Coping With the Stigma of ADHD
Tired of battling other people’s opinions about ADHD? Learn how adults with the condition and parents of children with ADHD can ignore the stigma, and also discover the best time to tell people about your diagnosis.
There’s nothing shameful about having attention deficit hyperactivity disorder (ADHD) — or at least there shouldn’t be. But in our society, people who have the disorder are seen as somehow “defective,” despite ample evidence suggesting that people with ADHD can be just as competent, personable, and skilled as “normal” people.
Can this stigma be avoided? How can children and adults with ADHD avoid being the victims of ridicule, contempt, or discrimination? ADDitude‘s Carl Sherman, Ph.D., posed these and other questions to Stephen Hinshaw, Ph.D., the author of The Mark of Shame: Stigma of Mental Illness and an Agenda for Change (Oxford). Dr. Hinshaw, who chairs the psychology department at the University of California, Berkeley, has done pioneering research on ADHD and the ways it affects children and adolescents.
Why does ADHD carry a stigma?
Despite evidence to the contrary, many people still don’t believe that ADHD is a bona fide medical condition. They see it as an excuse for sloppiness or laziness. The fact that ADHD symptoms appear to come and go, depending on the situation, only feeds the doubters’ contempt. They say, or think, things like, “Why can’t you pull it together? You’re fine with certain friends — how come you can’t sit down and do your homework?”
Another factor is the widespread negative feeling about the use of psychiatric drugs. In recent years, there’s been a surge in the number of people taking medication for ADHD. Some wonder if this increase is justified.
Finally, the fact that ADHD can undermine academic performance worsens the stigma. Our society seems to think, “If your grades are poor, you’re not worth much.” This is especially true if the cause of poor performance is hidden, as it is with ADHD.
What harm does ADHD stigmatization cause?
There are obvious things, like social problems and workplace discrimination. But the greatest harm often comes from self-stigmatization — that is, when people with ADHD internalize negative stereotypes.
In the course of my research, I’ve gotten to know hundreds of children who have ADHD, and I’ve heard many say things like, “I just can’t make it,” or “I’m just not cut out for school.” The stigma has so corrupted their motivation that they’ve given up even trying to be successful.
The flip side of self-stigmatization is denial. You consider the stereotypes of ADHD and think, “That’s not me.” You want nothing to do with such a shameful identity.
People with ADHD tend to have trouble seeing themselves realistically, and the desire to avoid discrimination makes it even harder. For example, if you believe that needing medication proves there’s something wrong with you, then not taking your medication “proves” there is nothing wrong with you.
Who is affected most by stigmatization?
Stigmatization can be difficult for anyone who has ADHD, but the burden falls more heavily on girls and young women. People continue to think of ADHD as an exclusively male problem. According to this stereotype, if a girl exhibits common ADHD traits, there must really be something wrong with her.
Something similar may be operating with adults. Since ADHD is commonly thought of as a childhood disorder, adults who have it, or claim to have it, come under suspicion. The thinking seems to be, “Either you made it up to compensate for the failures in your life, or there’s something very wrong with you.”
What should you do if you hear a hurtful comment about ADHD?
A firm, but gentle, discussion with the person making the remark goes a long way toward raising awareness.
“I have ADHD,” you might say, “and it’s just as real as other medical conditions.” Or you might say, “I work hard, and I bet that you have no idea how demoralizing it is to hear a comment like that.”
What else can people with ADHD do to counteract the effects of stereotyping?
The more aware you are of stereotyping, the easier it is to recognize when it is affecting you. Take racism. Research has shown that, if people understand that they were snubbed or rejected for a job because of discrimination, their self-esteem stays high. They realize that they are not at fault, the system is.
Of course, it’s also important to recognize that negative feedback about oneself is occasionally valid — and valuable. If you believe that all criticism leveled at you is the result of stereotyping, you’ll be less motivated to seek appropriate treatment.
Taking positive action is another way to avoid the negative effects of stereotyping. Joining others in the struggle to do away with discrimination is empowering. So, when you encounter biased, belittling portrayals of people with ADHD in the media, write a letter to the people responsible for those portrayals.
If you’re not already involved with advocacy groups, like CHADD and ADDA, consider getting involved. Or contact your elected representatives to ask them to consider needed policy changes, such as parity. This means putting insurance coverage for mental health problems, like ADHD, on an equal footing with coverage for physical illnesses.
What can parents do to help protect their children with ADHD?
If you’re the parent of a child with ADHD, make sure that he or she understands what that means. ADHD should never be used as an excuse, but it probably explains why your child has trouble doing certain things, and why she or he might have to work a little harder than other kids to get the same results.
Make sure your child’s school understands that ADHD is a legitimate disorder — and that it may be legally obligated to provide accommodations.
How or when should you reveal a diagnosis of ADHD?
It’s a dilemma. If you conceal the fact that you have ADHD, you avoid the ADHD label and the discrimination that can lead to. However, you risk a kind of indirect discrimination. People who notice you being disorganized, impulsive, or forgetful might assume that you are simply rude or lazy.
When is the right time to talk to your boss about your ADHD? When to tell a new friend? It’s a judgment call, and timing is crucial. If your employer has a reputation of being good about providing accommodations, for example, you might broach the subject. Otherwise, it might be better to keep it quiet, at least until you get established in your job. Advice from a therapist or consultant can be helpful.
There’s no need to tell everyone that you or a loved one has ADHD. But if you feel you shouldn’t tell anyone, you’re wasting energy — and reducing the likelihood that you will get treatment.
Secrecy fuels feelings of shame. Better to seek out people and places that make secrecy unnecessary, and open up.