ADHD in Women: What Does It Look Like?

Do you feel overwhelmed for much of your day? Do you recall getting really into something and giving a task a lot of attention (otherwise known as hyperfocus)? Do you find it hard to internally relax? Do you frequently forget where you put items? Do you find that you are often late for appointments or that your estimate of how long it takes to complete a task is usually “a little off”?

Do you have a hard time attending to many demands or tasks at the same time, or find that you can really get into a project, but toward the end, you begin to lose interest and leave the previously fascinating project (or topic or hobby) incomplete?

If you answered yes to many of the above questions you may be struggling with Attention-Deficit Hyperactivity Disorder (ADHD). If you are an adult and female, the last sentence may be particularly shocking to you, and the gender gap in accurate diagnosing of ADHD is unsettlingly high.

If you are like most North Americans, when I say “ADHD” the primary image that comes to mind is: A young boy in elementary school who is wiggling in his seat, and frequently reprimanded by the teacher to “please wait your turn/ raise your hand/ stand still and be quiet in line/don’t distract your seat partner/ask to play along before taking the toys.”

The error does not lie in the specifics of the above image but rather how it has come to be the only story. What does ADHD look like in a story where anyone but a white young boy is the main protagonist?

What about a highly functioning woman? Or young adult of color? It is a matter of ethics and appropriate practice to consider how ADHD displays in all clients, not just the ones that society has created as the archetype.

Without the knowledge of why one does what they do, it can lead to chronic low self-esteem, shame, depression, anxiety, marital confusion, occupational difficulties and more. This information is not shared to ignite fear in the hearts of anyone, but because individuals (children and adult, male or female) are not getting the help that they need to improve their lives.

An ADHD diagnosis often invites the introduction of medication (or different medications – more on this later), behavioral modification support from a counselor or ADHD coach, and nutritional changes.

Because of society’s preconceived notions of what ADHD looks like, we miss hundreds of thousands of individuals who would love to know that they are not flakey or lazy (check out a popular read). With the proper management, ADHD can become a managed part of your life rather than controlling it.

The remainder of this article will explore how ADHD presents in women and what you can do about it if you think that you, or a woman whom you care about, has undiagnosed ADHD and it is negatively impairing her life.

Christians may recall the popular verse in Matthew 11:28, “Come to me, all who are weary and burdened, and I will give you rest.” Though this verse has primary reference to the burden of sin, it also has application for all struggling, overloaded mothers.

These mothers believe (at least in part) that they are failures because they are dropping balls or forgetting appointments, who may constantly find themselves thinking that they cannot get their act together and they want to behave differently but they just cannot catch an energetic, internal or external break to do so.

Women with ADHD have often gone decades without the knowledge of why they feel like life is an uphill battle for them more than their counterparts. This can and often does, wreak havoc on one’s esteem. ADHD is not an excuse, and it is not a false disorder. ADHD is a real, scientific, disorder, and it matters to your life. Maybe most important of all for you to know, is that ADHD is manageable.

Women who have ADHD often experience their hyperactivity and/or inattentiveness internally, such as jumping from thought to thought, experiencing mental unrest, and a perceived inability to hold information in mind (or otherwise known as Working Memory).

This means that women with ADHD often do not share the image of the young boy above. In fact, many women do not resonate with acting that way even as a child.

A woman with ADHD may recall daydreaming a lot as a young girl, or getting bored easily, or being called a “Chatty Cathy” but rarely (if ever) being like the classroom disrupting boy with more energy to spare than a Redbull commercial.

Women with ADHD are often more challenging to diagnose because the symptoms are more likely to be experienced internally. Because of societal pressures, the way in which we often raise girls to behave, and the stigma of ADHD, women often do not ask whether they have ADHD, they merely assume that it is Depression or Anxiety.

When the symptoms of ADHD become too much and begin to impair a woman’s life in at least one major area (e.g. work, marriage, social dynamics), they may seek counseling services or mention the symptoms to their doctor. Sometimes, well-intentioned professionals hear these symptoms, notice the individual’s gender, and conclude that the woman is likely suffering from anxiety.

The woman may then be instructed to seek counseling that provides Cognitive Behavioral Therapy (CBT) skills training or to make a handful of wellness behavioral changes. The woman who has ADHD may attempt these treatment steps, and it is very likely that they will improve her life. Behavior modification and increased attention to exercise and nutrition will reduce the impact of ADHD symptoms.

The major point to note, however, is that the woman with ADHD will still feel like something is “off,” like she may need medication to help manage her “anxiety,” or maybe she will tell herself that even with the additional support she still cannot “live up to her potential.”

While it is possible that the problem may be rooted in a lack of dedication to behavior modification, in this case, the inaccurate, or at best incomplete diagnosis, muddies the waters.

Another woman may seek professional support and communicate that she too is experiencing mental restlessness and experiencing constant feelings of being overwhelmed. The professional may inquire how these symptoms manifest themselves or interrupt, her day-to-day life.

The woman might explain that because she feels so overwhelmed, she often finds herself zoning out, or feeling exhausted and requiring extra sleep/rest. For example, she might express the desire to say call her long-distance friend more often, but cannot ever seem to make it happen.

This professional hears these symptoms and, understandably, decides that the woman’s constrained functioning sounds like depression, and recommends CBT, exercise/nutrition changes, and an SSRI (Selective Serotonin Reuptake Inhibitor – typically used as antidepressants).

The woman follows through on her treatment plan but still feels unbalanced, or maybe she thinks that it is her fault because she sometimes forgets to take her medication, or does not complete her CBT homework as much as the counselor recommended.

Due to upbringing, cultural messages to women, and years of build-up, women have been shown to be more likely to blame themselves than question a diagnosis or consider external factors. This is particularly troublesome because we now know that some SSRIs aggravate symptoms of ADHD, rather than alleviate them.

When reporting symptoms to your Counselor, Psychologist, Psychiatrist, or Primary Care Physician it is very important to communicate as many as you can think of, even if you think they may be unrelated.

This is an especially difficult task for individuals with ADHD for many reasons including: (1) a general propensity for living in the present moment (rather than looking back over patterns of behavior from weeks, months, or even years ago), (2) difficulty connecting past experiences with present situations, (3) struggles in labeling feelings as specific emotions, (4) problems with self-monitoring (the ability to evaluate one’s own behavior), and (5) task initiation.

It is recommended that you set a timer for 20 minutes per week before your appointment (set a reminder in your phone or calendar to schedule a specific time for this activity) and sit down with three items.  First, you will need some way to document the symptoms.

If you can access your email on your phone, consider sending an email to yourself, so that you can easily pull it up on your phone in the lobby or in the doctor’s office. If you cannot access email on your phone, possibly consider using the note app on your phone, or using a handwriting not to keep in your wallet until the appointment occurs.

Second, you will need an emotion wheel to help you remember emotions that you may have recently felt, but did not quite register, or for which you cannot remember the label. Check one out here. Third, you should find an adult ADHD checklist that is geared toward understanding how women experience this disorder. You can find one here.

Remember to limit demands on your attention during the above task. You may be tempted to have your laptop out to “jot down ideas/notes” but then decide to research ADHD a bit. Suddenly you remember that you need to quickly respond to your friend’s message on Facebook, and then you pop back to researching ADHD, but then decide to get up for a cup of tea (to enhance your focus on researching symptoms).

While up, you decide to check the mail and then come back for your tea, which is just a good use of your time, you tell yourself, as you open the mail and remember that you need to pay the garbage bill. You grab your tea, sit down to your laptop and begin paying the bill when the 20-minute timer goes off.

As ADHD researcher and author, Dr. Edward Hallowell said, “Multitasking is shifting focus from one task to another in rapid succession. It gives the illusion that we’re simultaneously tasking, but we’re really not. It’s like playing tennis with three balls.”

It is important to set yourself up for success. Clear a space, limit the items you have within reach, reduce extra noise (which can lead to you feeling overwhelmed or distracted), bring a beverage or snack with you to the table, and set a visual kitchen timer in front you. Tell yourself that when the task is complete at 20 minutes you can get up and do something completely different, something that you would find more rewarding.

From the ends of the earth I call to you, I call as my heart grows faint; lead me to the rock that is higher than I.  – Psalm 61:2

Remember, the ADHD brain is neurologically different than the non-ADHD brain. Individuals with ADHD are often known to be very creative and think outside the normal constraints.

It is understandable that women, especially (again, who generally experience their symptoms internally and are therefore less disruptive to others in their environment), would develop ways of working around the ADHD. They are often very successful at this until they hit a major disruptive milestone and the degree of ball juggling is just too much for their work-around ideas to remain successful.

Often, we see ADHD diagnoses in women around major lifestyle shifts, such as college (where the routine of home life disappears and they need to create the structure themselves), marriage, the birth of a child, or when one of their own children becomes diagnosed with ADHD – ADHD is highly genetic compared to other mental health disorders – and the mother identifies with the symptoms after they begin researching it more on behalf of their child.

The hope is that this article would give more women access to information about what ADHD can look like. If these symptoms resonate with you, you should not waste any more time. Make that list of symptoms and seek professional support. Advocate for your health!

For Further Web Reading:

“That Explains Everything!” Discovering My ADHD in Adulthood

http://www.chadd.org/Understanding-ADHD/For-Adults/Living-with-ADHD-A-Lifespan-Disorder/Women-and-Girls.aspx

https://childmind.org/article/how-girls-with-adhd-are-different/

https://childmind.org/article/how-to-tell-if-your-daughter-has-adhd/

ADHD in Women 101