The call for more transparency and acknowledgement of research gaps and gender bias in health and psychological studies has been sounding for some time. Women were finally included in ADHD studies 20 years ago, and we now have longitudinal research to provide insight on how ADHD presents differently in women.
Evidence has shown that women who come to learn they have ADHD in adulthood are highly likely to have been labelled with an Anxiety disorder in the past; and there is a significant number of women who have been diagnosed, medicated, and managing Major Depressive Disorder (MDD). It is becoming more evident now that more information is known about women and ADHD that these individuals were diagnosed based on the intensity of the symptoms they presented at the time of seeking help, often when the ADHD nervous system is in a hyperactive, or dorsal vagal (low energy) state. Young girls with undiagnosed ADHD commonly learn maladaptive coping which is carried into adulthood, causing additional issues and distress.
The ADHD nervous system is sensitive and requires attunement to its needs in order to manage fluctuation of symptoms. Women not always, but more likely have difficulty with inattentive symptoms of ADHD, rather than the generally assumed hyperactivity. Arguably, women can also experience this level of hyperactivity, but due to cultural/social norms and expectations, girls with ADHD learn early to turn the physical hyperactivity into more thought-based hyperactivity (rumination).
Hormones throughout the lifespan are also a considerable factor in the management and expression of ADHD symptoms in women. Monthly cycles, pregnancy, and childbirth/loss have a significant impact on hormones. Low estrogen can contribute to fatigue and low energy, influences working memory, sensory overload, feelings of overwhelm, difficulty filtering out irrelevant information- all common symptoms of ADHD. Parenting, new careers, travel, and life transitions are particularly difficult for women with ADHD.
If you are a woman who has recently learned or suspected you have ADHD, sharing this with others will possibly be met with some shock and bemusement. Many people have preconceived ideas of what ADHD is, rooted in the original diagnostic criteria for young boys. Remember that even if you are not validated and met with compassion from others, it is ok that they do not understand yet.
This is your journey. You have gained valuable information about yourself and your life. This will give you tools to enhance aspects of your life that “ADHD” was holding you back from. Remember that ADHD is just a label with a list of descriptions attached to it… everyone is unique, and your neurodivergent brain has a skill set that the world needs.
COMMON ISSUES FOR WOMEN WITH ADHD
Procrastination/avoidance (too many steps ,or too much time before end date).
Sensory/Nervous System sensitivity/Overwhelm: Sensory overload can look like restlessness in the body, difficulty focusing in busy environments, unsettled feeling at bedtime, emotional breakdowns, fidgeting, running into things, weird/random sitting positions (trying to calm the nervous system though pressure).
Easily distracted by extraneous stimuli or irrelevant thoughts.
Impulsive decision making.
Difficulty stopping activities once you have started.
Starting projects without reading or hearing full directions.
Difficulty doing things in proper order.
Trouble winding down/relaxing.
Drive faster than others.
Disconnection from body (hunger and pee cues).
Binge eating (food is a source of stimulation/dopamine) often with salty, sweet, sour, crunchy foods (sensory experience).
Debating/arguing when bored (for dopamine).
Chronic headaches: due to hyperfocus/poor eating and sleeping.
Dissociating /daydreaming: brain is either conserving metabolic energy or searching for something more interesting.
Struggle with working and short term memory/time is perceived differently.
Low frustration tolerance: motivation is hard with ADHD. If you have barriers to your task come up, you may get easily frustrated and quit.
Difficulty with organization.
Hyperfocus on new ideas/hobbies.
Large swings in energy/productivity: “I accidentally relaxed too much and now I don’t have enough anxiety to do anything”.
IDEAS TO HELP INFORM LIFE WITH ADHD
If you have the possibility (or luxury) make your job something you enjoy. You will struggle with boredom in a position that is not stimulating enough for you. Find a way to make your livelihood relate to something you love.
Diet trends and exercise packages are not the way to go for most women with ADHD. Exercise needs to be a sensory (enjoyable) experience and also relate to activities or spaces you love. Extra tip: change that activity with the seasons to switch things up and bring novelty (the ADHD brain loves that).
Deep pressure massage is helpful for the nervous system regulation.
An anchoring activity in a cozy space activating senses.
Less artificial lighting.
Transition routines (helps the brain move into different states) particularity at night before bed, involve stretching/yoga if you struggle with physical discomfort at night.
Sleep hygiene and nutrition are worth investigating and applying, as evidence shows these two factors are the most influential of symptom management (as with any health or psychological issue).
SELF COMPASSION: managing expectations and not judging yourself for the difficult days is key to moving forward in a meaningful way. Therapy can help to achieve this.
Ask for help when you can. Expressing how/when things become difficult to manage to your partner or family member can help gain support going forward. If you aren't sure where to start, asking for simple things like a deep pressure hug during a state of overwhelm will go a long way! You can also look up: “The butterfly hug”, “face tapping exercises”, and “self hug”, “progressive muscle relaxation” for things you can do on your own.