ADHD in Older Adults

The Transformative Power of an ADHD Diagnosis for Older Women

Receiving an ADHD diagnosis (not to mention treatment), is tremendously healing – and life-changing. That’s the overwhelming message I heard from the dozens of women I interviewed, all over 60, who were diagnosed with ADHD later in life. Here are solutions to the Top 5 challenges facing women with ADHD.

Credit: The Good Brigade/Getty Images
Credit: The Good Brigade/Getty Images

Regret is a common (and understandable) reaction to a diagnosis of attention deficit hyperactivity disorder (ADHD) later in life. Some newly diagnosed lament how undiagnosed ADHD interfered with their lives and threw them off course. They feel angry, bitter, and sorrowful over the preceding years of self-blame and shame.

But many, many others experience relief as the primary response to an ADHD diagnosis — and the answers it brings. For them, a late diagnosis invigorates their resolve, and fundamentally alters their path and outlook for the better.

These are the experiences of about 75 women I interviewed*, all aged 60 or older, who were diagnosed with ADHD later in life. They describe the lead up to their diagnosis, and how knowledge of ADHD helps them cope with related challenges that follow them to this day.

The ADHD Turning Point

What leads women to seek an ADHD diagnosis later in life? Expanded awareness of the condition, especially as it presents in females, is a common catalyst. Many women also seek help when daily demands finally exceed their coping abilities, or when the hormonal changes of menopause cause symptoms to spike.

Here’s what women told me:

  • “I was an ER nurse and did well for many years. Then I was reassigned to a desk job, which was torturous. I got fired because I couldn’t keep up. My supervisor told me I was disorganized and forgetful. That’s when I sought help for ADHD.”

[Get This Free Download: Menopause & ADHD — Treatments & Interventions]

  • “I’m a therapist and suspected that I had ADHD for about 20 years. At age 60, I tried to start a private practice, but I had a lot of difficulty because of the lack of structure. I decided then that it was time to seek a formal diagnosis.”
  • “I was having a lot of problems with clutter. I went to a class about getting rid of clutter and the trainer mentioned ADHD.”
  • “I was in therapy. My sister gave me a book on ADHD, and I recognized many of the traits in myself.”

Though the challenges of undiagnosed ADHD are formidable, it sometimes takes decades to arrive at diagnosis, in part, because women feel pressure to conform to societal norms — from the role of primary household manager to that of the detail-oriented friend who remembers everything — that are often at odds with the nature of ADHD.

[Read: Why ADHD in Women is Routinely Dismissed, Misdiagnosed, and Treated Inadequately]

In the field of psychology, we say that ADHD is egodystonic for women, as it conflicts with our personal ideals and expectations. (I, too, am a woman with ADHD.) In other words, ADHD makes us feel like we’re terrible at being women. That may be why women with ADHD are more likely than their male counterparts to experience anxiety.

Post-Diagnosis: Clarity, Acceptance, and Hope

Yes, some women expressed tearful regret about their ADHD diagnoses, connecting the once-undiagnosed condition to failed marriages, friendships, and careers, and to difficulties raising a child (often alone), and other painful experiences of the past.

However, most of the women I interviewed affirmed that their diagnosis was transformative, exciting, and enlightening. It drove them to learn more about ADHD and to find unique coping strategies. Most importantly, their newfound knowledge led to self-acceptance:

  • “I have felt re-energized in a very positive manner. I can manage not to ruminate too much on the problems I had as a child, and I am still glad that I am here, now, and learning.”
  • “It literally felt like a band was removed from around my head the first time I took stimulants.”
  • “I have much better self-esteem. I feel like I’m becoming a different person.”
  • “I enjoy and embrace my ADHD, now that I understand it. Others may have a problem with it, but that’s their problem! Now, I accept who I am.”

Top Challenges Reported by Older Women with ADHD

Even after a diagnosis, ADHD is not without its ongoing challenges. Some women noted that they put all their energy into their careers and into “masking” ADHD at work, at the expense of family and other aspects of life. Others reported financial struggles, admitting that they’d be in ruin if it weren’t for their spouses.

No matter the challenge, I constantly advise the following to people living with ADHD:

  • Find or create an environment that is much more supportive of what you need.
  • Think: “How can I create a life that is more functional, more comfortable, and more satisfying for myself?”

Below are the top issues associated with ADHD in later life, according to the women I interviewed, followed by suggested solutions.

ADHD Challenge #1: Getting Things Done

Procrastination, low motivation, lack of focus, and poor self-discipline plague older women, especially in retirement.

Solutions

  • Reassess your motivations. Are your to-do list items motivated by shoulds? Does your list align with what you truly want to get done? Your list – and stress levels – might just change based on your answers. Don’t be afraid to set your own agenda. You have the right to not live up to standards set generations ago.
  • Aim for simplicity. Those of us with ADHD often create way too much complexity in our lives. (Part of it has to do with impulsivity.) Order calms the brain. Think through the activities, items, and other parts of your day that you enjoy, and those that drag you down. As one interviewee told me: “I try not to schedule too much in a day. I used to make lists and then feel despondent, as nothing would get done. Now, I tell myself, ‘I’ll do the best I can.’”
  • Recognize that it will always take conscious effort to get things done – but it’s well worth it to lead an orderly life.

ADHD Challenge #2: Social Difficulties

“People issues” – from saying the wrong thing and talking too much to missing social cues – are especially burdensome for women, who are wired to socially connect. The resulting pain of feeling misunderstood weighs heavy on this group.

Solutions

  • Join a support group. Social connection is one of the most healing experiences that we can have as women with ADHD. I’ve witnessed older women find acceptance, safety, camaraderie, and validation like they’ve never experienced before in the support groups I’ve led over the years (both online and in-person).

ADHD Challenge #3: Emotional Dysregulation

From irritability and anxiety to meltdowns and rejection sensitivity, the women with whom I spoke reported that emotional dysregulation interferes with relationships and daily living.

Solutions

  • Emotional dysregulation is a natural, significant part of ADHD. Not many people recognize that ADHD impacts emotions, too. In my view, it’s necessary to view ADHD as a disorder of self-regulation first before you begin to develop emotional regulation skills.
  • Assess your triggers. What stresses you out? What pressures are you under that cause you to lose your cool? Even identifying a few pain points can make a difference.

ADHD Challenge #4: Time Management

Older adults experience the following issues with this classic ADHD pain point:

Solutions

  • Find structure. A lack of it is almost always the cause of time-management difficulties. Start small with a few anchoring elements — bedtime, mealtimes, etc. Some older adults may benefit from living in a retirement community, where structure is created for them. (I think of it as a summer camp for grownups.)

ADHD Challenge #5: Restlessness

Physical hyperactivity lessens with age, but internal restlessness continues. Women told me that they needed to do something (or multiple things) at all times, and couldn’t bear to sit still or relax. As a result, they often took on too many things and left projects unfinished. Hyperactivity also manifests as racing thoughts — a major reason behind sleep difficulties.

Solutions

  • Practice moderation. You have more time than you think to pursue hobbies and interests. Channel your ambition and restlessness a few small steps at a time. Instead of buying 200 bulbs to plant in your garden, start with a small flat of flowers. You can always get more if you’re up for it.
  • Focus on exactly one thing to calm racing thoughts before bed. Listen to a podcast, for example, while you’re comfortable in bed with the lights off.

Remember, no matter our age, we are always a work in progress. There are many things we can learn to change in our later years to make our lives more satisfying and fulfilling.

*interviewee responses edited for brevity

Over 60 with ADHD: Next Steps

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, Regret and Resolve: How Women with ADHD Can Transform the Challenges of a Late Diagnosis [Video Replay & Podcast #392], with Kathleen Nadeau, Ph.D., which was broadcast on March 15, 2022.


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