Portland Therapy Blog

Portland Therapy Blog

Local experts share the latest information and resources on all things mental health.

Women and ADHD

Posted: October 04, 2021 by Ladan Radafshar

  • Do you experience an abundance of creative ideas and easily draw big picture connections?

  • Have you thought to yourself, “if I just had my own personal assistant or project manager I could accomplish anything”?

  • Do you also struggle with time management? You’re always late, have to be super early, or tend to overschedule?

  • Do you find that daily responsibilities overwhelm you and you’re embarrassed that you can’t “keep up”?

  • Do you feel strong emotions that you’re not sure how to manage?

If these experiences resonate, you may have ADHD. Unfortunately, only 25% of women ever receive a diagnosis. This is in part due to how ADHD presents in women versus men. Women’s symptoms are often more subtle and can be confused with personality traits like being absent-minded, forgetful, or talkative. Without a proper diagnosis, women tend to internalize their symptoms, blaming them on underachievement and personal failure rather than a neurological condition. According to Dr. Michelle Frank, a licensed clinical psychologist, this leads women and girls with ADHD symptoms to have a higher incidence of anxiety and depression.

Undiagnosed ADHD

Undiagnosed ADHD often goes hand-in-hand with depressive and anxious feelings -- a phenomenon called co-occurrence. When these symptoms go unaddressed simple tasks seem overwhelming or even impossible. Add in the stress of big life changes such as going to college, getting married, or pregnancy and women often feel confused and helpless. At this point, a woman may experience feelings of intense shame and, sometimes, despair and not know that it stems from ADHD.

Imagine you’re struggling to keep track of important details, planning for the short and long term, keeping papers and personal items organized, and communicating effectively with friends and colleagues. Over time, the weight of these “mini-failures” can make managing your symptoms too much to bear. The pressure can show up in many ways, affecting your self-esteem, self-worth, and ability to achieve both personally and professionally.

The lack of information around ADHD symptoms in women and gender-based stereotypes about the disorder lead to roughly three-quarters of women with ADHD never being diagnosed.

Inequity of ADHD Diagnosis for Girls in Childhood

ADHD begins in childhood and a key component of the diagnosis is a significant impairment in both school and home environments. However, girls are slipping through the cracks. According to Dr. Michelle Frank, boys are diagnosed two to three times as often as girls and are more likely to be diagnosed early in life. This disparity is due, in part, to the way symptoms present in boys versus girls and the blanket use of research based on how ADHD affects boys.

What ADHD looks like in boys vs. girls

The most noticeable type of ADHD is a combination of both hyperactivity and inattentiveness. This combined ADHD is found more often in boys and is easier to spot in a classroom setting. Girls present with hyperactivity much less often than boys, but their symptoms, related to inattentiveness and distractibility, can be just as harmful if left untreated.

Imagine a classroom. A girl daydreams through class and a boy fidgets and disrupts the group. Both children in this instance may be living with ADHD, but only one is likely to get the support they need.

Many girls are unaware that they process the world differently. This can lead them to internalize their symptoms and attribute them to personal failings and underachievement rather than neurodiverse functioning. Receiving a diagnosis early in life can support women in their awareness and understanding of how ADHD impacts their cognitive processes and their interaction with the world around them.

What’s Next? Find What Works For You

Even without an early childhood diagnosis, you can get answers now and successfully manage your ADHD. An accurate diagnosis will help you understand which tools and medications will give you relief and the coping skills to overcome challenges related to ADHD. Here’s some guidance on where to begin:

Awareness: The first step is understanding how ADHD impacts your life. What do you struggle with on a daily basis? How are the symptoms showing up? This awareness is essential to taking action. Ask your friends, family, and colleagues what they notice. These observations may not always feel accurate, but if they’re coming from empathetic sources they can help you paint a complete picture.

Therapy: Working with a therapist who specializes in ADHD can help you identify classic symptoms and collaborate with you to develop a treatment plan. Incorporating a consistent practice such as mindfulness can also enhance focus and attention. Group therapy focused on ADHD is another great way to feel seen and heard while gaining valuable skills.

Medication Management: Along with a healthy sleep cycle and proper nutrition and exercise, medication can greatly reduce moderate to severe symptoms of ADHD. Medication can help enhance concentration, organization and impulsivity. There are a few forms of medication that are used to manage ADHD that broadly fall into two categories: stimulants and non-stimulants. If you work with a therapist, they can often assist in finding a psychiatrist to determine what medication is right for you. You may also research psychiatrists or nurse practitioners in a network with your healthcare provider. They can support you with the prescription and diagnosis process.

Accommodations: There are useful changes to consider when managing work and school. These might include optimizing your environment with exam accommodations to minimize distractions at school or requesting a quieter workplace setting. This could also look like support with time management by allowing extra time for deadlines and appointments. For example, a cushion of 10 minutes between activities can help with the transition time. Utilizing digital calendars with reminders or timers can also help organize your time. And, assist with memory recall by saving information on notecards or post-its. In conversation, you may want to avoid “jumping in,” by counting to five before you share your thoughts. There are also online resources, guides, and blogs written for women by women to gain perspective and ideas for managing life tasks.

Support and knowledge tailored to women living with ADHD is expanding. You’re not alone in seeking help to better understand yourself. Starting small and trying different solutions can be helpful. Over time, you will gain more self awareness about what works for you and your goals.

Ladan Radafshar (She/her)

Licensed Professional Counselor

MA, LPC, NCC

I am a multicultural therapist offering compassionate, EMDR, EFT, and mindfulness-based care to individuals and couples.

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Anxiety, ADHD, Personal Growth, Relationship / Marriage Issues, Coronavirus/COVID-19
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