Michelle Coyle, an independent political consultant in Alexandria, Virginia, was a solid B student through high school and college. Her teachers told her she was really smart but not trying hard enough. It wasn’t until she went to graduate school for her MBA at Dartmouth College that she began exerting real effort — and failing.
“I think it was the first time where the material was really challenging for me,” recalls Coyle, 35. She went to a therapist, who asked if she got a lot of parking tickets, shopped too much or spent excessively.
The ultimate diagnosis: attention deficit hyperactivity disorder, or ADHD. Though often characterized as a failure to pay attention, the condition actually indicates an inability to filter an excessive amount of stimuli, says Terry Matlen, a psychotherapist, ADHD coach and author of “The Queen of Distraction: How Women with ADHD Can Conquer Chaos, Find Focus, and Get More Done.”
[See: 8 Things You Didn’t Know About Counseling.]
Men vs. Women
For a long time, ADHD was the domain of rowdy little boys. But over the past two decades, clinicians have realized it affects girls, too — differently than it affects boys. These differences explain why many women aren’t diagnosed until adulthood, while their male peers are often diagnosed in elementary school.
A 2014 review of women and girls with ADHD, published in the Primary Care Companion for CNS Disorders, found that girls were two- to ninefold less likely to have ADHD as boys; that gap narrowed to only a twofold difference in adults. The findings indicate 3.2 percent of women have ADHD compared to 5.4 percent of men.
Women are often underdiagnosed because they have the “inattentive” subtype of ADHD — instead of being hyperactive, they’re introverted but high-achieving. “Inattentive women may be physically sluggish or prefer quiet activities, but many have hyperactive brains that crave stimulation as well,” says Matlen, who’s based in Birmingham, Michigan, and focuses on helping women with ADHD. And many have a combination of the two types, sometimes behaving hyperactively, other times withdrawn.
Crystal Battagliola, of Vancouver, British Columbia, was a “daydreamer” in school — hypersensitive, shy and super smart. In second grade, she was reading at a sixth-grade level and writing at a 10th-grade level. “Yet my room was always a mess,” she says. “I got on the honor roll, [but] I couldn’t find something to wear.”
“Not everyone [with ADHD] is hyper and can’t sit still,” she continues. “I was the opposite. Because of that, it went unnoticed and I had to figure it out myself.”
It wasn’t until Battagliola had kids in her late 30s — following a career as a financial trader — that she was diagnosed with ADHD. “When you up the ante, like having kids and staying home with them, it [can explode],” she says. “Hypersensitivity goes hand-in-hand for people with ADHD. My first daughter was colicky. She would scream her head off.”
Symptoms in Women
In addition to being very sensitive, women with ADHD are often forgetful, easily distracted and disorganized. They feel overwhelmed in environments with a lot of choices, such as malls and grocery stores, Matlen says. Those feelings can lead to impulsive or excessive behavior — which can then cause anxiety and depression.
That can mask underlying, undiagnosed ADHD, says Sari Solden, an Ann Arbor, Michigan-based psychotherapist, ADHD expert and author of the ground-breaking 1995 book “Women with Attention Deficit Disorder: Embrace Your Differences and Transform Your Life.”
“Internalized gender expectations collide with ADHD,” Solden says, meaning that women tend to be people-pleasers and internalize ADHD symptoms as character flaws. “Women don’t hit a wall until college, or a job or they have children,” she says. “By then they are confused about how to view themselves. They don’t pick the right jobs or relationships. Behind the scenes, there’s some price they’ve paid.”
[See: 11 Simple, Proven Ways to Optimize Your Mental Health.]
Treatment
A certified mental health provider with expertise in ADHD is best to diagnose the condition, Solden says. The Attention Deficit Disorder Association, for example, offers a database of providers.
Many women initially take stimulants such as Ritalin, Adderall or Concerta, which increase dopamine and norepinephrine, the neurotransmitters that research suggests are lower in people with ADHD. “It’s a neurobiological condition,” says Solden, who runs an online resource and support group for people with ADHD. “The medications give you the fuel that gives you the wherewithal to strategize. Often for women, just a small amount of the stimulant can make a difference.”
Coyle and Battagliola both take Concerta, a slow-release stimulant. “My grades immediately went up,” Coyle says. “I could focus for the first time in my life.” Battagliola says the medication has the same fog-lifting effect as that first cup of morning coffee.
In addition to traditional therapy, many women belong to online peer support groups. Matlen runs a few private Facebook groups, like one called Queens of Distraction, where women can pay — $77 for three moths, for example — for access to a 24-hour chat room plus one-on-one sessions with Matlen. Women in the group hold each other accountable for completing certain tasks. Matlen also runs a rapidly-growing Facebook group called “Moms with ADD,” and another called “ADDConsults,” which includes thousands of members from around the world.
Living With ADHD
Matlen suggests ADHDers take advantage of visual reminders such as index cards, calendars or bulletin boards, since “people with ADHD tend to be highly visual.” And Battagliola keeps a color-coded calendar to track her two kids’ activities.
Another coping strategy is “twinning,” or pairing activities. “Boredom is a death sentence for people with ADHD,” Matlen says. She recommends, for example, doing laundry along with another 30-minute activity. She also recommends avoiding over-stimulation: “Facebook is a black hole.”
Sharing an ADHD diagnosis with others can be tricky, Solden says. “I always encourage people to describe what [they] have difficulty with,” she says. “You might say, ‘I have trouble listening to you in this crowded room’ instead of just saying, ‘I have ADD.'”
However, “I’ve learned to be very upfront and let people know it’s my thing,” Coyle says, adding that her communication mitigates later misunderstandings that may arise as a result of ADHD.
[See: How to Find the Best Mental Health Professional for You.]
Focusing on Strengths
It’s important for women with ADHD to emphasize their strengths — since the hallmark traits of disorganization and distraction aren’t typically valued in society. Consider that the flipside of distraction is hyper-focus, Matlen says: “When we love what we’re doing, nothing stops us.”
Perhaps not surprisingly, women with ADHD gravitate toward professional fields that involve passion and focus, such as finance, media, the arts and, notably, athletics. In September, Olympic Gold medalist Simone Biles announced she has ADHD, and swimmer Michael Phelps has shared his diagnosis.
People with ADHD are often intuitive, creative and free-spirited, says Coyle, a mother of two. “We tend to be more exciting and fun. You can be a really fun mom because you understand the sensitivities of children.”
The key, Solden says, is finding an environment that allows these strengths to shine. “You can’t fight your brain,” she says., “Make things work for you. Find people, places and environments that really value you.”
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Understanding ADHD in Women originally appeared on usnews.com
