There, I said it

Safely out of politics, nearly three years of counselling, and free of all meds, I think I'm finally ready to talk about my mental health and neurodivergence. I've been reluctant to talk about it until I felt I understood it and, frankly, I also didn't want to give people another stick to beat me with.

These are obviously deeply private issues and I'm hesitant to share them with the world, until now I've kept my emerging thoughts to the people who needed to know. But in the spirit of the theme of today's World Mental Health day “Livedexperiences heard: real voices, real change”, I thought I'd share the note I wrote three years ago for the people who worked closest with me at the time. 

For context I was a Minister in the Welsh Government, a year earlier I became very unwell with burnout and took 12 weeks off work. During this time an occupational therapist counsellor suggested to me that I had undiagnosed ADHD and so I set about getting a diagnosis (aged 47). I returned to work, took through two major reforms (the roads review and the 20mph speed limit change) and then became ill again, taking a further two months off work. 

I was very fortunate to have the ability to get a private diagnosis (my GP told that as I wasn't in prison he didn't see the need for an ADHD diagnosis!), and to have access first to a specialist ADHD coach and then a specialist counsellor who I saw weekly for over two years. I was referred back into the NHS local mental health service and tried a variety of medicine, and whilst I found the antidepressants very helpful for a good while I did not find any of the ADHD meds worked for me (I'm envious of those who have a different reaction).

When I returned to work there was talk of 'reasonable adjustments' (ADHD can be a disability and employers have a responsibility under the Equality Act to take steps to support people). But other than therapy (which has been the single most effective intervention I've had), I reflected that the most helpful thing would be for the people I interacted with the most with to have an explanation for the way I sometimes behaved. 

Below is the note I circulated to them, and their response thankfully was supportive and empathetic. I've continued to share some basic details with new teams of people I work with. 

In terms of the themes of “Lived experiences heard: real voices, real change” of today's World Mental Health day I have found that flexibility from employers, and empathy from colleagues are for me the most effective 'reasonable adjustments' that can be offered.

I'm still coming to terms with, and understanding, my brain and how it works. There are ups, and there are downs. That's life. But it helped me to know the stories of other people and so in that spirit I share mine (and hope people will take it in the spirit it is offered).

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ADHD and me - 'I just thought I was an arsehole' (September 2023)

“How on earth did you vote the wrong way three weeks in a row?

I know, I know. Believe me you can’t make me feel any worse. It is incredibly frustrating

How could you not be paying attention?

I find it hard to concentrate on following instructions and I have several things on the go at the same time”

So went the conversation with a colleague after I jeopardised the passage of an important law I’d worked on, and then repeated the mistake, the following week. And again the week after.

I was mortified (and still am), and very frustrated with myself, but that’s nothing new. Forever losing glasses, keys, pens, coats is a given. But torpedoing legislation was a new development (thankfully it was later put right, but only after a lot of work for people who could have done without it). I’m not being flippant; I still feel terrible about it.

This all came six months after I’d had a formal diagnosis of ADHD. The suggestion was first made to me a year earlier by a counsellor after I’d completely burned out and had to take three months off work. It was a scary experience. I felt broken.

To the irritation of many people with ADHD commentators like to describe it as a ‘superpower’. “Yes”, says ADHD UK Chief Executive Henry Shelford, “but let's talk about kryptonite!”. 

I’ve long had a pattern of running at walls in eighteen-month bursts, followed by a couple of weeks of exhaustion, then I’d start running at walls again. To be fair, the walls usually moved, but often at my expense.  

It had been four years since I’d last fallen over, the need to keep going during the Covid crisis, followed by an election and then a new Ministerial posting which required a huge injection of energy, had all delayed what I now see was inevitable - a crash. 

People with ADHD often say their mind is a machine that won’t switch off. That describes me perfectly; I find it very hard to be still, my brain is always busy. 

On the plus side it has always meant that I’ve had huge amounts of energy for work, the ability to analyse multiple complex problems simultaneously, and see a way through. I’m good at juggling tasks. On the negative side, it came at a high personal cost - a real difficulty relaxing, a constant racing mind. A rolling cycle of exhaustion.

A former colleague of mine who had also had an ADHD diagnosis illustrated it brilliantly, “Yesterday I was up at six thinking about urban regeneration. I didn’t stop until I collapsed asleep after researching new fountain pens for 45 minutes. We lack the ability to stop”.

The thing I find oddly amusing looking back is that some things I saw clearly, others I was completely blind to. A constant feeling of stress and tension that I’d had for years that I’d attributed to high-blood pressure was in fact anxiety. I’d seen anxiety in others but hadn’t seen it in myself. It is hard to describe the ever present knot in the stomach, and pressure in the head, an ongoing feeling of horribleness and dread. I’d become used to it, but it made me miserable.

The diagnosis of ADHD, which I reluctantly had privately having been told by my GP that there was no pathway open to me on the NHS, was a great relief. It finally gave me an explanation for the things about myself I have struggled with.”I just thought I was an arsehole” I said to the psychiatrist after he told me the result of his thorough evaluation.

During the assessment he asked quite a bit about what I was like at school. I winced. ‘Lee makes careless mistakes’, ‘Lee is enthusiastic, sometimes too enthusiastic’, ‘He needs to concentrate’, ‘Lee seems to have a hearing problem’ were all mentioned in my school reports. 

If the teaching of a subject didn’t engage me I’d lose interest, start chatting and distract others and often end up standing in the corner facing the wall, or outside the classroom in the corridor. But if I was engaged I was voracious in my appetite for a subject. 

I was a regular topic of conversation in the staff room but nobody seemed to think my pattern of behaviour needed any more than a bollocking. But reports did usually comment that I was a nice lad. “He had the cheek and charm of the devil” my A-Level English teacher commented some years later. A twinkle in the eye and a rapier-like disarming barb have always been my shield.

‘’Generally, a likeable person but can be hard to be around because can come across as being blunt, disruptive, tactless in relationships and communications’’ my new diagnosis reads. Amen.

I’ve always struggled with my filter. If a thought is in my head it usually soon comes out of my mouth. People remark on my honesty, or less flatteringly my ‘directness’.  It does me few favours in politics, but as a friend of mine who works in software says about problems: Is it a bug or a feature? 

In truth it can be both. Talking over people, changing subjects, getting up and down all the time during the conversation, and being ‘very stressy’ or hyper when discussing things are all features people have noticed. I can come across as rude and arrogant, though I don’t mean to. When someone gives me what I consider to be an over-long explanation I drift off; in meetings I interrupt because my mind has moved on to the next thing.

“It’s as if you can’t concentrate on one thing“ my wife told me when trying to reflect on how I’d shown all of the above traits during a dinner conversation with friends. 

It has become a family joke that when dinner is served I start doing a new task (‘I’ve just put dinner on the table, why are you starting to unload the dishwasher?’!). I need constant stimulation, why bother with the preliminaries when I can be doing something productive?

A common reaction when describing symptoms of many neurodevelopmental disorders to people is “isn’t everyone like that?”. The straight answer is no. It’s a matter of frequency, severity and impact of symptoms. For example, everyone occasionally gets up in the night for wee. It’s an inconvenience. Getting up three times a night, every night is a problem. ”Just as sadness isn’t the same as depression, worry isn’t chronic anxiety and the common experience of inattention isn’t ADHD” Henry Shelford, ADHD UK Chief Executive, agrees. 

But there are upsides too. “Borderline rude but usually right” is my adviser's pithy summary of me. I can be insightful and quickly get to the heart of an issue. I can directly fix on the key problems that need addressing and focus on practical solutions. I say the thing people are often thinking but aren’t articulating (a mixed blessing) which can help focus a discussion on what needs to be done. I’m good and calm in a crisis because I can absorb large amounts of information quickly and see things clearly. I’m creative and can (often) generate (usually) good ideas.

I’ve never only got one tab open on a browser, I rarely focus on one task at a time. I have a wandering focus. I’m told it's called ‘diffuse attention’ when you rapidly switch between aspects of a task under consideration. I start one thing and concentrate intensely, and then within a minute or so I start on another thing, then switch back, then onto another, oh yes and I must start to respond to that other email, wait - I’ll come back to that because I’ve just had a Facebook notification, anyway where was I? And so it goes. I cascade from one task and thought to the next. A cognitive whirling dervish.

When someone has my attention I get impatient if they fritter it with ramblings. ‘Get to the point! And there’s no need to repeat the point’ my internal voice is screaming. As soon as I grasp a point I don’t need the person making it to finish the sentence, move on!  ‘Why write out all your thoughts on a PowerPoint slide and then just read it aloud? I’ve read it already, get on with it mun!’ I think to myself.

I like short, snappy, action-focused meetings. Let’s get straight to the guts of an issue (preliminaries and preambles bore me). Clear, straight, honest analysis. I get frustrated by people who don’t say what they are thinking. Spit it out, then we can figure it out.

It is exhausting. 

When I have energy and am feeling resilient I can manage these racing thoughts, I can self-censor and keep my monologue internal. But when I’m not these feelings can leak out. 

Like most people with ADHD when I need to I can ‘hyperfocus’. Far from an ‘attention deficit’ disorder, it is more of an issue of attention control. Ministerial life in particular demands a grasp of detail. Long, complex, often opaque, documents need to be digested, analysed and dissected - every day, and fast. It's hard, but I can do it.

My brain is always on, always scanning for new things to do or think about. My head is a noisy place. It is very hard to relax. 

Deep breathing can help in the moment, and exercise definitely helps - particularly in changing your mental focus in the hours afterwards, but I get bored. Sustaining a training regime or a hobby has so far proven elusive. 

The easiest balm to apply is alcohol. A glass or two of red wine (and some chocolate) is fast-acting stress relief. I could happily drink half a bottle of wine a day. It is a very bad idea and I usually don’t, but I’d like to.

“People with ADHD know themselves well” my ADHD coach has told me. I’m certainly self-critical and often harsh on myself. ”We don’t fit the normal lines, and we have to recognise that. There’s nothing we can’t do, but there’s a price to be paid it” he said. And that’s the point, it doesn’t stop me from doing things it just makes it hard. “I can do everything, it just costs me’’ he added. 

I like the idea of ‘neuro-diversity’. Like other areas of diversity we recognise that people who are different can make a rich contribution. Sure, people who are not neuro-typical may act and think in a way that hits against social norms, but they can do other things that aren’t ‘normal’ too.

That’s not to diminish the additional burdens people have to carry. ADHD is a disability and to receive a diagnosis you need to have been found to have significant difficulties in at least two areas of daily life. It is thought that 1 in 10 men with ADHD will attempt suicide, 1 in 4 women. 

I usually skirt on the edges of mild-depression (using the Warwick-Edinburgh Mental Wellbeing Scale), and cumulative stress and tiredness can tip the balance. Holidays feel like life-savers, albeit I tend to use them to recover rather than to rest. The idea of rest is an interesting one I’ve discussed with my coach. Sitting still and staring at birds is not really an option for me; rest is finding absorption in other things. Even though it is obvious to me now that I have ADHD, it took a breakdown and a highly-skilled counsellor to point it out to me.

“Why do you need a diagnosis, you are a successful person” the first GP I saw told me (rather glibly in my view). “Yes, but I’m miserable most of the time and hard to be around” I quickly fired back. It is estimated that 3-4% of adults have ADHD, but only 1% have a diagnosis. 

Even amongst health professionals ADHD is a label that’s not fully understood. I grew up with the prejudice it was something that parents who couldn’t control their children would blame for their poor parenting. It has baggage. And as with all stigmas, opening up about it can only help people understand - themselves and others.

It helps me to know that there are very effective people who have ADHD - swimmer Michael Phellps, Heston Blumenthal the chef, broadcaster Adrian Childs, Richard Branson and many more. In politics former Labour Deputy Leader Tom Watson has talked openly about his late-diagnosis which I have found really helpful.

As well as having ADHD many of these also have a very strong sense of purpose and here’s where not being neuro-typical can be an aid. People with ADHD can be single minded in pursuit of goals; they can be disruptors to an orthodox way of doing things. When you have a strong sense of mission ADHD can be rocket fuel.

When I look back at my life and look for patterns, I certainly recognise a zest for a challenge – there’s a reason that my favourite poem is Robert Frost’s The Road Not Taken, I’m always inclined to take the ‘one less travelled’.

I daresay there’s a dash of the contrarian in my personality but more than that I’ve tended to scan the horizon for the mountain that’s in the way and try to move it. The move from a career in television journalism to environmental charity was seen as a quixotic move (my boss laughed in my face when I told him I was off) but it was powered by the need for a new challenge. I’d finished the puzzle and needed to start a new one.

And the pattern repeated itself. I quickly assessed the landscape and figured out a strategic fix and spent six years chipping away at changing the law in Wales to nudge the mountain. I did it. And it moved, a bit.

When I got elected (itself a huge challenge in a seat everyone told me was lost) I again scanned the horizon for challenges and spotted that the analogue nature of public services in a digital age was a serious threat to the fairness agenda. The need for digital transformation was not a fashionable topic, and little understood by policy makers, it had all the contours of the mountains I like to move – seen as unfashionable and boring, dominated by an orthodox profession and vested interests, but reform had the potential to unleash people’s potential and advance social justice. Again I threw huge amounts of energy at analysing, dissecting and setting out practical ways to change. It took four years this time, but the mountain moved, a bit.

When trying to change roads policy and lowering the speed limit it helps to have a brain in overdrive, and a determination to achieve change. By keeping at an issue, and being demanding of others working with me, is not a sign of disagreeable personality but a reflection of the fact I genuinely care about the mission at hand, and will keep going until there’s a result. When a personality type (ENTJ) and a neurological disorder come together it can create a powerful fusion. But it can also produce the odd spark.

“Yes of course you have” is a common reaction I’ve had when I’ve told people I’ve recently had an ADHD diagnosis. It fits. It makes sense. It comes as no surprise.

Apart from pissing people off it generally does not especially scar my life, but it does make it harder. And sometimes I get lost in things and make mistakes, that’s what happened when I voted the wrong way (three times). My mind was busy elsewhere. That’s not an excuse, I need to concentrate extra hard to make sure it doesn’t happen again, and figure out a system to keep me on task.

“I want help with a coping strategy” I told my ADHD coach in our first meeting. He’d heard this before. His hair nearly went on fire. “Cope! Cope?! Who wants to just cope?!’’ he said.

He has a point.

With his help I’m working on strategies, and I’m beginning the trial-and-error process of looking for medication. The diagnosis and the coaching have made me reflect on the impact these traits have had on me through my life. It is an emotional process. It is painful to recall the collisions between a neurotypical environment and a non-neurotypical brain. It is dawning on me that ADHD is a bigger deal than I have allowed myself to concede. 

I don’t want a label. I don’t consider it an excuse. But it is an explanation for me for why I am the way I am. 

Everyone is different and has different experiences, but I hope by talking about my experience will be of help to others who might recognise some echoes of themselves.

But as a friend reminded me ‘remember, just because you have ADHD, it doesn’t mean you’re not still an arsehole‘. Quite.

Right, what’s next?