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“What Does ADHD Look Like? In My Family, It Depends on Who You Ask.”

ADHD isn’t a cookie-cutter condition. No two people face the same challenges. Some common threads weave through individuals’ symptoms, but the presentation is always unique. Understanding this truth is key to bringing patience and empathy to our relationships and helping our loved ones with ADHD thrive.

In my family, ADHD is the background music playing through every room, every conversation, every milestone. The joys and challenges of ADHD sing out loudly from my home – both of my daughters, as well as my husband, have attention deficit hyperactivity disorder (ADHD or ADD). My son and I do not.

Sometimes, the rhythm of ADHD is soothing. Other times, it’s loud, vibrant, and energetic. Occasionally, it’s a chaotic, disorganized mess. But learning to live and thrive amidst the ever-changing melodies has become my life’s work, and a mission I take up each day in my work as a counselor. Teaching people about ADHD, dispelling ADHD misconceptions, shouting about the importance of early diagnosis and intervention, helping families accept the diagnosis without shame — these are my life’s goals.

ADHD, however, isn’t a cookie-cutter condition. No two people face the exact same challenges. There are common threads that may weave through each individual’s symptoms, but the presentation is as unique as each personality. Understanding this truth is key to bringing patience and empathy to our relationships and helping our loved ones with ADHD thrive. I am reminded of this truth every day by the three amazingly unique humans in my home, each one with their own set of ADHD challenges.

What Does ADHD Look Like? In Girls, It’s Not Always the Same

The Daydreamer

Emily, now 19, struggled in school from the beginning. Reading and math were incredibly difficult for her, and she was almost held back in First grade. We spent a lot of time with tutors and other supports. I knew she was working hard, but I still couldn’t make sense of what was happening. What’s more, Emily’s test scores were actually too high qualify her for title services in school.

Stomachaches mysteriously crept in every night before school. She chewed on her hair and the sleeves of her clothes. She was a quiet, sensitive daydreamer who was incredibly forgetful and disorganized. She was also observant, creative, and funny – nothing I considered signs of ADHD at the time.

[Read: Easy-to-Miss ADHD Symptoms in Girls]

It was a young patient of mine who opened my eyes to the possibility that Emily could have ADHD. My patient’s recent neuropsychological evaluation showed that she had been diagnosed with ADHD – Inattentive Type (also called ADD). This little girl’s experiences, down to bouts of anxiety, resembled my daughter’s in so many ways. I remember crying as I realized that Emily probably had ADHD – and I had missed it. Teachers had missed it. Doctors had missed it.

Emily was at last diagnosed with ADHD at age 9 – a turn of events that stunned her teachers, who were convinced that ADHD didn’t look like Emily’s problems.

Medication was life-changing for Emily. She quickly caught up to grade-level expectations, her nightly stomachaches disappeared, and she started gaining confidence in her abilities. Eventually, she didn’t need a tutor and became an “A” student through high school. Sports became a healthy outlet for her anxiety.

We openly talked about her challenges through the years, and found tools and strategies she could use to manage them. I made sure she knew enough about her issues to advocate for herself in the classroom.

[Essentials: How to Support (Not Enable) a Child with ADHD]

Today, she’s attending college to be a teacher, has a part-time job, and is coaching a volleyball team. Her confidence radiates, but the mom in me still worries that she won’t be able to juggle everything to stay on top of her life. Still, I know it’s past time to let go of those concerns. Her ADHD is a part of her, but it doesn’t hold her back – she’s learned to manage it.

The Energizer Bunny

In contrast to her older sister, Sidney seems to travel exclusively by cartwheel.

Sidney was born crying, and didn’t stop for four years. When she wasn’t crying, she was busy getting into everything. She would climb inside cupboards and take out every item. She routinely emptied drawers, basket, bins, and boxes. She jumped, ran, climbed, hung upside down, and generally had no fear. She didn’t seem to require much sleep. Getting her down at night was a monumental task.

She would also change her clothes 10 or 12 times a day. We thought all the dressing up was cute at first, but then she became very particular about her clothes. She hated socks, wouldn’t wear jeans, and refused to keep on her shoes. Then she couldn’t handle the seam in a shirt sleeve or the way her pants felt on her leg. A shirt she wore yesterday wouldn’t feel good to her the next day.

She started to refuse to wash her hands because the water made her hands feel “sticky.” If she felt sticky, she’d have a meltdown. If she felt too hot, she’d have a meltdown. It would sometimes get so bad that she would cry, scream, throw things, kick the walls and tear apart her room multiple times a day.

I grabbed a copy of The Out of Sync Child (#CommissionsEarned) as I was trying to solve the puzzle surrounding my daughter’s behavior, and realized Sidney probably had significant sensory processing issues. She was evaluated and started occupational therapy at age 4, which improved her life (and ours) drastically. But as I learned about the ADHD-SPD connection, I sensed there were still hurdles for us to overcome.

Her sensory processing issues were manageable by the time she started school but she was working way below grade-level expectations. Sidney, however, was unfazed – she didn’t even realize she was behind, and was more focused on the social part of school!

Her teacher did not mention that her learning issues could be the result of ADHD. But given Emily’s diagnosis and my growing knowledge about ADHD, I was confident Sidney had it, too — just the hyperactive type. Her pediatrician agreed.

Weighing the decision to start Sidney on a medication at such a young age was tough. It was the pediatrician who helped me feel confident in our decision to start: “Let’s see if we can head off some of the hurdles Emily had to face by treating it early,” he said. To this day, it’s one of the best parenting decisions we’ve ever made. In just a few months, Sidney was working above grade-level.

Despite the challenges of her first few years, Sidney doesn’t remember ever struggling in school. In fact, she’s always been an “A” student who loves school. She also has a level of self-confidence I wish we all possessed. She’s still an energizer bunny who sings and talks non-stop; a social butterfly with a huge heart. She needs a lot of physical activity to function at her best, but these things are part of what makes her wonderfully unique.

Same Name, Different Needs

Sidney’s challenges are different than Emily’s. Both were diagnosed early, but one had more difficult years than the other.

Sidney’s challenges are controlling her hyperactivity and emotions, managing her time, and picking up on social cues when she’s overwhelming people around her. Medication evens the playing field for Sidney and gets most of her symptoms under control.

Emily has needed medication and lots of tools and strategies to help with executive function deficits. Years of struggling academically, however, made her doubt her abilities. She had to work hard to overcome some negative messaging – “just try harder,” “this is easy, everyone knows this,” and so on – that she had heard over time.

My daughters are lucky compared to most girls and women with ADHD. Girls tend to fly under the radar because their behaviors don’t match stereotypical ADHD symptoms. They aren’t disrupting a classroom or getting into trouble because of their impulsive behavior. They quietly struggle, but don’t understand why. They may even be diagnosed with another condition — like anxiety or a mood disorder — before ADHD. The majority are teenagers or adults by the time they get an accurate diagnosis. That means 15, 20, 30 years or more of negative self-talk and not feeling good enough.

Early diagnosis and treatment could save so many women from years of shame and anxiety. In my practice, women are often angry after receiving an ADHD diagnosis – they realize a lifetime of struggles and self-doubt could have mostly been prevented and undoing 30 years of negative messaging and shame is tough work.

Some Boys Get Missed, Too

Girls fly under the radar often, but so do some boys.

Not all boys with ADHD present with hyperactive symptoms. Even then, parents may attribute these behaviors to “just boys being boys.” Academic struggles might be overlooked because “he just doesn’t like school” or “sports are more his thing.”

My husband was one of these boys. He’s 47 now, and most people hadn’t heard of ADHD when he was growing up. Even then, he wasn’t bouncing off the walls or indicating other stereotypical behaviors tied to ADHD.

When we started learning about ADHD with Emily, Todd looked at me and said, “This is me!”

School had never been easy for him. He worked very hard to get Bs and Cs. We took the same college class once – in his major. I would study for 30 minutes before a test and get an A. He would study for 3 hours and get a C. He had to read information multiple times, make notecards, and have someone quiz him. Looking back, I’m so impressed with his perseverance now that I understand why it was so hard for him.

After college, he found a career that suits all of his best qualities. He gets to travel, talk to people every day, and train others in something he loves. For over 20 year he’s been in the same industry but changed companies seven times. Each time was a better move for our family, but I used to think his job changes were a problem.

I worried it meant that he wouldn’t able to settle down. I eventually realized, however, that he always left a position because he wanted to. He gets bored easily, he thrives on new challenges, and a new job is a dopamine hit for his brain that keeps him motivated and at the top of his game.

Todd also struggles with time-management, He is the classic example of someone who is “time blind,” chronically underestimating how long a task will take to do. It used to drive me crazy, but the more I’ve learned about ADHD, the more understanding I’ve become. We can now have productive conversations about helpful strategies.

Todd has not yet tried medication to manage his symptoms, and instead relies on behavioral strategies – with much success.

What Does ADHD Look Like? Education Goes a Long Way

If you are a parent or spouse of someone with ADHD, I cannot stress enough the importance of educating yourself about the disorder.

One book or a few articles will not be enough. This is a life-long learning process for you and your loved one. New information and new tools come out every day. The more you understand ADHD, the healthier your relationships will be. You’ll be better able to identify symptoms and help create tools and strategies needed for your loved ones to be successful.

Education will also allow you to relinquish resentment and stop the character attacks, absolving your loved ones from feeling shame for their ADHD.

Through education, you’ll see that ADHD doesn’t have to be an ear-piercing heavy metal concert all the time – it can become your background music, and a colorful melody at that.

What Does ADHD Look Like? Next Steps

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