One of my areas of specialty is working with women with ADHD in New York City. I am passionate about this area because there are many women out there, silently – and unnecessarily – suffering with this disorder. It is negatively affecting their relationships, work habits, self-image, eating habits, and more. Their symptoms have not been given proper attention, and as a result they suffer in silence.
The following article is based on The Secret Lives of Girls With ADHD by Ellen Littman, PhD.
Why have women with ADHD been ignored?
Historically, girls were not often diagnosed with ADHD. The criteria for diagnosing ADHD was based on hyperactive, impulsive, and willful children – most of which were boys. ADHD became known as a condition that primarily affected boys.
In 1980, a huge stride was made: New diagnostic criteria allowed for the possibility of inattentiveness without hyperactivity. Once this happened, girls with ADHD started coming out of the woodwork. Now, a third of ADHD cases are inattentive types, and most of these are girls. Still, more progress needs to be made, as many girls do not start manifesting obvious symptoms of ADHD until puberty (when estrogen levels rise and social interactions become especially important) – and one of the requirements of an ADHD diagnosis is that symptoms be present before age 7.
How ADHD Affects Girls and Women
If you’ve ever been a teenager, you will agree that peer interactions are powerful determinations of self-worth. This is even more true for girls, and even MORE true for girls with ADHD. Unfortunately for girls with ADHD, social interactions are not their strong suit. Girls’ socialization is uniquely demanding, so girls with ADHD are likely to find themselves unable to keep up.
As a result, they may:
- withdraw from social interactions
- avoid participation in school
- turn to self-injurious behavior
- attempt suicide
- self-medicate with drugs or alcohol
- have an unhealthy relationship with food
- engage in high-risk sexual behaviors and tolerate unhealthy relationships
- struggle with anxiety and depression, especially into adulthood
While symptoms do change with maturity (for example, years ago boys were mistakenly thought to have “grown out of” their ADHD after puberty because their hyperactivity decreased so drastically), yet other symptoms and unhealthy behaviors can continue into adulthood if no intervention is made. Also, many individuals, particularly those with high intelligence, develop coping strategies that mask ADHD impairments and therefore they do not seek diagnosis and treatment.
Early intervention is key. Parents or teachers may suspect ADHD but since their child isn’t “having trouble” in school or with friends, they do not seek professional help. This is an unfortunate mistake.
How to Help Girls with ADHD
1. Find a mental health professional who specializes in girls and/or women with ADHD. Don’t wait, as early intervention is key and while symptoms may change, they do not disappear.
2. Learn about what your child is going through and how best to react to it. Create an ADHD-friendly environment for her with structure, consistency, and clear expectations and consequences. Learn to control your own emotional responses to her at-times very frustrating behavior.
3. Be a source of hope! Help her find an area of strength in which she can excel. Help her redefine herself in a way that reduces stress and pressure.
4. Researchers need to continue to explore why the impact of ADHD is so much greater for girls than for boys, so health care professionals can develop more strategies to respond to their needs.
According to Ellen Littman, PhD:
“When girls are missed by the diagnostic checklists, they aren’t included in subject pools for new research, their numbers and experiences are not accurately documented, and they continue to live secret lives. Today, an astoundingly small percentage of research focuses on females and, in existing studies, the smaller percentage of subjects are the inattentive type. Until we find ways to access the internalized experience of all girls, they will continue to wander about in a world that feels less predictable and less secure than that of their peers.”