this post was submitted on 19 Nov 2023
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ADHD Women

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Are your goals too high? When you explained your job to me…” the psychologist trailed off. I knew where this was going. I was here after six visits to the GP in two years, all for unexplained exhaustion. Burnout, I guessed. Whatever that means.

It felt like my brain had been tossed into a washing machine, and all of the delicate bits that made it sparkle had dissolved. Everything took three times longer than it should have. Somehow, over the past few years, my already-frayed cognitive controls had just … evaporated. “I can’t keep it up any more,” I said wearily. “It” being life. I wasn’t suicidal; I was chronically overwhelmed.

The psychologist tightened her lips. “You know many women in your industry put pressure on themselves to be perfect.”

My eyes began to sting. I had a lot on, but it wasn’t anything someone with my experience shouldn’t be able to handle – I just needed someone to show me how. “There are women out there my age running the world! All I’m trying to do is send a few emails, keep my house clean, be creative and still have free time! I’m not curing cancer or raising a family. I am just trying to live.” I’d always been chaotic, but this was a new level.

The session, I can say with full confidence, was a failure. I left the psychologist’s office with zero helpful tools and as much hope. I had known depression. This wasn’t it. Stress? Anxiety? Sure. But these were byproducts, not the cause. What is wrong with me? As soon as I got home, I collapsed on to the floor and tucked my limbs under myself into a ball – which I did often. How does everyone else cope with life?

It would be another burnout, two more doctors, a blood test, a hormone test, a three-month wait to see a psychiatrist and another year-and-a-half before I had an answer. It turned out, like many women in their 30s, I had been masking severe ADHD my entire life. And like so many more, I had no clue what that meant.

Attention deficit hyperactive disorder is a condition that presents at first in childhood but often goes undiagnosed. In Australia, it affects approximately 814,500 people and around five to 7.1% of the population globally. Despite the name, ADHD doesn’t exactly result in a “deficit” of attention, but more an issue regulating it, making it harder to plan, prioritise, avoid impulses, remember things and focus.

On a good day, it’s like watching a train whizz past you while you’re trying to read the text on the side and make out faces in the windows. On a bad, a bird might land in front of you. Curious, you pull out your phone, Google the bird and get stuck in a “pigeons of the world” vortex.

You discover cassowary eggs are bright green and in 2005, UK police found a leg of swan in the Queen’s Master of Music’s freezer. Two terrine recipes later, the train has long passed and night has fallen. Dazed, you sink under a dark cloud of self-loathing, lamenting another lost day. You don’t remember what kind of bird it was.

The default assumption about ADHD is that it’s what makes little boys disruptive. But it can also make little girls feel like they’ll never be good enough. Statistics have traditionally shown ADHD is more prevalent in males, but recent research suggests this could, in part, be due to misdiagnosis. Unsurprisingly, ADHD in women is hugely under-researched – females weren’t even adequately included in findings until the late 90s. And it wasn’t until 2002 that we got our own long-term study.

ADHD presents differently in girls and boys too. Women are more likely to have inattentive ADHD, rather than the more observable impulsive type. Because of society’s gender norms, girls with ADHD are often dismissed as “daydreamers” and “overly sensitive”, as if we are a romantic, quirky caricature from a John Green novel or the Disney Princess canon.

The frequency of zone-outs, disassociations and meltdowns caused by our hidden internal restlessness and our brain’s inability to regulate information and emotion goes unnoticed. The cherry on top is that girls who do suffer from impulsivity are often palmed off as “tomboys”. As a child who was prone to inattentiveness and impulsivity, I was repeatedly told to “stop daydreaming”, “slow down”, “hurry up” and “act like a lady.” Overwhelmed by the world, it wouldn’t take much for my cup to runneth over or for me to completely disassociate – I got very good at both.

There are many women like me: “lost girls”, so we’ve been called. Chaotic and curious, sometimes we feel like superheroes; other times, super-failures. It’s not always a lack of interest that makes it hard for us to process information, but our brain’s desire to absorb so much of it. We are jacks of many trades, purveyors of information, collectors of hobbies, beginners of tasks and finishers of few. And we all have similar stories of missed red flags that haunt us.

When I was nine, my teacher told my parents I was all over the place. I already had the energy for five dance classes a week, netball, French lessons, piano lessons, a book club and school band. However, she thought I still didn’t have enough channels for my “creativity” and suggested they enroll me in drama school as well, so they did. Did it help me focus? Of course not.

Neurodivergent women often slip through the cracks of diagnosis because they can appear smart or gifted. This is because we’re more likely to be perfectionists or suffer from low self-esteem, so we work extra hard to prove ourselves (see also: my burnout). Combined with hyperfocus – the flipside of the attention coin where one zones in on a single interest for hours – this results in flashes of brilliance.

We’re also experts at masking symptoms. We form habits by mirroring the social behaviours of those around us. You think imposter syndrome sucks? Try keeping it together when your brain is a wind-up puppy doing backflips while singing the chorus of Ricky Martin’s The Cup of Life – for no apparent reason. And don’t ask what the obstacles involved in dating or starting new relationships might be!

As I discovered, burnout is what happens when the mask slips. Your entire world comes crashing down, and you don’t have the executive function to figure out which way is up. ADHD adults take an extra 16 days of absence a year, according to a report by the Australian ADHD Professionals Association, so while it certainly makes life interesting, it is a rollercoaster for your REM sleep patterns.

According to the Under the Radar Report, released 25 October by ADHD Australia, there is a lack of education and understanding around the condition. The pandemic has caused ADHD children to feel swamped by the struggles of at-home learning, and adults like me are burning out. Anxiety in those with ADHD is skyrocketing, with 52.4% of children and 64.7% of adults reporting an increase. Keep in mind, neurodivergent conditions often co-present with other mental health disorders, so the scales are already tipped. “It’s been a living hell with no escape or support, I’m mentally exhausted,” a parent of an ADHD child is quoted as saying in the report.

Alas, if there ever was a time where neurotypical people could relate to the anguish of fuzzy focus, it’s now. That absence of motivation and productivity you’re feeling from stress? It’s not far off. The chaos of the pandemic has activated everyone’s fight or flight response and time-blindness.

The new normal sees us assaulted by a relentlessness stream of backlit information stained with emotion and outrage. Anxiety is high. Stunned by stimulation, suddenly it’s harder than ever to silence the background noise. Blend all this with the pressures of attempting to work at a regular pace in an irregular environment, without allowing room for adjustment, and you’ve almost got an ADHD tasting plate.

Seven months on, my diagnosis has become something of a bereavement – I’ve cycled through many stages of grief. I am comfortable with my chaos and relieved I now have answers and an arsenal of tools to prevent me from falling into a hole again. But I keep thinking about all the other lost girls out there. I find myself angry and sad, mourning on behalf of my younger self.

I mourn the unnecessary pressure and all the times the world was too loud, bright or grotesque. I mourn the things she forgot, the skills she could have learned and the relationships her impulsivity, perceived detachment and unhealthy coping mechanisms sabotaged. But most of all, I mourn time lost. Because even though my neurodiversity has sometimes made me the loudest person in a room, because I was a woman, nobody noticed.

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[–] [email protected] 32 points 1 year ago (4 children)

For me as a man all it took was trying a few antidepressants, some terrible therapy, and a 5 minute assessment to get my ADHD diagnosis.

My wife had the same doctor as me, did the same evaluation, scored worse, and he refused to diagnose her. She did get one eventually, but the evaluation took over 3 hours.

[–] ickplant 12 points 1 year ago

Oh, man, that's infuriating and yet not surprising. I'm glad she was finally able to get properly diagnosed, but wow.

[–] Mohkia 7 points 1 year ago (1 children)

That is so frustrating. I'm glad your wife finally got help but that must have been stressful for her. Also a 5 minute assessment is just silly, for anyone it should be longer. Funny how they so easily diagnosis it for men without question. Not trying to discount your diagnosis but just wanted to state the hypocrisy between the two evaluations (yours and your wifes).

[–] [email protected] 5 points 1 year ago

I am definitely more functional on meds, but I'll always wonder where the cptsd ends and the ADHD begins.

[–] cmbabul 6 points 1 year ago

I’ve been diagnosed since I was 7 as a cis-male, had I been born differently I’m positive I’d have killed myself by now because there’s no way even my glaringly obvious symptoms would’ve been diagnosed and wouldn’t be able to get the meds that make surviving in our society possible for me

[–] [email protected] 5 points 1 year ago

When I was a like a toddler, my doctor tried to put me on ADHD meds. My mom was against it and still haven't tried medication. Doctor tried to guilt her by saying I'd do terrible at school. But I didn't: school was something I excelled at. But I also could get distracted from video games by math at times.

[–] uuseernaamee 18 points 1 year ago (1 children)

Oh hey that's the article that lead to me getting diagnosed! I read this right after coming back to work after a long COVID furlough. I had been finding it really hard to be back at work and was seeing a therapist for depression (again) then read this and realised that it had actually definitely been ADHD the whoooole time and the current problem was the complete atrophy of all my coping mechanisms after so much time not using them.

[–] ickplant 8 points 1 year ago (3 children)

It's so fucked up how depression is a natural consequence of untreated ADHD in women, yet it's not widely recognized by the mental health community. Honestly, it's the same with trauma. I'm a trauma therapist. People will come to me with "treatment-resistant depression," having tried TMS and ECT, and every med under the sun. And we start digging... bam, trauma. Treat the trauma, and depression slowly starts to improve.

Makes me think we should routinely screen women with depression for 4 things: ADHD, thyroid issues, bipolar disorder, and trauma. Treatment plans would look wildly different for those cases.

[–] uuseernaamee 4 points 1 year ago (1 children)

The way I see it, I never actually had depression. I was sad-ish and struggling with life in a way that caused me to get full marks on a depression self- assessment questionnaire, but that was because of the ADHD. So when every time I got told I had depression, the attempts at treatment did nothing, it was because I was being treated for a symptom without anything being done about the underlying cause. Stick 30mg of Elvanse into me every day, and hey presto I'm no longer depressed at all.

[–] ickplant 2 points 1 year ago

That's a very good point - how do we differentiate between true depression and feelings of inadequacy induced by ADHD shame? We need better screening tools and way, way more education for mental health professionals. But I'll get off my soapbox. I'm so glad you were able to find the right meds and that it cleared up those feelings of sadness. Treat the underlying cause, and voila.

[–] [email protected] 4 points 1 year ago (1 children)

I feel that autism also belongs in that list, due to the different presentation in women, and the underdiagnosis because of masking. Adhd/autism pairing also happens. If a person then already doesn't have trauma, they risk encountering it. Ofc I also very much agree bio markers like thyroid must be investigated.

[–] ickplant 3 points 1 year ago

Oh, you are absolutely right about that. I would definitely add autism to the list exactly for the reasons you described. And yes, being neurodivergent can be traumatic in and of itself, as many of us can attest to. The way our society treats anyone who doesn't fit the mold is less than ideal, from bullying to lack of support and accommodation.

[–] IanSomnia 15 points 1 year ago (1 children)

Thank you. I'm glad I read this.

[–] ickplant 9 points 1 year ago

Thank you for commenting, glad to hear you liked it!

[–] Mohkia 12 points 1 year ago* (last edited 1 year ago) (1 children)

Thanks for posting this. Definatly resonates. Makes me sad to think of how many women have lived most of their lives struggling more than they should be because it was thought it just wasn't a thing women had. Barely anybody does studies or research on women,we are just to complicated with our hormones they say. But that is unacceptable. It's getting better slowly, but we still have a long way to go.

I wasnt diagnosed until this year at 44. It had come up as a suspicion when I was doing a search a few years prior to why I was having certain issues but I didn't take it serious. Like many I didn't understand what adhd actually was, just thought it was the stereotypical view most people have. Then a therapist I was seeing for depression this year suggested I get tested. It wasn't easy, first try was very dismissive and rude, I almost just gave up then, the second time went much better, they actually let me talk and got a proper history from me. I am finally getting help for all my problems, adhd included.

I just want to encourage any women out there that are struggling and think maybe this might be a possibility to at least try to get tested. Don't suffer in silence. We need to speak up louder when the world won't listen. I wish you all the best in your journey wherever you are on this path.

[–] ickplant 3 points 1 year ago

This is so well-said, thank you. I want to sign my name under every word of your encouragement. It's infuriating that we have to fight harder, and yet we cannot give up

[–] toasteecup 12 points 1 year ago (1 children)

Very interesting to learn how adhd is similar and different between women and men. I (male) was diagnosed as a young kid in the early 90's but I had only ever been told about the attention parts and impulsivity which as I just learned is much more frequently observed in men.

That helps to explain why I'm able to have a better control over my attention (mind you, I have to exert mindful effort which taxes my energy for the day) and my bestie (female) has a much more difficult time with that but we both have no issues being ridiculous together because we can be impulsive and silly.

Thanks OP! I also shared with the bestie hopefully it helps her cause she's been having some struggles lately.

[–] ickplant 9 points 1 year ago (1 children)

I sincerely hope it helps your friend!

[–] toasteecup 8 points 1 year ago

She definitely saw plenty of similarities

[–] [email protected] 9 points 1 year ago (2 children)

Oh burnout, my old nemesis. I'm so incredibly grateful to have a job that lets me work four longer days. I will have a mental breakdown if I work five days a week, but I can work 11 hours like it's nothing. It has happened literally every time I have worked five days a week. But my current job appreciates my desire to concentrate my time on our busiest periods. I can maintain my high performance indefinitely with three days off.

[–] ickplant 3 points 1 year ago

It's awesome you found what works! I also take 3 days off a week because the alternative is to completely burn out. I wish society and the government would take measures to make that an option for everyone.

[–] [email protected] 3 points 1 year ago (1 children)

The dream. I am infinitely envious.

[–] [email protected] 5 points 1 year ago

I don't take it for granted that my job is amazing. My GM also has ADHD and can't always work five days. She very much prefers working long shifts a few days a week when she can. I actually got promoted on my four day schedule, and our new management team is half orderly brained and half ADHD women. It actually works phenomenally well. We're finally getting back to stability after 3/4 of the management team quit within 3~4 months. We're gonna have such a beautifully functional dispensary, and I'm so glad I'm part of it.

[–] Robsadaisy 8 points 1 year ago (1 children)
[–] ickplant 18 points 1 year ago (2 children)

If this resonates, it might be a good idea to get assessed. Of course, it's up to you if you want to seek out diagnosis or not, but for me it was a big deal to know something was actually different about me. And then the meds really helped. I wouldn't be able to run my own business without them. I was even able to go to grad school and do really well. I'm saying all of this to let you know that even if you do have ADHD, you can still live a good life. I have shitty days, but overall my life is much better than before I got diagnosed.

I'll leave this here:

[–] [email protected] 10 points 1 year ago (2 children)

I tried to get an ADHD diagnosis and my report came back with a mini-novel about how I was just a hysterical female with self-image issues I displayed as a way to garner praise and attention from those around me. My attention and focus problems were only because I just found the everyday stresses of life so difficult, being so fragile.

Any one who knew me felt disgusted reading it. But it's made me very hesitant in trying again to get a diagnosis.

[–] Mohkia 7 points 1 year ago (1 children)

That is so demeaning! Fragile? Like what? If you have adhd it can make every day things stressful and difficult and dont evem gdt me atarted on self image. I would definitely get a second opinion. Could be you have it, could be you don't but at least find someone that has more to offer for an explanation than that. It's exhausting and nerve-wracking for sure but don't give up.

[–] ickplant 4 points 1 year ago

Makes me think of how women also disproportionately receive the diagnosis of borderline or histrionic personality disorder because we are so hysterical due to our wandering uteruses (uteri?)

[–] ickplant 6 points 1 year ago* (last edited 1 year ago)

This is such bullshit, I'm so sorry you went through that. Of course, it's us "fragile" and "emotional" women and not differences in brain structure. And to say that your symptoms are a way to garner attention.... how dismissive. As a mental health professional, this makes me angry, sad, and many other things.

I completely understand you wouldn't want to go through that again. It would be easy for me to say "don't give up, keep trying," but I know it really depends on the area you're in and what insurance you have or what you can afford out of pocket - not to mention this experience. Makes me realize I got lucky with my psychiatrist, and I will be grateful for that.

Edit: unrelated, but I love your pixel art!

[–] Robsadaisy 3 points 1 year ago
[–] [email protected] 1 points 2 months ago

jfc, I feel like my brain has been scrubbed with steel wool and left to sit in raw sewage, and it's all thanks to the fact that I only got a diagnosis in high school. I can barely talk normally, and if I manage to spit something out that makes any sense, it doesn't feel like I actually said it. It's like I'm not even a real person anymore. Please kill me.