06.30.14 9:45 AM ET
Adult Women Are the New Face of ADHD
Attention Deficit Hyperactivity Disorder (ADHD) was once thought to be the purview of hyper little boys, but a recent study shows that women are the fastest growing market for ADHD medication.
While debate rages over ever-increasing diagnosis rates of ADHD in children, a quiet minority has been slowly building. The study found that between 2008 and 2012 the use of ADHD meds jumped a whopping 85 percent among women ages 24 to 36.
What’s going on?
Girls with ADHD are significantly less likely than boys to be diagnosed with it during childhood. Many girls fall into the inattentive type of ADHD, and even those who tend more toward hyperactivity don’t necessarily match the stereotypical symptoms. Next to their squeaky counterparts these silent wheels roll right through the cracks.
“Women are less likely to be diagnosed,” Dr. Geri Markel, an educational psychologist and founder of the website Managing Your Mind, says. “As girls they just don’t look like what people think of when they picture ADHD.”
Without access to the support and services diagnosis can yield, girls develop elaborate, energy-sucking coping mechanisms that allow them to compensate for the symptoms of ADHD. These systems may work during their school years when things are more structured, but faced with the ever-shifting maze of responsibilities ushered in by adulthood, their defenses start to crumble. “It’s common for women with ADHD to cope until they can’t anymore,” Dr. Markel explains.
The years between 26 and 34 are rife with those kinds of life changes so heavy they earn moniker of “milestones.” College gives way to the greater demands of grad school, gainful employment, and career planning. Time and money management become paramount. The pressure to find a long-term partner is ratcheted up, cohabitation is the norm, and many women become mothers for the first time.
A tall order for anyone, but for women with undiagnosed ADHD, each added pressure comes closer and closer to breaking the coping camel’s back. “The bar,” says Dr. Markel, “gets so high their strengths can no longer circumvent their weaknesses.”
The bad reputation attached to ADHD drugs isn’t totally unwarranted, largely because ADHD is a pharmaceutical marketer’s dream. Characterized by symptoms that to the casual eye can apply to anyone who loses their keys sometimes, ADHD is often the diagnosis du jour. The less scrupulous have made financial hay out of a diagnosis that promises easy access to stimulants.
Despite the fact that we know ADHD to be a neurobiological disorder, the acronym has become shorthand for the case that we are an overmedicated, perpetually distracted culture. The overblown lore around ADHD dilutes the seriousness of the condition and creates a stigma of skepticism that harms those who truly do have it.
The stigmatizing of medication can take an even greater toll on women, inundated as we are with television caricatures portraying women who abusing medication or put some pep in their step with modern-day mother’s little helpers. The desperate housewife popping her kid’s Adderall with one hand while she decorates bake-sale cupcakes with the other. The ambitious college girl, speeding her way through the test in more ways than one, her unfair advantage hiding beneath a childproof cap. The dieter, surreptitiously swapping snacks for pills.
Inherent in these shaming stereotypes is the insidious, pervasive message that to be considered successful women must be the ultimate multitaskers: standout academics, empathetic friends, driven careerists, loving partners, focused parents, thin, pretty, and put together, without ever pulling back the curtain to show the incredible effort it takes to be even one, let alone all of these things.
For women with ADHD conforming to these problematic standards is a herculean task. “It’s harder because women are expected to play a wider variety of roles,” says Dr. Markel. “The majority of women are running the house as well as working. Any woman will find clutter and organizing and scheduling and prioritizing difficult in this situation, but when you add the ADHD it becomes completely overwhelming.”
The price of being unable to perform is often paid in self-esteem.
Women with ADHD are more likely to internalize the negative experiences associated with their ADHD, and many report feeling that they are broken, flawed, or stupid. Girls with ADHD show higher rates of anxiety, depression, eating disorders, self-harm, and suicide attempts as they move into adolescence, and women who have gone undiagnosed are more likely to have experienced divorce and unemployment, and to suffer from poor self-concept.
It’s not all bad news, however. The study’s findings that young women are availing themselves of treatment at higher rates than ever before can be taken as a sign of hopeful change. With better and more comprehensive information on girls and women with ADHD becoming available, those that have been left in the cold may finally have the chance to come in.
“When a person first understands that they have ADHD they often feel very relieved,” says Dr. Markel. Having a reason for why things are so difficult means women can finally stop thinking of themselves as “lazy, crazy, or dumb…once you have the diagnosis there’s more acceptance, more self-awareness.”
Finding the drugs that work for you and your body takes time, and it’s important to work with trained physicians who understand how ADHD affects women of different ages. Meds do help, says Dr. Markel, but they should be one aspect of a multifaceted treatment strategy. “You might start with medication, but it’s vital to get counseling just to reorient yourself,” she explains. After a lifetime of dealing with the stress of ADHD, it can be hard to give up old patterns and let go of painful memories. “We have decades of research that suggests therapy is indispensable in helping to make the transition from feeling out of control to building understanding and feeling more prideful,” she says.
The focus shouldn’t be on “curing” your ADHD, but on finding effective ways to manage the symptoms. Mindful activities such as yoga and meditation can help calm and focus the mind. Physical exercise has been shown to be extremely helpful in regulating mood, energy levels, and concentration. There is also evidence to suggest that diet and nutritional supplements may have an impact on ADHD symptoms, but as yet most studies have focused on children and the findings are not certain. Women seeking to manage their ADHD through nutrition should work with a physician or a nutritionist who is aware of ADHD to create a healthy eating plan.
What we know for sure is this: For women who’ve spent decades in the dark, the light of understanding can begin to make the invisible, inexorable weight they’ve felt for so long into something tangible, manageable, and even hopeful.