ADHD in Women

“That Explains Everything!” Discovering My ADHD in Adulthood

“Many women may cruise along until, as in my case, things start to fall apart. The unraveling often coincides with marriage and having kids. Suddenly, you have to organize not just yourself, but the kids, too. These added responsibilities can push a mom’s ‘ADHD stress-o-meter’ over the top.” Read one woman’s story of a late ADHD diagnosis, blooming self understanding, and effective treatment — at last!

Question marks, representing the questions about ADHD in women
Cartoon question marks, blue and orange and green, also some eyes for some reason?

“Can’t you sit still for just five minutes?” Apparently not. But at least now, years later, I have an explanation in answer to my mom’s question — if only she were alive to hear it. Turns out, my excess energy is attention deficit-fueled hyperactivity.

Perhaps I should have been tipped off by the tempo of conversations I had with my friend, Chris (who was diagnosed with ADHD as a child). Our dialogues have always been like a pool game, with both of us taking shots at the same time, bouncing rapid-fire thoughts off each other without skipping a beat. One evening, Chris suggested I take an online quiz for ADHD. I assumed he was kidding. He wasn’t.

The results? I did very well. So well, in fact, that Chris declared, “Zoë, we’re going to make you president of the club.”


The Gender Gap: Girls and Women with ADHD


Along with credulity came clarity. Maybe this was why I’d spent every day of the last eight months spinning in a circle in the middle of my living room, unable to decide what to do first. I’d repeat this procedure in my kitchen, bedroom, and office, then go back to the living room to start over. By mid-afternoon, I’d accomplished nothing. At this point, I couldn’t afford to pay my rent. I was in trouble.

Here I was, a 47-year-old woman who had written a book, run for MPP (Member of the Provincial Parliament) in Canada, earned two university degrees and three college diplomas, spinning like Maria von Trapp in The Sound of Music. How do you solve a problem like Maria?

Desperately Seeking Treatment

The morning after my online quiz, I found myself in my doctor’s office, bawling as I described my out-of-control life. I left with a prescription for a long-acting stimulant (one of several medications used to treat ADHD), and began my quest for the Holy Grail — a way to make my crazy life work.

The medication calmed the frenetic energy I’d felt my entire life. Soon after taking that first pill, all the cells in my body stopped jumping on the trampoline and lay down. The feeling of being overwhelmed, anxious, and out of control also seemed to subside. Now I could begin my long road to discovery and, I hoped, recovery.


Sister. Wife. Mother. Adult with ADHD.


When I told my sister, Melissa, about the test results and the symptoms of ADHD, her first remark was, “That explains everything.” Having grown up with me, Mel could provide insight and anecdotes from our childhood, both of which are integral to a diagnosis.

According to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the professional reference of mental health disorders, symptoms need to be present before age 12 before a diagnosis of ADHD can be made. Having spent most of my public-school days in the hall for talking too much, I fit the bill. The same combination of intuition and impulsivity that earns kids a walk to the principal’s office can earn women and men their walking papers from jobs, friends, family, and bewildered lovers, who can’t take the perpetual lateness and off-the-wall remarks any longer.

Women and Their Symptoms

Kenny Handelman, a child psychiatrist and an adjunct professor of psychiatry at the University of Western Ontario in London, calls the observational abilities of adults with ADHD a paradox.

While we’re inattentive to some social cues, droning on while the listener checks her watch and mutters, “Gotta go…,” we can also use our constant scanning ability to gather cues that others don’t get, coming up with intuitive insights and responses. The problem is, sometimes we can’t stop ourselves from blurting out our thoughts.

When I started public school, ADHD wasn’t even a glint in a child psychiatrist’s eye. Kids like me were out-of-control demon spawn, creating mayhem in class, community, and home. After professionals began to recognize ADHD, about 25 years ago, it was mostly boys who were diagnosed.

While impulsive blurting and hyperactivity have been hallmarks of my life, females are often not blessed with the H-for-hyperactivity part. Instead of racing around classrooms with the boys (and me), many girls stare dreamily out the window. And so it continues into adulthood — 90 percent of women diagnosed with the condition fall into the inattentive type of ADHD (the condition comes in several flavors, but all are clinically known as ADHD).

Living the ADHD Life

At 44, Denise Difede was diagnosed with the combined subtype of ADHD. She began taking a stimulant, and it worked. The true test that her medication made a difference came while a friend was visiting Difede for a month. One weekend, she decided to take a meds break. “I didn’t tell him I had been on [then went off] medication,” says Difede. Come Monday, her friend remarked, “You’re so much more together today, you were out of it most of the weekend.”

“It was a shock,” says Difede, who now works as an administrator at the Canadian ADHD Resource Alliance in Toronto. “I asked him to describe what he saw on the weekend. He just said he thought I was not quite on my game.”

Difede and I are in good company: Some of the most successful athletes (Michael Phelps), actors, and entertainers (Justin Timberlake), not to mention scientists, entrepreneurs, and academics, display traits of ADHD. On the other hand, being one of only 10 percent of women with the hyperactive form of ADHD, I ‘present’ entirely differently from Difede. Professionals tell me that having the “H” is actually a good thing: Hyperactivity can lead to earlier diagnosis and more energy later in life.

For me, it’s been a mixed blessing. Being hyperactive helps me when performing standup comedy, but it does me no favors when I come across as near-manic during a job interview. After learning that I had the disorder — and a euphoric moment of realizing that my apparent road to nowhere was not my fault — a sense of embarrassment and failure flooded in.

“People will say they’re addicted to crack, gambling, sex, but they don’t want to say they’ve got an inherited neurobiological condition, like ADHD,” says Pete Quily, an ADHD coach in Vancouver, who has been diagnosed with the condition.

Fighting the Stigma

Because the medical field is just beginning to recognize adult ADHD, the condition is rife with stigma and stereotypes. My response? I resolved to become an ADHD crusader, and I made my first public confession at my local pet-food store.

When the store owner asked if I wanted to apply for a frequent-buyer card, I said, “Sure, why not?” Rifling through her records, she discovered that I already had not one, but two, cards. I laughed. “There’s a reason for that,” I said. “I have ADHD!” Poor memory — not to mention a cluttered wallet and purse — can be an ADHD symptom.

Her face dropped. I could have sworn she backed away. Then, in hushed tones, she confided that doctors had told her that her son had it, too. But, she said, “I knew he didn’t, because he’s highly intelligent.”

She might as well have taken a 10-pound bag of dog food and smashed me in the face with it. Stereotype confirmed. Fact: ADHD has nothing to do with lack of intelligence.

The Canadian Mental Health Association’s website (where else would you go for information about a mental health issue? I naively thought) wasn’t any better informed. ADHD is mentioned, but only in reference to children.

“That’s a big oversight,” says Lily Hechtman, a professor of psychiatry and pediatrics at McGill University in Montreal, and coauthor of Hyperactive Children Grown Up. Hechtman explains that the medical profession is beginning to realize that, not only can many symptoms continue into adulthood, they can cause significant difficulties. Yet, she says, the reality is “all the medical students at McGill get one lecture on ADHD, only part of which is on adult ADHD.” In Canadian medical school, adult ADHD is mentioned briefly, unless one is specializing in child psychiatry. This is why a child psychiatrist, not a general practitioner, may be the best person to diagnose an adult.

Finding Help

Consequently, women like Difede are left to seek out the rare psychiatrist who can diagnose them (as she did) by attending conferences on ADHD, finding a coach, or finding or starting their own support group.

Many women may cruise along until, as in my case, things start to fall apart. According to Quily and others, the unraveling often coincides with marriage and having kids. Suddenly, Quily explains, “You have to organize not just yourself, but the kids, too.” These added responsibilities can push a mom’s “ADHD stress-o-meter” over the top.

As if that’s not enough, chances are that the kids have the condition as well (some estimates suggest that up to 80 percent of ADHD is inherited), giving Mom an even greater challenge, as she’ll have to organize both herself and her kids.

Juggling career, marriage, and child rearing can be challenging for anyone. But for someone with ADHD, it can feel impossible. Add to that the increased demands of household management, and a woman with undiagnosed ADHD can feel completely overwhelmed. Let’s face it: Filing and paperwork are the nemesis of most people with ADHD.

In fact, the only part of Martha Stewart a mom with ADHD can understand is the going-to-jail part (it’s not uncommon to be so disorganized that taxes haven’t been filed for years). Perfect pastries? Forget it! It’s no wonder that some women end up feeling ashamed at their inability to keep up with their more organized friends and family. In the extreme, some women with ADHD tend to isolate themselves, unwilling to expose their self-perceived deficiencies.

Instead of receiving a diagnosis and treatment, many women with ADHD have been told since childhood, even by well-meaning but uninformed professionals, that they’re lazy and should just try harder. No wonder one of the ADHD classics is called You Mean I’m Not Lazy, Stupid or Crazy?!, written by Kate Kelly and Peggy Ramundo, both diagnosed with ADHD.

Diagnosis during menopause can be even trickier, as problems with memory, organization, anxiety, and mood disorders that arise at that time of life can all mimic ADHD symptoms, says Hechtman. “One of the ways I would differentiate [ADHD] is to get a good longitudinal picture of that person from childhood onward,” she says. If there were no ADHD symptoms prior to menopause, the symptoms are pointing to something else.

Another imposter is learning disabilities (LD), which up to 20 percent of those with ADHD also have. Like mood disorders, anxiety, post-traumatic stress disorder, and other ailments that accompany adult ADHD (80 percent of us have at least one co-existing condition), LD can be mistaken for ADHD.

You and Your ADHD

But, hey, let’s not get all stressed out about it; stress, according to Quily, is like adding fuel to ADHD symptoms. We can take some solace in the fact that, although it’s not perfect, a newly minted set of diagnostic tools for adults was introduced with the DSM-V.

This is a good thing, because two of the current diagnostic criteria (developed solely for kids) are climbing trees and running about excessively. It’s no coincidence that hyperactive kids like to move their bodies: Physical activity is an excellent way to diminish ADHD symptoms. While tree-climbing and excessive running might not be realistic pursuits for adults with ADHD, the best treatment, according to long-term studies that observed kids into adulthood, is “multimodal,” using a variety of approaches — from medication and behavioral therapy to biofeedback, exercise, and other alternative therapies — to treat symptoms.

“Detailed, boring stuff is like kryptonite for people with ADHD,” says Quily. So delegate — or find a boss who will embrace your creative side, your mind that’s so out-of-the-box it’s from another planet, and let the regular humans handle the paperwork.

As for me, I’ll keep using deadlines as my organizing principle, and accept the fact that, even when I’m hyperfocusing, I’ll still have to jump up, water the plants, check e-mail, and pet the dog to keep me on track.

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