ADHD in Women: Let's Talk About It
My story is similar to many stories I’ve heard from others and is similar to the story in the video.
I was a straight-A student, helpful, had strong leadership skills, and outwardly ‘had it all together’ while I was in school.
I received awards for ‘most likely to forget their child in Walmart.’ In high school, I developed body inflammation leading to a 4-week hospital stay, 30-pound weight loss, and close to organ failure due to the stress I was under in Grade 11. Doctors still had no idea what caused it. Only after speaking to a holistic practitioner was I able to put the pieces together. I literally pushed my body to the point of failure as a way of trying to fit into the mold I was expected to be in…whoah.
I didn’t stop there after I got sick even…it actually got much, much worse. I partied too hard to fit in during university, was constantly concerned about others’ perceptions of me, and was very concerned about my body image.
I was called lazy, irresponsible, forgetful, and clumsy.
I had a lot of challenges with social situations, leading to crippling social anxiety that still sometimes tries to pop up during professional networking events.
Ugh, it was yucky…for a long time. No one had any idea. My mom still to this day doesn’t believe in ADHD, and thinks I can just ‘think my way out of it.’
Science Lesson Time-ADHD Version
ADHD is a neurological disorder that affects both children and adults. It is characterized by problems with focus, impulsivity, and hyperactivity. People can be diagnosed with predominantly inattentive type, predominately hyperactive type, or a combination of both. Although it is often diagnosed in childhood, it can also affect adults.
Though women are diagnosed less than men on average, ADHD has a significant impact on their lives. Many women feel like they are struggling alone and don't know where to turn for help. This may be because the symptoms of ADHD are often different in women. Women with ADHD may have trouble with organization, time management, and multitasking. They may also struggle with anxiety and depression. Because many women don't exhibit the 'outward' signs of ADHD, it becomes challenging to identify. At school they may be the 'prized student' doing well on all their assignments, are quiet, or are considered shy. There is so many variances in what ADHD looks like on the outside, but what is happening in the brain is all very similar.
ADHD and the brain
There are three parts of the brain that are impacted in ADHD: the frontal lobes, the basal ganglia, and the cerebellum. The frontal lobes are responsible for organizing and planning, the basal ganglia are responsible for movement control and inhibition, and the cerebellum is responsible for balance and coordination.
When someone has ADHD, these three parts of the brain don't work together as well as they should. This can lead to problems with focus, impulsivity, and hyperactivity. There can be challenges in executing different functions either in their personal lives or professional. Often, I see that women create habits that mitigate many of the symptoms (like fidgeting, taking notes, teaching themselves, being overly organized or perfectionistic, etc), but when stress increases from other factors in the person's life or there is a challenging learning curve, that's where those older strategies begin to work less well than before.
ADHD overall creates challenges with executive functioning. Executive functions are skills that help us manage our lives. They include organizing, planning, time management, decision-making, and problem-solving. Executive means ‘to execute’ and in relation to ADHD, it means the execution of tasks becomes disrupted.
There are two types of memory: working memory and long-term memory. Working memory is what we use to remember things in the short-term. Long-term memory is what we use to store information for the future. People with ADHD often have problems with both types of memory.
Short-term or working memory is essential for many everyday activities, such as following instructions, having a conversation, or doing math in your head. If you can't keep information in your mind long enough to use it, you will have trouble completing these tasks. Many women that I've worked with in therapy report feeling like they're 'losing their mind' because they can't keep track of all the different tasks they need to complete in a day.
ADHD is more than just being impulsive, forgetful, or hyper
The symptoms of ADHD can impact women's lives both at work and at home. Women with ADHD may find it difficult to meet deadlines, stay organized, or handle multiple tasks at once. At home, they may have difficulty keeping up with housework, managing their finances, or taking care of their children. Let’s talk about some of the lesser-known symptoms of ADHD.
Hyperfocus
Hyperfocus is an intense form of concentration. People with ADHD can hyperfocus on things that interest them. This can be a good thing if it's something productive, like work or a hobby. But it can also become unhealthy if the intense concentration is on something that could be risky or harmful (i.e. excessive social media use, binge-watching TV for days/weeks on end, drug use, gambling, etc). Generally, I would consider hyperfocused states as less healthy when it negatively or adversely interacts with ones’ major life areas (i.e. financial, social, mental, educational/work, physical, emotional, spiritual).
When women with ADHD are in a state of hyperfocus, they may not hear people talking to them, or they may not notice when someone else needs their help. They may miss important deadlines or appointments and may miss taking care of themselves while in a hyperfocused state. If interrupted, they may experience an intense rush of irritability or distress. And they may have trouble completing tasks that are boring or difficult.
Rejection Sensitivity Dysphoria
Other, less known symptoms of ADHD include rejection sensitivity dysphoria (RSD), which is feeling extreme emotional pain in social situations due to the fear of being rejected. This can manifest as pervasive feelings of loneliness, shyness, or insecurity.
RSD is a condition that can occur in people with ADHD. It means that a person feels overly sensitive to rejection or criticism. This can lead to feelings of anxiety, depression, and low self-esteem.
For women with ADHD, RSD can show up as a fear of failure. They may avoid taking risks or speaking up for fear of being rejected or criticized. This can make it difficult to succeed at work or in relationships. RSD can also cause women with ADHD to doubt their abilities and feel like they're not good enough.
Bedtime Procrastination Revenge
Additionally, there is a phenomenon known as 'bedtime procrastination revenge', which is where a person with ADHD will put off going to bed as long as possible because they know that once they're in bed, their brain won't stop racing and they'll have difficulty falling asleep. This can lead to sleep deprivation, which can make symptoms worse.
Bedtime Procrastination Revenge is a term used to describe the act of staying up late in order to do something we want to do. It's a way of getting back at someone or something that we feel has wronged us. This could be others, or society itself (I’ll explain that in a bit). For many of the women I have worked with, they have described bedtime as the only ‘me-time’ they have during the day, and the only time they feel like they can enjoy themselves without pressure from outside sources.
However, it’s important to recognize that bedtime procrastination revenge can have negative consequences for both our mental and physical health. It can lead to fatigue and sleep deprivation, which can make it difficult to concentrate and focus during the day. It can also lead to weight gain, high blood pressure, and other health problems.
Women and impulsivity
One of the most common symptoms of ADHD is impulsivity. This can manifest in a number of ways, such as interrupting others, making careless mistakes, or taking risks without thinking them through. For women, this can often lead to problems with relationships. They may say things they regret, act out of anger, or make decisions that are not in their best interest.
Time Blindness
ADHD can also lead to what is known as 'time blindness'. This is where a person experiences a sort of 'time dilation', where time seems to move either slower or faster than it actually is. This can make it difficult to estimate how long tasks will take, leading to problems with planning and time management.
ADHD and Being Clumsy
Another common symptom of ADHD is clumsiness. This can be due to problems with coordination or balance. Women with ADHD may find themselves tripping, dropping things, or bumping into things more often than others. I constantly have a bruise about thigh-high because I run into my desk and the corner of my bed all the time. I have one on my hip from my kitchen counters, and my tailbone is currently sprained because I missed a stair when I was rushing down the stairs a few weeks ago. My son and daughter are constantly falling off the dining chair, and sometimes I'll go to sit down and miss the chair altogether. I'm quite graceful when I think of it.
Memory Problems
ADHD can also lead to memory problems. This can manifest as forgetfulness, difficulty retaining information, or problems with organization. Women with ADHD may find it difficult to keep track of their belongings, remember appointments, or pay bills on time. For me, the item can LITERALLY BE IN MY HAND AND I CAN'T SEE IT! It's the weirdest thing... its like... the object just *poof* disappears. No other way to explain it.
Except there is... and it's called Object Permanence
There is a concept in psychology known as 'object permanence’. This is the idea that once an object is out of sight, it no longer exists. This is something that typically develops during childhood, but for some people with ADHD, it may never develop. This can lead to problems with losing things, as well as difficulty understanding why others are upset when something is lost.
Emotional Regulation
Many women with ADHD also struggle with emotional regulation. This means that they have difficulty controlling their emotions, leading to outbursts of anger, sadness, or anxiety. They may also find it difficult to cope with stress or manage their mood swings. For me personally, I've always been a very 'emotional' person. I cry at the drop of a hat, and my mood swings are legendary. I can go from happy to angry to sad to anxious all within the span of an hour, and it's honestly exhausting.
ADHD and Relationships
Finally, women with ADHD often have difficulty with relationships. This can be due to any number of factors, such as impulsivity, emotional regulation, or memory problems. Women with ADHD may find it difficult to maintain healthy boundaries, communicate effectively, or handle conflict in a constructive way. They may also find themselves in abusive or codependent relationships. My first relationship was severely abusive, but I thought the problem was me, because at the time... I already thought of myself as the problem because of the struggles I had growing up. In my healthy relationship, I still am challenged to open up and communicate with my partner or manage conflict, because in those moments, my own brain gets 'stuck'. The words are there, but they won't come out. For me, this is one of the more frustrating symptoms.
ADHD: It isn't all bad. Creativity, complex thinking and other benefits
It's important to recognize the Yin and Yang with ADHD, as many things about it are not all unhealthy. There is evidence to suggest that individuals with ADHD are more likely to become successful entrepreneurs. People with ADHD often thrive in environments that are fast-paced and filled with challenges. This is one of the reasons why they are more likely to be successful entrepreneurs.
There are a number of other benefits to having ADHD. For example, women with ADHD often have creative minds and are good at thinking complexly. They may also be more spontaneous and adventurous. Research has found that women with ADHD tend to score higher on measures of abstract reasoning, critical thinking, and divergent thinking than women without ADHD. This suggests that women with ADHD may be better at thinking outside the box and seeing the world in different ways.
These qualities can be helpful in many areas of life, such as in relationships, work, and parenting. Additionally, women with ADHD often have strong willpower and are able to bounce back from setbacks more easily than others. Many are very passionate and determined, often driven to succeed, and are willing to work hard to achieve their goals.
For myself, I see my own neurodivergent brain as the powerhouse behind my company, brand, clinical style, and research. I think differently than others because I see things (i.e. problems) as different than the dominant discourses in our society today. I often see a figurative puzzle in my brain, and every conversation I have with someone is the puzzle coming together in beautiful little “aha” moments. Maybe it’s also why I’m able to catch these signs in clients I see clinically. I don’t rely though, on my own skills to diagnose ADHD in women. I see it too often and can claim some cognitive bias at times, even though I work to limit that. Though… every person I have worked with where I recommended further assessment came back with the conclusion the client and I similarly did. Still! Important to thoroughly have these things assessed by a psychiatrist, doctor, or assessing psychologist who specializes in adult ADHD for cis-gendered women.
ADHD and the Relationship with Patriarchy
Now I’m going on a soapbox because there is something very important I need to share with you. And that’s the relationship patriarchy has with women and with ADHD.
There are a number of reasons why women are less likely to be diagnosed with ADHD than men. First, the symptoms of ADHD can be easily mistaken for other conditions, such as anxiety or depression. Additionally, women are more likely to internalize their symptoms, which means they are less likely to seek help. Finally, women are more likely to be diagnosed later in life than men, which can be attributed to the fact that women's symptoms are often more subtle than men's.
If we critically examine this, there is a clear link to women being diagnosed less with ADHD and the relationship with patriarchal systems. The diagnosis of ADHD was created by men in a western eurocentric ideological model, for boys, based on behaviours that were seen as disruptive in the classroom.
Women have been socialized to be in compliance with the patriarchal order, which includes suppressing their own needs in order to take care of others. This can often lead women to underestimate or ignore their own symptoms. In a patriarchal society, women have often been punished for exhibiting the same symptoms as men who are diagnosed with ADHD. This can be seen in the way women are treated by their families, educators, and employers.
So when individuals socialized as girls exhibited these same behaviours, they were often not diagnosed because they were not considered disruptive in the same way. Women's symptoms can often be more subtle than men's, which can be attributed to the fact that women are socialized to be quiet, compliant, and accommodating. In fact, due to the socialization experienced by women in a patriarchal system, ADHD symptoms were often punished in women, as opposed to rewarded in men.
For example, women may be scolded for talking too much, being too active, or being unable to sit still. They may be told that they are lazy, undisciplined, or out of control. Girls who exhibit ADHD symptoms may have trouble in school due to the fact that their behaviour is not tolerated in the same way as boys. They may be given less attention in class, be disciplined more harshly, or even be expelled from school.
This led to a reinforcement of the idea that women's symptoms were not valid, and further contributed to the underdiagnosis of women.
The Social Construction of Women's Health
There is a growing body of literature that discusses the social construction of women's health. This perspective takes into account the way women's health is shaped by society, rather than being seen as a natural phenomenon. It recognizes that women's experiences with health are not universal, but are instead shaped by their position in society.
When we take into account the social construction of women's health, it becomes clear that women's experiences with ADHD are not simply a result of having the condition, but are also shaped by the way society expects them to behave. This includes the way women are expected to take care of others and put their needs last.
Feminist perspectives offer us a much-needed lens through which to view women's experiences with ADHD. This perspective helps us to see how women's symptoms are shaped by their position in society, and how this can lead to them being underdiagnosed and misunderstood.
One can conclude that women's experiences with ADHD are shaped by the way society expects them to behave. This includes the way women are expected to take care of others and put their needs last. The feminist perspective helps us to see how women's symptoms are shaped by their position in society, and how this can lead to them being underdiagnosed and misunderstood.
The Long Term Effects on Women
ADHD can have a profound impact on women's lives, both at work and at home. Due to the symptoms of impulsivity and time blindness, women with ADHD can often struggle with planning and time management. This can lead to problems at work, such as missed deadlines, lost projects, or difficulty meeting quotas.
In addition to the challenges mentioned above, women with ADHD may also struggle with low self-esteem, anxiety, and depression. These challenges can make it difficult to succeed in school or at work and can lead to problems in relationships.
At home, women with ADHD often find themselves taking on more than they can handle in an effort to be 'perfect'. This can lead to feelings of inadequacy, frustration, and burnout. In addition, women with ADHD often have difficulty maintaining healthy relationships due to the impulsivity symptom. This can be a result of arguments, misunderstandings, or hurt feelings.
ADHD and comorbid conditions in women
ADHD often co-occurs with other mental health conditions, such as anxiety, depression, and eating disorders. This is known as comorbidity. In women, the most common comorbid conditions are anxiety and depression.
Anxiety and ADHD often go hand-in-hand, as women with ADHD may worry about the things they are forgetting or the mistakes they are making. This can lead to a feeling of being overwhelmed, which can be debilitating. Depression is another common comorbid condition in women with ADHD. This is likely due to the fact that ADHD can have a negative impact on every area of life, from work to relationships.
Eating disorders are also common in women with ADHD. This may be due to the fact that women with ADHD often feel out of control and may use food as a way to cope with this feeling.
Treatment for women with ADHD.
There are a number of systemic barriers women face when it comes to ADHD diagnosis and treatment. For example, women are more likely to be uninsured, underinsured, or have no insurance at all. They are also more likely to live in poverty, making it difficult to afford expensive treatments such as medication or therapy. Additionally, there is a lack of female-specific ADHD research, which means that many healthcare providers are not knowledgeable about how ADHD manifests in women.
There is no one-size-fits-all treatment for women with ADHD. However, there are many different options available, and the best course of treatment will likely vary from person to person. Some common treatments for women with ADHD include medication, therapy, support groups, and lifestyle changes.
There are a number of different treatments for women with ADHD. The most common is medication, which can help to reduce symptoms. However, there are also a number of non-medication treatments that can be effective, such as therapy, coaching, and support groups. Additionally, lifestyle changes, such as exercise and a healthy diet, can also help to improve symptoms.
There are many women who live successful lives with ADHD. They have figured out what works for them and use their unique strengths to thrive. However, it is important that women feel understood and not alone in their experiences. There are many resources available to help women with ADHD, including books, websites, articles, and support groups. It is possible to live a happy and productive life with ADHD!
If you think you or someone you know may have ADHD, talk to a doctor or mental health professional who can assess and provide an accurate diagnosis. It is important to speak to your health professional and not self-diagnose, even with the amount of information available to you through online resources and social media. ADHD as we discussed can also look like other mental health concerns, so it is imperative that you reach out to someone who can ethically and responsibly assess your individualized needs.
External Resources for Further Research:
Nussbaum, N. L. (2012). ADHD and female specific concerns: a review of the literature and clinical implications. Journal of attention disorders, 16(2), 87-100.
Waite, R. (2010). Women with ADHD: It is an explanation, not the excuse du jour. Perspectives in Psychiatric Care, 46(3), 182-196.
Rucklidge, J. J. (2008). Gender differences in ADHD: implications for psychosocial treatments. Expert Review of Neurotherapeutics, 8(4), 643-655.
Babinski, D. E., Neely, K. A., Ba, D. M., & Liu, G. (2020). Depression and suicidal behavior in young adult men and women with ADHD: Evidence from claims data. The Journal of clinical psychiatry, 81(6), 22578.
Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., ... & Woodhouse, E. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC psychiatry, 20(1), 1-27.
References:
How to ADHD (2021). [Video]. ADHD in Women. Retrieved from https://www.youtube.com/watch?v=EMpt40zNK-w.