being their safe space as they navigate systems that aren't made for them. We were determined to do everything in our power to minimize their struggling and advocate for their success.

(Above: Our daughter giving an unprompted yet perfect example of ADHD during testing)

Over the past several years, we have all learned to adapt to our new path. What we thought we knew about raising children was now defunct. One of the first recommendations from our pediatrician was a parenting class for parents of children with neurodiversity. It was life-changing. Based upon positive parenting principles, we learned how our children were likely to respond to traditional punishment and consequences, and we saw real-life examples of the warnings immediately. Slowly and painfully, we adapted our parenting style to the exact opposite style in which we were raised with and currently surrounded by. We educated our family, friends, and teachers on how our children learn differently, and exhaustively explained why stricter punishments weren't going to improve their behaviors.

We have learned to be fierce advocates of not only our children but the neurodiverse community. Assisting them with navigating a world built for different minds by helping them succeed and grow with whatever support they require. We have initiated 504 plans and behavioral interventions in school, scheduled consistent meetings with teachers to encourage positive support and reinforcements to allow them to receive equal education, and attended constant medical appointments as they navigate personal growth and milestones in their own journeys.

At the ages of eight and ten, I was excited for the opportunity to share an example of what lies on the other side of this diagnosis. I struggled through many emotions from diagnosis until now, and would have welcomed the knowledge that I wasn't alone. Through my personal journey, I know they can grow to be happy and successful adults. Watching them grow and learn, there have been many difficult times but also wonderful moments that shine through as they overcome their individual struggles and reach both inchstones and milestones in their development.