ADHD in Women

Jillian Enright

ADHD in Women*

Yes, Women can have ADHD too.

A Q&A with the Centre for ADHD Awareness, Canada

My ADHD Diagnosis Took More Than Three Decades

The Centre for ADHD Awareness, Canada (CADDAC) is raising awareness about the presence and impact of ADHD on women* and girls.

I wasn’t diagnosed with ADHD until the age of 36, and this was largely because my son had been diagnosed seven months prior. If it weren’t for him inheriting this part of my genetics, I may never have discovered my own neurodivergence.

Throughout October, the CADDAC asked women and girls to share their experiences with being diagnosed and living with ADHD.

Q. How do you think being a woman impacted your ability to get diagnosed?

Being female absolutely delayed my ability to be accurately diagnosed. In my teens and early adulthood, I was misdiagnosed with depression, and then Borderline Personality Disorder.

Symptoms from both depression and BPD overlap with ADHD, but are commonly overlooked due to gender bias.

Traditional “female” presentations refer to internalizing symptoms, for those with ADHD, that would include symptoms such as inattentiveness and anxiety. These symptoms are often overlooked when considering neurodiversity, and a female-presenting patient would more likely be labelled with an anxiety or personality disorder.

Traditional “male” presentations include externalizing symptoms such as impulsivity and aggression, which are more disruptive to others, and as a result are more often brought to the attention of clinicians. These externalizing symptoms are also more in line with the stereotypical view of ADHD, making it easier for male-presenting patients to receive a diagnosis.

In contrast, BPD is often considered a mental illness primarily impacting young women. Doctors hear of women making impulsive decisions, feeling anxious or emotionally dysregulated, and label them “borderline”. They hear the same symptoms in males and are much more likely to consider ADHD.

Recent studies have illuminated the gender bias in diagnosing personality disorders. For example, Busch and colleagues (2016) found minimal gender differences in Borderline Personality Disorder severity, and Skodol & Bender (2003) found that the differential gender prevalence of BPD in clinical settings appears to be largely a function of sampling bias.

Q. What are the unique challenges of being a woman with ADHD?

Most of my challenges stem from societal expectations, rather than actual disorder. People tend to expect females to behave in a certain way, and when they don’t, they are put off by that.

It seems neurotypical people become uncomfortable when I show what they perceive to be too much emotion, even when it’s “positive” emotions, such as excitement or joy.

Women are often expected to be subdued, controlled, and less opinionated than men. It feels as though we’re still living in the 40s and 50s sometimes. The men can drink beer, get loud, and have lively debates about politics or sports, but if women join in on the conversation it’s like an intrusion.

We womenfolk are apparently supposed to have quiet, polite conversations and not get too worked up or be too opinionated. Well, I’m educated, I’m opinionated, and I’m proud of it. I am also interested in politics, and I’m an athlete and love talking sports, so deal with it.

One thing I do struggle with socially is interrupting people when I get very interested in our conversation and am eager to respond. I don’t intend to be rude, and I am listening to what they are saying, but my brain works on hyperdrive and it’s hard to reel things in.

Q. What symptom management strategies do you find most effective being a woman with ADHD?

Education and self-knowledge. Since my son, and then myself, were diagnosed with ADHD, I have put forth great effort to truly understand our complex neurology, executive functioning, and neurodiversity.

Knowing myself and what works best for me allows me to work toward arranging my life in a way that sets me up for success. I am an entrepreneur, which allows me to set my own schedule and work in the ways that suit me best.

Being self-aware allows me to have more realistic expectations of myself, and to advocate for myself when necessary. The more I learn about the neurodiversity movement, the more I embrace my unique brain and am proud of my differences, rather than fighting against them or being ashamed of them.

Q. What about your ADHD makes you awesome?

I enjoy the ability to hyperfocus. When I am incredibly interested in something, I can tune the world out and deep-dive into a subject or task.

I am extremely observant. Some people call it distractible, but I am proud of the fact that I notice things most others miss.

My ADHD contributes to my outside-the-box thinking and problem-solving. I work really well under pressure, I am energetic and dedicated when I find things I am passionate about, and I am creative.

Over the past few years, I have become more accepting and appreciative of differences in others and in myself. Where previously I tried to hide what I thought were “flaws,” because they were parts of me that were different from the majority, I am now comfortable and sometimes proud to be unique.

This internalized ableism also impacted how I viewed others, but I am very happy to say that I have moved past that, to the point where I actually prefer people who are atypical. I appreciate and enjoy quirky personalities and find myself drawn to people who tend to stand out as different like I do.

I believe a lot of my strengths come from my divergent neurology and ADHD.

Q. What is one thing you want people to know about ADHD?

ADHD has no relationship with intelligence. People with ADHD are just as smart as anyone else (Schuck & Crinella, 2005). There are a number of comorbid conditions that can impact one’s learning, such as learning disabilities, but ADHD does not make a person any less intelligent or capable when given proper accommodations or supports.

My son and I are both twice exceptional (2e), gifted with ADHD, and our intellect is often overlooked because people focus on our differences or struggles, rather than our strengths.

I want people to understand that a different brain is just that: different. One neurotype is not better than another. The environment, context, and circumstances determine whether a person’s neurology will be advantageous or not in any given situation.

When people with ADHD are given the proper supports and accommodations, they can thrive, and their strengths can shine through.

© Jillian Enright, ADHD 2e MB

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A note about gendered language:

*The CADDAC used the terms “women and girls” for their campaign. For the purposes of my writing, this includes CIS-women, trans women, AFAB, non-binary folks, and anyone else whose gender identity or presentation has impacted their ability to be diagnosed.

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References

Busch, A. J., Balsis, S., Morey, L. C., & Oltmanns, T. F. (2016). Gender Differences in Borderline Personality Disorder Features in an Epidemiological Sample of Adults Age 55–64: Self Versus Informant Report. Journal of personality disorders, 30(3), 419–432. doi.org/10.1521/pedi_2015_29_202

Schuck, S. E. B., & Crinella, F. M. (2005). Why Children with ADHD Do Not Have Low IQs. Journal of Learning Disabilities, 38(3), 262–280. https://doi.org/10.1177/00222194050380030701

Skodol, A. E., Bender, D.S. (2003). Why Are Women Diagnosed Borderline More Than Men?. Psychiatric Quarterly 74, 349–360. https://doi.org/10.1023/A:1026087410516

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Neurodivergent. 20+ years social work and psychology experience. I write about mental health, neurodiversity, advocacy, education, and parenting. Founder of ADHD 2e MB. CYW, BA Psychology.

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