Updating My Diagnosis at 51—It’s Adult ADHD and RSD, Not Anxiety and Depression

I have Adult ADHD. I was diagnosed at the age of 51, last Fall. Sharing this was not easy. In January of 2023, I shared for the first time publicly that I had been sexually abused by a neighbor when I was seven years old. In February of 2024, I shared for the first time publicly that I suffered from anxiety and occasional depression. The support I received in both instances was incredible. I am taking another leap of faith in sharing my ADHD diagnosis. It took a while before I could talk about it. I still wonder how people will react.

ADHD wasn’t something that was on my radar. My wife noted a few behavioral patterns and said it might be worth looking into. I did a quick online screening and then a full diagnostic test. I scored off the charts. At first, I was a little taken aback. I didn’t know how to process the news. When people think of ADD / ADHD, they usually think of young boys who are bouncing off the walls, who can’t sit still.

Adult ADHD is very different. Of course, like any diagnosis, it presents differently for different people. I’ve learned a great deal about it over the past several months. I have continued with therapy, started taking medication and signed up for a coaching program (a combination of group sessions, lectures and one-on-one support).

As difficult as it is to live with ADHD, it might be equally difficult to live with someone who has ADHD. Pam, my wife, has read more about it than I have. Her support has been invaluable.

I will talk more about my Adult ADHD diagnosis and evolution as a mental health advocate on Ep. 28 of “Shining Light on Shadows: A Candid Conversation About Mental Health” on Thursday, April 24 at 7 p.m. ET / 6 p.m. ET. I will be the guest. Dawn Helmrich Neuburg will be the host. You can watch the live show or recording on Facebook, Twitter, LinkedIn, YouTube, Instagram or my website.

*We won't know the exact urls for Twitter and Instagram until we go live. For now, those links go to the main pages on my main accounts on those platforms.

It’s Adult ADHD and RSD, not Anxiety and Occasional Depression

Here’s what having Adult ADHD means for me. Instead of constantly bouncing off the walls, or always fidgeting, most of my time is spent in two different frames of mind, hyperfocused and unfocused. Occasionally I wondered if I was bipolar, or even manic. It turns out that my anxiety and occasional depression were not the diagnosis, but rather symptoms of my diagnosis. I suffer from Adult ADHD and my anxiety and occasional depression are two of the symptoms.

I think that many of the instances when I thought I was depressed could actually have been instances when I was unfocused and just not physically/mentally/emotionally able to perform at the high level that I usually do. As much as I would like to, it’s not just possible to maintain the high levels of productivity that I have when I’m hyperfocused. My body sometimes just says, “No más.” I misread that as depression.

In general, people who have ADHD experience the same challenges, emotions and hang-ups as people who are “neurotypical.” The difference is that for people with ADHD, it’s more pronounced. It might last longer or be felt more deeply.

Rejection Sensitive Dysphoria

Another significant way in which Adult ADHD plays out for me is Rejection Sensitive Dysphoria.

From The Cleveland Clinic, people with RSD often show the following traits:

It’s very easy for them to feel embarrassed or self-conscious.
They show signs of low self-esteem and trouble believing in themselves.
They have trouble containing emotions when they feel rejected.
Instead of losing control of their emotions outwardly, some people with RSD may turn their feelings inward. This can look like a snap onset of severe depression, and sometimes, it’s mistaken for sudden emotional shifts that can happen with bipolar disorder or borderline personality disorder.
They’re often “people pleasers” and become intensely focused on avoiding the disapproval of others.
They may avoid starting projects, tasks or goals where there’s a chance of failure.
They compensate for their fear of failure or rejection by going all-out or striving for perfectionism. However, the downside of this is that they often experience intense anxiety and may not easily make self-care or downtime a priority.

Some of those traits are spot on. Feeling self-conscious, self-doubt, turning feelings inward, people-pleasing, perfectionism. For too long, that was me in a nutshell.

RSD is an intense feeling of anticipating criticism or assuming that someone is criticizing you when they’re not. A simple, “We need to talk” from a colleague, supervisor or even a loved one can send someone who experiences RSD into a tailspin, imagining what that conversation will be like.

When you are your own worst critic, it feels like it’s only a matter of time before someone will find you out and call you out for the things you feel you’re doing wrong. There’s a lot of Imposter Syndrome wrapped up in RSD.

Real Talk About RSD

Real talk? Another challenge for people with ADHD, to different degrees, is certain Executive Functioning. Two examples. I sometimes have trouble getting myself organized to submit invoices and requests for reimbursement. There’s a part of me that is afraid that they won’t want to pay me, that somehow they’ll realize I don’t deserve it. That they’ll regret the decision to take me on in the first place. That’s never been the case, and there’s no evidence to assume that would happen, but that’s still a real fear.

In another example, I have a client who has consistently praised my work, who has nothing but good things to say about what I do. I still remember a time when they sent a simple email saying, “We’ll have to talk about this.” I don’t even remember what it was in reference to. But, I do remember my mind racing. Despite a ton of evidence to the contrary, and no previous indication that there was any criticism of my work, I still had a hard time convincing myself I wasn’t in trouble.

There are examples I can think of all the way back to high school and college where I think ADHD and RSD were playing havoc with my emotions. I was a good student in high school. I’ve never been afraid of public speaking. But I remember that there were a few occasions when I had to give a presentation – even in my favorite classes – where I just froze and couldn’t go to school that day. Or times when I didn’t start a paper on time because it wasn’t going to be as good as I thought it needed to be.

My wife and I have been together since college. She remembers, and we still talk about, a research paper I was working on for a particular class. I had built it up into a dissertation-level report. There were probably four or five individual papers that I somehow had rolled up into one. I was on the verge of not finishing it because I couldn’t get my final product to match the grand vision I had in my head. She helped me just submit a scaled down version of the paper, just so I didn’t fail the class. I got an “A” on the paper.

The pressure I put on myself is enormous. The expectations are enormously high. It’s just not possible to live life like that every day.

I go through a version of this regularly. It is easy to beat myself up about what I am working on and what I’m not working on. Even when I’m working on something, like this blog post, I question how much time I’m spending on it, worried that I’m getting sucked in. Or, I constantly worry about whether I’m doing enough to promote the shows I’m producing. Did I give people enough notice for the show? Did I set up the livestream links early enough? Did I send the email early enough? Did I do enough with the social media posts?

Things Are Improving

If you’ve made it this far, the good news is that things are improving.

I’ve beaten myself up in the past for small mistakes, ones that may not have even been noticed by anyone else. Over the past few weeks in particular, I’ve dealt with a few issues that were legitimately more significant. As recently as six months ago, I would have gone into a tailspin. I feel like for the most part, I’m more calm. I’m more even-keeled. I don’t get worked up about things the way I used to. Frankly, I almost don’t recognize myself. Although it’s very much a good thing, it just feels very different. I’m not used to it. Something has definitely changed.

Early on, I was told that a little exercise, better sleep and a healthier diet were key factors in managing ADHD. Almost at the same time, my doctor told me that making changes in those areas would help with my diagnosis of pre-diabetes. I haven’t made those changes yet, but I know I have to.

One of the things I keep thinking about: Would things have been different if I’d known about ADHD/RSD when I was younger? What if I had been diagnosed when I was in high school or even college? ADD/ADHD was treated very differently back then. I don’t know that I would have gotten the same kind of support then as I am getting now. One person told me recently that I found out when I was ready to find out. If that was at the age of 51, then so be it.

Calibrate ADHD

I do want to give a shout-out to the coaches and fellow travelers at Calibrate ADHD. I did my testing through them and then joined the coaching program. I’ve learned a lot about myself and have learned a lot from the other participants. Although I’ve been in therapy my entire adult life, I’ve never done group coaching sessions before. The coaching has made a big difference. I still struggle at times, but now I have a better understanding of why I feel the way I do AND I have a strong support network.

If you’ve thought you might have ADHD and want to get tested, or if you know you have ADHD and you’re looking for support, feel free to reach out to me. I’d be happy to tell you more about my experience.

The more we talk about it, the more we lower the stigma, right?