The phrase, “Speak the truth, even if your voice shakes,” has been resonating with me lately, leading me to explore its origin. It comes from Maggie Kuhn, the founder of the Gray Panthers, and her full quote is profound:

“Leave safety behind. Put your body on the line. Stand before the people you fear and speak your mind – even if your voice shakes. When you least expect it, someone may actually listen to what you have to say. Well-aimed slingshots can topple giants. And do your homework.”

This sentiment of courage in the face of adversity feels deeply personal to me. I had an appointment with a psychologist a few months ago to discuss restarting ADHD medication. Having been diagnosed in the past, I’ve seen firsthand how transformative stimulant medication can be for me. It enabled me to go from struggling as a high school student to achieving honors in college. I know my body and what works for me.

However, this experience highlighted the shortcomings within the mental health system. I was transparent about my past, about the challenges I’ve faced and the harm I’ve endured at the hands of the system. I offered to provide my medical records to confirm my diagnosis and explained how non-stimulant treatments had proven ineffective. I also shared the significant negative impact this untreated condition was having on my life, including jeopardizing my career.

Despite all this, the psychologist’s response was disheartening. Instead of offering the appropriate support, I was prescribed sleeping pills and told I would need to undergo three separate psychiatric evaluations, all to ensure her own comfort in prescribing treatment. Her reasoning was, “It would make me feel better.”

This left me shaken. Through tears and frustration, I asked, “So, you would rather have me continue to suffer, endure further re-traumatization, and risk being misdiagnosed again; all for you to feel better?”

The systemic issues I encountered are not unique. Several studies affirm that women with ADHD and CPTSD are at a higher risk of being misdiagnosed with conditions like bipolar disorder, leading to delays in appropriate treatment:

• The Misidentification of Trauma Symptoms as Bipolar Disorder in Youth discusses how trauma symptoms are often mistaken for bipolar disorder, particularly in adolescents, highlighting systemic diagnostic challenges (Fitzsimmons, 2015)

• ADHD Versus PTSD in Preschool-Aged Children notes the misdiagnosis potential between ADHD and PTSD, especially when primary care providers lack diagnostic expertise (Stewart, 2015)

• Reconceptualizing Complex Post-Traumatic Stress Disorder delves into the risks of CPTSD being misdiagnosed as bipolar disorder, particularly in women, and the systemic implications (Livingston, 2023)

• Assessment of Bipolar and Psychological Trauma Spectrum Disorders examines overlapping symptoms between CPTSD and bipolar disorder, underscoring diagnostic complexity (Evans et al., 2023)

This research highlights how systemic failures in diagnostic accuracy disproportionately impact women, often compounding the challenges they face in accessing effective treatment.

A critical issue within the mental health system is the pervasive failure to truly listen to patients. Women, in particular, are disproportionately affected by entrenched biases that unfairly characterize them as "over emotional," resulting in unwarranted scrutiny rather than meaningful understanding. Such biases erode trust, compromise diagnostic accuracy, and significantly delay or obstruct effective treatment. Eliminating these harmful stereotypes is imperative for fostering ethical practices and achieving diagnostic clarity.

To reform the system, it is essential to prioritize empathetic, unbiased listening and an approach that centers the patient’s voice and lived experience. These systemic barriers, coupled with a lack of diagnostic expertise, disproportionately harm women and perpetuate inequities in care. Addressing these challenges goes beyond improving individual outcomes, it requires a comprehensive transformation of the mental health system to prioritize equity, integrity, and the highest standards of care.

This experience reinforced the importance of speaking up, even when it feels impossible. Bravery is advocating for yourself when fear and doubt threaten to silence you. It’s standing firm in the face of injustice, even as tears fall. This kind of courage, fueled by truth and resilience; has the power to drive change.

We must do better. As individuals and as a system, we need to listen, learn, and act with compassion. It’s only through collective effort that we can begin to address these systemic issues and ensure that no one has to fight so hard just to be heard.