After receiving my ADHD diagnosis at 47, I did all I could to learn about the traits, treatment, and how I could overcome the devastating effects ADHD had wreaked on my life.

It was then that I discovered the similarities between what I'd experienced as an adoptee, the effects of undiagnosed and untreated ADHD – and the connections between them.

The ADHD / Adoption Connection

While approximately 9-11% of children are thought to have ADHD, according to the CDC, amongst adoptees it can be as high as 20-30%. With high impulsivity as one predominant ADHD trait, and unplanned pregnancies occurring up to nine times more often for girls and young women with ADHD, it's easy to see how ADHD crops up in adoptees more often than in the non-adopted population. After all, ADHD is believed to be hereditary.

But that might not be the full story.

Early Environmental Stressors on an Adoptee

According to Gabor Maté, MD, author of Scattered Minds: The Origins and Healing of Attention Deficit Disorder, any mom who has to give her baby up for adoption is by definition, a stressed mother. This means that for nine months the baby is awash in high levels of stress hormones, “… a negative influence on [the baby's] developing [brain] even before birth,” says Maté.

Like me, throughout the '50's and into the early 1980's, most adoptees were taken away from their birth mothers at birth. In Scattered, Maté also suggests that the separation from our birth mothers may affect our brain's neurotransmitters. In a study where four-month-old monkeys were separated from their birth mothers for only six days, major alterations in dopamine and other neurotransmitters occurred.

Whether ADHD is caused by genetic inheritance or environment - or both - there are several challenges in common to ADHD and adoption.

Impact on Self-Esteem

Historically, adoptees were described in disparaging terms, including being “illegitimate.” Early on, I internalized the message that I was less worthy than others, and my self-esteem plummeted.

Today, the terms “illegitimate” and “bastard” may no longer be in vogue, but the fact remains that, before being “chosen” by our new families, we must first have been “unchosen.” It's not just moms who relinquish their babies, it's an entire ancestral line. Two, in fact. Being both intelligent and emotionally hypersensitive, two typical traits for ADHD children, this insight was not lost on me as a child. As a result, I grew up feeling rejected by my birth parents.

If adopted internationally, this feeling of rejection can extend to the adoptee's culture and country of origin. Parents who are aware of and sensitive around this possibility may be able to lessen the impact through open discussion with their child, and through validating their adopted child's feelings.

Feeling out of Place

As an adult with ADHD, I've often felt that those with ADHD have a unique culture. We speak to each other differently; understand our shared ADHD traits; and often refer to each other as “tribe members.” As an adoptee, it seemed to me that I did not fit in with my adoptive family tribe. I loved them, but my personality, mannerisms, and ethnic background (not to mention undiagnosed ADHD) set me apart. If an adopted child is the only one in the family with ADHD, their feeling of not fitting in or belonging can be exacerbated. Viewing ADHD as a different culture can take the hurt and shame out of seeing it as an illness or disability.

The Adoptee / ADHD blues

 In my first book, Adoption Reunions, I began the chapter “Growing up Adopted” with: “At age 15, I began to realize that I had been melancholy most of my life.” I wrote this decades before my ADHD diagnosis.

I'd assumed that this melancholy (what we would now call dysthymia) was due to the losses that accompany adoption: loss of ancestry, medical history, and the knowledge of my birth mother.

While being adopted contributed to my melancholy, those with ADHD also suffer depression and dysthymia more often than others. Being aware of this potential double-whammy might help adoptive parents to be vigilant about watching for the signs of dysthymia or depression in their ADHD child.

Stigma

When I grew up, being adopted held the sting of stigma.

Perhaps today's schoolyards aren't the arena for the kind of ostracism I suffered when the other kids shouted, “Nyah, nyah, you were adopted!” But children with ADHD also suffer from stigmatization.

It may be that the sense of being stigmatized might be more keen for the child with both A's in their lives – adoption and ADHD.

Embracing the difference

One of the best gifts a parent can give a child with ADHD, or a child who's adopted, is self-esteem and self-acceptance. Both conditions present challenges; and both also offer opportunities.

Whether a child is adopted, diagnosed with ADHD, or both: if parents can acknowledge that we're different, but emphasize that we're not less than others, they'll be giving their child a solid foundation of self-love and self-confidence. With these, adoptees with ADHD can thrive.

For more information on how to identify and respond if you suspect depression in your child, please read: What to do if you suspect Depression in Your Kid, Signs of Adolescent Depression and Recognize and Treat Depression and Anxiety Disorder with ADHD.