Suicidal ideation, masking, and overlooked ADHD: A Coast Guard veteran’s story

Inattentive ADHD often goes unnoticed. It’s an easier type of ADHD to miss because it’s more internal and less outwardly visible than its hyperactive, impulsive counterpart. But left unaddressed, inattentive ADHD can be just as disruptive.

Boys with the inattentive type are especially overlooked — they don’t match the stereotype of what an “ADHD boy” is supposed to look like.

So when Brandon Saiz wrote to us about his experience getting diagnosed with ADHD later in life, we knew we had to talk to him. After meeting with Brandon, it was clear his story needed to be shared.

Content warning: This episode includes discussion of suicide. Please skip it if that’s not something you’re up for right now.

Related resources

• The 3 types of ADHD

• Listen: The “devastating” findings of a decades-long ADHD study

• Brandon Saiz on Substack   

• Duck, Duck! It’s a Goose: Brandon’s video game 

Timestamps

(01:54) Brandon’s background

(09:23) How Brandon’s inattentive-type ADHD was overlooked

(14:00) On suicidal ideation and inattentive ADHD 

(19:57) Brandon’s advice to others

We love hearing from our listeners! Email us at hyperfocus@understood.org.

Episode transcript

Rae Jacobson: Hi everyone. Just a heads up before we start the episode that we'll be talking about suicide in case you'd rather skip this one.

Brandon Saiz: I'm a 20-year Coast Guard vet who struggled with suicidal ideation my entire life until my diagnosis at 43 years old. So much of my life has been swallowed by shame and it's only just recently I've started feeling pride about the number of survival mechanisms I invented for myself. The timing of discovering your podcast came just as I was seeing my mostly estranged mom and stepdad at my daughter's college graduation last weekend.

Rae: That's Brandon Saiz. A few months ago, he wrote to us after hearing an episode of the show, and his letter was so lovely and so moving, we decided to ask if he'd be willing to come on and talk to us. Fortunately, he said yes, and we asked him to begin the recording by reading some of his letter for our audience.

Brandon: The visit was super awful and it brought up so many feelings of inadequacy. Thanks in part to listening to you, I had a super productive therapy session today pulling on threads of just how exhausting it is to handle all of this and how overwhelming it is to have to do this for the rest of my life. Anyway, thanks for all the work your team has put into this. I really appreciate the perspectives and the knowledge.

Rae: We asked Brandon to come on, not only because we wanted to hear more of his story, but also because we were really interested in talking to someone who had personal insight into two very important but rarely discussed experiences: being a veteran with ADHD and being from a group of folks we often hear from at the show but rarely hear about — overlooked men with inattentive ADHD. This week on "Hyperfocus," Brandon Saiz.

(01:54) Brandon’s background

Brandon: I live in Sitka, Alaska. It's in the southeast. I have referred to it as like neighbors with Canada. We're not really because it takes a boat or a plane to get out of here. So it's kind of semi-isolated. It's not wilderness adjacent, it's in the wilderness. While I was doing dishes, I had a deer in my yard yesterday and it's the same route shared by some grizzly bears and it's the same one I walked to work on.

Rae: So, I mean, first I have to say, you say grizzly bears, the only wildlife I ever see on my walk to work is a rat. So I feel like your walk is probably a little more scenic. But one of the reasons I was so interested to talk to you is your ADHD story is not like one I've heard before. Would you mind just telling me the story, starting where you feel comfortable starting?

Brandon: Yeah, I think someone I know that I was having a conversation with her at one of the bars in town about someone I know that is diagnosed bipolar. And the way I was describing my interaction with this person was like so many layers of connection with them, but knowing that a lot of what they went through didn't apply to me. It was in many cases too extreme, it was for longer periods of time, but like something just made me feel, I think at the time I used the word crazy, but just like something's not quite right in my head and I can't quite figure out what it is.

And fast forward to after retiring from the Coast Guard, I started with regular therapy sessions thanks to a diagnosis of generalized anxiety that I got on retirement from the veterans association. So I was pretty grateful to be in therapy. I was able to get through moments knowing that I had someone to chat with about things that were maybe panic-inducing before.

When I lost that therapist due to childcare concerns during COVID and I got a new therapist and she got to see me start a new job, which was in kitchen management for long-term care, something that I should have been hugely successful at because that's what I did in the Coast Guard: manage kitchens for many, many years. And I fell flat on my face and I had a great boss that was super supportive and I gave indefinite notice telling her that it wouldn't work out. She needed to find a replacement.

And I think that prompted my therapist to dig a little deeper into why someone that seemed so perfectly set up for a job like that would fall on his face. And she recommended I get screened for ADHD. And so yeah, I got screened. The day of the screening was a treat because my transmission went out on my way to that particular appointment. And so I left my car with its hazards on and jogged to the appointment and then knowing that I got to walk home from there, I was like, well, I could go visit my boss who works in a different work location. And I was like, these are all the things that I was thinking of while I was clicking through the little test because I was like, well, I already have this mastered so I can move on to the next thing. It was great.

Rae: I know a lot of people who are veterans and people who are in active duty service right now in varying parts of the army or armed forces or Coast Guard. And I wonder often how people with ADHD cope with that level of rigidity because to me that seems like from the way that my brain works, look at all those places to make mistakes where you could literally go to jail for being late. Like, I can't imagine trying to fit myself into that structure, but I hear from the people I know who are veterans or who are still in service, that actually is really helpful that the structure gives them a focus and a way of like managing things and the predictability of the structure makes ADHD more manageable. And I wonder what your experience with that was because I can see it going one of two ways. Like either the rigidity exposes your ADHD because you cannot function in that system, or it's kind of the thing that holds you together long enough, but not well enough to hide it.

Brandon: Yeah, I think it's both. I've been getting back into video game development lately. And one of the things that I hear on like social media or like podcasts is building a structure allows for more freedom of creativity because you're not worried about hitting the edges of what can be done. I guess you're, like, it's very well defined. You're going to work in this space and you're going to move in the ways that you can.

And when I think about that in the Coast Guard, like I was in food service and I think that has a huge, like, a huge element of structure and room for creativity. And I think that made things interesting every day. The idea of having 50 people on a boat where they're like pulling buoys and like giant cement sinkers out of the ocean. So they're burning a lot of calories and if your potatoes are raw, they're going to hate you, like so much. And like, the thought of that made everything very interesting. Like I need to be mediocre at worst because if I'm not, like I won't last. I will get fired. I will get run off the boat, maybe literally.

The other thing that I avoided in my Coast Guard career as much as possible was anything where I had to get dressed up in a fancy uniform because like the amount of work they, they've had like these great companies that will like construct your ribbon bars and stuff. There's one in particular, it's a good conduct medal. It's like automatic if you don't get like a DUI, like every, every three years or something, you get an additional bronze star on it and eventually that turns into a little silver star. Well, all those things were like poked into fabric where you would have to push these little prongs one way or the other to like and then like center them. And then if you push the prongs the wrong, like if you apply too much torque one way or the other, then it's a crooked star. And so like I always look like shit. And I would do my best to avoid those.

And when you do your best to avoid things in the military, then people that really don't know you will just assume that you're anti-establishment and that you hate rules and that you're a troublemaker. And for the first time in my life, I was a troublemaker. I was becoming like the Bart Simpson instead of the Christopher Robin. And that followed me. I got my lowest evaluation score of my career on my very last set of marks at my 19 and a half year. I got a three out of seven in military bearing because I missed a uniform inspection because I was quote unquote cooking for the base. Like I sent all the cooks down and I stayed myself so that I didn't have to go. And those things are supposed to be for a year, so it shouldn't ever reflect like one incident, but they really wanted to make a point. So they made a point on my way out that I was unacceptable.

(09:23) How Brandon’s inattentive-type ADHD was overlooked

Rae: These days, we talk a lot about how many girls with ADHD have gone overlooked and untreated. And there are a lot of reasons for this, but one of the big ones is because girls are more likely to have the inattentive type of ADHD — easier to miss, more internal, less noticeable than its hyperactive impulsive cousin, but just as destructive if left unchecked. What we don't talk about as often are the inattentive boys, kids who, like Brandon, don't fit the stereotype of what an ADHD boy is supposed to look like.

Brandon: My favorite English teacher, like I remember her, it was junior year and I wanted to go to college and she's like, you are risking everything you want to do by not doing this. Like, what are you doing? And it wasn't, like, it's not, it doesn't have to be her fault that she didn't understand that my brain was different. Like, I don't think that if she were a teacher 10 years ago, she wouldn't know it much less like forever ago because like the knowledge base wasn't out there, especially for a well-behaved boy. Like why you're not doing your homework is nonsensical to adults around you because you're nice and you are pleasing everyone.

Rae: And you don't look like what we think boys with ADHD look like. You don't act like them.

Brandon: Right.

Rae: In short, Brandon was a kid with undiagnosed inattentive ADHD. These boys get left behind too, labeled as slackers who don't live up to their potential — the P word we all shudder at. And Brandon — smart, people-pleasing, undisruptive, and failing — was just such a kid, undiagnosed, ducking and diving his way through school, as baffled as anyone as to why he couldn't just do what he needed to succeed.

Brandon: Yeah, and I work with insurance companies a lot because I'm at a dental front desk and I think multiple therapists have pointed out to me that I tend to take like large organizational moves as personal to me or someone I know. And it is a constant thing. And that's what this feels like, is it like, if I were that same adult in that same situation, I probably would, no, I don't know that I would because it's hard because like by the time I was their age, which is now, I'm looking at kids that are growing up and I'm just like, well, like maybe something works differently in their brain than in my brain because like, I don't think I would do that, but they're their own person. They have their own struggles and like, I guess like even from role models and and like family members that I've enjoyed, there was not, there was not, there was not an acceptance that I could be operating on a different frequency on a lot of levels.

I lost the structure of public school close to my parents and I went to college for a semester where my D minuses turned into incompletes. I did get one D minus.

Rae: Congratulations.

Brandon: Thank you. Like, I never went to that class. I don't know how I got one. But I think the professor just felt bad for me.

Rae: Brandon was at a loss for what to do next. He'd grown up in San Diego watching military planes roaring overhead, and at that point in his life, joining the service seemed like a why not next step. But the Coast Guard wasn't something he knew a ton about.

Brandon: I grew up in San Diego county, which is very close to some Coast Guard units. There was like a Learjet that they used to close down the road to wheel over to the airport. And I didn't know anything about them except that they would occasionally close down the road to wheel their jet over to the airport. Like, I probably knew that they had boats. Like if you had to ask me before I looked into them, I probably knew they had boats because they're the Coast Guard, but I had never seen one.

And I went to school in Indiana and one of the students there, their uncle was an officer in the Coast Guard. And I was like, I don't know what my options are. I guess military. And she's like, you should look into the Coast Guard. And when I went in, when I went home, I knew a, another, a person that was with another federal agency and he said that he had thought about joining the Coast Guard, but he was 28 when he did and that was the cutoff at the time and he was so upset that he didn't get to join. And that was all it took to call the recruiter. And I think that there's, like, it took a long time, but I think that was maybe the most impulsive thing I've ever done in my whole life.

Rae: Brandon's impulsive choice turned into a 40-year career. And by his own telling, despite the hiccups — uniform inspections — those years were often full of joy and excitement. But there was something else, something that had been there long before the Coast Guard, something he came to think of as the ambient noise of his life, a low-level thrum that never left him — anxiety, self-doubt, and intermittently, thoughts of suicide.

(14:22) The link between inattentive ADHD and suicidal ideation

Here's what we didn't know when Brandon was a kid. There's a link between ADHD and increased suicidal ideation, particularly for people with the inattentive type, like Brandon. Studies show that people with inattentive ADHD are significantly more likely to have experienced suicidal thoughts or have attempted suicide. The reasons for this aren't fully clear yet. It might be because ADHD has what's called high comorbidity — read, co-occurrence — with other disorders like depression and anxiety. And that, combined with the challenges caused by ADHD can create a kind of perfect storm.

Rae: You've talked about suicidal ideation in your email and here. Like I said, we know, and I feel like this is something that a lot of people don't know, which I always feel very compelled to be like, I want to make this very clear because like you said, when you can pull it out and name it and like understand what it's connected to, it's a lot easier to face it, that suicidal ideation and suicidality in general is significantly more likely if you have ADHD.

And there's a myriad of factors that go into this, but the on the ground real life experience of it is terrifying and it's not something that people talk about. And if you were comfortable talking about it, I wonder if I could ask you a little bit about what that's been like.

Brandon: Yeah, for sure. I can tell you that those like ambient thoughts is what I would call them. Like, I think that the day that, the day before I called to set up therapy was my 40th birthday. Like I was on my way home from a pretty epic day and evening, night, I was leaving the bar, a little bit of the morning too. And it was like, it should have been like a joyous walk home and it and like the suicidal ideations turned a bit ugly.

And that was at 40 exactly. But like those, the ambient thoughts that had just been like, what ifs, like, what if I wasn't here mostly? Like those had been around, I can think of a specific event freshman year. It wasn't an event, it was just like looking outside my bedroom window and having these thoughts in freshman year. So like I know that they've just been a part of me for at least that long, probably middle school, but I think they don't get talked about and I think that what drove me to therapy was knowing, knowing how sharply they turned in that one evening and knowing how that has turned out for other veterans especially.

Rae: And when you were going through life with these thoughts, there is the ambient backdrop. And they are, I'm trying to think of how to ask the question I'm trying to ask, not because it's such a hard question, but because like you say, you don't really talk about this that much. So talking about it in an upfront way like this, it feels like swimming up from the bottom of a lake a little bit.

I think about all the things we do to mask as people with ADHD. And something like saying to someone, hey, I'm thinking that I might not want to be here anymore, if it's after a negative experience or it's just during the walk through the park, that's a very hard thing to get out of your mouth. Yeah. And during that time, did you ever find a way to talk about it with anyone? And when you did, did it ever have a benefit? Or was it just like, I'm just letting you know what's in here.

Brandon: I don't know. Often I had conversations about anxiety with people, but it was never saying, hey, like this is how my chest feels right now. This is like how my arms feel like they're falling asleep because I'm so freaked out right now. And I would never say that to someone back then. But I definitely had conversations around that where I got the feeling from the other person, they're like, oh yeah, yeah, I know exactly what you're going through. And I, I remember specifically, probably my best Coast Guard friend, the first time I ever talked to her in depth conversation was over lunch while we were both in a an ASIST class, which is like first responder for suicidal ideation. It's not even ideation, it's like the idea that like you experience something that might be someone's suicidal ideations and what you do about it.

Rae: Oh yeah, cause there's an action associated with it.

Brandon: Yeah, it was basically a first aid for suicide class. And we were both in it and we were coming out of the lunch break knowing that we were going to do role-playing exercises and we needed a partner. And when we went to set up partners, she looked over at me and pointed at me. And I was like, sure. And she's like, let's go grab lunch and we can talk about this. And then we went and talked about something completely unrelated and just had like an in depth like, here's who I am, here's who you are conversation, like really honest, really open, but never directly about, like, I still don't know if I've talked to that person about like her specific thoughts on suicide or suicidal ideation. I know that I've talked to her about mine.

Rae: Yeah.

Brandon: But well after the fact, like she's one of the people that I reached out to on my 40th birthday because I knew that she, like, there was going to be no level of rejection for sharing that part of me. But I think that's what it is, is that like--

Rae: You felt safe.

Brandon: --As soon as you go to talk about something that, like, you're, you're going to like shave someone's mask off if you just bring that up. Like, you're going to find out what level of support they're ready to give you if you bring up suicidal ideation. And that's terrifying, like, because you don't want people to like see that is fully unmasked. And we just don't do that.

(19:52) Brandon’s advice to others

Rae: One of the things that we hear a lot from listeners, and that I've heard a lot from my friends who are veterans kind of separately, is like, nobody really talks about how this is for me. Like I go through this as an undiagnosed or a late diagnosed man with ADHD. I wasn't attentive, nobody noticed. That's a very common issue. We talk a lot about women with ADHD. We don't talk as much about undiagnosed men with ADHD, which is a really significant group and people who don't get a lot of visibility or advice. And then on the other hand, we also talk to veterans who are saying like, I don't really have the language I need to process all the things I'm experiencing as a person with ADHD who's working within this system. But you do. And I was wondering if you have any advice. I know I just put a lot out there and on you.

Brandon: Yeah.

Rae: For those two groups of people.

Brandon: I guess I feel rather privileged to have had guidance through the process of figuring out all of this. Like the therapy sessions that I've had have been like, while they've been free, that's a huge deal. Like not everyone gets that. And I do think that for veterans specifically, one thing that you can do, no matter what, is try to get that anxiety that you feel like, especially if you're still active duty, like get it documented because even if you get like no disability rating, if it shows up as a disability rating of 0%, then you're covered for that if it becomes a problem later.

And so like, I don't know if that's common knowledge, but you don't have to retire from the Coast Guard or any other service to get a disability rating from the VA on a specific thing that you experience while you were in service and anxiety is one of those things. And that will qualify a veteran for like coverage for life on that specific topic. And if you have enough back injuries and shoulder injuries and etc, etc, then like other things are covered at a higher degree too.

But yeah, like that specifically is a huge deal because I don't know any veteran that isn't like a little bit disordered from their anxiety, whether they talk about it or not. It's visible. You don't have to hide it, but I also understand that sometimes you have to hide it. And like for the, for anyone else that doesn't have that privilege of like veteran health care, I don't know, I might not be qualified to say this, but I think that masking is like super important and super necessary to keep jobs, to function in a society that isn't built for someone that's unmasked all the time.

And I don't think that I survived 20 years in the Coast Guard without masking and I don't know that I survived a career that's customer facing without masking. Like masking is something you have to do in customer service whether you're neurodivergent or not. And so I don't think that there should be shame attached to that. If you're behaving in the way that keeps your job, then great. But if you're doing that and you're not processing the back end of that, I think it can be really long-term harmful. It has been for me.

I think that hiding yourself and then not ever letting that out in any other setting is harmful. And so find ways to be yourself. Personally, I signed up for a musical when I was 45 having not sung in front of anyone since high school. You don't have to do that, but like find a way to be yourself is what I'm saying.

Rae: In addition to being an all-around sweetheart and performing in his first musical, Brandon is also a writer. You can find him on Substack. And he recently wrote to us to say he's gotten into video game design and just finished his first game. It's called "Duck Duck, It's a Goose," and we'll leave a link to that and his Substack in the show notes so everyone can check them out.

I also want to acknowledge that we talked quite a bit about suicidality in this episode. So if you or someone you know are experiencing suicidal thoughts or struggling with mental health, help is available. Don't keep it to yourself. Talk to a friend, a loved one, a mental health professional, or you can also call 988 to speak to a trained counselor, and the conversations are free and totally confidential. Thanks for listening, and we'll see you next time.

"Hyperfocus" is made by me, Rae Jacobson, and Cody Nelson.

Our music comes from Blue Dot Sessions. Our research correspondent is Dr. KJ Wynne. Video is produced by Calvin Knie and edited by Alyssa Shea.

Briana Berry is our production director. Neil Drumming is our editorial director. Production support provided by Andrew Rector.

If you have any questions for us or ideas for future episodes, write me an email or send a voice memo to hyperfocus@understood.org. 

This show is brought to you by Understood.org. Our executive directors are Laura Key, Scott Cocchiere, and Jordan Davidson.

Understood 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.