Lizzy is sitting in the back of her 4th grade classroom, twirling her hair, looking out the window and staring at the clouds, mentally transforming them into unicorns and puppies. She is adored by her teachers because she is always pleasant and smiling, even if she is often inattentive in class and forgets to finish her homework regularly.
Jake is in Lizzy’s class. He’s sitting in the front row, exactly four feet away from their teacher, Mrs. Monroe, who has had enough of his constant interruptions and class clown antics. And his inability to sit in his chair for longer than three minutes has her pulling out her hair. She knows Jake is smart. But why can’t he get his act together? She must supervise him as if he were a kindergartner, not the 10-year-old that he is.
There was a time not that long ago when it was thought that primarily boys had ADHD, and that they outgrew it by the time they reached adulthood. Now we know that both boys and girls can have ADHD — and that they don’t always outgrow the condition.
Boys are typically diagnosed more frequently than girls, possibly because they tend to exhibit the hyperactive or impulsive symptoms and behaviors of ADHD, such as acting out more in school and drawing the attention of their teachers. Girls, on the other hand, may be more likely to exhibit more of the inattentive symptoms, like Lizzy. Teachers may not pick up on this inattention and distractibility as often as the more hyperactive symptoms, because they are not as obvious.
As girls with undiagnosed ADHD grow into women, many are seeking out mental health services because they find that they “hit the wall” as life becomes more complicated with more responsibilities, like work, parenting, keeping up a home, etc. And now, studies are showing that more women are being diagnosed with the condition than ever before, though many may still be unidentified.
In adults with ADHD, men and women may experience similar symptoms, such as hyperactivity, impulsivity, distractibility, and inattention. However, these symptoms may manifest differently in the two sexes.
One significant difference between men and women is how hormones manifest themselves in ADHD symptoms. Women’s ADHD symptoms may fluctuate during various times in their lives, such as during puberty, pregnancy, and later, menopause due to various changes in estrogen levels.
There are other issues that can impact an ADHD diagnosis in women, such as society’s expectations of women, which girls may internalize at a very young age. In many cultures young girls may be taught that women are expected to take on specific roles within a family structure. That might include caregiving responsibilities, meal planning and preparations, and preparing for motherhood, along with tending to the emotional needs of the family. As a woman with ADHD myself, I can tell you that when you add a 9 to 5 work day into the mix, it can be completely overwhelming.
Men may also face challenges in reconciling their diagnosis with societal expectations of manhood and masculinity. For example, growing up young men are often taught to be “tough,” and keep their emotions inside, which can be difficult for a person who struggles with emotional regulation or mood swings.
How does this all play out for women with ADHD?
Women may be more likely to internalize their feelings, which can lead to more depression, anxiety, and loss of self-worth.
Although women are more likely to reach out to healthcare professionals for help, they may be misdiagnosed with depression or anxiety. This may be because untreated ADHD can make people anxious and depressed, and some mental health professionals may not look beyond these symptoms for possible underlying ADHD.
The results? Women may be getting treatment for those conditions, but the underlying ADHD is missed.
A vicious cycle
My own experience with ADHD matches what the literature and research show. My self-esteem crashed once my children were born. Before children I was able, for the most part, to handle a full-time job, a marriage, and a small apartment. When I added two children to the mix, I became so overwhelmed I thought there was something terribly wrong with me.
How could I earn two college degrees but I couldn’t remember to return signed school papers in time so my daughters could attend field trips? I questioned my sanity at times, overwhelmed with the noise and chaos of a busy household.
What you can do to cope
Recognize your strengths and weaknesses. Feel comfortable asking for extra help when you need it. For example, if you struggle to get household chores done, it might help to hire a cleaning crew every once in a while. It’s important to let go of internalized expectations of “taking it all on” and allow yourself to reach out for support, including the support of your partner.
Finding healthy physical outlets is essential when dealing with hyperactivity or impulsivity. Exercise can help reduce stress, anxiety, and self-destructive behaviors and can be especially beneficial for people with ADHD.
Ask for support at your workplace.
Most of all, get evaluated if you think you might have ADHD. ADHD is considered a highly treatable condition, and if you are diagnosed a trained mental health professional can help identify a treatment plan that will help to manage the symptoms of ADHD.
ADHD may be experienced and expressed differently in some ways for both men and women, but generally the tools to manage the condition are very similar. If you follow through with them, you can help manage your ADHD.
ADHD-US-NP-00027 OCTOBER 2018