This is an extract from Em Rusciano’s ‘Blood, Sweat and Glitter’ – out now.
On 18 March 2021, after a long and painful time away, I finally got to do the thing I do best: get on stage and prance and sing and generally show off.
Many. Many. Months of pent-up frustration and angst exploded out of me and, I suspect, out of the audience, too. It was a fantastic, life-affirming, glorious one-of-a-kind show I’ll never forget.
And even though I was well on my way to an ADHD diagnosis, I didn’t say a word about it during the show.
Not one mention.
Not even a hint.
I knew I didn’t want to share it publicly because I still wasn’t sure what it meant privately. That was new for me. Normally, I would have posted about it between sound check and curtain call, followed by an Instagram story and a mental- health PSA. But this time . . . I kept it close.
Quiet.
I was officially diagnosed at the start of April, and I didn’t immediately tell the public. Not because I was ashamed – though there was definitely some internal wrangling going on – but because I needed to know what this meant for me before I made it mean something for everyone else.
It was the first time in forever I didn’t feel the need to turn a trauma into a teachable moment. I just let it be mine.
For a little while, at least.
During my final assessment appointment via Zoom, I found out I had combination type ADHD. Which is both inatten- tive and hyperactive, though I lean towards the hyperactive side. I wish I could tell you I had a profound reaction at that moment – some cinematic breakthrough where everything clicked into place, and I whispered, ‘I knew it.’ But honestly? I just blinked. Nodded politely. Pretended I understood what the hell it meant. As we were finishing our Zoom, the psych told me, with a completely straight face, that he could cure ADHD if I enrolled in his behaviour modification program.
I was incensed! No, thank you, sir. Hard pass. I’ll take my neurodivergence straight up, no snake oil.
Fuck that guy!
At the time, my knowledge of ADHD was still pretty limited. I vaguely knew there were types. I vaguely knew hyperactive meant bouncing off the walls, and inattentive meant a bit floaty. But beyond that? Not much. So when he said, ‘Combination type,’ I just wrote it down like it was a wine recommendation and hoped I’d figure it out later.
Now, with hindsight, it makes so much sense.
Of course I was both.
Of course I was.
Here’s the rundown I wish someone had given me at the time. It is obviously not my intention to present myself as a medical professional or diagnostic expert. I am not saying that if you see yourself in the following descriptions, you have ADHD. But I’m not not saying that either . . .
There are three main categories of ADHD, and they can show up really differently depending on your age, gender, hormones, history, and whether or not you’ve been pretending to be a functioning adult for decades.
Inattentive Type (formerly ‘ADD’)
This one doesn’t usually look disruptive, but inside? Absolute chaos.
You might be inattentive type if you . . .
- constantly lose things (keys, phones, ideas, entire weeks);
- zone out mid-conversation and then panic-laugh to cover;
- have 74 tabs open (in your browser and your brain);
- miss details and forget instructions – even when you care;
- struggle to finish tasks unless they’re urgent or interesting;
- procrastinate until the last possible second . . . and then sprint to the finish; and/or
- feel like you’re never really ‘here’ – just adjacent to life.
It’s often missed, especially in girls and women, because it doesn’t cause classroom disruptions – it just causes internal panic, disorganisation and decades of self-blame.
Hyperactive–Impulsive Type
This is the one people think of when they hear ‘ADHD’ – loud, fast, bouncing off the walls. But it can look more subtle in adults.
You might be hyperactive–impulsive type if you . . .
- talk fast, think fast, interrupt without meaning to;
- struggle to sit still (jiggle your leg, tap your fingers, pace during phone calls);
- blurt things out before you’ve thought them through (and then regret it deeply);
- get bored easily – and crave stimulation to stay engaged;
- take risks or make impulse purchases for the dopamine hit;
- find quiet environments weirdly uncomfortable; and/or
- start a million projects, and finish . . . none.
This type tends to be more visible in boys (especially when they’re young), so it’s diagnosed earlier. In adults, it can look like being ‘driven’ or ‘passionate’ or ‘a bit intense’ – until you burn out.
Combination Type (Hi, it’s me)
This is when you meet the criteria for both inattentive and hyperactive types. It’s like a chaotic brain bingo.
You might be combination type if you . . .
- forget appointments, but remember every lyric from the 90s;
- are constantly moving and constantly zoning out;
- feel like your mind is either racing or buffering;
- interrupt people, then forget what you were saying;
- overcommit, overfunction, overthink, then crash;
- feel like you’re never doing enough – even though you’re doing everything; and/or
- are labelled ‘high energy’, ‘high maintenance’ or ‘high functioning’ . . . while quietly falling apart.
It’s not a vibe. It’s a full-time neurological performance piece.
When he gave me that label – combination type ADHD – I didn’t know any of this. No one sat me down and explained it. No one said, ‘Hey, you’re not lazy, scattered or dramatic. You’re wired differently.’
Because now I knew. ADHD was the thing. The answer to so many huge, hard questions I’d been asking my whole life. And I was furious. Furious that it had taken 42 years to find this out. Furious that I’d been overlooked, dismissed, underestimated – by doctors, teachers, adults, colleagues, even friends. Furious that I had believed them. That I’d internalised it all and labelled myself lazy, disorganised, erratic, emotional, unreliable.
I felt ripped off. Like someone had handed me a game to play, but never told me the rules – and then acted shocked when I kept losing. I was angry at the adults who were around me growing up and didn’t see it. Angry at the teachers who called me bright but distracted. Angry at myself for not putting it together sooner – how did I not know?! I became irrationally angry at anyone who had ever met me and not asked the question.
Not once.
Not even a gentle, ‘Hey, do you feel like you’re in a constant state of forgetting what you’re doing, while doing five things at once, and still feel guilty for not doing more?’
But now I know about symptom recognition bias. Now I know why it didn’t happen. ADHD wasn’t on anyone’s radar – especially not in women or AFAB people. We weren’t bouncing off the walls or setting classrooms on fire. We were performing. Masking. Over-functioning until we burned out. We were ‘gifted’ or ‘moody’ or ‘dramatic’ or ‘spacey’. We were told we were just bad at coping, not that our brains were built differently. We were told we were hormonal, anxious, disorganised, sensitive, overreactive, and inconsistent.
We were missed.
We were misdiagnosed.
And we paid for it in shame, in exhaustion, in the tiny private battles we lost daily while everyone else seemed to float through life. And even now – even with the diagnosis in hand – I was still angry. Because now I knew, I couldn’t un-know. I couldn’t go back and redo school, my twenties, early motherhood, the jobs I torched, or the relationships that flamed out because I didn’t understand my brain.
There’s no refund policy on a mislabelled life.