Why I’ll still be taking pills even if I get pregnant: a follow-up

A few months ago, I shared a post in which I revealed I’m planning to continue taking my ADHD medications even if and when I someday get pregnant. I explained that I literally wouldn’t be able to afford to stop taking my daily dose of CNS stimulants; sans pills, I can barely function, which means I would be unable to work (or even drive to work, for that matter). In short, I would have to risk exposing my unborn child to all manner of adverse health outcomes in utero.

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As it turns out, however, such exposure may be far less likely than originally thought. As reported in a Nov. 29 ADDitude article, “The risks associated with taking an ADHD stimulant medication during pregnancy are real, but quite small,” according to an extensive population-based study published last month in the journal Obstetrics & Gynecology

In the study, the authors examined a cohort of pregnant women “and their liveborn neonates” enrolled in Medicaid from 2000 to 2010. They compared women who took Adderall or Ritalin alone in the first half of pregnancy to unexposed women, and women who continued to take the medication past 20 weeks’ gestation to women who discontinued.

The takeaway? 

Psychostimulant use during pregnancy was associated with a small increased relative risk of preeclampsia and preterm birth. The absolute increases in risks are small and, thus, women with significant ADHD should not be counseled to suspend their ADHD treatment based on these findings.

This is an indisputably significant development in the field of ADHD research. Until now, studies of methylphenidate (Ritalin) use during pregnancy were based on cases “not representative of the general adult ADHD population having methylphenidate as monotherapy during pregnancy,” according to a 2014 systematic review published in the British Journal of Clinical Pharmacology. That is because “all the articles reported combinations of methylphenidate with either known teratogenic drugs or drugs of abuse.”

But this new revelation is equally noteworthy for what it represents. In the past, discussions of whether women should discontinue their ADHD medication during pregnancy were cloaked in foreboding language, declaring it should only be done “if the potential benefits to the mother outweigh the potential risks to the fetus.” To me, it seems inevitable any woman faced with such tacit guilt-tripping would opt to go off her daily pill regimen — to, in short, prioritize the safety of her unborn child over her own well-being.

Also, this new knowledge has given me a newfound sense of legitimacy. While I’m an ardent feminist, I can’t deny that in Western society, motherhood is held up as the quintessential state of womanhood. So when years ago I found out having ADHD may mean I could not become a mother — at least, not if I wanted to continue to receive treatment for it — I felt like an essential part of myself was forcibly eroded. It was as though I was no longer a real, full-fledged woman because I probably wouldn’t be able to have a baby. And it wouldn’t be for a legitimate reason, like income or infertility; it would, like so many other things, be dictated by my need to take medication, to engage in preemptive damage control of my disability. In essence, it would have meant a disability I had from birth would prevent me from giving birth, myself. And when that dawned on me, one thought repeatedly ran through my mind: “It’s not fair.” 

I don’t know if I’ll ever end up having a baby. As I said in my earlier post, because of the strong likelihood my offspring would have ADHD as well, I would only want to bring a child of mine into this world if I knew it were a world more tolerant of ADHD than the one in which I grew up. Plus, I couldn’t handle single parenthood, and I don’t know what the future holds for me vis-à-vis finding a life partner. 

But with the publication of this study, for the first time in my life, I know if circumstances do align for me, I’ll be able to do what I’ve always wanted — become a mother — without stigma and without the overwhelming fear of putting my baby at risk in the process. 

That’s an invaluable gift. 

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7 things about ADHD I wish I had always known (ADHD Awareness Month post #6)

This is the sixth and final post in my series on ADHD Awareness Month. But rest assured, although the series is wrapping up, I’ll still be publishing writings on ADHD-related issues; just not necessarily so many per month. — DRD


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Having lived with ADHD for as long as I can remember — and even longer — I’ve learned a few valuable lessons about my disability the hard way; I’ve done my share of learning by doing. I can’t help but feel that my life would have been a lot easier if I had known said lessons from day one. I hope that someone out there reads this and they — or their child — can benefit from my experience. Read on!

1. People will tell you to go easy on yourself, but still, expect you to be ‘on.’

I’ve found that even if you tell your manager, for example, that you have ADHD, and he claims to understand that this makes you function differently, his understanding nevertheless flies out the window when you have a deadline to make but quite clearly aren’t going to be able to. 

2. ADHD has nothing to do with your personality or morality.

I spent a horrifying number of years of my life feeling guilty — often, despite not having done anything wrong. And even when I did err, I was convinced that whatever act of misbehaving I had committed was evidence that my character left something wanting. Moreover, I was sure that with the right resolve, I could ameliorate this situation and become a better (read: less ADHD) person. I don’t think I’ll ever stop regretting this now that I’ve realized how wrong I was back then. I’ll never get back the time I wasted feeling guilty for nonexistent or out-of-my-control incidences of ADHD-ness. Don’t make my mistake.

3. You shouldn’t necessarily believe teachers who say, “Oh, I’m so ADD too!”

I was diagnosed relatively young, back in pre-k; meaning that I knew I had ADHD — and all of my teachers knew it too — for all 12 years of my lower education. And I swear, every single year a new teacher would tell me upon learning of my ADHD diagnosis, “OH, that’s totally fine, I’m really ADD too.” Unfortunately, that usually turned out to mean, “I don’t understand ADHD at all, but I think I’ll bond with you by saying I have it and referring to it in the pejorative.” Over the years, I heard many teachers say a lot of stupid, cruel things without seeming even to give it a second thought, but that is not ADHD. There’s a difference between wanting to think before you act and not being able to, and just deciding that you’re so wise, you never need to think twice. In the end, only one of my teachers ever turned out to have ADHD, my AP World History teacher during my senior year of college. How did I know he had it, and that he was the only one of my teachers who did? One day I was sitting in his classroom at the end of lunch when he walked in, looked around his desk, and announced that he just realized he had lost a pair of Bruce Springsteen tickets. I’m totally serious. But you know what? He was also one of the best teachers I ever had. 

4. Medications may “last” 12 hours, but that doesn’t mean you will.

Here’s a fun (by which I mean, not fun at all) fact: Even if the prescribing information for an ADHD medication says it lasts up to 12 hours, that doesn’t mean you’ll be able to use all 12 of those hours effectively. You see, even when medicated, people with ADHD have to expend more energy to complete tasks that seem to take our neurotypical counterparts no time at all. Do that for a full workday, and the remaining man-made focus you have left in your nervous system via medication is reduced to the equivalent of potential energy,  never getting used. (This is a lesson I’ve started learning literally in the last few weeks.)

5. Stimulant medication isn’t the be-all, end-all. 

From ages 5 through 22, I was on some form of the stimulant medication methylphenidate (aka Ritalin). For over 5 years now, I’ve been taking both an immediate-release dosage and extended-release dosage of dexmethylphenidate (aka Focalin). I first went on Focalin because when I was a senior in college, I discovered, to my horror, that my medication did not seem to be working anymore. Like, at all. That’s when I went on Focalin. But just two years later, I again ceased to feel medicated enough on a day-to-day basis. It was then that my PCP put me on bupropion (aka Forfivo), which belongs to a class of antidepressants known as Norepinephrine and dopamine reuptake inhibitors. Later, I also started taking guanfacine (aka Intuniv), a non-stimulant ADHD medication initially formulated to treat hypertension. As it turned out, for me, at least, these Forfivo and Intuniv were the magic bullets of ADHD treatment regimens. 

6. Coffee is your friend.

During my ‘bad concentration’ time of the month, and especially toward the end of it, my verbal acuity temporarily goes out the window. Somehow, this always seemed to happen *right* when I had a big paper due imminently (like, in two days, or even sooner). One day, in desperation, I did some Hail-Mary googling, seeking confirmation that yes, in fact, coffee does help ADHD people concentrate. According to a post published recently on ADDitude, it “arouses the central nervous system by stimulating the release of dopamine and other neurotransmitters, and by blocking the absorption of adenosine, which induces sleep.” I’ve found that a Starbucks frappuccino with a shot of espresso enables me to write even when my medications are at their least potent. Pardon the pun, but I really do think you should give it a ‘shot!’

7. ADHD is nothing to be ashamed of. People should be ashamed to think it is.

…Self-explanatory!

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Why I’m thankful that I have ADHD as a millennial (ADHD Awareness Month post #5)

For an ADHD blogger, you may have noticed my feelings about ADHD aren’t exactly of the warm-and-fuzzy variety. It’s true: I’m far from attention-deficit hyperactivity disorder’s biggest fan. It’s not that I believe this kink of the human nervous system is anything to be ashamed of; in fact, I’ve spent a great deal of my life attempting to convince people it’s not. It has just had too deleterious an effect on my life for me to join the ADHD-is-an-evolutionary-adaptation camp. If I had to be born with ADHD, though, I’m glad my birth year of 1989 classifies me as a member of Generation Y, aka the millennials. 

Technology 

Young asian student on university campus with computer laptop

(Photo credit: Adobe Stock)

I honestly don’t know what I’d do without the internet and my various electronic devices. And I’m willing to hazard a guess that I’m far from the only ADHDer who feels this way. I first knew modern technology would be my ADHD-related salvation in middle school when my math teacher started posting homework assignments online — not just textbook page numbers but scanned copies of our worksheets we could print out if we didn’t make it home with the sheets distributed in class. There was something so liberating about being thwarted by my ADHD, as I inevitably was from time to time, but then being able to reverse the damage right from home, with no one else but my mom the wiser. Of course, not even 2002 Drew could have conceived how integrated the internet would end up being in my education, from googling for research on weekends in high school to emailing professors term papers late at night in college.

As I got older and technology more advanced, I found additional workarounds for my pesky ADHD problem in the form of various hi-tech devices. When I was 22, for example, I bought tickets to a concert in my hometown, but when the day of the show arrived, I realized I had left the printable tickets in my college apartment, a two-hour drive away. Suddenly, I remembered having received a confirmation email I could pull up on my iPhone, which I did, and was granted admission to the concert as a result.

Over the years, the combination of my iPhone and my MacBook Pro has been my saving grace; in a future post, I’ll explain exactly how. But trust me, we ADHD millennials have benefited immeasurably from the ‘i’ revolution.

Treatment

My gratitude for being born with my particular disability in my specific generation is also due in part to the fact that there are a variety of pharmacological treatment options available today. By my count, based on the most recent information on WebMD (last updated in April 2016), there are five short-acting CNS stimulant medications, 14 intermediate and long-acting stimulants, six nonstimulants, and seven antidepressants used in the treatment of attention-deficit hyperactivity disorder. That’s 32 in all. Now, granted, many of these medications are chemically the same drug, just prepared in different strengths and dosages. And I’ll be the first one to tell you it is essential for Big Pharma to prioritize developing entirely new medications for those whose ADHD is unresponsive to any drugs currently available.

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Nevertheless, this is a leaps-and-bounds improvement over the breadth of options (or rather, the lack thereof) on the market not very long ago. Between 1936, when the first ADHD medication, Benzedrine, was approved, and 1982, only six medications were developed and released on the market. And after that, there were no new ADHD drugs for another 14 years, when Adderall first hit the market in 1996. In other words, for almost half a century, a new ADHD medication only became available once every seven years or so. Subsequently, Concerta, an extended-release preparation of methylphenidate I took from ages 13 to 22, was released in 2000; Focalin, the stimulant I’m on now, hit the market in 2001; and the FDA didn’t approve the non-stimulant medication I take, Intuniv, until the year 2009. Imagine if I had been born just a decade earlier: I wouldn’t have had Concerta to get me through all of high school and college, Focalin to get me through my ’20s, or Intuniv to get me through grad school. And I definitely wouldn’t be able to write this post now!

Tolerance

But perhaps the no. 1 reason I’m glad I was born when I was is that in the 1990s, ADHD awareness spread like wildfire. It was unprecedented. There were conferences and self-help guides, not to mention the first issue of ADDitude! And things are only getting better. Gone are the days when jokes about parents putting their kids “on Ritalin when they just…won’t…behave!” were fodder for popular primetime comedies (*cough*”FRIENDS”*cough*). With every passing year, ADHD is shedding the stigma that surrounded it in the past and getting closer and closer to its rightful place in the public consciousness as just another fact of life. And if this is a trend, you know what the very best part about being a millennial with ADHD is? It means the next generation may live in a world that would never conceive of ADHD any other way.

What is it with ADHD people and time, anyway? (ADHD Awareness Month post #4)

You know that song “Time is on my side”? I’d bet you a million bucks whoever wrote it didn’t have ADHD. After all, people with attention-deficit hyperactivity disorder are often — OK, fine, usually — late. Recently, however, I’ve learned that there’s a neurological explanation for why I’ve had to send so many messages to my friends over the years containing some version of this text:15 mins lateApparently, we function on a different timetable. In other words, ADHD people experience time differently

In an article in ADDitude, ADHD specialist Ari Tuckman notes, “Because everyone — not just those with ADHD — feels the present more strongly, it’s difficult to do challenging things now that won’t have an immediate positive impact,” but even so, for people with ADHD, “It’s difficult … to plan for the future because they don’t see the future as clearly as their peers.”

Still, I don’t believe we ADHDers are entirely at fault here.

To feminist philosopher Alison Kafer, the concept of ‘being on time’ isn’t innate; instead, it’s something society has created. What if we ceased to place such a high value on punctuality, she muses — what if we stopped penalizing people for being late, and viewed such punishment as ableist?

Naturally, as someone with chronic ADHD, this intrigued me a lot. But my boyfriend, who is neurotypical, just could not wrap his mind around the idea that our social mores exist outside us, meaning that they could be changed to be more inclusive of people with disabilities (PWD). Now, he is a scientist; abstract thinking has never exactly been my boyfriend’s forte. And yet, in this case, I think it’s just impossible for neurotypical people, much as they may love us, to understand how far removed their world is from ours — or, for that matter, that their world isn’t the only world.

Punctuality can be a struggle for all PWD: a need for “extra time,” according to Kafer,

might result from a slower gait, a dependency on attendants (who might themselves be running late), malfunctioning equipment (from wheelchairs to hearing aids), a bus driver who refuses to stop for a disabled passenger, or an ableist encounter with a stranger that throws one off schedule.

ADHD people practically invented the concept of needing extra time. If you have ADHD, from the day of your diagnosis, you know that you and time will always be at odds. Think about it: The longest-acting CNS stimulant medication lasts 12 hours; but many people, from attorneys to high-school students, work far more hours a day than that — often well into the night. And even so-called regular people, who only work in a professional sense eight hours a day, are born with the ability to concentrate and be at least slightly productive the moment they get out of bed in the morning and only resting their brains after they get back in at night.

That’s not how it is for us ADHD people, though. The simple fact is that it’s impossible to have an average life if you have less than the average amount of time. And not having enough time, well, that’s ADHD 101.

When I was younger, I used to apologize anytime I was even the slightest bit tardy to an appointment or late on an assignment. Now, I’m trying something new. As I near my 28th birthday, I remind myself that life is short; the time in which we actively live, even more so; and for people like me, with only 12 hours of each day at our disposal, time is the most fleeting — and the most precious — thing of all.

I guess what I’m trying to say is that I would feel guilty at my lateness, but I just can’t seem to find the time. 

7 reasons people with ADHD should work from home (ADHD Awareness Month post #3)

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People with ADHD who work from home get to sit wherever and in whatever position is most conducive to their productivity. (Photo source: Adobe Stock)

When I think about the best choices I have ever made in my life, two come to mind. First and foremost was my decision, three years ago, to quit my steady job at a newspaper and apply to the graduate program in WGSS at Oregon State University. But a close second was deciding not to go back to work after I graduated. 

Don’t get me wrong — I still work; just not in an office, and not for someone else: I’ve chosen instead to work as a freelance writer and editor to support myself as a feminist blogger. This is self-employment. And you know what? It is fan-freaking-tastic. Why? Well…

1. You make your schedule. 

One of my greatest downfalls as a ‘traditional’ employee was my schedule. If you have ADHD, you know what I’m talking about: ascertaining when your medications would be in effect and having to plan — or at least trying to plan — your working time around that. Unfortunately, my pill breaks very rarely coincided with my lunch breaks, because I would always unintentionally wake up very early in the morning — We’re talking 5:30, daily — and my morning medications only lasted four hours, maximum. But when you work at home and are self-employed, you don’t have to contend with human resources forbidding you from starting your workday before 9 a.m.; this is especially useful if, like me, you concentrate best in the morning. Also, this builds flexibility into your schedule for the doctor appointments and monthly (and, inevitably, often more than monthly) visits to the pharmacy that come with the territory of having ADHD and taking medication for it. 

2. You choose your position — your sitting position, that is.

Less noticeable to others, but still highly impactful to me, was the unspoken expectation that I would, you know, sit in a chair. When I was working at the newspaper offices, I often interviewed sources over the phone, and apparently, I — entirely unconsciously — used to lean back and twirl around in my swivel chair while doing so. It drove my boss CRAZY. What he didn’t realize, though, is that people with ADHD have the symptomatic tendency to sit in odd positions; that’s how we help ourselves concentrate. (I’m not entirely convinced that it would have made a difference to him had he known, though, to be honest.) At home, I can work sitting on a couch or lying face-forward on my bed under my weighted blanket, and no one can say boo.

3. You have fewer stimuli to filter out.

Newsrooms are obviously an extreme example of this, but traditional, brick-and-mortar offices are hotbeds of cacophony. That’s just the way it is. Ringing phones; copy machines; water cooler talk — you get the idea. Suffice it to say that such an environment is anathema to the ADHD brain. When working from home, by contrast, the only sounds you have to grapple with are the ones you make (see below), which is essential, because “Problems with external distractibility (noises and movement in the surrounding environment) … can be the biggest challenge for adults with ADHD.”

4. You have more freedom to listen to music/use alarms.

A weird thing about ADHD is that dealing with multiple stimuli of external sources, filtering them out and concentrating on your work, is virtually impossible; however, you can enhance your productivity through the use of one, single stimulus: music, of your choosing. I know from personal experience that listening to classical music can have a tangible positive impact on focus; I prefer baroque musicians, including Bach and Albinoni:


On a related note, while phone notifications and computer alert tones are distracting for EVERYBODY, for an ADHD people, such distractions are actually welcome when we have pre-set them to remind us of appointments and upcoming responsibilities. (Additional pro tip: I set my computer preferences to have my MacBook announce the time every half-hour. Try it! You’ll be amazed at your newfound punctuality and time-management.)

5. You aren’t required to sit through seemingly endless meetings.

Raise your hand if you have ADHD and have ever honestly thought you might die while being forced to sit through a long meeting. … Ha! I knew I wasn’t the only one. As I mentioned above, people with ADHD have a propensity to sit in odd positions and to move around if they are required to have sustained attention and direct it to one specific, often profoundly dull thing. Working at home, however, circumvents the requirement to remain stationary of that trope of brick-and-mortar skilled employment, the sit-down meeting. And it’s a good thing, too, because “Adults with the hyperactive presentation of ADHD often do better in jobs that allow a great deal of movement.”

6. You don’t have to contend with rush-hour traffic on your way to and from work.

This reason is pretty self-explanatory. Goodness knows we were driving distracted before ‘distracted driving’ was a thing. Luckily for us, no workplace outside the home means no driving to work, which means no risk of getting in a collision while driving to work — or exhausting all of our remaining focus trying to avoid it. 

7. You get more time with your pets.

This reason is relatively straightforward, as well. Not all of us have officially designated service animals, but pets regardless provide a genuinely crucial service. First of all, people with ADHD, including and perhaps especially young women, often have comorbid depression (I know I do), on which dogs have a proven ameliorating effect. And the petting of furry animals, such as cats and rabbits, has been shown to slow one’s heart rate and reduce anxiety. Free of the distractions of feeling depressed and anxious, it is much easier to get your work done! Don’t already have a pet? Adopt one from your local animal shelter. Easy!

woman working on tablet / laptop at home. Dog helps her

ADHD people who work from home get more time with their pets, reducing depression and anxiety and thereby improving concentration. (Photo source: Adobe Stock)

Why I’ll still be taking pills even if I get pregnant (ADHD Awareness Month post #2)

I’ve always wanted to be a mom. I have an objectively kick-ass mother, so I have an excellent model to emulate. I have a weird knack for relating to the tiny humans of the world, so communication wouldn’t be a problem. And I have ADHD, so I’m intimately familiar with the vulnerability, the lack of being taken seriously that all children experience to some degree. And it would just be a ton of fun: getting to trick-or-treat again…teaching your offspring the subtler points of swinging on a swing set…BABY CLOTHES…need I continue?!

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Focalin 10 mg, one of my daily medications. (Photo source: WebMD)

…ANYWAY, ever since my diagnosis about 23 years ago, I’ve been on some form of methylphenidate, which is one of two go-to pharmacological treatments for ADHD, the other one being amphetamine (aka Adderall). The medication I take now, dexmethylphenidate (aka Focalin) is technically a different drug, but medically, dexmethylphenidate is basically just a more potent form of regular methylphenidate.

Over time, two antidepressants (Effexor and Forfivo) and one non-stimulant (Intuniv) have joined the party that is my ongoing ADHD treatment regimen. Be that as it may, stimulants aren’t just the first-line recommended pharmacological treatment, but the square-one treatment altogether — beating out behavioral therapy and other non-chemical methods — because they’re the most effective. So, yeah, Focalin: kind of a big deal for me.

One problem, though: You’re not supposed to take CNS stimulant medications if you’re pregnant. Well, let me rephrase that. You may continue to take these medications, but in the words of Dr. Patricia Quinn, “the prevailing recommendation is that stimulants should be used during pregnancy only when the potential benefits to the mother outweigh any risk to the fetus.” 

What are the potential risks?

This is from the drug label information for Adderall:

There are no adequate and well-controlled studies in pregnant women. There has been one report of severe congenital bony deformity, tracheo-esophageal fistula, and anal atresia (vater association) in a baby born to a woman who took dextroamphetamine sulfate (a form of amphetamine) with lovastatin during the first trimester of pregnancy.

By contrast, according to an article from a 2013 issue of Basic & Clinical Pharmacology & Toxicology, “Methylphenidate exposure during pregnancy does not appear to be associated with a substantially (i.e. more than twofold) increased risk of congenital malformations.”

Even so, unfortunately, in an article published in the journal Drug Safety in 2014, its abstract states, “[T]here is recent evidence that the rates of fetal loss both through abortion and through miscarriage are increased with methylphenidate.” 

I’ve also read of lower Apgar scores, reduced birthweight, and heart problems. 

So why ignore the risks?

We live in a capitalist society. So even if I stay single and childless all my life, I’ll still need to support myself financially. Translation: I’ll need to be gainfully employed. And sans medication, I lack the concentration even to start brushing my teeth. (I say ‘start,’ because if your ADHD is severe enough, you don’t have to worry about getting distracted — because you can’t even start concentrating in the first place. Yes, I am speaking from personal experience.)

Medications for ADHD are Pregnancy Class C; i.e., you shouldn’t take medication while pregnant because it could expose your unborn child to birth defects and long-term medical issues. However, according to another 2014 article, published in the British Journal of Clinical Pharmacology, “Although the default medical position is to interrupt any non-essential pharmacological treatment during pregnancy and lactation, in ADHD this may present a significant risk.”

The ‘significant risk’ in question could be an adverse reaction to having one’s medication dosage lowered or cut altogether, i.e., withdrawal. But trust me, danger also lurks in the decision to put an unmedicated pregnant woman with ADHD behind the wheel.

Consider the following passage from a recent Washington Post article on the subject:

Christina Wichman, associate professor of psychiatry and obstetrics and gynecology at the Medical College of Wisconsin, says that pregnant women with milder ADHD symptoms can go off meds and ‘do quite well.’ But she also makes the very real point that ‘there are other women with more severe symptoms which interfere significantly with their daily functioning, including ability to work, go to school or impact their relationships, and may potentially affect their pregnancy.’

Ironically, according to the abstract of a 2008 article published in the Journal of Psychiatry & Neuroscience

Children with ADHD whose mothers were exposed to moderate and severe stress during pregnancy tend to develop more severe symptoms than children with ADHD whose mothers were not exposed to prenatal stress. It is therefore important to minimize stress in pregnant women.

All of this is to say that I would take the risk because not doing so would pose a greater one. And yes, those would be my only options, because I’m determined to be able to have a baby. My ADHD has affected me in so many ways: I didn’t find true friends till I was 15; didn’t get my license till I was almost 18; didn’t have my first kiss till I was 21; the list goes on and on. But with this, I’m not going to let my ADHD stand in my way.  In matters of maternity, my disability will not be my destiny. 

 A new world = a new baby

If I do become a mom, it would most likely happen sometime in the next 10 years. When I contemplate this reality, what gives me greatest pause isn’t biological, but sociological in nature. Kids with ADHD are four times more likely to have a relative with it. And, of course, if a child of mine has ADHD, I would want them to spend their childhood (and their adulthood, for that matter) never feeling misunderstood or looked down upon for their ADHD symptoms. Nobody ever talks about the inherent dangers of being born, in any discernible way, different. But I will only bring a child into this world if and when I know they would grow up in one more accepting of ADHD and more open-minded about people who have it — a world not of hate and prejudice, but love and tolerance. 

Won’t you create this world with me?

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