After struggling through years of eating disorders, depression, anxiety and all the medications that her doctors prescribed, Samantha Boyce finally found out why she had felt different since childhood. Undiagnosed ADHD was behind her overwhelming experiences in social, career and family life – this is how she finally discovered the truth, and the long road she had to take to get there.
“My brain always feels like a tiny room filled with thousands of bouncy balls in motion, pinging around past my eyes, and it's so hard to just grab onto one of them.”
Girls and women with ADHD have long been left to suffer in silence without a diagnosis or access to medical treatment, often with the symptoms beginning in childhood and affecting every aspect of their life – from schooling to health, home life and eventually work and other responsibilities. Decades later, people like Aussie mum-of-two Sam are left trying to maintain their health, navigate social lives, uphold social and familial responsibilities, all while managing the development of comorbidities like anxiety, depression and eating disorders.
Sam first remembers experiencing eating disorders as a teenager.
“It all started, when I asked my mum if I could join Weight Watchers – I wasn’t particularly overweight, I was always taller and felt different to everyone,” she says. “With the point system I became quite obsessed with getting less and less and less points, it was my main focus.
“I started binging and purging, it was an obsession – I would always be thinking about what I ate.”
This ignited a decades-long journey to healing after the now 37-year-old’s mother took her to psychologists, counsellors and doctors for help. The only problem was, these medical professionals didn’t take a holistic look at Sam, rather, they isolated the symptoms.
“They would tell me it was depression, anxiety, eating disorders not specified,” she says. “At one point I was in an eating disorder clinic and they discharged me because I wasn’t making any progress and that was all they could do for me, I wasn’t at a risk-of-death weight range, they already medicated me which I really didn’t want but my mum convinced me."
The mum-of-two was trialled on a number of anti-depressants, but she found they did little to help – and after being discharged, she was left with debilitating symptoms and no answers.
“I really felt left alone and that no one was going to help me, I went to a fake it ‘til you make it point of view where I tried to tell myself no one’s going to help me except me.”
Sam’s not alone here – many people, particularly women, go undiagnosed with ADHD, and the consequences are vast. Many will experience a – and eating disorders are one of the most common comorbidities. Both ADHD and eating disorders have been associated with difficulties in executive functioning, which includes processes like impulse control, emotional regulation, and decision-making. These shared challenges may contribute to difficulties in managing eating behaviours. There’s also the element of emotional dysregulation that can crop up in ADHD and a number of eating disorders – for some people with the former, food can be used as a way to cope with emotional struggles or stress, which can lead to disordered eating patterns. Take a look at the number of other links:
- Impulsivity is a hallmark symptom of ADHD and is also associated with binge eating disorder. Some individuals with ADHD may engage in impulsive binge eating episodes, leading to an increased risk of developing an eating disorder.
- ADHD can impact self-esteem, and body image concerns are prevalent in eating disorders. These factors may interact and contribute to the development or maintenance of disordered eating behaviours.
- Some medications used to treat ADHD can affect appetite and weight, potentially influencing eating behaviours – of course, this is more relevant to diagnosed ADHD than undiagnosed.
It's essential to recognise that individuals with ADHD are not going to develop eating disorders, and not everyone with an eating disorder has ADHD, but there is a close relationship between these conditions. For instance, take binge eating disorder – studies have found around 12% of adults with ADHD to have this condition as well, while 13% also have bulimia nervosa. Evidently, there’s a strong link, made all the worse by the masses of people left undiagnosed – research suggests only 20% of adults with ADHD know they have it.
But to better understand these comorbidities, it’s vital to first understand ADHD. Short for attention deficit hyperactivity disorder, ADHD affects 1 in 20 Aussies, and contrary to popular belief, this condition doesn’t only affect children – more than 3 quarters of kids diagnosed with ADHD will continue to experience symptoms as adults. It’s categorised by the following groups of symptoms, and can include mostly one group or a combination of them:
- Inattentive: This includes have difficulty focusing on things and seeing tasks through to their end point, along with avoiding tasks that require prolonged attention. Forgetfulness and difficulty managing time are also common symptoms.
- Hyperactive and impulsive: Hyperactivity is more common in kids and usually involves restlessness, fidgeting and disrupting others. Impulsive symptoms can include interrupting and talking over others, along with taking others’ things without permission.
The US Centre for Disease Control found that while boys are more likely to be diagnosed with ADHD than girls, it’s not because boys are more susceptible, but because girls are so consistently underdiagnosed. One such reason for this centres around the differing ADHD presentations, while boys more often present with hyperactive and impulsive symptoms like fidgeting, restlessness and displays of mood swings, girls will frequently have more inattentive symptoms like struggles with concentration and time management.
Now let’s fast-forward a few years to when Sam met her husband – she still hadn’t found any answers and was struggling with feeling different.
“I really wanted to pretend that part of me didn’t exist because I didn’t want to ruin his life like I felt I’d ruined everyone else’s lives with my eating disorder,” Sam shares. “I got to the point where I asked myself so many times why could I not think normally and what was normal? Why could I not stop and why was it that when I kept seeing all these doctors it never felt like we were getting to a point of anything?”
After marrying and having her first son, Sam only became more overwhelmed by her symptoms – but she still didn’t have answers as to why.
“I had a very traumatic birth, he got stuck, he wasn’t breathing and they weren’t able to resuscitate him, they took him away and my brain went into shock because I thought he was dead and no one would tell me otherwise,” she says. “If I had other avenues of help or if I’d known what was going on in my brain, I could have found other ways to deal with it.”
It was at her latest job working for a fashion ecommerce business that first started to wonder if her thought processes, mental health conditions and life struggles might be related to undiagnosed ADHD.
"I started to get to know one of the other women I work with and she was saying something about neurodivergence and some of the qualities she’d said, and she’d commented on things I’d said,” Same says, adding she returned to her doctor to look further into the possibility. “He said it sounds very likely, so we had to go through diagnoses process because there is no finite scan or blood test. Then he started me on a low dose of Vyvanse and of course I had anxiety about taking it, but I bit the bullet."
Vyvanse is a medication commonly prescribed to treat ADHD, and once ingested, it becomes a stimulant that works by increasing the levels of certain neurotransmitters in the brain like dopamine and norepinephrine. These neurotransmitters play a role in regulating attention, focus and impulse control. It can come with side effects like headaches, insomnia, emotional changes and higher blood pressure.
But Sam says the diagnosis alone has been life-changing – from helping her understand her thought processes and struggles to deciding a path ahead.
“Since diagnosis, I have been able to see that so many personality traits/quirks that I often felt embarrassed about are related to my neuroscience, and I just wish that any of the health professionals I have seen in the past could have diagnosed it,” she says. “I’ve learned a lot on breath work and taking time, sometimes I just need to stop and get my breath and it’s hard when my mind’s racing but it seems more possible now than ever before.
“Advocating for myself is something I’m still learning to do, it’s been programmed into me my whole life to apologise for everything. I can say now this is me and I like it - I know I’m rambunctious.”
Head on over to ADHD Support Australia to find out more about the condition and where to get help and resources if you feel you might be neurodivergent.