ADHD in Women and Girls: Finding Our Power
GUEST WRITER: Did you know that ADHD in women and girls is more likely to go undiagnosed than in boys and men? Alexia is a university student at UCL who learned the hard way that:
- Girls are more likely to suffer from undiagnosed ADHD.
- Undiagnosed ADHD is a well-being issue; it impacts a child’s self-esteem, anxiety and stress levels.
- Shame, self-hatred, and thoughts of unworthiness can occur (in spite of academic achievements) when girls have ADHD and they don’t actually know it.
While at school, Alexia Psalti consistently scored top of the class. She got 11 A*s and one A in her IGCSEs – hardly an academic profile we’d tend to associate with a child with ADHD. In this article, she shares her story of how undiagnosed ADHD impacted her health and well-being as a teenager.
Alexia urges teachers and schools to keep an eye out for possible signs of ADHD in girls who have always had difficulties concentrating and keep missing deadlines for essays and school projects; telling a child they “just need to try harder” and care more doesn’t help when they have undiagnosed ADHD. Schools bringing in specialists who can train their teachers to identify possible signs of ADHD in girls would help support the well-being of girls with undiagnosed ADHD sooner, rather than later.
CONCENTRATION DIFFICULTIES, STRESS AND ANXIETY
For the past couple years, I’ve been exploring the possibility that I may have a learning difficulty, particularly in the realm of ADHD. I’ve always had difficulty concentrating, and throughout my school life I’ve always been the ‘capable one’ who for some reason (probably laziness) keeps missing deadlines.
I now realise that my difficulty in concentrating made it so that I was perpetually frustrated with myself and increasingly anxious, to the point where I ended up studying less and less. Whenever I did study and found it challenging to do so, I’d feel these thoughts of ‘you’re not doing enough’ and ‘what’s wrong with you’ coming back.
Whenever I’d try to explain myself to my parents and teachers, I’d often get this answer: “You can’t really be that upset at missing this deadline because, if you cared as much as you say you do, you would have just done the work!“
When I went to boarding school for my last two years of school (a decision largely impacted by how stressed I had become in my environment at the time), I was able to observe better how others worked compared with me, as I was living with and spending most of my time around friends my age. That’s when I realised it couldn’t have been lack of motivation; I cared way more about my academic performance than a lot of my friends. And yet it seemed like, for them, it was a piece of cake to just pick up the book / notebook / computer and start studying. I was gobsmacked.
That’s when I decided to start looking into learning difficulties and was eventually assessed by specialists at my school. They gave me extra time in exams and advised me, if I felt I needed, to further look into getting a diagnosis from an educational psychiatrist. Since then, I’ve been officially diagnosed with Attention Deficit Hyperactivity Disorder – Predominantly Inattentive presentation.
ADHD IN WOMEN AND GIRLS: WHAT IS ADHD?
There are a lot of misconceptions about what ADHD is. ADHD is an impairment in the brain’s self-management system, its neurotransmitter systems, including that of dopamine. As I understand it, the ADHD brain does not produce enough dopamine (i.e. reward) for certain functions. So, while a person might recognise that they should stop procrastinating, stop fidgeting, or pay attention, their brain is quite literally unable to turn that desire into an action. We are constantly dopamine deficient – and we take the brain stimulation wherever we can get it. As ADDitute, a magazine specialised on the ADHD mind, explains:
Looking into what ADHD might have looked like in hunter-gatherer times and even later has given me a new outlook. In our most primal state, the ADHD members of the community were the best hunters and protectors, the ones who would be able to spring into action when a threat appeared. Today’s ‘neuro-typical’ people were the ones keeping things going in the everyday routine, the ones governing, cooking, and generally taking care of the communities in every-day life. The ADHD caveman is the adventurer. He travels the world, doing things, seeing things, fighting, making spur-of-the-moment decisions. There’s a reason why we’re dopamine-deficient: humanity needed people who need more stimulation for their brains to be content. People with ADHD were the best at reacting on-the-spot, knew a little bit of everything, and were able to keep up with the circumstances of such a life filled with unpredictability. In an article titled ‘Did ADHD Help Keep Humans Alive?’, the writers state:
ADHD is a ‘disorder’ in today’s society because we’re the minority and there’s not as big a need for these kinds of people. We’ve settled down and now need people who radiate stability and are good at keeping things going at a steady and regulated pace. No wonder people with ADHD really struggle to fit in within this system. ADHD is not inattentiveness, daydreaming, hyperactivity and fidgeting; these are the symptoms of being forced to live in a system that’s not designed for you. You’re ready to fight the bear that’s about to attack your village, and you’re being told to sit in one room all day and do one thing. No wonder your body reacts in the way it does – it’s trying to break free.
ADHDH IN GIRLS AND WOMEN: VALUE OF VALIDATING FACTS
Getting my suspicions confirmed was so validating; for the first time, I was able to look at my academic life without the level of shame and self-hatred it had always been accompanied with. Another side-effect of my diagnosis was that I started learning about different ways in which ADHD manifests, especially in women. Labelling ADHD as a learning difficulty is only partially accurate; the disorder affects many other aspects of daily life. Behaviours I’d once been told made me ‘irresponsible’, ‘immature’ and ‘careless’, now started making a lot more sense. My room is messy (apart from when I get the sudden motivation and can hyperfocus on cleaning it up!), I am always late getting places, despite planning to get there on time (and then feel awful about it), and I often zone out when I am spoken to (listening to instructions or details of any kind is extremely difficult and if I don’t write the words down or replay them in my mind, their meaning doesn’t register at all). It wasn’t that deep down I didn’t care; but society (and eventually myself too) told me that I was a bad person.
Habits of thought such as shame and thoughts of unworthiness formed over so many years are difficult to get away from. I often find myself back in the common mindset of ‘it’s so simple, why on earth can’t I just start working on this project earlier??’
I, for one, am really only ever able to do something when, either this activity seems to me like the most fun thing I could be doing in this moment, or the circumstances of my situation make this activity seem like life-or-death in the very short term (or, in the context of today’s society in terms of stakes, pass-or-fail!). Large, long-term tasks seem impossible to me because I’m not the one who’s supposed to be doing them. I’m not designed to sit and work on one thing for hours – I’m designed to want to learn a little bit of everything. I’m slowly starting to look at my ADHD as a type of superpower – I am great in a crisis, love adventure of any kind and constantly crave variation and new things in my life.
ADHD IN WOMEN AND GIRLS: A REQUEST TO SCHOOL LEADERS
Undiagnosed ADHD in girls is, above all, a wellbeing issue. Boys are three times more likely to receive an ADHD diagnosis, but girls are no less likely to have the disorder (Kinman, 2016). For many girls and women like me, we end up doing alright in school – what suffers is our mental health and self-esteem. Teachers need to be trained in the difference between girls’ and boys’ behaviours of ADHD. They need to be given the right criteria to look out for.
There is a widespread fear surrounding the rising number of ADHD diagnoses. People worry that this ‘trend’ is nothing more than making excuses for poor behaviour and laziness in children. What I hope this article has shown is that, far more often than not, when children seem to mean well and keep falling short of their obligations and responsibilities, there’s something behind that.
Getting the diagnosis didn’t give me a ‘free pass’ for irresponsible behaviour – instead it gave me an explanation for why I’d been so powerless to stop behaviours I’d become so ashamed of in myself. I could finally start letting go of that shame. And, more importantly, I could find techniques that work for me and make informed decisions about my future and what kind of career might be best for me, knowing what I know about the way my brain works. If we don’t change our attitudes toward ADHD, as Noelle Faulkner (2020) puts it, girls like myself will keep “slipping through the cracks of ADHD diagnosis” with poor self-esteem, anxiety, and burnout. It’s a high price to pay.
REFERENCES
ABOUT THE AUTHOR
Alexia Psalti is a student at UCL studying Spanish & Philosophy. She went to St Catherine’s British School, Athens, before boarding at The King’s School, Canterbury for her two final school years, receiving four A levels and an Extended Project Qualification.
