Unmasking ADHD in Women: Understanding, Acceptance, and Strategies

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Introduction and Housekeeping

Welcome back to the Developmental Digest! I'm your host, Natalie, and I'm thrilled to have you here. It's been a while, but I'm back, refreshed, and full of new ideas. I have some exciting guests lined up for the upcoming weeks.

Let's start with a little check-in. I just finished the school year and took two weeks off for what I like to call a short sabbatical to catch up on early intervention work. Over the summer, I picked up some early intervention (EI) kiddos and focused on prioritizing my business. Oh, and I also went on a nine-day adventure to Italy, visiting Sardinia. It was gorgeous! I'll put my vlogs in the show notes for you to check out. I love watching vlogs while I work; it feels like having another body with me, which ties into our topic today: ADHD and unmasking what we've been trying to hide for so long.

The Developmental Digest has evolved over time. Initially, it was called Save Your Spoon, focusing on my autoimmune diagnoses. Now, it has shifted towards self-development, whether you're in your teens, twenties, or thirties, trying to better your life. We discuss parenting styles, speech therapy, neurodevelopment, and other child development domains. I love having other clinicians on the show, so feel free to reach out if you're interested.

ADHD in women: historical context and disparities

Today, we're going to talk about ADHD and unmasking what we've been trying to hide for so long. Developmental Digest has really shifted since the beginning. As you know, I started off with Save Your Spoon, which focused on my autoimmune diagnosis. Now, we've shifted to self-development, whether you're in your 20s, teens, or even 30s, like me, as I'm approaching that. We're looking at parents trying to be the best they can for their children, exploring parenting styles, and discussing speech therapy, neurodevelopment, and other domains within the field of child development. I love having other clinicians on here, so feel free to reach out to me.

We're discovering ourselves, and this has really impeded my progress in the past. Over the past couple of weeks, I've dug into different books, and, holy cannoli, do I have things to report today. The diagnosis of ADHD in women has seen a significant increase in recent years. Historically, ADHD was underdiagnosed in females due to differences in how symptoms manifest compared to males. Girls and women with ADHD often exhibit more inattention, such as difficulties concentrating and attending to things in front of them, and less hyperactivity, like fidgeting. This makes their symptoms less noticeable and frequently misattributed to anxiety or depression.

This diagnostic disparity means that women are typically diagnosed around four years later than men, with an average diagnosis at age 23 compared to 19 for men. From 2020 to 2022, the percentage of adult women newly diagnosed with ADHD doubled. This increase could be partially attributed to increased awareness and the impact of the COVID-19 pandemic, which disrupted the routines and coping mechanisms that many women with undiagnosed ADHD relied on. Despite improvements in seeking evaluations and uncovering ADHD, this diagnosis isn't easy to pick up, as it's often masked by anxiety or depression. Women are also less likely to receive medication compared to their male counterparts, complicating effective management of the disorder. According to the National Comorbidity Survey Replication, the prevalence of ADHD in adults aged 19 to 44 is 3.2% for women and 5.4% for men, but the gap has narrowed in recent years.

ADHD in women: symptoms

What does ADHD look like in women? Let me tell you, I've dealt with my fair share of depression and anxiety, and I have weird obsessive tendencies, especially aligning with perfectionism. So, it was a bit tough reading some of these. The first one is inattentiveness: difficulty concentrating, forgetfulness, losing things, being easily distracted, disorganization, difficulty keeping track of schedules and appointments, and trouble organizing or setting priorities. Then there's hyperactivity: restlessness, fidgeting, difficulty relaxing, talking excessively, and always moving. Impulsivity includes interrupting others, making quick decisions without thinking, and engaging in risky behaviors. Emotional dysregulation involves mood swings, irritability, hypersensitivity to criticism, difficulty handling stress, anxiety, and low frustration tolerance. Social difficulties include navigating friendships, feeling overwhelmed or shy at social gatherings, drifting off during conversations, and forgetting to reply to friends. Repetitive behaviors, like face-picking and nail-picking, and perfectionism, the pressure to look right and be perfect, also come into play. These lead to other mental health issues such as depression, low self-esteem, feeling out of control or overwhelmed, and experiencing shame or embarrassment.

Traditionally, ADHD is categorized into two types: inattentive and hyperactive. However, many people exhibit characteristics of both. ADHD and executive dysfunction go hand in hand, affecting cognition, planning, self-control, memory, and impulse control. There are strengths and weaknesses in every aspect of neurodiversity. For example, some people with ADHD can multitask very well or dive deep into topics, uncovering every recent research article and digesting it thoroughly.

Using a strength-based approach for students with executive dysfunction, we can empower them to reach their full potential. I want you to see how you can reach your full potential too. Okay, I got sidetracked for like half an hour and tried to pull up more research, but I had too many tabs open, so my computer was slow. I have my notes on my phone, though.

I've been reading this book called "A Radical Guide for Women with ADHD." I don't have a proper diagnosis, but I handle things differently than the neurotypical person, leading me to this assumption. It's been difficult to work on some tasks. For example, filling out time sheets, clearing schedules, and doing billing takes me the longest. I can easily whip up a report, but billing takes forever. Everyday situations like recording a podcast are easy, but editing is hard. Talking on the phone is easy, but calling three people on a to-do list feels like moving a boulder.

ADHD and Self-Concept

Looking at our faults, especially if you're a perfectionist, is threatening. It can lead to burnout. Accepting that there's no true normal brain is crucial. Many people deviate from the norm in cognitive processes. Are you going to let courage lead you? Courage is worth pursuing. It's more important than fear. If you fear you can't accomplish your goals, you're going to let that fear win.

Reflect on yourself and how you feel tension in your body. The way we talk to and about ourselves can have profound consequences. Statements like "This has impeded my progress" are common. Other common ones include "Something is wrong with me," "I am broken and need to be fixed," "I will never reach my potential," "I'm unacceptable as I am," "I'm a mess," and "I can't let people know the real me." If you pause and journal out some of these traits that resonate with you, you'll see how they impact you. Recognizing them is the first step.

People with ADHD may have poor time management skills, which can relate to anyone with mental health concerns. The author refers to an identity triad: your core sense of self, your brain, and your relationship with the world. ADHD, anxiety, or depression can make these look tangled, leading to shame. Your core sense of self is a composite of all things you are. ADHD is one part, but you're also your interests, experiences, and social roles. This helps form a compassionate, radically accepting relationship with your core self. Brain differences manifest in unique strengths and needs, requiring strategies like using a planner or timer. You and the world reflect on skills and societal norms, like the 9-to-5 system. People with ADHD are 500% more likely to be entrepreneurs, and 20% of entrepreneurs have ADHD. We're redefining what it means to live authentically as yourself.

Fulfillment comes before success, or at least they go hand in hand. You don't have to be a cookie-cutter housewife who does everything. As you gain a stronger sense of your core self, you can lead a life of purpose and fulfillment. Dispel things you've heard from others and rewrite neural network patterns. Focus on your strengths and tackle your goals.

I didn't finish the book yet, but I checked Goodreads to see what people with ADHD thought about it. There were mixed opinions, but those recently diagnosed found it beneficial. I recommend checking it out, especially if you're in the beginning stages like me.

I've always wondered why I can't be normal and not feel compelled to do things I really like. If you resonate with this, feel free to message me. Figuring out who you are in this world is not easy. Practice self-compassion and self-love at the end of the day. Our core sense of self might be all we have. The book didn't mention disparities in ADHD diagnosis, such as racial differences and socioeconomic status. I'm sending you love and light, especially if you're facing difficulties.

Practical strategies for managing ADHD symptoms

Now, I want to bring a couple of tips to help you support yourself. I was an academic coach at the Disability Resources and Educational Services Center at U of I. I loved that job. I helped kids with ADHD once a week, breaking down tasks and trying different techniques. There's no one-size-fits-all solution, but some things have helped me.

There's an "I Have ADHD" podcast with an episode on ten things that helped. One of the biggest challenges was finding stimulation. Sitting at a computer doing billing was not stimulating. What's your why? Our brains like reasoning. My why is that I have to bill Medicare and Medicaid to get reimbursement for the services I provide. Another tip is time-blocking. In grad school, I time-blocked everything, and it was during COVID too. Today, I define my win for a set amount of time, like finishing a podcast episode in the next 15 minutes.

Another tip is making an estimate of the time and multiplying it by two. We overestimate what we can do in an hour but underestimate long-term. Allowing more time gives us compassion to meet our goals effectively. Having three piles—untimed, urgent, and not urgent—helps. The third column shows what you can outsource, what you don't truly value, and where to redirect your energy.

Creating different types of environments can help with stimulation. Small changes in routine, like different lighting, temperatures, or drinks, can spark your brain differently. Morning routines are crucial, as dopamine levels are highest in the morning. Adjusting your routine to suit your peak times can maximize productivity.

The importance of self-compassion and a strength-based approach

I don't officially have ADHD, but I've always experienced difficulties with attention. I attributed it to a concussion. Navigating this has led me to explore various strategies and seek support. If you see parallels in your life, consider reaching out to a professional who works with ADHD or neurodivergent individuals.

Keep your eyes out for more updates. I plan to post every Wednesday and have been doing my research. See you next time, and enjoy the Developmental Digest!