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“The ADHD Symptom Women Might Be Overlooking”

I didn’t have a Borderline Personality Disorder, after all.

The name “Attention Deficit/Hyperactivity Disorder” misses one of the symptoms that is hardest to live with — emotional hypersensitivity.

When you think about ADHD hypersensitivity, you might think being sensitive to loud noises and scratchy labels in clothes. In many cases, the sensitivity also applies to our emotions. We cannot bear the pain of criticism; we are unable to brush off personal slights the way other people do.

The emotional side of ADHD hypersensitivity is often not present in children, especially in boys, which means it is rarely discussed in detail on the symptoms pages of ADHD websites. It doesn’t show up in online searches.

[Free Resource: 15 Ways to Disarm (and Understand) Explosive ADHD Emotions]

So it’s not surprising that some adults with undiagnosed ADHD (like me) searching the Internet for answers about feeling emotionally overwhelmed think we have Borderline Personality Disorder (BPD).

The emotional symptoms of BPD are the cornerstone of the disorder. In fact, the new name for the condition is Emotionally Unstable Personality Disorder! So if you have undiagnosed ADHD and find that you suffer from persistent sadness, a mood disorder, and anxiety linked to your emotional hypersensitivity, a BPD diagnosis makes sense.

Those with BPD have bouts of extreme sadness, mood disorders, and anxiety as well as unstable family and social relationships. They find it difficult to cope with changes in plans. They quit jobs. They overeat. So I found myself nodding along to many of the symptoms on the list. But one stuck out that I absolutely knew wasn’t me: the “push/pull” symptom — a chronic pattern of sabotaging and re-establishing closeness in a relationship without appropriate cause or reason.

Many of those with BPD have suffered neglect or a significant rejection, or they have struggled with separation issues in childhood. This results in wildly fluctuating feelings in which a sufferer goes from idolizing to hating someone at the drop of a hat.

[Download: 3 Common Diagnosis Mistakes]

The reason for this is that sufferers have an unstable self-image, so if someone gets too close to them, they feel engulfed and in danger of losing themselves. But the minute the same person steps slightly out of reach, they are overwhelmed with fear of abandonment.

It is this pushing-and-pulling that earns BPD sufferers the unfair label of being “manipulative,” when they are, in fact, trying to balance their emotions.

Instead of having these fluctuating feelings, when I’m emotionally overwhelmed, I withdraw into myself, the shutters come down. How could I have BPD and not display one of its key symptoms? I needed to ask an expert.

I saw a psychiatrist and he dismissed my self-diagnosis. Without the fluctuating emotions and the push/pull behavior, he confirmed that I didn’t have BPD. I wasn’t completely surprised, but I also felt that a diagnosis of mood disorders and anxiety that the psychiatrist handed out wasn’t correct.

I struggled on, trying to cope and taking SSRI medications until I had a breakdown and ended up in a hospital. Another psychiatrist I saw suggested that I might have ADHD.

[When It’s More Than ADHD]

I thought she was mad. I had suicidal thoughts and had suffered an emotional collapse, so who cared if I found it difficult to sit still or concentrate? But then she explained how emotional hypersensitivity manifests itself in female adult sufferers of ADHD, and everything fell into place.

In ADHD, emotional hypersensitivity comes with an “off switch.” Not being able to abide boring conversations, cope with personal slights, or tolerate arguments were examples of hypersensitivity that were just as valid as having to cut the label out of a new jumper.

I had an off switch. The shutters coming down had a name!

Since my ADHD diagnosis, I’ve started taking the ADHD medication, which reduces the noise in my head, making it easier for me to think. I feel calmer, and I am better able to cope with overwhelming emotional responses to other people’s behaviors.

My hope is that my story will help other adults with undiagnosed ADHD get a better understanding of debilitating emotional symptoms. I hope that reading my story will persuade them to see a psychiatrist and perhaps get the diagnosis that alluded me for so long.

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  1. Largely, what I’m seeing about “female” ADHD is just symptoms that are more heavily typical of primarily inattentive ADHD than primarily hyperactive ADHD. ADHD-PI is more common in people assigned female at birth, but ADHD is a spectrum condition, and ADHD-PI occurs in people assigned male, too. As does emotional dysregulation. I understand that talking about symptoms that are not often discussed is useful, and I know talking about where they tend to appear is helpful – but honestly? Talking about this as a symptom for ALL adults with ADHD would be helpful. Talking about it as specifically a “female” symptom hurts men and non-binary people who exhibit this symptom as well.

    This is coming from an adult-diagnosed man who also considered a BPD diagnosis, for the record.

    1. Hi “Gatsby”

      I’m the author of this article and I have combined subtype, not inattentive subtype – a conclusion you jumped to because I’m female! Emotional hypersensitivity is caused by “flooding”. This is an ADHD-wide symptom, not an inattentive subtype symptom.

      The reason for the “women” slant of this article is to improve its chances of showing up in the search engine results of females trying to understand their symptoms. (This was a decision made by the ADDItude editorial team.)

      Why? When a man with ADHD seeks help from the medical profession he is more likely to receive a diagnosis of ADHD than a female in the same situation. So it’s important to have “women” articles for those less likely to get an ADHD diagnosis.

      (As a member of the ADDitude community, you are welcome to submit a guest post of your own covering the male and/or non-binary aspect of emotional hypersensitivity.)

      I would dispute ADHD being a spectrum condition and I think references to it as being such are unhelpful. I think you are using the term to explain the different subtypes but, medically, spectrum is used when everyone can be placed on it. ADHD is something you have or don’t have, rather than it being a spectrum disorder where “everyone is a little ADHD”. Research so far points to it being a dopamine disorder and an issue relating to the frontal lobe area of the brain.

      Kind regards
      SMG

      1. I may be wrong, but I think the new DSM-V is responsible for ADHD(and most other disorders) “spectrum”. Look it up. I read this in a book(can’t remember the exact name) Simplified Version of The DSM-V.

      2. Hi I found the article on emotionally sensitivity very interesting. It was said that this symptom was rarely seen in children especially boys. My son who has a diagnosis of ADHD showed signs of emotionally instability and hypersensitivity since the age of 7 he is now 12 and it has got worse. Just one slightly negative comment from his friend or siblings can upset him for days. I have thought for some years that he may have Borderline personality disorder (referred to in the UK as emotionally unstable personality disorder) he has all the symptoms apart from the fact he has had a very stable and loving and supportive upbringing. He also has social anxiety which I assume is linked to the fact that he is so hypersensitive about what people think of him. I have wrestled with the question is this just part of his ADHD or is it a separate disorder ? I presume not all children with ADHD with be so emotionally sensitive but I would be very interested to hear from other people on this issue.

        Thank you

        Sharna

        1. My son is also very emotionally sensitive. Dr. Dodson says there’s an emotional component for every individual with ADHD. When I discovered Rejection Sensitive Dysphoria, it described my son (and my husband) to a T. Here are some articles on RSD:
          https://www.additudemag.com/rejection-sensitive-dysphoria-how-to-treat-it-alongside-adhd/
          https://www.additudemag.com/slideshows/adhd-emotions-how-they-affect-your-life/

          Penny
          ADDitude Community Moderator, Author & Mentor on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism

        2. Hi Sharna, I wanted to give you a perspective from someone that had untreated ADHD for 60 years and also hypersensitive emotionally. I had the classic “boy” ADHD at age six but also very sensitive like your son. I got great relief from hyperactivity that I thought was anxiety with aderall after a month or two. This post really brought to light the impact of emotional sensitivity in my life. As of 3 months of aderall no relief from that yet, but here I am learning about it. Counseling may eventually be what helps your son, but I have one caution. As an older man my therapy has been largely about making me more sensitive as the assumption was that I might be un empathetic. I suspect counseling often aims to make people more sensitive. I hear a lot about how men are not sensitive enough, so I hope your son keeps the right amount for him. Best to you and your son.

    2. Hi Gatsby, I also see ADHD as being some type of spectrum because ADHD can only be confirmed by symptoms and so many of the symptoms are experienced by a much larger portion of the population than people that have a dopamine condition called ADHD. So many people don’t even think ADHD is a real condition. If we try to define forgetting your car keys as ADHD we lose a lot of credibility. I think the diagnosis requires a certain degree of difficulty but that rarely comes across in the conversation. No explanation yet why so many fewer women are diagnosed. It does remind me of a horrible but funny story about my parents. My poor mother had a stroke and fell over and broke my father’s arm on the way down. Now I want you to guess who got taken to the hospital. I must admit that like most people my age I grew up believing that you were either a girl or a boy. I also worry that some women are not diagnosed because the hyperactive component does not display as it does in the typical ADHD 6 year old boy. Hyperactivity probably shows as anxiety or insecurity and probably could be written off as “girls” problems much like the “boys” problem that ADHD is most known for. And yes, boys and girls with ADHD vary.

      1. If someone is wheezy when they have a cold, do you say they are “on the asthma spectrum”? No you don’t. Because people being wheezy when they have a cold doesn’t mean they have asthma. You either have asthma or you don’t. If someone has aching joints, do you suggest they are “on the arthritis spectrum”? Of course not. With both of these, as with ADHD, you either have it or you don’t. Your asthma or arthritis could be mild or severe, but these conditions aren’t on a spectrum where everyone sits on it. The neurodevelopment issues causing the ADHD brain can be seen on an MRI scan – the lack of communications function in the frontal lobe is either there or it isn’t. You either have ADHD or you don’t. We don’t say someone is “on the ADHD spectrum” just because they forget their keys occasionally. By calling ADHD a spectrum condition you are actually damaging the work put in by so many professionals who have worked hard to show there is a cause and you either have it or you don’t.

        1. Thank you for your passion, I too would like to see more credibility and treatment for ADHD. While I understand that you probably can’t be a little pregnant ADHD is a condition defined by it’s symptoms. Scans are not used for diagnosing. ADHD is diagnosed, and treatment offered based on fairly subjective criteria and the severity of the symptoms. A certain number of symptoms with the prescribed severity gets a diagnosis, or at least treatment. Among ADHD population there is considerable variance, you don’t simply have it or you don’t. When I do try to explain to people that don’t understand ADHD I say everyone forgets things like their keys, but let me know when it really screws up your life. My best to you and your efforts.

          1. The best diagnosis we have is a person’s reaction to stimulant drugs. Someone with normal levels of dopamine gets “high” on stimulants, whereas someone who has dopamine deficiency doesn’t. How someone’s body psychically responds to the drugs answers the physical question as to whether or not they have the condition. The “symptoms diagnosis” is only the first step.

          2. You can’t get treatment based on it might work, I tried. You have to do the profile or some type of screening. My other comment below explains that I agree that the medication working is the proof. The proof is not the sense of concentration and focus that comes with the first dose, anyone can get that. If you take amphetamines for a month and your hyperactivity and impulsivity go down that would be ADHD People with ADHD certainly will get high if they take too big a dose of amphetamines. The desirability of these drugs for abuse is why it is so hard for the people who need it to get it. I think we both agree the people that need treatment should be able to get it.

          3. I tend to agree with Ken that ‘spectrum’ seems to apply more to the severity of the disability caused by the ADHD symptoms. The differences in the brain vary significantly among the various types of ADHD (see Amen’s work) and how those unique differences are expressed as symptoms are also uniquely expressed per individual. Additionally the symptoms vary in intensity per daily situation so deciding how to approach managing the concept of the symptom is further complicated.

          4. I completely agree that there are different levels of severity of symptoms. But I would liken this to mild versus severe asthma, in that people HAVE asthma or they don’t. The issue with calling ADHD a spectrum disorder is that ADHD is not caused by different wiring (as ASD is) but faulty systems. So you could have mild faults or severe faults, but you also get people with NO faults.

          5. I think the spectrum can refer to the list of symptoms and their severity in all people, that is the current system to figure out who does and does not have ADHD. Once you meet the diagnostic criteria for ADHD there is another spectrum of just those people who have ADHD. As far as I know when they talk about the autism spectrum they are only talking about people with the diagnosis. You can be on the autism spectrum if you have any of the various types. We simply don’t have a way to diagnose ADHD without a symptom checklist and a severity questionnaire. Almost everyone has some of the symptoms used to determine who is ADHD and who is not. Acknowledging that non ADHD people do in fact share some symptoms with ADHD people is true and ultimately part of the process of educating people that ADHD is real and people should be treated if that is what they want. To espouse the opposite is just asking for ridicule because the critics do like to point out that they have the same symptoms. We very much seem to be headed for the same goal.

    3. I was diagnosed by a board certified psychiatrist with
      borderline personality disorder before I was diagnosed with ADHD by a board certified psychiatrist . Never believed the personality diagnosis

      1. I have been diagnosed with BPD as well, I am even attending intensive treatment for it called DBT. It was my DBT psychiatrist that recognized my ADHD! She said she is seeing it more and more – women coming to the clinic for treatment for borderline – and they end up being diagnosed with ADHD. Although the DBT treatment for borderline is very good for ADHD as well, especially for those with extreme emotional sensitivity I feel that there is a serious breakdown of information sharing in the psychiatric community. I’ve been through hell throughout my life with all kinds of impulse control related issues and subsequent diagnoses’. Why wasn’t I properly diagnosed by one of the dozen psychiatrists I’ve seen in the last 10+ years? I did not believe I had BPD either, and I know I am lucky to have a well informed psychiatrist. But I wonder and worry about all the women out there suffering and being told they have a personality disorder when they don’t. And they keep on suffering with antipsychotics, mood stabilizers, and the expected feeling of hopelessness and depression from these drugs (i’ve been there…. for years). I started a stimulant and stopped all the other meds and it turns out…., I am NOT depressed! My whole life changed thanks to a well informed Dr. who was able to recognize ADHD in me at 38 years old.

  2. I am sickened by how easily so many mental health professionals are so quick to label their female patients’ problems as depression, bipolar, or even borderline. I believe that this “lazy” psychology has conspired to prevent women from achieving their full potential in the case of missing the ADHD or worse, keep them mired in emotionally abusive situations. Thank you, Additude Magazine for starting to shine a light on this problem.

    1. Thank you for your positive comments. I’m really lucky that the consultant psychiatrist I saw that gave me my ADHD diagnosis was not only an ADHD/ASD specialist, but was also FEMALE. Up until that point, I’d been referred to male psychologists, many of whom don’t think to look for ADHD/ASD symptoms in their female clients.

    2. Thank you for saying this. i completely agree! attitudemag.com was recommended to me by my (female) psychiatrist the day she told me my results from the ADHD clinic. I am 38 years old and have struggled for YEARS. In and out of hospital, diagnosed with borderline 3 years ago, eating disorders, addictions etc. I’ve got 9 diagnoses (including BPD) on my chart from the time I was 12 yrs old. Every one of them related to impulse control problems, yet in 20 years of non-stop therapy/hospital/treatment not a single mention of ADHD ever occurred until I started with my new psychiatrist who suspected, sent me for testing and diagnosed within 3 sessions. This website has the most clearly understandable, honest and VALIDATING information I can find. My entire life makes sense. So thank you attitudemag, for shining the light on ADHD in Women. I very much look forward to reading more articles, research and help guides that pertain to women.

  3. What is your “off switch” for this? This is something I’ve struggled with my whole life and if I could figure out how to “off switch” it, I’d be ecstatic. Meds help, but I am still overwhelmed by emotions pretty much all day everyday.

    I too have had BPD ruled out 🙂

    1. Hi YVR The first thing I would want to know is if you have tried taking the medication regularly, like every day for 2 months. I started to get relief after a month. You also have to do the counseling because the medication can make you able to learn what you need to know , you still need to learn what it is you don’t know. It is also possible that if the fog clears and you see better there might be someone in your life creating a problem. One exercise I did was simply listening to what people have to say. I think for me hyperactivity showed in the form of emotional hyperactivity and anxiety as I aged.

    2. The “off switch” I refer to in my article is not a positive thing – it’s a description of how I shut down when my emotional responses become too much for me. What I can say is that I’m feeling much more in control of my emotional responses since starting on a stimulant drug.

  4. Wow, good information. I was looking at BPD and thought it made sense because I did have maternal separation as an infant for a while. I recently started treatment for ADHD at the age of 60. Despite being a big construction worker I have over sensitivity. I was pretty much required to try anti depressants before I could try the amphetamines that actually work for ADHD. I have found a few things to be true, at least for me. Almost all people my age that are eventually diagnosed with ADHD knew long before their doctors that they had ADHD. I remember when they first started talking about ADD and knowing that I would have been a prime target for medication when I was a child and being very much against it because it sounded like they were knocking the kids out to make the teachers job easier. So after spending my life hiding and avoiding treatment it looked like I was just asking for medications that have a high potential for abuse when no doctors want to give such a prescription. The thing that changed my mind about the medications is that they are a stimulant. Everyone gets a little extra focus and energy by taking stimulants, and children could become hopelessly energetic. If you have ADHD and take the stimulants for a month or two there is something like an 88% chance that you will be less impulsive and less hyperactive. The best method to determine if you have ADHD is see how you react to the medication with regular use for a month or two. Even the doctors know this if they know anything about ADHD. The other thing I figured out was that there is no longer a valid diagnosis for ADD because despite what people think there is an element of hyperactivity if you have ADHD. For me it looked just like anxiety when it was time to sleep. I knew of a teenage girl who was convinced they had ADD but no hyperactivity yet couldn’t understand why she was anxious at seemingly random times. She had a prescription and found it helped with homework but she never took it long enough regularly to ease the hyperactivity. Thank you for your comments and giving me a place to vent.

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