Boxed In by ADD, Part 2
In any case, many of the women who consult Nadeau do so only after months or years of frustration during which doctors were unable to provide relief for their problems.
"The most common diagnosis of a woman before she receives her ADD diagnosis is depression," says Nadeau. "So many women have come in to my office and said, 'I've been in therapy for years and I've been diagnosed with anxiety and depression, but I am still having problems.' It's maddening, and it's such a treatable disorder. There's no excuse for that."
According to Nadeau, many women go undiagnosed because the criteria doctors use to diagnose ADD are outdated. For example, the criteria indicate that ADD is to be considered as a potential diagnosis only if the patient has experienced significant symptoms from an early age. Yet, as doctors are starting to realize, many girls with ADD "fly under the radar" during early years with the disorder.
"The way the American Psychiatric Association currently defines ADD is absurd," Nadeau says. "That is, if you have five symptoms, you don't have ADD. If you have six or more, you do."
One mother's story
Rachael Hall, a 26-year-old mother of three from Sandy, Utah, spent years struggling with anxiety and depression—and never knew why. Whenever anything went wrong in her life, she overreacted.
Hall, a patient at Reimherr's clinic, recalls falling apart during her honeymoon because she couldn't decipher a set of driving directions: "I told my husband, 'Why don't you just leave me? I'm worthless.' One little thing would just blow out of proportion. And then I would start to feel guilty afterward, and the more guilt I felt, the more depressed I got."
The stresses of motherhood made things even worse for Hall. While she was pregnant with her third child, she broke down and was hospitalized for depression. Doctors prescribed an antidepressant. "It didn't work at all," she says. "It made it like I didn't care. It took away everything. I didn't feel happiness. I didn't feel sorrow."
After the birth of her daughter, Hall began experiencing frequent outbursts of anger. "One second I would be fine, and the next second I'd be a raging banshee," she recalls. "I was so mean to the people I cared about. I couldn't do it anymore."
Hall thought she might be suffering from postpartum depression. But her obstetrician ruled that out, saying it was too long past her delivery date for that to be a possibility.
One day, Hall saw an ad for a mood disorders study at Reimherr's clinic. She decided to enroll.
"I got frustrated at first," she recalls. "I told my husband, 'Well, I must be on a placebo, because it's not working.' Then as soon as I started into the second five weeks, I noticed a difference."
She didn't know it at the time, but during the second five weeks, she was taking the ADD drug Concerta. The drug seemed to make her thinking "more logical." She was less forgetful, less edgy. "I'm just generally in a better mood," she says. "I feel happy. I don't blow things out of proportion."
Since continuing with treatment, Hall's relationship with her family has improved, and she no longer feels awkward in social situations. "I've always been the hyperactive, talkative, center-of-attention type," she says. "I'm a very friendly person, but to the point where I would embarrass myself. Now I'm able to be the center of attention and be funny and have people like me, but not to the point that I become obnoxious."
Pressure to perform
Nadeau says Hall's experience is far from unique. "The pressure on women to be organized, self-controlled, to be the one who's keeping everybody else organized, is a societal expectation that's very deeply ingrained," she says. "Women feel very much a failure if they can't keep their house in order. There is a tremendous toll of having to keep up appearances, struggling, having embarrassing moments. Things like, 'I forgot to pick my kids up after soccer practice, and they were the only ones left standing out there.' It's a very public failure, and women are often not forgiven for these types of things. With a man, they'll say, 'Oh he's so busy, of course he forgot.'"
Quinn agrees, adding that the very fact that a woman senses that she is "different" from her peers is often difficult to bear.
"She develops anxiety, demoralization, low self-esteem, and looks depressed," says Quinn. "So she's painfully aware. She really does suffer, but she suffers silently."