In this commentary, Dr. Bunny McFadden talks about the financial implications of supporting herself as a person who has ADHD.

This commentary is part of the Voices of Disability Economic Justice Project, a partnership with TCF’s Disability Economic Justice Collaborative. Voices of Disability Economic Justice showcases disabled writers’ first-person perspectives on the economic issues that matter most to them.

When I was a kid, I frequently forgot the forms for my school lunch account. There was always an alternative, usually a bland sandwich on Pizza Friday, so I never went hungry. But for things like field trips, when I forgot the forms, I got left behind. As I grew older, it got worse. Back in the Blockbuster days, I qualified for a card and within a week owed a fine on my video rentals. It kept happening—Netflix DVDs in the mail, phone bills, renewing my vehicle registration. The consequence was usually only a fee, so I didn’t lose out on these things. But it did start impacting my credit, which meant I didn’t qualify for certain jobs and couldn’t rent certain apartments.

An ADHD diagnosis (attention-deficit/hyperactivity disorder) in college helped me pull through. Like many women and femme-presenting people, I got diagnosed a lot later in life because my symptoms don’t match up with what a “typical” (read: white, male, suburban) ADHDer looks like. Once I got therapy, I started learning more not only about how to change myself in small ways to meet the world’s expectations, but also how to make my world fit me better. It costs money, time, energy, and emotion, but not coping would cost me more.

The hidden costs of pursuing a diagnosis, getting medication, and getting therapy are enough to push away most people who suspect they’re neurodivergent. There’s a whole economy around neurodivergence, and it’s taking a serious toll on ADHDers like myself. I spend $50 each month on a mandatory consultation with a prescriber, in addition to paying for my medications and jumping through hoops to get them. And recently, when I brought up that I am worried I might have a comorbid case of depression or anxiety, I was told to book a separate $300 session with the same provider to diagnose it. ADHDers are a lucrative market.

ADHD medication is a $13 billion industry. It’s slated to grow to $20 billion by 2030. In pre-inflation numbers from 2021, the average adult ADHDer paid $2,228 a year for doctors, therapy, and medications. Since my health insurance only covers a telehealth specialist, I pay extra for convenience fees and am not allowed to fill my prescription at my nearby pharmacy; in fact, several of the chains in San Francisco have stopped accepting my insurance or telehealth prescriptions. Instead, I face added time, hurdles around transportation, and a sense of shame when getting my medication. Sometimes the pharmacists ask invasive questions or give me horrible looks. Once, a pharmacist looked me up and down and suggested I spend more time exercising. Still, medication helps me feel functional as a mom, friend, spouse, and community member. I’m used to the cost that comes with managing my unique brain.

And the cost isn’t limited to the medical industry. Services like HelloFresh and Kindle Unlimited benefit when people with ADHD fail to unsubscribe, and then apps like Rocket dangle the possibility of unsubscribing all at once, for a fee. Wellness influencers market their spreadsheets and apps, fidgets, and timers. Sensory tools are a brilliant example of things in the wellness industry that help with managing symptoms. My noise-canceling headphones, weighted blanket, fidget spinners, visual timer, and sticky notes are what keeps this human machine running. As some of these tools have become popularized, it’s led to cheaper alternatives, like how weighted blankets cost a lot less now that they’re mainstream. But for other things like visual timers, adding the word ADHD to the product means it’s suddenly more expensive for me.

When I build up the courage to check my bank accounts, I feel ashamed at the subscriptions I’ve forgotten to cancel, the tally of impulse spending, and the copays I forfeit monthly to continue proving I have ADHD and deserve medication to treat it. Sometimes it feels like I am single-handedly keeping the medical industry, wellness influencers, and fidget spinner manufacturers afloat. Being an ADHDer is expensive.

The industry that’s popped up around neurodivergence sometimes means that other ADHDers are able to turn our shared problems into networks of support. However, so many of the tools and medications I need are financially inaccessible because they’ve become money-makers. I have privilege because of my education and job experience, so I can financially and socially survive on lean months. Still, I feel like I’m a month away from losing it all.