What I Didn't Learn in Training

I've been sitting with something personal lately.

The possibility that I have ADHD.

Not officially diagnosed. Still in the territory of pattern recognition and quiet reckoning.  The kind that happens when something you've read or heard or stumbled across suddenly makes a whole lot of sense about a whole lot of your life.

And I keep questioning it. Because what I experience doesn't match the version of ADHD I learned about in training. No obvious hyperactivity. No chaos visible from the outside. Nothing that would have flagged in a classroom or prompted a referral or fit the picture I was taught to recognize.

Just an internal experience I didn't have language for until recently.

What we were taught to look for.

ADHD, as most of us learned it, presented a certain way. Fidgety. Disruptive. Struggling to stay in the seat. The kid who couldn't stop moving, couldn't stop talking, couldn't seem to get it together no matter how hard they tried.

What we were not taught, or not taught well enough, is how differently this can show up. Especially in women. Especially in people who were smart enough or compliant enough or motivated enough to develop compensatory strategies so effective that the underlying pattern stayed hidden for decades.

The hyperactivity that isn't physical but internal. The racing thoughts that look like productivity from the outside. The hyperfocus that gets mistaken for passion or discipline. The exhaustion of managing a brain that works differently while appearing, to everyone around you, to be managing just fine.

We graduated without a complete picture. And some of us have been living inside that incomplete picture ever since...without knowing it was incomplete.

The hesitation to claim it.

Here's what I keep noticing in myself—and I suspect I'm not alone in this.

The reluctance to name it without official confirmation. The sense that my own pattern recognition doesn't count until someone else validates it. That I need a diagnosis, a score on a screening tool, an outside authority to tell me that what I am experiencing is real before I'm allowed to say it out loud.

Which is interesting, isn't it? Because pattern recognition is exactly what we do. It is the core of our clinical skill. We sit across from people and notice—the way things connect, the threads that run through, the shape of something that hasn't been named yet.

And yet when the pattern is our own, we hesitate. We hold ourselves to a standard of certainty we would never require of a client sitting across from us having the same realization.

Why do we trust our pattern recognition for everyone except ourselves?

The women in their 40s and 50s.

I wonder how many of us are quietly having this realization right now.

Clinicians, specifically. Women, specifically. In midlife, specifically.  When the compensatory strategies that worked for decades start to cost more than they used to, when the hormonal shifts of perimenopause interact with executive function in ways nobody warned us about, when something that was manageable becomes suddenly, noticeably harder and we don't entirely understand why.

We are sitting across from clients who are having this realization about themselves. Clients who are grieving the diagnosis that came late, making sense of a lifetime through a new lens, renegotiating their relationship with their own brain.

And some of us are doing the same thing. Quietly. Without much language for it. Without a community that knows this part of us. Without having told anyone yet.

What this has to do with doing our own work.

Everything.

If we are going to hold space for clients discovering something significant about themselves.  Something that reframes their history, something that requires grief and curiosity and patience and a willingness to sit with not-knowing.  Then we need to be willing to do that same sitting with ourselves.

Not because we have to have it figured out before we can be useful. But because the work of being genuinely present with someone else's self-discovery is different—richer, more honest, more grounded—when we know what that territory actually feels like from the inside.

I don't have a diagnosis. I'm not sure I need one to move forward. What I have is a growing sense that something I've always attributed to personality or quirk or just the way I'm wired might have a different name, and that the name changes something about how I understand myself.

That's enough to work with. It might be enough for you too.

A note.

If you're a clinician reading this and something is landing.  If you're somewhere in the middle of your own quiet reckoning about something you didn't expect to be reckoning with...I wrote about this from a different angle for a general audience over at Inner Revolution. You're welcome to read that one too, if it's useful.

Dr. Jamie English is a licensed clinical social worker, supervisor, and educator. The DJ English blog explores the inner life of the clinician — the parts of this work we don't always talk about out loud.