What ADHD Looks Like, and What It Doesn’t

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Debate captain, model UN delegate, editor-in-chief of the school newspaper, and female. Does this sound like someone who has ADHD (Attention Deficit Hyperactive Disorder), to you? Most people would say “No.” Maybe that’s why I went undiagnosed for 17 years.

Once someone diverges from the commonly accepted notion of what ADHD ‘looks like,’ it’s much easier for others to discount their struggles telling them, instead, that they ‘just need to try harder’ or are ‘just oversensitive.’ What people don’t realize is that behind the good grades, behind the accomplishments, and behind that ‘quiet’, ‘conscientious student,’ there is someone else. 

This is the overlooked and often unknown reality many women with ADHD face. It is estimated that approximately four million women around the world are living with undiagnosed ADHD. One of the main reasons for this phenomenon is that research funding has predominantly focused on studying children at the average age of seven. Females, however, often present symptoms of ADHD much later than their male counterparts, since their symptoms increase as their estrogen levels rise.

The lack of awareness regarding gender differences in the manifestation of ADHD means the majority (including parents, teachers, and even clinicians) are not attuned to the more nuanced presentation of ADHD in females. Male ADHD symptoms continue to be the benchmark against which females are assessed, thus causing many girls, such as myself, to fall through the cracks. This referral bias has engendered an entire ‘lost generation’ of girls, plagued with feelings of inadequacy from a disorder they don’t even know they have. This is further evidenced by surveys conducted by the Centers for Disease Control and Prevention, which shows, “Boys were more than two times as likely to have ever been diagnosed with ADHD, as compared with girls.”

Even when girls are fortunate enough to obtain a referral, we face the likelihood of being misdiagnosed and mistreated for another disorder whose symptoms mimic those of ADHD (such as depression, anxiety, and obsessive-compulsive disorder). Furthermore, many women with ADHD present coexisting conditions that may mask their ADHD symptoms. Consequently, this prevents females from receiving the treatment they need, exacerbates the effects of ADHD, and leads to more significant challenges in the future.

Females with ADHD are more prone to eating disorders, obesity, anxiety, depression, low self-esteem, and are even more likely to self-harm or commit suicide. The mitigation of these calamitous effects lies in early diagnosis which, given the inordinate obstacles women with this disorder face, is challenging, to say the least.

Gender roles dictate that women be passively compliant, organized, work cooperatively with others, and not show excessive outward displays of emotion. This immense pressure placed on women with ADHD, coupled with our inability to conform to societal expectations, can leave us feeling like constant failures riddled with the shame and fear of being discovered as ‘impostors.’  We often therefore go to great lengths to mask our perceived ‘flaws,’ internalizing our pain, and placing a ‘ cape of invisibility’ over our disorder. Doing so only further alienates us from our peers and worsens our silent suffering.

Even though most of the students at my school carry backpacks, my backpack seemed to weigh as much as twenty times its true weight. But that was three months ago, before my diagnosis. Since then, my circumstances have vastly improved. I still, however,  face discrimination because I don’t fit the ‘ADHD archetype.’ I have been told, “You can’t have ADHD, you’re smart,” “only little boys have ADHD, so it’s impossible for you to have it”, “you’re just lying to get extended time on tests”, and “you probably just want Adderall to lose weight.”

Until we increase public awareness, these pervasive gender stereotypes will continue to paint a one-dimensional, misinformed  picture of a complex disorder, and women with ADHD will continue to be marginalized, misrepresented, and misunderstood. ADHD doesn’t discriminate based on gender, socioeconomic status, or any other factor: so why are we still treating it like it does?

  • disqus_mrussellgab

    The lack of resesrch into how disease affects women and girls is a widespread problem, but the reason is quite easy to understand. A female research model will exhibit hormonal periodicity, which a male research model does not, adding a complicating variable a scientist must track and account for. It is already difficult to isolate a research variable in a male research model, and to do so in a female research model is sometimes impossible. So, there, in a nutshell, is the problem. What’s the answer? I have no idea.

    • Gayton Judy

      An important statement that is responsible for a lot of the misdiagnosis of “mental illness” that women are accused of and suffer from the mistreatment of.

      Dr. Caplan and Dr. Kelly Brogan speak to this. I urge We.news to read their work.

      http://www.feministvoices.com/paula-caplan/

  • Mona

    Love it! So powerful! This is such an important issue that is rarely discussed and affects so many girls in this world! We need to have more conversations regarding this issue and offer more support to our girls. Keep it up, Teen Voices!

    • Gayton Judy

      Setting teens up for a life time of psych stigma, neurotoxic drugs and systemic abuse well documented to come part and parcel of being labled as some kind of “defective” is not supportive.

      For one example, the DSM5 was going to scrap “personality disorders” in this addition but did not, thus leaving countless people to become victims of this stigmatizing, discriminatory and harmful label -most of whom are actually victims of CSA who were drugged and trapped in the no-exit, “mental health” system, many for life, rather than being provided with appropriate trauma informed care and being supported to heal and move on with their lives.

      The NIMH withdrew all funding for the DSM5 owing to its lack of scientific credibility; it could never withstand a junk science litigation. By law misdiagnosis, is medical malpractice and filing a dx claim in order to get someone (help) into the system or get paid, is insurance fraud. All DSM dx’s are a medical frauds, given without full legal informed consent stating that fact.

      Two important legal actions, both against the same psychiatrist recently came out in Canada who admitted that there are not brain diseases. Hopefully this starts a trend that will eventually shut down this mass fraud against the public health and safety and the billions of dollars wasted on ‘mental health” can be spent on the things that are proven to build health, the Social Determinants of Health (SDOH) to the betterment, vrs the detriment of society.

  • Eleanor Michaels

    I had to live with undiagnosed ADHD for over 25 years, and I wish I would have seen this article when I was “carrying this backpack” and struggling to find a way to ask for help for an issue I couldn’t articulate. I hope this makes others more informed and accepting and helps other girls seek help so they don’t have to experience the pain of living with undiagnosed ADHD.

    God Bless

  • Paula J. Caplan

    Unfortunately, both the author of this article and most people are sadly mistaken in believing that “ADHD” is a scientifically validated condition rather than one made up by the American Psychiatric Association for its diagnostic manual (the DSM) and NOT scientifically based. I am not saying that some people are not more distractible than others, and of course it is not their fault if they are. But there are many reasons for distractibility, and Big Pharma and the APA want people to believe that “ADHD” is real and that stimulant drugs will help. They fail to warn people about the dangers of such drugs. And using the “ADHD” label tends to make therapists stop working with the person to figure out what is causing their distractibility so that the real causes can be dealt with. For instance, MANY girls and women who are very smart and whose minds work fast get misdiagnosed with “ADHD” instead of being helped to understand what is really going on. Also, many real causes for upset that causes distractibility are masked when the person is diagnosed with “ADHD” or other mental illnesses, and their real causes for upset (including sexism) should not be masked but should be dealt with, because if that is not done, that is another way to oppress girls and women.

    • Mona

      I’ve lived with this disorder for over 20 years. I can tell you, it’s certainly not ‘fake.’ Saying that this disorder is ‘made up,’ is not only extremely offensive to all ADHD sufferers, but also minimizes the many struggles we go through on a daily basis. You’re entire post contributes to the oppression of women with this disorder. You discuss the ” dangers of such drugs,” used for ADHD treatment, but the only thing those drugs have done for me is save me from a life of misery and underachievement.

    • BlueLanternMonk

      Girl’s and women……

  • Gayton Judy

    Why is We.news pushing “mental illness’ myths as if they were accurate?

    This is not remotely helpful to women, who have historically been “othered” as “emotionally defective” and inferior from the witch hunts and continues to this day.

    Although I do not feel that We.news has ever done a good job of addressing critical medical issues facing women, of late it has taken a serious turn in for the worse.

    Does We News have conflicts of interest to disclose? Are you accepting pharma money to push these false memes?

    Where is the balance that argues against “mental illness” misinformation and exposing the medical monopoly as presenting every manner of life challenge, as if it was a “brain disease”?

    I honestly never thought I’d see the day when this organization became yet another mindless voice, regurgitating mainstream propaganda about women’s “mental health” and the business interests that control the discourse insisting that we are all some kind of ‘crazy”.

    Pushing this on teen readers is particularly unethical.

    Further to that, I urge We.news to take Dr. Paula Caplan’s post below very seriously, as well as to review her website, books and posts. She sat on the board of the APA that wrote the DSM for 2 years and has thoroughly exposed the fraud that it is more than any of it countless other critics. Here is but one of her many contributions to exposing the truth, verses the lies that so adversely affect women’s health.
    https://www.youtube.com/watch?v=K12jE7TH7zQ

    Here is but one article from Mad In America dispelling the lies and misinformation about ‘ADHA”.
    https://www.madinamerica.com/2015/03/no-no-thing-adhd/

    Thank you.

    • Paula J. Caplan

      Judy Gayton, I share your concern about WomensENews helping perpetuate the many myths about what gets called “mental illness” without having commentary by scientists who know the research and have worked for decades to educate the public about the myths and what the actual research shows. Balanced journalism would include that kind of thing for sure.

      • Gayton Judy

        It is the responsible and least We,news can do is not add to Pharma’s mass propaganda and encourage more women to uncritically live as if they are “disabled” based on zero scientific credibility and subject themselves to ineffective and dangerous drugs that could cost them their health and in fact their lives.

      • Gayton Judy

        I am calling on We.news, editor in chief, Rita Henley Jensen, the Barbara Lee Family Foundation and NOW Legal Defense and Education Fund to uphold the values of journalism by seeking the truth and reporting it, to act in a manner that minimizes harm with accountability and transparency as stated on your website page, About Women’s eNews.
        The manner in which you are currently allowing anecdotal self-reporting from lay people who have been mislead about ‘mental illness” fails to adhere to your stated mission.
        Please address this serious concern. Thank you

  • Paula J. Caplan

    There is also this, which hardly anyone put on drugs after being diagnosed with ADHD are alerted about: https://www.madinamerica.com/2017/09/stimulant-medication-use-linked-sharp-increase-bmi-eighth-grade/

  • Margaret Dupree

    I positively loved this article! My two daughter’s and I all have ADHD and it’s nice to feel represented in the media for once and have our true voices shared and true narrative told. No one should ever underestimate the power of a girl or the power of a girl with ADHD! You rock, Teen Voices!

  • Paula J. Caplan

    Mona, Dr Thomas Insel announced when head of NIMH that psychiatric diagnosis/DSM is not scientific. The American Psychiatric Association publicly acknowledged there is no evidence that chemical imbalance in the brain causes “psych disorders.” And CHADD is known to be heavily funded by Big Pharma. Citing the claims of powerful lobby groups that masquerade as professionals caring about patients doesn’t help an argument. By all means, do what you feel helps you, and I wish you well, but don’t make uninformed arguments that distort the facts. Since you don’t want even to give your last name, for all anyone knows, “Mona” could be an employee of Big Pharma.

  • HottMashoogana

    How about the other side of the spectrum? I know that’s not what this article is about but there are a lot of people who were falsely diagnosed. People who don’t have a learning disorder but are mandated prescription to stop symptoms of a disorder that they don’t have. The entire world should not be a diagnosis. I would like to meet someone who is diagnosed as “normal” and can’t be disqualified fromantic the military for such diagnosis. There’s also the concept that no one likes to touch base on that once diagnosed you can be cured. Since everyone is different and the human body changes over time with each individual, who is to say that someone diagnosed with a learning disorder can’t become better on their own, in time with out meds. The social services state department would argue that it’s not possible for people to become “better” in order to keep people locked into the system which creates revenue for their department.

  • BlueLanternMonk

    In the 1990s, the male to female ratio for ADHD was estimated to be about 9 to 1 in clinical settings and 3 to 1 in the general population.3
    http://www.psychiatrictimes.com/adhd/neuropsychiatric-differences-between-boys-and-girls-adhd
    In 2011–12, some 76 percent of public school teachers were female, …
    https://nces.ed.gov/fastfacts/display.asp?id=28
    “A clear pattern shown in all four studies is that men do not like themselves automatically as much as women like themselves,” Rudman says. “This contradicts a lot of theoretical thinking about implicit attitudes regarding status differences.”
    http://www.apa.org/monitor/dec04/women.aspx