“Courtney was diagnosed with Obsessive Compulsive Disorder in middle school, anxiety and depression in high school, and ADHD just five months prior to the festival. Now, she wonders if the childhood OCD was a misdiagnosis, as she’s learning that many of her rituals stem from the chaos of navigating ADHD.”
“”I thought I was stupid. I couldn’t figure out this material. I would read the same page over and over again and not retain anything. It felt like there was a missing piece. People told me, ‘You need to study harder!’ But there was no one who studied harder than I did.””
“That’s why it’s so difficult for millions of girls and women to receive accurate ADHD diagnoses, if any; not only can ADHD can look like depression, OCD, and anxiety disorders (and vice versa), but psychiatrists, parents, and educators are less likely to suspect that a well-behaved girl—let alone a high-achieving woman—could be struggling with a condition associated with boys who maintain gym-class-dodgeball levels of hyperactivity at all times.”
“The Better Together Festival, a daylong celebration of women with ADD that took place near Ann Arbor, Michigan, in the middle of May, was conceived by psychologist Michelle Frank, and Sari Solden, a psychotherapist who pioneered and popularized the idea that adult women like Courtney, me, and thousands of others could, in fact, have something in common with hyperactive boys.”
“There were many big health revelations in the early 90s. Aspirin can help ward off heart attacks. Trans fats are a thing, and bad. There was also the lesser-known discovery that adults, in addition to hyperactive boys, could have ADHD. Several revelations followed in quick succession: You can continue to have difficulties even if you lost your hyperactivity. You never even had to have hyperactivity to have ADD.”
“When Solden, who was then working with individuals, couples, and groups with “invisible disabilities” at a counseling agency, got her hands on the book You Mean I’m Not Lazy, Stupid or Crazy?!, written by Peggy Ramundo and Kate Kelly in 1993, she started putting the pieces together.”
“”Many of my clients were saying stuff about disorganization, but the women were also much more ashamed about it,” Solden told me. “We started looking at the gender differences—not even so much in how they manifested, but how women felt about them, due to these culturally idealized roles. We had a feminist kind of perspective. It was really about what happens to women when they can’t meet those expectations.””
“Despite increasing awareness that women can have the disorder, the shame part has stuck around. Solden still encounters clients who are paralyzed by the embarrassment of not meeting these “deeply embedded expectations” of how a woman should be.”
“In 1995 Solden wrote Women with Attention Deficit Disorder, a work largely acknowledged within “the tribe” of adult ADD professionals as pioneering for recognizing the centrality of gender role expectations on a woman’s self-esteem.”
“In 2013, a Centers for Disease Control and Prevention study found that 6.4 million children between the ages of 4 and 17 had received an ADHD diagnosis at some point in their lives, up 16 percent since 2007. This is, understandably, terrifying, and has colored the coverage of ADHD in the media, where the current line is that kids (read: boys) are being over-diagnosed and over-medicated.”
“Early clinical studies in the 1970s focused on hyperactive white boys, which shaped the diagnostic criteria we still use today, making it very difficult for girls—let alone women—to get diagnosed if they don’t behave like hyperactive white boys.”
“So as the serious conversation surrounding misdiagnoses and stimulant abuse dominates the public perception of ADHD, there’s an estimated four million girls and women who are not receiving the treatment they desperately need because no one realizes they have the disorder.”
“(A 2009 study from the University of Queensland found that girls displaying ADHD symptoms are less likely to be referred for mental health services than boys.)”
“Even those who manage to get diagnoses can’t always escape the embarrassment of having a condition that doesn’t look the way people expect it to. You always have to explain yourself. Or, if that’s too exhausting, hide.”
“ADHD symptoms can appear later in girls than they do in boys, which challenges the common perception that the disorder is a kid thing. The symptoms are also different—think less running around a classroom throwing Cheez-Its and more having a nervous breakdown because you lost your passport somewhere in your laundry basket, which is really just a trash bag at the bottom of your closet.”
“A 2005 study published in the Journal of Clinical Psychology notes that girls’ ADHD symptoms are “less overt” than the disruptive behaviors typically seen among males, which further blocks girls and women from getting diagnoses.”
“The lack of treatment is the scariest part; according to the American Psychological Association, girls with ADHD are two to three times more likely to attempt suicide or injure themselves as young adults than girls who do not have ADHD.”
“In her keynote speech at the Better Together Festival, Dr. Ellen Littman, who wrote Understanding Girls with ADHD in 1999, recalled once hearing men refer to girls as “ADD wannabes” at a conference.
“Rather than allow the point to be dismissed, I argued vociferously,” Littman said.”
“”I’m a mess!” I said, instinctively, to a woman who asked me if I needed help. “I really should get a wallet.” This line usually kills. In the real world, the idea of not having a wallet to store your credit card, cash, and ID is so wacky as to be laughable.”
“Women diagnosed later in life can experience burnout from the exhaustion of concealing their symptoms, a phenomenon known as a “mask of competency”—the extraordinary lengths ADHD women go to conform. “They may be rigidly hypervigilant about controlling their behavior, investing extraordinary amounts of energy in the goal of maintaining a seamlessly ‘appropriate’ façade,” Dr. Littman wrote in a 2012 essay.”
“”This may prove effective in the short-run, but it comes at a heavy price: as they pursue the perfectionistic demands they deem necessary, they are constantly burdened by anxiety and exhaustion. Struggling to do what appears effortless for other women, they feel like impostors, fearing discovery at any moment.””
“Nantais found that medication alleviated some of her symptoms, but none of the shame.”
“”Because I lacked education and information about ADHD, I still had deeply held beliefs about the JUSTS,” she said in her presentation. “If I ‘just’ tried harder, was ‘just’ better at managing my time, or if I could ‘just’ get a handle on organization, I could fix my ADHD.””
“A major discovery for many women is that they aren’t stupid or bad. Rather than laboring to maintain a “mask of competency,” Nantais allowed herself to shape her environment around her ADHD brain.”
“”It takes such an observational stance on everything you experience; you watch it happen,” she said. “‘Oh, I’m distracted by this pretty color, even though I should be focusing on this report that the boss needs by the end of the day.’ OK, you’re distracted, but it is a pretty color, so enjoy that. You have to believe in the power that other people are able to adapt.””