Understanding women and ADHD
Deena Kara Shaffer
In my work teaching learning strategies to parents and students of all ages, attention deficit hyperactivity disorder (ADHD) is increasingly present in the conversation. I hear from clients wondering about symptoms to making sense of the intricacies of a diagnosis, from practising the art of self-advocacy to learning skilful ways to not just cope but also tap into its potential gifts.
For insight into the complexities of ADHD, I turned to René Brooks, founder of Black Girl, Lost Keys, who has been diagnosed with ADHD three times, once at age 7, once at 11, and finally at 25. I also reached out to Dana Daniels, founder and CEO of Blue Sky Learning in Toronto, and Ellie VanBerkel, ADHD coach.
ADHD is a neurodevelopmental disorder or impairment in regulating attention. It affects the parts of the brain that help us plan, focus on, and execute tasks. In Canada, 4 to 6 percent of adults and 5 to 7 percent of children have been diagnosed with ADHD—that’s roughly one out of every 21 people across the country.
ADHD symptoms vary by subtypes—inattentive, hyperactive, or combined. People who present as predominantly inattentive might struggle with paying close attention to details, resisting distraction, following through on instructions, remembering routine chores, sticking to lengthy tasks, and listening in conversation.
Those who present as hyperactive might struggle with sitting still, fidgeting, impulse control, interrupting, or moving or talking excessively. Someone with combined ADHD experiences both inattentive and hyperactive symptoms.
Compared to children, adults with ADHD symptoms may present differently: starting new tasks before completing old ones, struggling with keeping organized; misplacing items; engaging in risky or dangerous behaviour without much fear over safety; or feeling forgetful, restless, impatient, or edgy.
When looking at the reported data, boys are about twice as likely to have been diagnosed with ADHD than girls, and some ADHD subtypes are more difficult to diagnose in girls and adults.
But growing research indicates that ADHD affects girls more than has so far been investigated. In fact, there may be a general bias toward diagnosing ADHD in girls because of the way their symptoms tend to manifest compared to boys.
“Girls are less likely to display hyperactive or impulsive symptoms,” says Daniels, “and can appear inattentive, which causes fewer problems in the classroom. Girls are socialized to people-please and can compensate for the disorder so well it becomes mistaken as immaturity or lack of academic skill instead of ADHD. Sexism plays a pervasive role in the performance of women overcompensating for their symptoms.”
Daniels points out that when we talk about the ADHD experiences of girls and women, we participate in a gender binary. This, says Daniels, “ignores or avoids transgender ADHD experiences altogether. Early diagnosis, coaching, and counselling support are often hindered or barriered for BIPOC and LGBTQ+ women.”
Gendered diagnosis is exacerbated by societal expectations, notes Brooks, with pressure on women to be in charge of household chores such as grocery shopping, appointment scheduling, balancing the budget, and housecleaning. Without support in working with their ADHD, it can mean more stress, resentment, and poor mental health care for those women.
“People often think that we’re careless or lazy, uncaring, or rude,” Brooks emphasizes. “That is because we have been taught that people who struggle with timeliness, procrastination, and other executive functions lack moral fortitude or stick-to-itiveness. This causes a lot of misunderstandings, miscommunications, and heartache for the person with ADHD.”
“When someone is experiencing symptoms that have a negative impact on their life,” says Brooks, “I think they owe it to themselves to investigate at the earliest opportunity.” Daniels adds that an “official diagnosis can be a sign of relief, a grieving process, a reconciliation, or spark an identity crisis.” For support before, during, or after a diagnosis, some places to start include a psychiatrist, family physician, or psychologist.
As important as any intervention, support, or medication, is the honouring of someone’s ADHD experiences. Without proper acknowledgment, says Brooks, ADHD can result in behavioural, emotional, academic, vocational, and social problems that diminish quality of life.
“Social media platforms can hold rich information about current practices of folks with lived experience who are trying to make ADHD strategies and ideas more accessible,” says Dana Daniels.
#NeurodiverseCrew and #ADHDer
r/ADHD and r/adhdwomen for specific support; some humour at r/adhdmemes
@howtoadhd and @connordewolfe for trending ideas with some comical flair
Dana Daniels, Blue Sky Learning, shares these myths and misunderstandings, and why we should think differently about them.
“Everyone has ADHD”
Assuming “everyone has a bit of ADHD” only increases stigma and delegitimizes folks who have daily executive dysfunctioning impacts. The cost of this statement can be detrimental for anyone seeking help for a condition that concerns planning, organizing, and executing tasks, because it hinders the motivation to find help.
“You’re just lazy! Try harder! Dig deep!”
ADHDers have executive dysfunction that prevents them from moving forward on certain tasks, as organization, prioritization, self-regulation, and planning can be challenging in many forms. When these types of statements are shared by family, friends, and colleagues, it can eliminate a safe space and silence the person with the invisible disability.
“Why are you so sensitive?”
ADHDers can have sensory-seeking, -avoidance, -sensitivity, or -low registration in responding to environmental stimuli. Thus, in ADHD coaching, we co-create goals to make the sensory experience more accessible.
Dr. Caroline Meyer, naturopathic doctor and reiki master, points out that the top well-researched interventions for those with ADHD include both the Mediterranean, veggie-focused diet and moderating screen time. In addition, several small studies support the use of certain supplements including omega-3 fish oil, Ginkgo biloba, ginseng, and B-complex vitamins.
Iron has been shown to help with focus in kids who have deficient iron stores. In addition, iron seems to make pharmaceutical medications work more effectively.
Zinc may have some effect in ameliorating the agitation and aggressive behaviours sometimes associated with some children with ADHD.
Melatonin may help adults with sleep disturbances associated with taking medications. Adequate sleep is important for mental focus and attention.
L-theanine has been shown to be effective in improving attention and calming mood in children with ADHD.
Symptoms and behaviours of ADHD most often appear by the age of seven, but sometimes can show up earlier. And, in half of cases, ADHD symptoms tend to continue into adulthood. At its most basic, difficulties in attention regulation look like challenges staying focused, being overfocused, switching focus, and boundarying focus.
A quick online search can have even the most health-savvy among us believing that we are a sufferer of any number of diseases and disorders. The danger of self-diagnosing ADHD is that you may take treatments that you really do not need. For children, in particular, being labelled with ADHD can affect how they see themselves as they are forming their identities. A psychoeducational or other assessment is important for a diagnosis of ADHD.