August 26, 2019 at 07:29PM by CWC
One of the most harmful mental health stereotypes out there: attention-deficit/hyperactivity disorder (ADHD) is only something that happens in little boys. While it’s true that ADHD affects three times more male than female children, it’s still an issue many women and girls face. Nearly 7 percent of female children are diagnosed with ADHD, per the National Institutes of Health—and 3 percent of adult women aged 18-44 years are diagnosed with it (which translates to roughly 3.4 million women).
ADHD is a brain disorder that can affect a person’s attention span, mood, productivity, and memory, no matter their age or gender. But recent research suggests that women and girls can experience ADHD a bit differently than boys and men—which can affect a person’s ability to get a diagnosis. In a 2017 study out of Norway, the authors wrote that, compared to boys, girls and adults with ADHD tend to exhibit more symptoms of inattention (one of the hallmarks of ADHD) and mood and anxiety disorders and fewer hyperactive and disruptive behaviors (the other, more stereotypical symptoms of ADHD). And inattention, according to the authors of a 2014 review of studies on women and girls with ADHD, is often not as noticeable as hyperactivity. “Because symptom severity contributes to the likelihood of referral for treatment, girls may be less likely to be diagnosed and receive treatment,” they wrote.
Another thing that may make an ADHD diagnosis complicated for adult women: per the Mayo Clinic, many of the symptoms of ADHD that adults might experience (like trouble dealing with stress and frequent mood changes), are similar to those of other mood disorders like anxiety. Eighty percent of people with ADHD also have some other kind of mental health disorder, from depression and anxiety to a substance use disorder, which may make it even harder to know what’s going on.
Treatment for ADHD typically involves behavioral therapy, lifestyle changes, and medication, all under the supervision of a psychiatrist. The condition isn’t always “outgrown” in adulthood—one-third of children diagnosed with ADHD still have that diagnosis as adults, per the NIH—so it’s an issue that can follow women into their adult lives, with serious impact. “Women with ADHD continue to experience lower self-esteem and more anxiety than women without ADHD,” the 2014 review authors wrote. “These women tend to respond to life stressors with emotion and feel a lack of control over their situation, which translates into difficulties in coping with home life, feelings of disorganization, somatization (including headaches, stomachaches), and/or sleep difficulties.”
So what is it like to finally realize that you’re struggling with ADHD? Four women share their experiences getting diagnosed as adults:
“My thoughts ping back and forth constantly”
“I was diagnosed with ADHD, inattentive subtype [meaning that primary symptoms are lack of focus and attention], around March 2019. I was seeing a psychologist for depression and therapy and asked him to test me for ADHD. I had a feeling that I had always struggled with it because I couldn’t stay focused on anything, but had never been diagnosed, or even had it questioned by anybody else, because it was all silent struggles in my head that nobody else could see. Studying for me was near impossible, yet I still somehow had A, B, and C grades all through school. Even as an adult, I can read a sentence or paragraph over and over and have no idea what I read. I cannot remember conversations. I am easily overwhelmed and overstimulated, and my thoughts ping back and forth constantly.
“I had no idea that all of these symptoms were part of my ADHD until my psychologist started me on Adderall last spring. My thoughts slowed down, and I could focus and remember. Unfortunately, we haven’t found the right dose yet, but medication definitely makes a difference and gives me hope.
“Life has changed since my diagnosis because I realize that all the things inside my head that were frustrating and overwhelming me are a part of ADHD, and that is treatable. I have a reason that my brain was not holding or retaining information, and it is not because I was stupid. I feel like once we find the right dose of meds, life will be so much more manageable, as I won’t feel so scattered and helpless.” –Makayla*, 38, Texas
“I decided to get tested again, for the memory of my dad and for myself”
“I was diagnosed [with ADHD] twice in my life: at 5 years of age while living in Rhode Island, and at 28 while living in Wisconsin. I don’t know in-depth about why my mother decided to get me an assessment when I was young. I do know that she noticed things being a bit ‘off.’
“I don’t know how I got through school. I didn’t do anything. I think a lot of it had to do with my disconnection from the classroom. I was way more concerned with the social aspects of life. I didn’t try hard and didn’t think I was smart. I’ve had trouble at certain jobs due to my inability to know how to ask good questions or to be fully engaged with what was going on around me. I gravitated to nanny jobs because it’s easy for me to nurture and take care of someone.
“When I was in my late 20s, my father passed away due to suicide. I related a lot to his struggles… He had a hard time with his cognitive functioning, and I personally know how that feels, especially in stressful situations where you’re not supported. I was doing poorly at my workplace, and had been reminded time and again from my partner that it seemed like I wasn’t listening. It really took a toll on me, and finally after doing more and more research about ADHD, I decided to get tested again, for the memory of my dad and for myself. I wasn’t going to continue to feel shame about being ‘stupid.’
“My most recent diagnosis has completely changed my life. I was so young when I got my first one, I even forgot that I had ADHD for most of my life. Now I know what I struggle with and why I struggle. There’s a reason why I don’t retain everything: My working memory is extremely low for my age range. It feels very empowering to know what my strengths and weaknesses are. I’m now medicated and feel like my best self. It feels good to say things like, ‘I need you to repeat that again because I didn’t get it the first time.’ It’s not because I’m stupid, it’s because my brain couldn’t hold onto it. There are so many misconceptions when it comes to the diagnosis. I feel empowered to educate people on all things ADHD now too.” —Kelsey*, 30, Wisconsin
“I finally had to address the issue”
“I easily flew under the radar in high school because I was in advanced classes and made good grades. However, I never really developed solid study skills, so when I got to college, I was completely taken aback by the course load, combined with working two jobs. I was placed on scholastic probation after my first semester, and that was pretty scary. Up until then I was always on the honor roll. I had to quit one of my jobs and essentially learn how to study. Even then, it would be 15 years before I would know that I was also competing with undiagnosed ADHD.
“In my various jobs after college, I never caught on that I had any learning issues. But now, in retrospect, it makes a lot more sense. In my first career I was a journalist, and everything was always chaotic and rushed because of daily deadlines. With my chaotic lifestyle, I fit right in and everything seemed completely normal. But when I moved onto a corporate job that was more structured, that’s when those breakdowns became more glaring. While I had issues with tasks in my journalism career, it could always be written off as, ‘Oh, I was in a mad rush, that’s why that typo, mistake, etc. happened.’ But when I was in a controlled environment, it was still happening and it was creating issues for my team. That’s when I finally had to address the issue and I was scared.
“I was diagnosed in 2015 at the age of 34. I was already seeing a psychiatrist for anxiety and depression (which I have battled my entire life), and she noticed I kept leaving my keys in the waiting room. Once I started telling her in detail about my workplace challenges, she ordered testing and I was formally diagnosed.
“It’s changed me completely. As someone who once thought I needed chaos to survive, I now rely on routines. My diagnosis has forced me to get really up close and personal with myself and identify what works best for me, what my weaknesses are, and how to best take care of myself. It’s also taught me compassion for myself and others. “ –Sarah*, 38, Texas
“I consistently felt like there must be something I was missing”
“I was diagnosed when I was 36 years old, a few months after my now-15-year-old son was diagnosed at age 3. As I was reading up on the signs and symptoms of ADHD in boys—and searching for the best course of treatment for Theo—I came across articles that talked about the signs and symptoms of ADHD in girls and women. I’d never heard that girls with ADHD could have hyperactivity, perfectionism, and extreme risk-taking and impulsive behaviors—all of which sounded a lot like me. I never struggled academically, but I got five speeding tickets and got in four car accidents in the first 18 months after I got my driver’s license. I always felt desperately apart from my peers, like they all knew how to do something that I’d never gotten the rule book for. I got heavily involved in drama at school and for a time was self-medicating with alcohol.
“I was able to succeed academically, graduate from college, get married, and have kids. I had a pretty solid work schedule, we had good help at home with housekeeping and childcare, and most things were manageable. But when I stopped working full-time to help care for our son (the one who was diagnosed with ADHD) my life completely fell apart. I consistently felt like there must be something I was missing. How did other women manage to keep track of all their kids’ schedules and sizes and appointments? How did they keep their houses clean and feed everyone something resembling a healthy meal every day, three times a day? I felt like I was drowning and thought I must have delayed postpartum depression. (I was, in fact, diagnosed with depression and started taking antidepressants; that only helped a little bit.)
“When I realized that I actually had undiagnosed ADHD, I was honestly thrilled. Having an explanation for why I still felt like I had to go, go, go all the time, and that I was spinning in circles… it was incredibly validating. I tried medication to help with organization and follow-through, and found that it helps some. I’ve always known that I need to work out almost every day in order to not lose my temper, so I fine-tuned that program a bit and started taking fish oil supplements and trying to eat more protein, which has helped too. [Editor’s note: There is some evidence that adding more protein and supplementing with omega-3 can help certain ADHD symptoms, but dietary changes are generally still considered complementary to traditional treatment of talk therapy and medication.]
“I also realized that I desperately needed other parents of kids with ADHD and other adults with ADHD to talk to. So I started the Kansas City chapter of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), ADHDKC. Along the way, my daughter was diagnosed with ADHD, as was another one of my sons. [Editor’s note: ADHD can run in families.] I became an ADHD coach, initially to find tools and techniques to help calm the chaos in my home, but ended up working with ImpactADHD to help parents like me. I’m actually going back to school next month to get my master’s in social work so I can diagnose adults with ADHD here in Kansas City.
“It’s been so rewarding to see more and more moms and dads get diagnosed when their kids get diagnosed, and to see more and more parents be okay with sharing the fact that both they and their kids have ADHD. The stigma connected with ADHD seems to be lessening worldwide.” –Jeremy*, 47, Kansas
*Last name omitted to protect privacy
Editor’s note: Quotes have been edited and condensed for clarity.