Over the years as an ADHD coach, my practice has changed to reflect our new understanding of ADHD and gender. When I first started, nearly all of my clients were men with ADHD. However, this morning when I looked at my list of current clients, I was astonished to realize that there were many more female clients than male. Luminaries in all-things-ADHD like developmental pediatrician Patricia Quinn and clinical psychologist Kathleen Nadeau have been writing and speaking about ADHD in girls and women for years. They describe how women tend to have a more inattentive, quieter form of ADHD than our more outwardly hyperactive male counterparts. A review of recent research on the subject agrees. In general, women tend to internalize feelings, confusion, and frustration more than men, which can make problems a bit less obvious. Or, at least less understood.
Recently, three resilient young woman writers have helped to make the picture a little easier to understand. The Cut's Rae Jacobson started off the writing frenzy with her exquisitely constructed article What It's Like to Have ADHD as a Grown Woman. She inspired two others to quickly add their voices: Bustle's Jaime Lutz with a clarifying What It's Like to Live with Adult ADHD – The Myth's Vs. The Reality and The Frisky's Rachel Brodsky with her intimate True Story: Learning to Love My Adult ADHD.
What makes these articles so compelling that I felt the need to follow them with one of my own? The simple truth is that these young women have lots to teach us about the experience of living well with ADHD. The lessons they teach mirror the conversations that I have with my clients in coaching sessions each day, and must resonate deeply with anyone struggling with ADHD, but particularly women. Let's take a look at what they have to teach us:
1. It's important to recognize that women have ADHD too.
As Rae Jacobson writes, "For decades ADHD was seen as a young boy's disorder. New evidence suggests that it likely affects males and females equally, but that girls are far less likely to be diagnosed. For years the diagnosis ratio of males to females was 10:1. These days we're looking at a slightly brighter 3:1." In my opinion, this change in the numbers brings with it an even more important change in perspective. Jacobson points out that although ADHD significantly impairs daily life, often times, especially in the old days, a girl's inattentive, disorganized, or even confounded behavior could easily have been chalked up to being "a ditz" as it was for Rachel Brodsky. There's also spacey, moody, or even simply blonde. These terms carry with them a sexist and implicit negative message permitting us to expect girls and women to be irrational and contribute less to the important work of our society. Sounds quite Victorian, doesn't it? With the appropriate understanding, diagnosis, and treatment of women with ADHD, we can continue to chip away at our collective sexist mindset.
2. Misunderstanding can lead to hurtful minimizing of ADHD.
Everyone has trouble paying attention, resisting distractions, remembering what they're doing, and regulating behavior and emotions sometimes. The difference is that for people diagnosed with ADHD these problematic symptoms create significant difficulties that get in the way of everyday life. Not showing up to class or work every now and again, losing your keys once, or occasionally procrastinating on an assignment is not the same as having ADHD. As Jaime Lutz writes, "ADHD is a joke to many. People will say 'I'm so ADD' to mean that they have a messy desk in the same way a neat freak will say 'I'm so OCD' to describe their tidiness habits." The clear message from all three of these young women is that ADHD brings with it repeated failures, frustrations, and the continuous effort to keep on top of things. This can be especially poignant for women with ADHD for whom, according to Jacobson, "not having your shit together can feel like a dereliction of feminine duty."
Reflecting on her life as a teen with ADHD, Rachel Brodsky writes that her family could surely "see how inadequate I felt next to them and everybody else. A neat and organized life came easily to my family." This feeling that life is easier for everyone else comes up in coaching all the time. In Natural Relief for Adult ADHD Dr. Stephanie Sarkis describes having ADHD like "being on a mountain with a backpack full of rocks: You're trying to climb, but your load is heavy and you're huffing and puffing. You see climbers passing you by on the way to the summit – and you can't figure out why things just seem so easy for them. By the time the other climbers reach the summit, you're only halfway there – and you're so exhausted, you need to take a nap." Those climbers with fewer rocks in their packs are referred to as "neurotypicals" in the "ADHDers" world. Jaime Lutz sums this up succinctly, "Effort has nothing to do with it, though – people with ADHD find normal tasks much more challenging than do neurotypical people." Neurotypicals are also the ones who can so casually minimize the effects of ADHD for those who struggle with it.
3. ADHD adults are overly familiar with shame.
Reminiscing about high school, Rae Jacobson talks about going home and crying after school. She writes, "Repeated failure is disruptive. It chips away at your self-confidence and eats at your resolve. It makes you hate yourself." When talking with my clients, they always bring up their shame, always; shame is more universal to my clients than inattention or distractibility, two of the core symptoms of ADHD. The problem with shame is that it's a double whammy. Not only does it feel awful, but it exacerbates the problematic symptoms of ADHD that made you feel ashamed in the first place. As Thomas E. Brown discusses in his book Smart but Stuck, often people with ADHD get flooded with negative emotions to such a degree that it "gobbles up all the space in their head, as a computer virus can gobble up all the space on a hard drive, crowding out other important feelings and thoughts" leaving them both ashamed and stuck.
For women with ADHD, shame can bring additional complications. My women clients describe being ashamed of feeling shame because as professional-women-with-their-act-together emotions shouldn't be getting in their way. One client lamented that she wished she could "be a dude" at work, releasing herself of the burden to care what her co-workers thought of her performance and her untidy desk. In general, women in our society are judged for being emotional and thought to be unsuccessful if emotions influence their decisions. For women with ADHD, this is particularly difficult because the challenges of ADHD exacerbate the emotions that can lead to feelings of failure.
4. The key to living with ADHD as a grown woman is acceptance.
For all three of these young women with ADHD, diagnosis and acceptance were the secret to moving beyond the misunderstanding and shame of their pasts. For Rae Jacobson "Getting diagnosed wasn't a cure, it was a key" that opened a gate to getting treatment, implementing appropriate strategies, and accepting that ADHD is not a character flaw. For Rachel Brodsky, being diagnosed as a child left her feeling like a freak, but as she got older she met other people with ADHD and learned to embrace "every last one" of her ADHD "deficits.” For Jaime Lutz, acceptance seems to be about supporting her "disability the best I can through standard time management stuff" and wishing for societal institutions more suited to "people who don't fit into the neurotypical box" which is a significant step toward not always being to blame.
In coaching, I find that the acceptance key needs to be specially cut for each individual. In general it means expecting and acknowledging struggles and limitations, implementing some useful strategies and creating new habits, getting support and treatment, and constructing a life that is custom fitted to who you are naturally, ADHD and all.
5. ADHD is not a gift, but can come with gifts.
If you're tuned into any social media, you will have bumped into the ADHD exemplars. These are the super successful celebs with ADHD. Most media lists are still made up largely of ADHD men, but a few famous women have talked openly about being diagnosed with ADHD. Among them are notables like journalist Lisa Ling (diagnosed at 40), Karina Smirnoff, Solange Knowles, Mariette Hartley, actress Michele Rodriguez, Roxy Olin, Zooey Deschanel, and Paris Hilton.
We love to hear about famous people with ADHD because they are proof that people with ADHD can find success.
And although neither Rae Jacobson, Rachel Brodsky, nor Jaime Lutz is thrilled to have ADHD, each of them, in their own way, has acknowledged that her ADHD has added something interesting, unique, and positive to who she is. Rachel Brodsky learned to love her adult ADHD claiming that "this so-called disorder makes you hyperfocused towards the things you love – something that's worked to my advantage in my professional life as a writer." She also speculates that she "might also be really, really boring" without ADHD. Jaime Lutz reminds us that "people with ADHD also report positive side effects to their so-called disability, including increased creativity, entrepreneurialism, and leadership." Rae Jacobson adds to that "a tendency to view the world from odd angles," which in my experience can lead to unique sensitivities, problem-solving abilities, and sparks of real genius.
For most of the women with ADHD that I work with, the journey from misunderstanding and shame to acceptance and even finding ADHD positives is not always as tidy and linear as it might appear in a short article. Often people with ADHD have to restart that journey with each subsequent failure, challenge, or frustration. With practice and increased self-knowledge, some extremely useful strategies, and the re-working of your life's situation to be a good match for you, restarting that journey can become less arduous and less frequent over time. For me, in the sharing of their stories and struggles, these three young women have taught us much about what it’s like to live as a woman with ADHD and have shown us how it is possible to live well with ADHD.