Jopie, ADHD and mental health.

Jopie, ADHD and mental health.

You might recognise Jopie, as she appears on our instagram feed from time to time, having forged either a second career or an elaborate hobby (her words) as a model. She tends towards the colourful and the mystical and isn't a traditional model size. She lives in Amsterdam, so it was a bit of a trek to get to this shoot!

Jopie was diagnosed with ADD as an adult, which is relatively unusual as it's classed as a developmental disorder, usually diagnosed in children between the ages of 6 and 12. Like most of these things, it's a bit complicated and people tend to have trouble recognising the difference between "stuff that everyone does" (we all have problems concentrating and there can be millions of reasons for that) and when it's a serious clinical condition. 

It's much easier to recognise when someone has ADHD - attention deficit and hyperactivity - because well, they tend to be bouncing off the walls. Or at least, that was my experience when I used to work meeting families in distress in London, but they did tend to be living in situations that made it worse.

To spot ADD, you're looking for someone that can't manage their attention. Signs of that might include being easily distracted, missing details, losing objects, switching from one thing to another quickly, being easily bored, not finishing things, problems listening, appearing dreamy or confused, difficulties following instructions, and problems with organising oneself or things.  

Much of this is initially dismissed as a "naughty" or "lazy" child. Oh, how I hate the word lazy. True laziness is very debatable, if a child can't concentrate on something, there's pretty much always another reason for it. And of course, you should check that these issues aren't caused by things like a child not getting enough sleep, food, sensible activities, or being stressed. It's worth noting that also some folks with ADD get hyperfocus -  when you're SO intent on something you're doing that you ignore everything else completely, including that you need to eat - something you also find in ASD and OCD. When your attention mechanisms work oddly, it can go both ways.

Hyperactivity is a physical thing, manifesting as movement; fidgeting, wriggling, bouncing about, rapid speech, fiddling about with things and not being able to do quiet tasks. 
Again, much of this is dismissed as "Naughty", and any of these can also be a sign of something else that's an issue (for example, fiddling is a classic "stim" for kids with autistic spectrum conditions). As with all these things, gendered expectations mean the issues often display differently in boys than girls. Boys can get away with being "boisterous", whilst girls will be more likely to talk loudly and fiddle with their hair, since bouncing about is firmly quashed.

A less recognised issue is the impulsivity that comes with both ADD and ADHD - acting without much consideration (which kids often do anyway), and all the concomitant problems of social stuff where you might be expected to repress your initial reaction. Impulsive behaviour can also be extremely physically risky.

Every single one of us already does most of these behaviours at some point, so the issue is NOT the behaviours themselves, but the frequency and intensity. To be counted as a problem the issues should be affecting badly one's ability to be in education, work or relationships. As with the other issues we've talked about, you can imagine that some tasks, roles and environments made attention, impulsivity and hyperactivity issues worse, and others can alleviate them or even make good use of them. You do get the jobs that require you to switch between activities frequently and/or be very physically active, where the downsides become upsides.

As people age the hyperactivity elements sometimes lessen, but people who struggled with ADD as kids mostly continue to do so. In the UK the focus with kids tends to be on management strategies, and in the US, medication. Due to a quirk of biochemistry, whatever produces ADD/ADHD (and we really don't know yet) means that if you take what would be a stimulant for most people, folks with ADD/ADHD can concentrate and focus instead. So, for example, the drug Modafinil, which I take as a stimulant to get me somewhere close to "alert" and help me get things done, will result in me bouncing from activity to unfinished activity unless I plan in advance.  My friends with ADD take it precisely because it means they can plan and focus!

As you can imagine, combining most forms of education and jobs with ADD and/or hyperactivity is stressful, and it can also strain relationships. When you have trouble regulating your feelings and the expression of them, that can be a bit of a challenge, and it's easy to interpret the lack of concentration and forgetfulness as a sign that someone doesn't care, rather than a sign that they have issues concentrating and remembering things. Some ADD/ADHD folk also report RSD Rejection Sensitive Dysphoria, where small incidents (your friend asked you to stop fidgeting) prompts you to have an intense, debilitating and painful onslaught of feelings about rejection and misunderstanding, instantly.

If you want to help with ADD/ADHD, then obviously remembering that folks reactions are not about you is a start. You can also reduce distractions in the environment, let people fidget/stim without comment, alert people when something that really needs focused attention is coming up, and take regular breaks. I'm told all the cool kids are on Tumblr these days so if you want to understand more, then this page should be pretty much endlessly educational!

Strained relationships and employment and education spaces are pretty much a recipe for mental health problems, so it's not really a huge surprise that Jopie was also diagnosed with depression and anxiety. Having to make it from childhood to adulthood without anyone recognising that you're having serious issues with your attention and similar is pretty tough. We also know that pretty much any form of disorder, chronic illness or life-limiting condition is associated with a higher rate of depression and anxiety because even if you have appropriate support and intervention, you can't really avoid the effects of marginalisation and other issues.

Mental health diagnostic labels are kinda stick-a-dart-at-random-in-the-board, * so I'm not going to cover them in much depth here as this is already quite long.

Suffice it to say that depression is more than normal or appropriate sadness, and anxiety is more than normal or appropriate worrying. As with ADD/ADHD, the symptoms and experiences are things that we all go through in course of our lives. The issue is are; they severe, persistent, intense, debilitating, and not explained by anything that's happened recently?

I'm writing this on the 21st December so it seems a good moment to remind people that Christmas tends to aggravate mental health issues, no matter what's behind them. What with the focus on family, relationships, home, the sometimes faux-cheer and money stress, it can get tough. Plus most mental health workers are on leave too, or you're tying yourself in knots about taking up their possible holiday time.

So please remember that if you're in the UK (we are) then you can always ring The Samaritans, who are there to listen. Their number is 116 123. If you can't use phones then you can email them on

If people could comment in with the appropriate organisation in their country, that would be amazing.

If you have a little cash to spare, then donating to Mind and The Samaritans is always helpful - they do great work.

* For those of you who don't know, my background is mental health and psychology. I have a few postgrads in the area including a post-masters in counselling psychology. Due to my own disabilities, I never chartered, but I'm qualified. I spent about a decade working in various roles, with specialities in eating disorders, family work, child protection, severe and enduring psychiatric work and domestic abuse. Like most people who work in the area and aren't burnt out, I genuinely loved my work and remain thankful to all the people who shared their experiences with me over the years. Their generosity is a large part of what makes me able to talk about complicated and difficult issues in public today. Please don't ever imagine that when you share all you are doing is using up resources; you are giving.