Fremantle Dockers AFLW player Emma O'Driscoll on how ADHD shapes her

Australian Football League Women's (AFLW) player Emma O'Driscoll believed she had anxiety her whole life growing up. "I always just put it down to being a highly strung person," the Fremantle Dockers defender told ABC Sport. "I got very anxious around exams and my time management has always been poor, and still is."

It wasn't until O'Driscoll, 24, started playing elite sport that she decided to investigate further. "I never sat down with a psychologist and tried to tackle this anxiety, especially when it was impacting my performance," O'Driscoll said. The result of the investigation was a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). "It was the last thing I ever thought that I would be considered a neurodivergent person," she said.

O'Driscoll has been playing for Fremantle since 2020, racking up more than 50 games. She was recently named in the AFLW All-Australian team for the second year in a row. "One hundred per cent I wouldn't be the footballer I am without ADHD," she said. "I use it as a strength, it's part of who I am as a person and it allows me to play the way I do." She describes her playing style as like a cat on a hot tin roof. "I've got my eyes wide open, I'm hyper-focused," she said. "That energy allows me to perform at my best and my teammates benefit from it. I can focus on where the ball is, where the opposition is. I can provide energy and enthusiasm for the team and it's great."

ADHD can be described as a neurodevelopmental condition associated with differences in brain structure. There are three subtypes, and problems may include difficulties with attention, organization, and motivation, as well as impulsivity and hyperactivity. Senior clinical psychologist Caroline Stevenson said women are often diagnosed later in life with ADHD. "Women are more likely to have the inattentive subtype of ADHD," she said. "If they have that subtype, ADHD rarely occurs on its own, and the condition that goes along with inattentive ADHD is anxiety." Inattentive ADHD refers to difficulties with focus, attention, and organization. Dr. Stevenson said it is often missed in girls. "Boys are more readily picked up because they tend to have behavioral issues, whereas girls with (inattentive type) ADHD don't."

Many professional athletes have shared their experiences of being diagnosed with ADHD, most notably perhaps US gymnast Simone Biles and swimmer Michael Phelps. There is little research on neurodiversity and elite sport, but a review published in the British Journal of Sports Medicine (BJSM) found ADHD affects 7 to 8% of elite athletes, compared to an estimated 2.5% of the general adult population. In 2023, former AFLW player, psychologist, and researcher Associate Professor Erin Hoare published a review with Deakin University concluding there was some evidence of over-representation of neurodivergent people in elite sport. The BJSM review found a reason for the over-representation could be that children with ADHD may be drawn to sports because physical activity can improve focus.

Dr. Stevenson said sport can be a double-edged sword for people with ADHD. "I think a lot of parents put their kids into sport to burn off some energy," she said. "There are just as many kids that completely fail in team sport because they can't follow instructions, they're silly, and the coach gets angry with them. But then you get these very special coaches who take these kids under their wing." Dr. Stevenson said for some people with ADHD, sport can be completely game-changing, particularly in harnessing things like hyper-focus, impulsivity, and lots of energy. "The thing with ADHD is you can be very distractible, (whereas) when you're hyper-focused it's the opposite," she said. "It's like you've got blinkers on and you can only see one thing. I'm 100% sure impulsivity is an advantage in sport because it means you can make quick decisions and you're not scared. When other people won't go for the ball, you will, that's definitely an advantage, so you've got hyper-focus, speed, and the ability to make decisions. You're absolutely going to have an advantage."

It's thought that people with ADHD have lower levels of dopamine and noradrenaline in their brains than neurotypical brains. Some people with ADHD use medication to boost these levels, but Dr. Stevenson said exercise can have a similar effect. "You can use it (exercise) in combination with medication or as an alternative to medication," she said. "If medication works for you and there aren't heaps of side effects, medication is fantastic. When medication isn't viable, we can get the same effect of the dopamine and noradrenaline boost through exercise, and we can use that for therapy. So first thing in the day, get up and exercise, you're going to get the same effect as Ritalin for a couple of hours after exercise. With exercise, you can get (dopamine) quicker, but with medication, you can get it for longer. So the combination works well."

O'Driscoll said she doesn't use medication when she plays football. "I think I like (being) a little bit highly strung," she said. "I kind of use my ADHD, that hyperactive but really fixated type to my advantage." While ADHD may be advantageous for athletes on the field, there is evidence it can negatively impact them off the field, including over-committing. "I put too much on my plate to the point where it's unsustainable," O'Driscoll said.

Dr. Stevenson said scheduling too many things into the same day is common and is another way of boosting adrenaline, which is a precursor to dopamine. She said she often discusses procrastination with patients. "So, you procrastinate, procrastinate, procrastinate, and then you get a massive hit of adrenaline," she said. "Being late or scheduling too much in the day is the same thing. You're constantly stressing yourself out by the adrenaline hit you get. I can tell you that most of the time what people with ADHD are doing is playing with their biochemistry."

Now, with her diagnosis, O'Driscoll has the knowledge and tools to strategize ways to help her balance commitments off the field and understand her body on the field. "It's provided so much clarity for how I've always felt," she said. "It's made me aware of over-committing and having realistic expectations to reduce anxiety. I've got the resources and help around me, whether that's medication or talking to a psychologist. I'm completely comfortable talking about it now and knowing there's no stigma around what you have to do to make sure your mental health is thriving."

In terms of creating more inclusive environments for neurodivergent people, O'Driscoll has this advice. "Let people be themselves," she said. "One of my biggest insecurities is being told that I'm too much. My friends and family know not to say to me that I'm too much for them or that I'm too hyper and need to calm down. If I do need to calm down a little bit or they need to help me problem solve, they know how to help me, rather than the language they used to use that might put me in a hole and make me feel really anxious, really down. I think just talking to that person and understanding what works best for them."