The Dilemma of Disclosing An ADHD Diagnosis To read the full blog visit
Dr. Rostain:
In our in our town, Dan Gottlieb, who does this thing called Voices in the Family, wanted to feature adults with ADHD, and he wanted me to find a patient who would come on. I literally had to ask about ten people before one of them said sure.
I said, look it’s no pressure, and none of them said it was about the being in a conversation. It was all about – I don’t want to be disclosing this on the radio. I don’t want to be found out.
So it really made me think about how easy it is to overlook this. We in the clinical world can think, oh I’m giving you a diagnosis; hey you should feel good about that, right? You should be ready to roll, and let’s get going. But for people to actually have to then not only process what it means to them, but how do you talk about it with people?
In a world that: a) doesn’t buy the ADHD diagnosis – you know thinks it’s like an Oprah, or a Hollywood invention on the one hand, or b) you’re in a job, and you don’t want your co-workers to start looking at you like, hey we’re not sure we can trust you.
If the ADHD diagnosis could be less stigmatizing then, boy the world would really look different, but right now I think of it something that everybody has to consider – how and when are they going to disclose, and who can you tell?
Should You Disclose Your Child’s ADHD?
Dr. Rostain:
Kids don’t have a choice, their parents find out, they tell the teacher, they get this special IEP or whatever they need, they get the meds, but even there it’s stigmatizing.
A funny story I remember, it wasn’t so funny at the time, but I really think about it. This mother came in one day and said, you know I told his teacher and I told the principal, but I didn’t tell anybody else, and I went to pick up my son the other day from school, and one of the secretaries from in the office yelled across the playground and said, “Did you give Tommy his medication today? He really was out of control.” In front of all of these parents, and the mom was livid.
So I just said to her, I think this is an important message. You have to go back to the school and say listen, the fact that you know about my child and that you’re responsible for his education does not give you permission to broadcast it.
I would say the same holds now, especially for when college students, and some high school students are applying to college. A lot of them really don’t want it to be disclosed, especially if they’re trying for a competitive school, because they’re afraid that that will be held against them.
So even the decision – will I go for an extended test time on the SATs? or what have you. Even that decision becomes an issue of disclosure and is subject to, is this or isn’t it’s not going to get me in trouble down the road?
Who Should I Tell About My ADHD?
Dr. Rostain:
So I think on all levels how you talk about it, and who you tell is really important, and I don’t think clinicians spend enough time on that because it’s actually a decision you have to make every day, consciously, or else it’s made for you.
For example. if you don’t say anything, and then suddenly you’re appearing in front of your supervisor, and he’s saying “Hey what’s up here? You’re late with your reports.” What do you do in that circumstance? Do you say at that moment, listen I have an explanation. Or, do you just buy into, “I’m not performing”?
People who don’t say anything, often times what they end up is learning the hard way that they’re not called ADHD, they’re called: underperforming, lazy, careless, unreliable. Huge. Unreliable. That word is like toxic. And then of course they’re tired of hearing from people they know, like, “You know you really need to remember to take your medication”. That’s another one of those you know? On the one hand it’s a mixed blessing, like okay, someone’s watching out for me. They can tell I haven’t taken my medication. But it does kind of put you in the child role.
So, we talk a lot about that too. How do you disclose, and how do you get the person who’s helping you to remember things? To talk to you like an adult, not like a kid who’s just been bad.
Shame, Fear, Stigma and Internal Stigma
Rick:
Stigma comes from fear. Fear of what others might say, but ultimately the person who has the final say is you, and in fact you may be stopped not by just what others say, but what your own beliefs are telling you.
Dr. Rostain:
We’re focusing right now on the stigma of what the world thinks of you. That’s part one of stigma – how does everybody take the diagnosis? I think that’s why discussions like this are so important, because it demystifies and gets people to understand this isn’t made up, and it’s not an excuse.
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