Women and ADHD

"There's just always way too much stuff going on in my head," says Michelle Suppers, of Manassas, Va. She is among a growing number of women who have been diagnosed with attention-deficit hyperactivity disorder, or ADHD.

WASHINGTON -- At a few minutes shy of 3 p.m., Michelle Suppers pulls her minivan into the parking lot at a Catholic school in Virginia, where her son, Anthony, attends first grade.

For most of the mothers already queued up in the pickup line, this is probably not a big deal. But for Suppers, who for as long as she can remember has always been late to just about everything, the effort required to plan her day, watch the clock and make it to the school on time is nothing short of Herculean.

"I lose track of time," she says, flushing pink with embarrassment.

On the console beside her seat in the van are two library books she needs to return. Both are overdue.

Anthony, 6, dressed in his nicely pressed blue uniform shirt and gray pants, smiles at her as he climbs into the car seat behind his 3-year-old brother, Christopher. Anthony chatters nonstop about the art project he did, what he ate for lunch and how he had a "green" day. A green day means he didn't interrupt the teacher, pester his classmates, jump up from his seat, fidget, forget to turn in his homework, space out wondering about the clouds outside the window or stare at the blank paper on his desk that is supposed to be filling up with classwork.

Suppers, 30, pulls out of the parking lot and begins to explain that Anthony has attention-deficit hyperactivity disorder, or ADHD.

"Mommy," Anthony chirps from the back of the van.

Though he's smart, he has a tough time sitting still, getting going on things that bore him, such as homework, and is easily distracted or frustrated in school.

"Mommy," Anthony persists.

And how, the more she learns about his ADHD, the more she wonders --

"Moooommmy!"

-- if she has it herself.

'The way I am'

Since Suppers quit a job a few months ago that she loved but felt she couldn't manage along with the house and the kids, she also is bracing herself for what is now her most stressful time of day: managing to keep their two dogs outside and Christopher downstairs in the playroom so the living room will be quiet. That's where she helps Anthony with the homework that is always a fight to get him to do.

The living room is neat despite the understandable chaos of toys and balls and piles of newspapers that come with busy family living -- the result of yet another late-night effort to tidy for company.

But in the kitchen, the counters and table are awash in scraps of paper, kids' artwork, opened and unopened mail, bills and toys. For meals, Suppers sometimes shoves the clutter to one end, and the family eats at the other. Lately, they've taken to eating in front of the TV in the living room.

When the homework battle has finally finished, her husband, George, arrives home. He takes over cooking dinner when she gets distracted looking through piles of paper on the counter for a sticky note he left her about a car repair the week before that she forgot about.

He is convinced that she has ADHD. He teases her that she has never made a decision in her life, not even about what to order for dinner. "There's just always way too much stuff going on in my head," she says. "It feels kind of silly trying to make serious conversation about it. Other people have it so much worse. I think if I didn't have the kids, I'd think, this is the way I am, so whatever. But I worry about passing it on."

Later that evening, after the boys are in bed, George finds an online ADHD screening quiz and has Michelle take it. Based on her score, she is advised to seek out a trained mental health professional. "Immediately."

The questions

Though she'd never really heard of ADHD before, Suppers first began to suspect she may have it in the summer of 2009.

Anthony was 4. He was a sweet, smart kid, but he couldn't sit still. He argued constantly. And he was getting into impulsive fights with other kids at two different preschools. On the advice of a concerned teacher, she took him to a behavioral specialist who gave her and George reams of questionnaires to fill out.

As they sat on the couch late one night completing the paperwork, Suppers began to see not just her son, but also herself. As a child, she was so wild that her Peruvian mother nicknamed her Terremoto Michelle, which in Spanish means "earthquake," and had a "Hurricane Michelle" T-shirt made for her.

She was always racing around, wrestling with the boys, talking a mile a minute and breaking things. She felt different but kept it to herself. And even though she went to a private Catholic school and spent hours with tutors, she had so much trouble learning that she thought she was just stupid.

That was what finally got her to take Anthony to the behavioral specialist. "Anthony started to say, 'I'm just so stupid. I can't do it.' " Suppers says. "That took me back."

Suppers herself had wanted to go to college. She dreamed of being a law enforcement agent for the FBI. But she didn't last more than a few weeks at community college. "I don't want him to feel different, like I did."

On the questionnaire, one question in particular hit her: "Does your child exhibit any repetitive or self-stimulating behaviors such as spinning, rocking, lining up toys or head banging?"

That wasn't Anthony. But it was her. She has always rocked. Even now. George just gently puts his hand on her arm to still her whenever they watch TV.

"Does that mean I have ADHD or should have gone to a doctor?" she remembers asking the behavioral specialist at their next appointment.

"No," she recalls the specialist answering matter-of-factly. "It means you should have been on medication."

Looking for answers

Suppers began reading about ADHD, often late into the night, and discovered that once it is diagnosed in a child, studies have found a 40 percent chance that one or both parents also have it.

It would take her more than a year, but what finally gets her to this nondescript waiting room at Family Medicine of Clifton/Centreville to pursue her own diagnosis was hearing about a friend's brother. He, like Suppers, had always struggled. Then his ADHD was diagnosed, and he began taking medication. All of a sudden, he became the person he always thought he should have been.

Physician Janine Brown calls Suppers into an exam room. Suppers begins to explain her problems with school, being hyperactive as a child and how the house is a mess, how she still talks too much and too fast, constantly forgets things, spaces out in the middle of conversations, rocks and can't sleep.

Brown explains how diagnosing ADHD is an imperfect science. And because most evaluations are designed for children, diagnosis is even more imperfect for adults. All that doctors have to go on, Brown explains, is what people tell them about their behavior. And since anyone would benefit from what are, in essence, performance-enhancing drugs, Brown says that doctors have to be particularly careful to prescribe them only to people who really need them.

"We all have moments of trouble focusing, but are you OK in your life? It's when you can't function that it becomes an issue," Brown explains. "As working moms, our houses are going to be dusty. They're going to be cluttered. That's just the way it is."

She decides to send Suppers to a psychologist for a formal evaluation.

'All jumbled up inside'

At the psychologist's office, Suppers sits stiffly on the edge of a chair and talks fast, interrupting herself, digressing and coming back to elaborate on points she'd made earlier, leaping decades forward and backward as her life story spills out.

The psychologist goes down a checklist. Difficulty concentrating. Distracted. Disorganized. Restless. Fidgety. Impulsive. Mood swings. And, finally, excessive talking.

The psychologist stops Suppers. "There's a party going on in your head. Everything's all jumbled up inside, and you don't know where to begin?"

Suppers nods.

"And this has been going on since you were a child?"

Suppers nods again.

The psychologist sets down her notebook. "You meet all the criteria."

Michelle Suppers is officially diagnosed with ADHD.

The psychologist tells Suppers that now she needs to work on learning life skills to better manage the disorder. She recommends some sessions of cognitive behavioral therapy and coaching. And if Suppers wants to see whether medication can help clear the fog in her brain, the psychologist tells Suppers to go back to her doctor for a prescription.

"You help yourself," the psychologist says, "you help your son."