ADHD in Women (& Me)

ADHD as a girl

I displayed what we now recognise as symptoms of Attention Deficit Hyperactivity Disorder (ADHD) from a young age but, as the disorder was most obvious and thus more studied in boys, it wasn’t caught. In fact, it’s likely that any doctor I may have seen 15-20 years ago would have thought that ADHD was a boy-only issue.

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ADHD in primary school

Girls are more likely to have inattentive-type ADHD – less of the H but plenty of the AD. While the boys are bouncing off classroom walls, causing enough trouble to be carted off to the doctor, the girls are drifting off into thought, quietly struggling to juggle responsibilities, and often slipping into underachievement and low self-esteem. This is a fabulous (and short) article by Rae Jacobson on the subject. This is a much longer and more technical one by E. Mark Mahone.

Little Me was a chronic daydreamer, a bookworm, a forgetter-of-homework (and thus, quickly, a proficient liar), a loner (sometimes by choice, often not), an interrupter, a fidgeter. I was thin skinned. I was bright, but, as my school reports parroted over and over, I “did not apply” myself.

I was a source of frustration for many teachers, and a source of derision for many peers.

I was very saddened by all of this. I desperately wanted to be liked and I couldn’t understand why I wasn’t. When the bullying ramped up, around 10-12, I became deeply depressed and often refused to go to school.

This article, from Voice, is about teenage girls – but I think it straddles these two ‘eras’ well. It has a lot of poignant and useful information, but one quote sticks out to me enough to pull it out:

Many women with ADHD often recall feeling “different” from the other girls when growing up and being marginalised by their peer group. The need to overcome this apparent “difference” and to be accepted by the peer group during the teenage years is intense and in an effort to “belong” it may lead to dangerous or self-destructive behaviour.

ADHD in secondary/high school

ADHD in teenage girls is a dangerous thing. Puberty is when a whole host of mental disorders come knocking, and untreated ADHD leaves the door wide open. Teenage girls with ADHD are particularly susceptible to anxiety, depression and eating disorders, as the social and academic pressures pile up. Substance abuse is common.

Many teenage girls with ADHD develop impressive systems to hide their self-perceived deficiencies, and in doing so further reduce the chance of a diagnosis. A curated, cool exterior also reduces the chance of understanding from family and peers. If everything seems OK in general, you’re less likely to be let off lightly when the dam bursts. The ‘thin skin’ I described is not unusual, and it leads to outbursts of emotion beyond what you’d expect, even from a teenager.

Lanky, Adolescent Me was much happier than Little Me, but not any more efficient. I had simply given up in most areas that required organisation, and embraced it as part of my new, painfully deliberate, “devil-may-care” persona.

I rarely did my coursework, and if I did it was late. I couldn’t focus in the lessons I didn’t like (or did I dislike them because I couldn’t focus?) and so I played the class clown rather than look a fool.

I still laughed too loudly at the wrong moments, and said strange things, and seemed odd to many; but I was now at an age where people didn’t care so much about that, and I was funny – so I became largely accepted, if not popular.

I had my first kiss at 14, followed alarmingly swiftly by my first everything else. That’s an early example of my poor impulse control, and so is the fact that I started drinking and occasionally smoking at around the same age.

I acquired a decent handful of GCSEs, including top grades in English and History, and I managed passes, at least, in the rest. However, I hadn’t revised for the exams – couldn’t, wouldn’t, hadn’t even opened a text book – and I was very aware that my intelligence wasn’t impressive enough to sail me through A Levels (16-18) in a similar fashion. I left school at 16.

ADHD as a woman

A late diagnosis is damaging and, sadly, common (although the trend is moving in an encouraging direction). Reading articles on women with ADHD, which I did a lot when I first began to suspect it in myself, can be disheartening. They cite studies which show that women are badly affected in the long-term by a non- or late diagnosis of ADHD.

I am a fairly typical case.

  • I have had difficulties in many jobs before settling at one which suits me (lots of variety) and gives me a reasonable amount of leeway.
  • While I have close friends, I am often considered ‘off’ by new people, and struggled to socialise and fit in while working in a ‘normal’ office environment (which is basically just School 2.0).
  • Related to the above, I over-share personal information (“No shit,” you say, reasonably enough), find it hard to listen when being spoken to – even when it’s very important – and interrupt people rudely.
  • I am an alcoholic (sober for two years).
  • I suffer from anxiety.
  • I have made poor romantic decisions in the past – obviously poor ones, not just bad luck – and have suffered from the aftermath of those relationships.
  • I am an impulsive spender, and struggle to stay in the black.
  • I am an impulsive consumer, of food and coffee and cigarettes (an e-cigarette, these days), and that has made my wallet thinner and my waist thicker.
  • I am chronically untidy and unorganised.
  • I struggle to get up in the mornings.
  • I start projects or hobbies (often impulsively spending in my initial fervour), get hyper-involved with them and, almost 100% of the time, give up on them entirely after a few days of low motivation.

It is easy to feel bitter.

If only I had been treated as a child – how much easier might social situations have been? How much better my academic prowess? How many impulsive, stupid decisions might I have stepped back from? How many opportunities have been missed, how much money spent, how many pounds put on? Might I, even, have avoided years of alcohol abuse and everything that came with it?

But, of course, such lines of thought are worse than useless, and I try to pull my mind back into reality.

It is unfortunate that I was not diagnosed 20 years ago, but I am incredibly lucky to have been diagnosed at all, when I look at the bigger picture. The vast, vast majority of women – of men, too – with ADHD over the millennia have had no help with the condition, and most of them lived far harder lives than I have.

Not only that, but I had the time, the support system and the mental energy to recognise familiarity in that first article about women with ADHD; to follow that up with conversations with friends and family; to follow that up with months of research (and, yes, procrastination); and to be able, finally, to plonk myself in front of the doctor with a sheaf of notes and the certainty of someone who is not going to be ignored.

Many people, even in this era and even in this wealthy country, do not have the same resources. So, yes, I am lucky.

My ADHD diagnosis was emotional. The main emotion was not bitterness, but relief.

It gave me hope that perhaps I wasn’t just a shitty human being. I have spent most of my life considering myself lazy, foolish, unlikeable and broken. There’s that classic ‘women with ADHD low self-esteem’!

I never thought to connect my oddities – my fidgeting, my daydreaming, my tendency to fixate on strange things to the detriment of others, etc. – to my failings. Now that it’s been pointed out to me, it’s obvious. And now that it’s obvious, it’s easier to deal with.

I’ve just started medication for ADHD (June 2018), and we’ll see how that goes (it’s why I started this blog, after all), but even if it fails I’ve got more confidence in myself to work around my limitations, instead of falling at the first hurdle and huffing off home.

You never know, I might even be able to keep a blog updated.