An unexpected ADHD diagnosis following her daughter’s traumatic birth (Erica Shoemate’s story)

When Erica Shoemate gave birth to her daughter Nia, she was told Nia wouldn’t survive. But today, Nia is 7 years old — and that traumatic birth became a turning point in Erica’s life. 

Erica shares how her postpartum experience led to diagnoses of anxiety and PTSD, and eventually ADHD. A former national security analyst turned maternal health strategist and policy advocate, Erica reflects on the layered stigma of mental health in the Black community. She also talks with Laura about ADHD and hormones. And she shares the comment her husband made that sparked her ADHD evaluation.

• Erica’s website, www.ericalshoemate.com

• A guide to ADHD and hormones

• From the Hyperfocus podcast: Did my ADHD make me more likely to have postpartum depression? 

• ADHD and pregnancy

We love hearing from our listeners! Email us at adhdaha@understood.org or record a message for us here.

(00:00) Intro 

(02:09) How Erica’s pregnancy journey led to her ADHD diagnosis 

(10:07) What Erica’s diagnosis has taught her about herself

(16:10) Why Erica speaks openly about her ADHD diagnosis 

(21:26) Erica’s maternal health advocacy work

Erica Shoemate: I remember being in the children's emergency room and the monitor started beeping and going off. And I just burst into tears. And I knew then something was off.

Laura Key: This is "ADHD Aha!," a podcast where people share the moment when it finally clicked that they have ADHD. My name is Laura Key. I head up our editorial team here at Understood.org. And as someone who's had my own ADHD aha moment, I'll be your host.

I am here today with Erica Shoemate. Erica is maternal health strategist, AI policy expert, and maternal health advocate. Erica, welcome. I'm so excited to be here with you today, and I love your shirt.

Erica: Thank you so much. I'm super excited to be here with you today.

Laura: For those who aren't watching on YouTube, Erica's shirt says neurodiverse universe, and it's got like a solar system thing happening. It's a great shirt. Nicely done.

Erica: Thank you.

Laura: Tell us about your daughter.

Erica: My daughter is now seven years old, and she is literally the light of my world, and you want to talk about the universe, she is my universe. And we had a very rocky start. She was not expected to survive birth. I literally spent the last 17 weeks of my pregnancy in 2017 expecting for her birth and death to be on the same day. And as a result of her journey, I would say my life redirected its purpose, and I became a maternal health strategist and advocate alongside my actual expert work as a former national security analyst and intelligence professional turned Big Tech policy leader as well.

And I call this my life's work outside of the things that I do on a day to day. And she literally is just a ray of sunshine. When people encounter her, they feel even her presence, her difference. And her name is Nia, and Nia means purpose. And it's the one name my husband and I could agree upon. So nothing is happenstance. And she is really living out her purpose and even giving us new found purpose to fight for other moms and babies.

Laura: She's so brilliant, Erica, truly and like such a beautiful name, Nia. Your ADHD diagnosis kind of stemmed from this experience. Is that right?

Erica: Yeah. So I mentioned that she wasn't expected to survive birth. She actually came out screaming, shocked the entire operating room. Everyone knew literally a miracle had transpired. Like they had like all the life support equipment set up and they were like, "Oh, don't need that, just need a little bit of CPAP."

And at exactly two months, she actually coded twice in one day. And I will never forget the first time. And I could see the worry in her eyes of looking afraid and she started to turn blue as I was picking her up. And I'm just so incredibly grateful that one of our favorite nurses who had been so attentive to her was the person that was with me because it was such a traumatic and horrific experience to hear my daughter's name being called, "Ence." which is like an emergency code, letting doctors know like people were flying from everywhere.

And even to this day, I can still see her blue lips at times when I close my eyes. And so as a result of her journey, I was diagnosed with postpartum anxiety and PTSD. And I should also say she has a very rare form of dwarfism that also comes with a congenital heart defect. So she's also survived open heart surgery at 16 months. So for going back to how did I get to my diagnosis? I started doing the work of realizing, you know, I was having something that was wrong with me, but that actually did not really come to light until our daughter was unexpectedly rehospitalized after she had graduated from the NICU.

And I remember being in the children's emergency room and the monitor started beeping and going off. And I just burst into tears. And I knew then something was off. And I spent the next five and a half years working through my postpartum anxiety and PTSD, which postpartum anxiety became generalized anxiety, and trauma impacts your DNA. It actually changes your DNA.

I am no longer the same Erica Shoemate that I was before my maternal fetal medicine specialist told us on June 1st, 2017, that our daughter actually had a lethal form of a rare form of dwarfism, which was a misdiagnosis and that we should terminate, heal, and try again in that order. Very matter of fact. Wow. No resources in the room with us and me trying to find my way out of this hospital building and my husband like almost in shock and trying to like not think the worst. Trying to be the positive light.

It and then just kind of kept reliving a lot of this trauma and going back to when the monitors at the emergency room happened, I did start to see a great perinatal psychologist. A lot of her focus was specifically on mothers who were either high risk pregnancy, dealing with kind of that same situation of like your child or baby is not expected to survive birth. And she, I'll never forget, I am generally a very happy soul.

Laura: I see that about you. Yeah.

Erica: Thank you. And I was doing a lot of masking.

Laura: I bet, yeah.

Erica: And I would come into therapy, maybe cry sometimes, but was like, "Oh, I'm okay." You know, still I'm okay. Yeah, yeah. From a cultural standpoint, I'm like, "I'm still okay."

Laura: What do you mean from a cultural standpoint?

Erica: For those who may not see me, I am also a Black woman, and while I would say in my family, we definitely talk about mental health a lot more than the norm, it still is a lot for even someone like me who's an extrovert, glass half full and lives life, honestly through the lens of even when I'm down at some point, I can come back up. Now you're talking about my mental health, though, and I'm like, I'm fine, I'm happy.

Laura: There's a stigma associated with it. It sounds like in your community as well. It's like maybe heightened.

Erica: Yeah, that's what I'm alluding to. Yeah. It's different and so going to my psychiatrist for the first time was really a blessing. She's a woman of color as well, same with my psychologist. And that was helpful in learning about my own lived experience.

Along the way of my mental health journey after having my daughter, there would be times that my husband actually would say like, "Oh my gosh, you're jumping around in conversation. I can't track." And I was like, "Well, women do it all the time. Like, what do you mean?" And he was like, "I can't follow." And my husband is an engineer by degree and profession. So just imagine that in this person.

Laura: I relate. Yes. Yeah.

Erica: He was like, "You know, this is not normal." And he was like, he didn't like say ADHD, but he was like, "Have you considered looking at to see how you can better support yourself to keep your thoughts straight?" And I'm like, "Okay." And so I mentioned to my psychiatrist, "Do I have ADHD?" I feel like maybe I do. And so we started doing the research, and find me an amazing private practice.

And I loved my clinical psychologist. She actually got into this work specifically for Black women and women of color so that we could finally feel like we could be seen. Because, yes, ADHD, honestly, is talked about in the wider society. But for Black people and even more importantly, Black women, it's not that same level of awareness, right? We're just the high-functioning kids. We're the super smart kids. And I was all of those things. And then all the things hit the fan after I had a kid.

And so, needless to say, I took the assessment, and in that huge analysis, the official diagnosis is ADHD inattentiveness. And major depression. It shocked me. They can go hand in hand. They can build on each other and fight with each other or feed each other. Yes. They feed each other. Yes. And then the coolest part, though, so I got those two new diagnoses. It reconfirmed my anxiety and PTSD. So I knew I was in the right place.

Laura: Hormonal changes in ADHD, I'm certainly no expert, but when you go through hormonal changes, which is something that happens through pregnancy and it's not just like that hormonal change is done the day after you have a baby.

Erica: Exactly. And that people don't talk about that. And like they'll typically say your postpartum period is up to one year, right? But what they don't say is, and this is actually something I've been slowly trying to bring to the forefront, is if you are nursing your baby, your hormones have not leveled. I pumped exclusively for 19 months, getting my daughter to open heart surgery.

Laura: That in and of itself is like sainthood. I...

Erica: Hey man, right? And so... It's a lot. Those hormones had to go somewhere when and I literally didn't feel like I had completely regulated again until probably the last year and a half. I'm not joking. My hair, my skin...

Laura: I believe it. Yeah.

Erica: ...all the things. I'm finally feeling like things are a bit more stable, normalized. I feel healthy overall mentally. But that diagnosis explained so much about me. As hard as it has been as a wife, as a mother, as a professional, and knowing what I feel like in many ways, the things it cost me personally, I am just incredibly grateful that I continued to push through getting the proper diagnosis.

And alongside this, I was also dealing with chronic pain. I was misdiagnosed for over five years with diastasis recti. And that's where the abdominal wall is split as a result of pregnancy. And because I'm so petite, things were just continuing to be missed. And I also had to endure a major surgery. And so you're dealing with that and then I still hadn't had my diagnosis yet and trying to show up, but struggling and it's causing all types of communication issues at home. And I'm not understanding why.

One thing early on that I would notice. So it can be pretty difficult for a neurotypical person to understand that the neurospicy person is not attempting to break their word. They are literally likely a dopamine issue is happening maybe that day or life starts to feel overwhelming because I've committed to something, I don't feel like doing it, and it's not just lazy.

Laura: I think there was an example that you gave last time when we chatted in the pre-interview about toast. You want to share that?

Erica: Absolutely. So for those who are listening, in neurospicy world specifically ADHD, and for anyone that's neurotypical, maybe you have a partner that is neurospicy as well. Imagine literally every day knowing you need to do something, a very important task, like eat to live and think about making toast as basic as making toast. Someone with ADHD will literally wake up, ready to go, and you know you need to make the breakfast, you know you need to get up and make the toast.

It will probably take no more than five minutes to make the toast, but as an ADHD person, you're lying in the bed and you're like, "Oh my gosh, I got to get up and make the toast. Oh my gosh, I got to put it in the toaster or I got to put it in the oven. Oh my gosh, that's so overwhelming. I got to put the butter. I got to get the knife out."

Laura: And I have to pee. I got to do this before.

Erica: I got to pee, right? Yeah yeah yeah yeah. I don't want to even go pee.

Laura: It's a task. Yeah.

Erica: It's a task. And I would literally just sit and sit and sit knowing I need to do something. I know it is the right thing to do but feeling paralyzed. And it has taken me now 8 hours later just to make the darn toast. That is the life.

Laura: I totally relate to that.

Erica: So again...

Laura: ...symptoms heightened with the hormonal changes. I remember you saying that you felt more capable around the house with like these everyday tasks prior to all of the hormonal changes. Is that true?

Erica: That is true. I would say things that I cared about before I had my daughter, I was one of those people. I would not leave my house without making up my bed. Had to, a must. And then after I became a mom, and I think not only becoming a mom but like in survivor mode too with making sure my daughter's alive, we have medical equipment at home, all of that went out the window and then things became very chaotic. Like I would have stuff everywhere. And I could see it, but I could not see it. I did not have the capacity to care enough to do something about it.

Now, the impulsivity would come in, and then I'm like, "Okay, I've had enough. I got to like," then spend hours.

Laura: Hyper focusing on it.

Erica: Hyper focus, right? Yeah. And I do go through those and I became a night owl. And I do some of my best work. Like people have seen, they're like, "Oh my gosh, that would take me days to do what you're doing." When I'm in it, there is nothing I cannot do, right? But that also lack of sleep, but I get my best ideas usually between 10 p.m. to 2 a.m.. And those things did not start to become an issue until after I became a mom. Like that part of it, like inconsistency, particularly not professionally, professionally, oh my gosh, that was like something to meet. But the commitment to my personal life was definitely a real challenge.

Laura: It sounds like maybe before the event of having your child and then everything that came after that, you were finding workarounds for everything probably.

Erica: Yes.

Laura: But then even a minor, like hormonal change, can kind of throw these things completely off.

Erica: Oh, it was off. Oh, it was awful. Yeah, and once you go through this trauma, all these things, you know, it can come off as if your neurospicy partner is not committed, don't care, we're not paying attention. We're not doing all these things and it's not on purpose. But when you don't have this diagnosis, it can be a real like, what's wrong with this person?

Laura: Do people ever say to you like, "You've been through so much, so much really, really big stuff and come out through the other side of it?" What's the big deal with ADHD? Is that something that you ever get?

Erica: Oh gosh, all the time. 

Laura: Really? 

Erica: Like people see you in a sense of like you have been through so much, but you're so resilient, you're so strong, all these things. I've kind of talked a little bit about ADHD, but not so much because again, the stigma that goes with it and particularly in this environment that we are operating in politically, you're almost afraid to say this is what you are enduring, particularly as a Black person because it can be weaponized against you. Because people think that now they understand and know why you do a thing and, "Oh, that explains this, oh, that explains that," when it's like, "No, you're just continuing to cause harm," is what you're doing.

And so for me to even be here on this podcast is a real courageous move personally, to put my mental health on full display at the risk that it could be used against me. Yes, it's technically illegal, but in reality, it can be used against me. But I think for me, it's more important to share what that feels like, particularly as a Black woman so that other women in general but another Black woman can understand that you are not alone.

You kind of do your neurospicy brain a disservice when you're like, "Ah, I think this is what it is," but then you never go and get the real diagnosis. And so when people do say things to your point about like, "Oh, what's the big deal?" It matters because I'm now informed that that is how I'm showing up. It's not that something is quote unquote wrong with me. It's not quote unquote I don't want to pay attention. I need things to be delivered a different way, especially after all the trauma I've gone through. I'm still brilliant, I'm still smart.

Also another thing that became a real thing after having Nia as it relates to the undiagnosed, untreated ADHD, being late. Oh my god, like, I have cried because I cannot understand how I've got to the point where I am just late. I was the kid that would be telling my mom, "We need to be leaving at this time. I need to get to school on time." I wanted my perfect attendance. I'm thankful though that's not even a whole ordeal.

And that is a real thing. I have some concept of time, right? Like I know I need to be somewhere, but then mornings I can be a bit slow, and then I'm also dealing with a complex medical needs daughter. I'm trying to make sure when she eats, she was previously G-tube fed and now she is eating by mouth and her belly is a lot smaller and she can have like these dry heaving episodes. So sometimes I'm like waiting to make sure she's going to be good for the day before I can take her to school. So she's also late to school. And I just, I want people to know to particularly start in our community that you can't just learn away ADHD. It's a perfect example. If someone had a kidney disease, you wouldn't just tell them maybe try to do things differently. Like okay, yes, eat right, those things, but okay, that kidney is broken.

And when you think about the brain, it's an organ as well. And we talk about it a lot in the abstract. And yes, there're a lot of chemicals and neurotransmitters, all those things. But the brain is wired a bit different from the everyday average person. And therefore, as my shirt says, it's okay to communicate differently. Celebrate those things, have patience, have grace, have compassion for people who have these big ideas. I can tell you, I've always been a dreamer, a visionary person, and now in this last year since I've had my diagnosis, I am fully honoring that piece of me because I know that that superpower for me personally and professionally not only saved my daughter's life being able to tap into my analytic tradecraft, but it's also saved other people's lives as I was also working in the national security space, seeing things that people actually brushed off and I'm like, I would keep at it and it like would open Pandora's box.

And so I just wanted to share that as someone who does have a late diagnosis and that has had to mask my entire life.

Laura: Erica, you're so fantastic. Everything that you just said really kind of knocked my socks off. Do you want to give a quick plug to your maternal health advocacy work if there's anybody out there who needs support?

Erica: Absolutely. If you're someone who is hearing this podcast and you're thinking like, "Whoa, that feels like me. I can relate." Do not hesitate to reach out to me personally. I can be reached at info@ericalshoemate.com. You can also find me from my maternal health work at ericalshoemate.com.

Laura: Well folks would be really lucky to connect with you, Erica. Thank you so much.

Erica: Thank you.

Laura: Thank you for telling me so much about Nia. She sounds amazing.

Erica: Thank you.

Laura: And, you know, here's to neurospicy women with neurotypical husbands just trying to make it work.

Erica: I know. No, absolutely. And then the last thing I will say, too, is you can also follow me on IG at The Policy Goddess as well. I talk a lot about all the things. And if you want to follow my daughter because we educate a lot at Nia's, N I A S, underscore journey on IG as well. So thank you.

Laura: Thanks for listening today. As always, if you want to share your own aha moment, email us at ADHDaha@understood.org or send a message to our voicemail inbox. You'll find a link in the show notes along with resources and links to anything we mentioned in the episode.

This show is brought to you by Understood.org. Understood.org is a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. If you want to help us continue this work, donate at understood.org/give.

"ADHD Aha!" is produced and edited by Jessamine Molli. Say "Hi," Jessamine.

Jessamine: Hi, everyone!

Laura: And Margie DeSantis.

Margie: Hey, hey!

Laura: Video is produced by Calvin Knie and edited by Alyssa Shea. Our theme music was written by Justin D. Wright, who also mixes the show. Production support provided by Andrew Rector.

Briana Berry is our production director. Neil Drumming is our editorial director. From Understood.org, our executive directors are Scott Cocchiere and Jordan Davidson.

And I'm your host, Laura Key. Thanks so much for listening.