She wrote the book on women, shame, and ADHD | 2

Summary

Climbing the Walls: She Wrote the Book on Women, Shame, and ADHD | Episode 2 Summary

Release Date: April 9, 2025
Host: Danielle Elliott
Guest: Dr. Sari Solden
Produced by: Understood.org

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Introduction

In the second episode of Climbing the Walls, host Danielle Elliott delves into the pivotal role Dr. Sari Solden played in reshaping the understanding of ADHD in women. This episode explores Solden's journey from personal struggle to becoming a leading authority, the emotional burdens of ADHD, and the societal shifts in diagnosing women post-pandemic.

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Sari Solden’s Personal Journey

Dr. Sari Solden shares her early experiences with undiagnosed ADHD and the pervasive shame it caused her. Reflecting on her professional life, she states:

“I had a great career. After the book came out, especially as somebody who never spoke, that became, like, my big thing.” (00:00)

Solden describes her transition from a successful career to moving to a farm in an attempt to escape external judgments. However, she encountered what she terms “sheep shame”—a metaphor for the internalized embarrassment she felt about her disorganization and perceived shortcomings.

“I realized… I was going to be embarrassed by it or feel shamed about it. I had sheep shame.” (00:54)

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Understanding ADHD and Shame in Women

Danielle Elliott highlights how Solden’s prolonged struggle with shame led her to uncover the deep connections between ADHD and societal expectations placed on women. Solden emphasizes that women with ADHD internalize pressures to meet domestic and social standards, exacerbating feelings of inadequacy.

“Women all the time say, how do other women do it? That's all they say is how, how do they do it?” (12:30)

Solden observes that while men with ADHD might not experience the same level of shame regarding their disorganization, women often hide their ADHD traits, leading to heightened emotional distress.

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Publishing “Women with Attention Deficit Disorder”

Driven by the need to articulate her experiences, Solden embarked on writing her seminal book, Women with Attention Deficit Disorder. Despite initial hesitations and organizational challenges, she successfully published the book in 1995 with the support of her husband.

“When I had my book out there, and we had to get this out right now.” (18:33)

The book focuses on the emotional and internal experiences of women with ADHD, diverging from the scientific and neurological discussions prevalent at the time. It became a cornerstone for many women seeking to understand their own struggles.

“a lot of this book on women is all about that internal experience, emotional experience, what's wrong with me?” (21:05)

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Reception and Backlash

Upon presenting her work at a major ADHD conference, Solden faced significant pushback from established gatekeepers in the field. During the keynote, a prominent figure publicly denounced her book, challenging its legitimacy and implications.

“He said, I’m just gonna… I'm gonna say what I wanna say. I felt like he was saying I was a child abuser.” (23:01)

Despite the hostile reception, Solden persevered, delivering a subsequent speech that resonated with many women in attendance. Her courage helped foster a supportive community where women could openly discuss their ADHD without shame.

“It was a triumph for me in the end.” (25:17)

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Impact on Other Women and Diagnosis Trends

Solden’s work inspired numerous women, including Terry Matlin, author of The Queen of Distraction. Matlin recounts how Solden’s book provided her with the vocabulary and validation needed to understand her own ADHD.

“This book gave me hope that, you know, this is a thing. I don't have to feel bad that I'm not like my friends or my relatives.” (29:45)

The episode discusses how, despite Solden's early contributions, ADHD diagnoses in women remained low for decades, primarily due to institutional biases and a lack of awareness. It wasn't until the COVID-19 pandemic and the rise of social media platforms like TikTok that awareness surged, leading to a significant increase in diagnoses post-2020.

“Everything exploded from really the pandemic and TikTok.” (33:08)

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Conclusions and Societal Shifts

Climbing the Walls underscores the critical need for gender-sensitive approaches in diagnosing and treating ADHD. Dr. Solden’s pioneering work illuminated the unique challenges women face, transforming societal perceptions and medical practices.

“Women have for decades been misdiagnosed.” (32:48)

The episode concludes by highlighting the ongoing impact of Solden’s work and the continued rise in ADHD diagnoses among women, attributing recent changes to both increased awareness and cultural shifts influenced by digital media.

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Notable Quotes

• Sari Solden (00:54): “I had sheep shame. So I realized. So it didn't matter, like, what the context was. I had internalized that no matter what it was going to be, I was going to be embarrassed by it or feel shamed about it.”

• Emily Mitchell (02:15): “Shame and overwhelm might even help explain the recent rise in ADHD diagnosis among women.”

• Terry Matlin (15:23): “The look on this man's face told me that a woman in her mid-30s who has not been in a serious relationship is a woman who might never be in a serious relationship.”

• Sari Solden (25:17): “Of copies and was translated into a lot of languages... women said, I felt like you followed me around this book.”

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Conclusion

This episode of Climbing the Walls not only celebrates Dr. Sari Solden’s groundbreaking contributions but also sheds light on the enduring challenges women with ADHD face. By sharing personal stories and expert insights, the podcast emphasizes the necessity for continued advocacy and nuanced understanding of ADHD across genders.

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Timestamps

• 00:00 Sari Solden discusses her career and the impact of her book.
• 00:54 Introduction of “sheep shame.”
• 12:30 Solden on societal expectations for women with ADHD.
• 18:33 Challenges in publishing her book.
• 21:05 Focus of Solden’s book on emotional experiences.
• 23:01 Backlash at the ADHD conference.
• 25:17 Success and impact of Solden’s book.
• 29:45 Terry Matlin shares her experience.
• 32:48 Discussion on misdiagnosis of women.
• 33:08 Surge in diagnoses post-pandemic.

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For more insightful episodes and resources on ADHD, visit Understood.org.

Transcript

[Sari Solden]

I had a great career. After the book came out, especially as somebody who never spoke, that became, like, my big thing. And I printed out my CV just to remind myself.

[Danielle Elliott]

I mean, so this is Sari Solden. We met at her house in Ann Arbor, Michigan. As I walked in, she joked that it isn't usually so clean. She pointed to a tray of cheese and crackers and grapes and said, this is all for show. She she knows it's what you're supposed to do when someone is coming over. It's expected. We set up in her office. She seemed a little nervous, and she held her resume in her hands as we started talking in case she forgot about any major moments in her career.

[Sari Solden]

I mean, so, like, for the 30 years, I, like, spoke everywhere constantly. And I became a really great keynote speaker. And this is a famous speech I did.

[Danielle Elliott]

She walked over to the door and pointed to a corkboard with photos on it.

[Sari Solden]

I moved to the farm and we had sheep. And here's one of my sheep, and you'll see what he looks like. So this is about shame. So we moved out to the country because I thought, oh, if I live out there, it doesn't matter. Nobody will worry about what my house looks like or anything like that. And then on the way home from work every day, I would pass in these beautiful pastoral scenes and there's all these beautiful sheep. And I got home and. And then I looked at my sheep and I kept getting depressed, and I realized my sheep were messy. And then I felt bad every time I realized what I had was sheep shame. So I realized. So it didn't matter, like, what the context was. I had internalized that no matter what it was going to be, I was going to be embarrassed by it or feel shamed about it. I had sheep shame.

[Danielle Elliott]

Sheep shame. I get it. Sheep shame was a fun way of talking about the shame Sari felt in most areas of her life. She struggled with it for decades without knowing why or even knowing that other women felt it. That struggle led her to a profound understanding of ADHD and how much shame plays a part in it for women.

[Terry Matlin]

She's written three books about it and helped women all over the world understand their adhd and how attempting to meet societal expectations of what it means to be a woman creates intense shame.

[Emily Mitchell]

Shame and overwhelm might even help explain the recent rise in ADHD diagnosis among women. And we might not know anything about it if not for Sari and a handful of others who have revealed the many ways ADHD impacts women.

[Danielle Elliott]

But Sari didn't set out to change global thinking. She was simply trying to figure out why her own life felt so hard and why she's always felt so much shame. This is Climbing the Walls, a podcast where I try to figure why so many women are being diagnosed with adhd. I'm Danielle Elliott. Sari wrote her first book in the early 1990s. It helped Emily Mitchell understand the ways she struggled with adhd, ways that weren't explained in the scientific journals or at her doctor's office. Nearly three decades later, Sari's books did the same for me. When I was diagnosed, my doctor recommended a stimulant and behavioral approaches. She talked about making lists and calendars and suggested I might want to see an ADHD coach. These things helped, but they didn't exactly change my life. A year and a half after I was diagnosed, a friend recommended Sari's books. Halfway through the first chapter, I felt like I'd joined a secret club of women who understand ADHD in a different way. Sari is the key to that understanding, and I wanted to know, how'd she figure it all out? Sari talks fast, cuts herself off, and switches directions, often. Before I could ask a question, she dove into her story. She said she did well in elementary school. She needed a tutor in third grade and developed social anxiety around sixth grade. But overall, she did well. She graduated from a fairly small, structured high school and enrolled at the University of Michigan.

[Sari Solden]

When I went there, everything sort of fell apart. I was messy, you know, and it caused a big problem. A lot of shame developed.

[Danielle Elliott]

She struggled, but she got through it and graduated on time. After school, she taught for a few years, then tried other things.

[Sari Solden]

I worked at mental hospitals. I worked in the inner city, you know, with farm labor camps. I did a lot of things in those days and then got married, then moved to California. And then I got unmarried.

[Danielle Elliott]

And after getting divorced, Sari started taking piano lessons. And then she married her piano teacher. They lived in Marin county, near San Francisco. In 1982, they started a rock and roll music school, you know, as one does. And at some point they had more than 200 kid bands. Sari developed programs about self esteem and self expression, and she realized she loved this type of work. She went back to school to get a master's in counseling. I jumped from job to job in my twenties. At some point I started saying I had a curiosity driven career. I think I saw that name on LinkedIn or something. Now I say I have ADHD. In the 1980s, Sari didn't have A name for it. She just kept following her interests. She became a therapist with a counseling program for adults with learning disabilities. She loved it, but she struggled in the same way she had since college.

[Sari Solden]

I couldn't keep things organized my whole life, you know, I couldn't keep things organized. I had no idea why.

[Danielle Elliott]

She'd treat patients, and after work, she'd look through the books in the office. She started looking for ways to explain herself. Did anything in these books say anything about adults who were disorganized? She didn't find much, but working at this clinic definitely confirmed that she was different.

[Sari Solden]

You'd have to move every hour, and I'd have to like, stuff these clocks into a drawer because I couldn't concentrate with the ticking. I put the fan on and closed the windows to block out that sound. And I was like hiding in shame from the administrative staff because I couldn't read my handwriting. And I wasn't talking at all in all these group settings. Nobody knew who I was. I was sort of.

[Danielle Elliott]

Sari was in her early 40s at that point. She'd always been introverted, but now it seemed even more intense. She couldn't figure out how to keep up. She'd watch her co workers taking notes in the middle of conversations and wonder how they did it. She could either write notes or talk. She couldn't do both. At some point, her boss assigned her to a new project. As part of the project, she'd be administering a test to clients at the clinic. Before starting, her boss asked her to take the test so that she'd know.

[Terry Matlin]

What it was like.

[Sari Solden]

Part of the test was showing me nonsense looking creatures and you had to remember their names. So nonsense names. And I got like a 16th percentile. I couldn't remember. And first time I've ever had a test score that was terrible. And they showed me like, that means like I had a terrible short term memory. But I've been compensating with context. So when there's no context, I didn't know how to do this. So I said, okay, that's interesting.

[Danielle Elliott]

She searched the books in the office again, now looking to see if anything explained her memory issues or difficulty organizing. She didn't find anything. But in the midst of her search, a client brought her a recording of a segment he'd heard on npr. In the segment, two Harvard University doctors discussed a book they were writing.

[Sari Solden]

I remember listening to it. And pretty soon after that, their book came out. And that was the first book, big book, that talked about the fact that adults continued to have difficulties even though they lost the hyperactivity.

[Emily Mitchell]

The book is called driven to distraction. This book explained that adults continue to have difficulties long after they outgrow their physical hyperactivity. It described dozens of ways ADHD shows up in adults.

[Danielle Elliott]

They're often impulsive. They struggle to stay organized, manage schedules, maintain relationships. For those without hyperactivity, ADHD can often look like laziness or inattentiveness. It has something to do with the way ADHD brains develop. The authors coined a new shorthand for explaining it. People with ADHD have a Ferrari brain with bicycle brakes.

[Sari Solden]

I knew I had massive problems with organizations, so, I mean, this all made sense to me. I wasn't looking at through the ADHD lens. All the books, though, about learning disabilities did talk a lot about disorganization, but they didn't attribute it to this.

[Danielle Elliott]

A few months later, two women published a book called you'd mean I'm not lazy, Stupid, or crazy. The book's blurb promises to help readers distinguish between ADD symptoms and normal lapses in memory and lack of concentration.

[Sari Solden]

I remember taking that book with me to a family wedding in Modesto, California, and that book really opened my eyes to that.

[Danielle Elliott]

Sari decided to talk to a doctor. She felt she might finally have found a way to explain what she'd been experiencing for more than 20 years. This was the early 90s. It was sort of the early stages of neuroscience. Congress declared the 1990s would be the decade of the brain. There was a huge push and lots of investment in attempting to understand how.

[Terry Matlin]

People develop mental health conditions, which is all to say, treating the brain was still fairly new.

[Danielle Elliott]

Her doctor suggested a full neuropsychological exam.

[Sari Solden]

Where they really test all of your, like, verbal abilities, all your memory abilities. It's very in depth test and your iq, and they're looking for problems, you know. So for me, I had a big split between my performance, like, visual spatial. I can't do that at all. I have like a 99th percentile in one of my subtests, like, for instance, of verbal, and a 9% in, like, putting things together in a thing, you know, so I can't unload the dishwasher. I tell my husband, look, here's my. Here's my test results. I'm not making it up.

[Danielle Elliott]

Sari scanned through scientific literature on learning disabilities for years and never found answers to explain the ways she was struggling. Two books published in the early 90s changed her understanding of her brain. And after a bunch of tests, a doctor confirmed her suspicion that she has ADHD. She was diagnosed when she was 43 years old. Her doctor prescribed Ritalin. She felt an immediate shift. For years she'd hesitated to raise her hand in class or speak up in meetings. She worried about being wrong or being laughed at. When she started taking Ritalin, those fears subsided. She started presenting in meetings and was surprised to realize she enjoyed it. Within a few years, she became director of the clinic, something she never could have imagined before. Throughout, she treated many people with adult adhd and she noticed a pattern.

[Sari Solden]

I'm seeing, okay, the women and men, even though they're telling me the same problems, having completely different reactions. So the men, they do not have the shame about the disorganization. And the women who are hiding and pretending and ashamed and not being able to, you know, achieve or get out there or there's such secrecy. That was the thing I saw. And it was really focused on their cultural expectations. What women internalized from the culture about what they should be able to do domestically, especially, you know, taking care of all the things, all the children stuff, all the responsibilities. So they internalize these expectations deeply, even today still. And they idealized them and then they toxically compared themselves to other people and their self narrative and the shame and the distortion. It was so much more for women. Women all the time say, how do other women do it? That's all they say is how, how do they do it? They fantasize about some kind of organizational nirvana. When I get to that level, then I'll be happy and everything will be okay. You know.

[Danielle Elliott]

It'S a nirvana they'll never reach. Without understanding why. She understood this because she'd felt it herself. She thought if she could just get organized, she'd enjoy work more. And just like she came up with workarounds, her patients figured things out as best they could.

[Sari Solden]

Often they're self medicating with diet coke or caffeine or sometimes you have like OCD looking compensation for the adhd and you know, and they're very like, I get like that before people like you come over.

[Danielle Elliott]

Because if a woman couldn't do the things women were expected to do, like keep a house clean, there was something wrong with her. Even when they were diagnosed with adhd, doctors acted like the goal of treatment was to meet these expectations.

[Sari Solden]

I used to have a woman see a psychiatrist early on. A guy told her, well, take this pill and when your house is clean, you're cured. I mean, it was bad on so many levels. That's what they used to tell women, like, okay, so the goal would be to have your clean your house. And the goal and this pill is going to cure you of who you are. You know, these are real life stories.

[Emily Mitchell]

This sounds completely absurd, but apparently at least one doctor in the 1990s saw an ADHD diagnosis as solely a way to get women back to cleaning houses.

[Danielle Elliott]

All of this relates back to underlying challenges with what's called executive functioning and what executive functioning looks like in relation to expectations on women.

[Sari Solden]

Executive functioning has to do with coordinating, prioritizing, synthesizing all the things it takes to run a household, to take care of your kids, to pack their lunches, to remember all the appointments, all the millions of things that women as mothers have to do, or even women as friends, remembering everybody's important occasions, buying presents.

[Danielle Elliott]

All the invisible labor, as we now call it in the 90s, when Sari was initially making these observations, it apparently wasn't even a question that women would manage their households. They could pursue careers if they wanted to, as long as they wanted to do that, in addition to all the things they were already expected to do. And this was hard, especially for women whose brains did not handle executive function and organization all that well.

[Sari Solden]

There's a lot of information overload or embarrassment about not being able to entertain the way maybe their mothers did, or easily or everything's a great stressor and a great they have a lot of overwhelm and stress. So all those executive function tasks make them feel bad that they can't keep up with or make themselves understood or make themselves seen by other people.

[Terry Matlin]

Women feeling bad that they can't keep up or make themselves understood or seen by other people.

[Danielle Elliott]

I get that.

[Terry Matlin]

I bounced around a lot in my 20s and by my 30s it wasn't amounting to anything. I felt like everyone was moving forward in life and I was just moving around when I saw my friend start doing everything as couples. I started dating more intentionally and I thought I was doing things right. Then on a second date, my date started telling me about his cats.

[Emily Mitchell]

He kept them.

[Terry Matlin]

When his ex moved out, he asked if I'd ever lived with a partner. No. Oh, he said, how long was your longest relationship? I answered honestly, it was about four months. He put down his martini glass and said, wait, how old are you? The look on his face told me there was something wrong with me, that I'd reached a point in life where it was not acceptable to have not been in a relationship. It didn't matter that I'd focused on work and grad school and friends, that I'd traveled that I just never met.

[Danielle Elliott]

Anyone who made sense for me.

[Terry Matlin]

The look on this man's face told me that a woman in her mid-30s who has not been in a serious relationship is a woman who might never be in a serious relationship. The next few years were weird. I was happy when I was alone or with people who truly knew me. I retreated a bit in a way I never would have expected. Other people didn't seem to understand me, and I didn't understand them.

[Danielle Elliott]

When I read Sari's books, I started to get it. She described exactly what I've been feeling throughout my 30s. And when we spoke, she reminded me that when she was first making these connections about shame and the way societal expectations impact women with age, these were brand new ideas. As a therapist treating all sorts of adults with adhd, Sari could see beyond any individual experience. She could zoom out and see the bigger picture. She figured out that women and men experience ADHD differently and that women work really hard to hide their ADHD traits or overcompensate for the ways they think. They fall short of expectations. Perhaps most damaging, they thought of their shortcomings as personal failures. They didn't know that their shame was sort of universal among women with adhd.

[Sari Solden]

These women had no way of knowing that anybody else was experiencing this. Can you imagine? I know people can't imagine that now. So there was no Google, there was no Internet. There was nothing.

[Danielle Elliott]

Sari wanted to create something to help them understand. Of course she has adhd, and her ADHD very much came into play. Her dad was about to turn 80, and he'd written a novel as a birthday gift. She wanted to get the novel typed up and printed into a book. She looked in the yellow pages and found the name of a typist. She called and the woman said, come over. I'll show you a proof of a book we're working on. My husband's a publisher. Sari went over and the book was by a man named Tom Hartman. It was about adult adhd. Sari couldn't believe it. She told the publisher what she wanted to write a book about women with adhd, and he suggested they work together.

[Sari Solden]

And we kept saying, okay, this is the time. We have to get this out right now.

[Danielle Elliott]

She still didn't get moving. Then her publisher told her there was going to be a conference in Ann Arbor, Michigan, the first ever conference for adults with adhd. She felt too shy to go to a conference, but her publisher mentioned that Tom Hartman would be there. Hearing this, she said, made her brave enough to Go. As she walked into the room, she.

[Sari Solden]

Saw hundreds of people bumping into each other, interrupting, laughing, you know, just having a great time. Not because other people had problems like that. Other people could keep up with them and talk like this, and they had a great time. And it was like the women were writing, like, their phone numbers on their. We didn't have cell phones. Writing on their arms and numbers or spilling their contents or their purse or, like, not hiding anywhere. It was, like, amazing. So that was the first time where I saw how much of the time, without knowing it, we're hiding or keep or passing for normal.

[Danielle Elliott]

Sari saw that when women with ADHD are together, they can stop hiding. They take off their masks. Their shame seems to disappear. They move at their natural pace in their natural way. They don't feel ashamed of being disheveled or scattered or talking too fast. They don't need to code switch.

[Sari Solden]

It was, like, really fun. And everybody was discovering them. All the people there were discovering themselves and finding people like them. But even us professionals were meeting people who we've never met before, those kind of people. It was a different. Whole different vibe.

[Emily Mitchell]

Sari lived more than 40 years of life not knowing how to explain the way she felt. As she started to understand, she counseled dozens of women who didn't realize there were others like them. And at that conference, she saw what happens when women with ADHD connect with each other.

[Danielle Elliott]

If she was going to write about this, it was time. Back in California, she got to work.

[Sari Solden]

So we had to, like, do it fast, maybe six months. I had no idea how I was going to organize thousands of ideas. I literally had to cut and paste all my ideas of different subjects into paper bags. And then my husband helped me put them into categories and help me. I don't know how this happened. And then I would rewrite it, and then he would edit it. It was really something to think about.

[Danielle Elliott]

Now she pulled it off somehow. And the book came out in 1995. The title is Simple Women and Attention Deficit Disorder. She keeps a copy on her desk. She reached for it.

[Sari Solden]

So a lot of this book on women is all about that internal experience, emotional experience, what's wrong with me? And the impact on people's identity as mothers, friends, wives, you know, and that's what this book is about. The Emotional Legacy, really.

[Danielle Elliott]

It's the first book about the emotions of adult ADHD rather than neuroscience or brain structures or chemical imbalances in the brain. It's also the first, as far as I know, or at least one of the first to describe the adult experience of inattentive adhd. And since this is a type of ADHD more common among girls and women, it's really the first time this type of ADHD got much attention. Sari's book came out three years after Driven to Distraction changed the long accepted notion that ADD is something kids outgrow. So scholars in the field were already adjusting to the idea that adults have ADD and then adhd. Then a therapist in Northern California writes a book saying that not only do women experience add, they do so in a way that is different from the way men experience it. Women praised Tesseri's book. They said they felt seen. But women weren't the only people reading Sari's book, and some of the others didn't like it. Sari was invited to speak at the annual conference for an organization called chad. Back then, CHAD stood for Children with add.

[Sari Solden]

Chad was academic white males and medical people talking to parents and teachers about the way it was. Okay, There were a lot of old guards, dear.

[Danielle Elliott]

Sari accepted the invitation, and on the first night of the conference, she went to the keynote address. An expert in the field stood in front of a crowded ballroom. He used a projector during his keynote, and he projected the COVID of her book onto a screen. He said, how dare she write this?

[Sari Solden]

And I had even. I had quoted him, I had liked him. He was in my book. But for some reason, he. I guess he got permission. He said, I'm just gonna. If I'm gonna be the keynote speaker, I'm gonna say what I wanna say. I felt like he was saying I was a child abuser. It was like, so. It was shameful. So even though I was talking about.

[Danielle Elliott]

Shame to other people, Sari was completely shocked. And it only got worse.

[Sari Solden]

There's a few snobs, you know, the gatekeepers were very used to being gatekeepers. So then the one other guy said, oh, if you're going to play with the big boys, you got to learn how to blah, blah, blah, whatever, you know, like, very condescending and you can't get your feelings hurt. And, you know, there's nonsense and there's science, there's non science and there's nonsense, but I think you're actually just non science. But the men there were all really arrogant, let's put it that way.

[Emily Mitchell]

The men at the gate, the gatekeepers, are the same men who, throughout the 1970s and early 80s, perpetuated the belief that attentional issues and hyperactivity are unrelated, that children outgrow ADD, that the ratio of boys to girls with ADD is 10 to 1.

[Danielle Elliott]

The authors of Driven to Distraction were also ridiculed, but they worked within a gatekeeping institution, Harvard Medical School. They had a much easier time ignoring the criticism. Sari ran a clinic for adults with learning disabilities in Northern California. She wasn't from any of these institutions.

[Sari Solden]

I had no idea I was being brave, let's just put it that way. I had no idea I was a pioneer. I just saw what I saw because I didn't come from that world that they came from. I wasn't in that field at all. And so this just happened to me. And so I had no idea that I was going against, you know, and this happened in every field where women weren't allowed to define their own experiences. So I really took a couple days to recover, and then I gave this huge speech there, and I was able to then frame it. This is what happens when women say what they see and know what they know. And anyway, I. It was a triumph for me in the end. Then it just, like, took off, and women started talking to each other and started defining for themselves what it was like for them not being defined by all these other gatekeepers.

[Emily Mitchell]

Sari became a godmother of women with add. Her first book sold hundreds of thousands.

[Sari Solden]

Of copies and was translated into a lot of languages. And it was funny because they were translated based on cultural norms. So, like in Jim. Japan, it was like, women who can't tidy up. We used to laugh. Like in France, it would be like, women who can't accessorize. But that was nice. In Germany, that was like the chaos princess, you know, women living between misery and talent or something.

[Unnamed Speaker]

It was beautiful.

[Sari Solden]

I didn't have anything to do with those things, but that's when women said, I felt like you followed me around this book. And they just were astounded, and it was healing because they realized if it was in that book that it must be real.

[Danielle Elliott]

The book's success launched her into a public speaking career, something that she never, ever could have imagined before she was diagnosed with ADHD. Back then, she hardly spoke at all. Since 1995, she's been speaking all over the world.

[Unnamed Speaker]

Sari was. She's my idol. She's the one that broke open the whole thing.

[Danielle Elliott]

This is Terry Matlin. She first heard Sari speak at a conference in the 90s. She's the author of a book called the Queen of Distraction. She trained as a social worker in the 70s. In the late 80s, she was a mom trying to figure out what was Going on with her rambunctious daughter. She started to learn about ADD and asked a doctor about. Took some time, but he eventually diagnosed her daughter.

[Unnamed Speaker]

So as I started learning more about ADHD and, you know, there was a few books were out there, and then boom, it hit me like a ton of bricks. The lights went on.

[Danielle Elliott]

Terry was reading about childhood add, but she started to think that she might also have it.

[Unnamed Speaker]

And so I started to. The best I could was to investigate. And I'm kind of interested in research and all that, but there wasn't anything out there. So I basically did a lot on my own, you know, Then books started coming out. It was a hot time for ADHD to become more publicized and stuff, but not a lot.

[Danielle Elliott]

Terri read the same book Sari read Driven to Distraction and you mean I'm not lazy, stupid, or crazy. These books helped confirm her sense that she might have adhd. She'd tried and failed to find treatment for herself as a social worker, she wanted to start treating other adults with adhd. She saw an ad for a conference happening in Ann Arbor and decided to go.

[Unnamed Speaker]

I went to that, and I was overwhelmed because I was in a big space with people who were just like me, and it was okay to be just like me. So I just felt comfort. I felt comfort in being around people who were also feeling like I was feeling. We were relaxed because we were okay. Now we were in a group of people where it was okay. It was normalized to feel this way, to look this way, disheveled. If we forgot different colored socks, I would see all kinds of things. It was fascinating. And so the person, whoever it was, said, I want to make an announcement. We have in our audience a woman who is writing her first book, Women with Attention Deficit Disorder. And she's in our room today. And this is a phenomenal book. Nobody was doing adhd, especially in women. And I grabbed the book, and that book changed my life. I was in tears that I was reading about me. I felt understood for the first time. It's the only book I ever read. More than. More than once, more than twice. I have no patience to reread books at all. But hers I did. I remember her talking about the secret, you know, having to keep it all a secret because we didn't fit the mold of a woman who could do what we do, you know, And I really was attracted to her whole idea. And I talk a lot about her work. When she says that girls are socialized to be the caregivers, to take on all these responsibilities, you know, home, work, children, partner, all that kind of stuff and we in our minds fail. And what does that do to your self esteem? Well, that just took my breath away. Took my breath away because I was really struggling in those early years when I first discovered her and I couldn't cope and I felt just horrible. So that book gave me hope that, you know, this is a thing. I don't have to feel bad that I'm not like my friends or my relatives. I don't. And I'm still working on it. To be honest.

[Danielle Elliott]

Terri reminds me of so many of the women who have been diagnosed in the last five years, and it doesn't make sense to me that they have the same stories 30 years apart. It seems like it could have been so simple.

[Emily Mitchell]

Doctors could have started addressing adult ADHD by 1992 in the wake of Driven to Distraction. Then three years later, when Sari wrote about the emotional toll that ADHD takes on women, scientists could have taken her findings seriously and started developing better treatments.

[Danielle Elliott]

Instead, diagnosis rates remained mostly stagnant for women for the next 30 years. Most of the people being referred for treatment in the 90s were boys. White boys. There's a long history of why this is true. In the simplest terms, teachers are often the first to suggest a parent look into adhd. So a teacher's perceptions dictate who gets tested. When black and Hispanic boys acted out in class, they often got disciplined. When white boys were hyperactive or argumentative, the teachers referred them for treatment. They got help. When women did get diagnosed, it was often because, like Terry, they went in search of more information about their kids adhd, and in the process realized, oh, I also have this. And because most of the kids being diagnosed were white boys, most of the parents recognizing their own ADHD were yes, also white. Things started to improve in the early 2000s. From 2000 to 2010, diagnosis rates increased the most among black girls.

[Terry Matlin]

The rates among adults rose, but not nearly as much as they would rise starting in 2020. Seri said. This is all about research. Doctors rely on scientific research and the diagnostic criteria. In the dsm, Seri and other clinicians base their findings on their patients. So as accurate as their work might be, it's not considered scientific in the traditional sense. For that, it would need to be validated by scientific researchers. And it never was. So it never became accepted science. And if it's not science, it's not incorporated into science and medical curriculums.

[Sari Solden]

So even though I see tremendous progress, obviously, because I have millions of people who are diagnosed and, you know, I know that no one's taught about it. So that's the problem. And so nobody's looking for it, so nobody recognizes it.

[Emily Mitchell]

And as a result, women have for decades been misdiagnosed. Terry agreed.

[Unnamed Speaker]

My experience, anyhow, to this day now, all the work that we've been doing, we still get misdiagnosed with depression or they see depression, but they don't see the ADHD component to it or the comorbidity.

[Terry Matlin]

So what changed in 2020? Why were so many women suddenly being diagnosed?

[Sari Solden]

Everything exploded from really the pandemic and TikTok.

[Danielle Elliott]

The pandemic and TikTok.

[Terry Matlin]

She insisted it's a simple answer. The way it unfolded is anything but. For many women, coming to terms with their ADHD during the pandemic was a complicated and emotional experience. I wasn't on social media during the pandemic, so to help me understand that experience, I called a friend who was.

[Unnamed Speaker]

I mean, I hate to say TikTok, but it was TikTok. There were certain things that TikTok figured it out before I did. My for you page started getting more and more ADHD focused and like, they knew something I didn't. And then it became like, are you a millennial with adhd? And I was like, am I?

[Danielle Elliott]

That's next time on Climbing the Walls.

[Emily Mitchell]

Climbing the Walls was written and reported by me, Danielle Elliott. It was edited by Neil Drumming. Sound design by Cody Nelson. Brianna Berry was our production director, Ash Beecher was our supervising producer, and Diana White was our associate producer. Fact checking by Mary Mathis. Research by Karen Watanabe. Our music was composed by Kwame Brant Pierce, with additional music provided by Blue Dot Sessions, and our mixing was done by Justin D. Wright. This series was brought to you by Understood.org, a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. From Understood.org, our executive directors are Laura Key, Scott Koshier and Seth Melnick. A very special thanks to to Ray Jacobson, Julie Zeitz, Jordan Davidson, Sarah Greenberg and Kathleen Nadeau. If you want to help Understood continue this work, consider making a [e-mail] give.