🔍💡 Understanding ADHD: Diagnosis, Treatment, and Key Considerations for Women

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ADHD: More Than Just Attention and Hyperactivity

 "Attention Deficit Hyperactivity Disorder" (ADHD) is a misleading name. ADHD isn't a disorder characterized by attention deficits or hyperactivity! On this page, we will explore what it is. We will also focus on the specific challenges ADHD women face, from diagnosis of symptoms to treatment.
 

 From Misunderstood Behavior to Recognized Neurodivergence: Understanding the True Nature of ADHD

Initially, ADHD was misunderstood as simply a behavioral problem.

When children showed symptoms of inattention or impulsiveness in school, they were diagnosed with ADHD. Teachers, parents, and therapists focused on controlling the child's behavior to manage these symptoms.

Today, we understand that ADHD is a form of neurodivergence. It’s recognized as a neurodevelopmental difference affecting brain development and function. ADHD is not something you outgrow; it persists into adulthood. Other neurodevelopmental differences are autism, dyslexia, and dyspraxia.

The ADHD brain operates, learns, and behaves differently from the neurotypical brain. It’s not about bad behavior.

No one should treat an ADHD child or adult as if they are struggling with a behavioral disorder.

ADHD influences how you experience the world, affecting your executive functioning, sensory processing, and emotions. For women, these "symptoms" can also fluctuate with hormonal changes.

 

What Causes ADHD?

Understanding ADHD begins with recognizing its primary cause - genetics. ADHD is as genetic as height! 
Although families can make ADHD children feel worse, parenting does not cause ADHD. Brain structures and neurotransmitter pathways are different in ADHD people, particularly in areas related to attention, reward systems, emotions, impulse control, and executive functions.
The neurotransmitter dopamine, crucial in attention and reward systems, is often disrupted. ADHD people have a dysregulation of dopamine. Genetic research has identified specific variations in genes such as DRD4 and DAT1.
 

ADHD Subtypes

adhd hyperactivity

Attention Deficit Hyperactivity Disorder is categorized into three primary types.

  1. The first type is Predominantly Inattentive Presentation. Girls and women are often diagnosed with inattentive ADHD. Inattentive ADHDers often struggle with maintaining attention, following detailed instructions, and organizing tasks. They might seem to listen but don't follow through on instructions. They usually get distracted easily.

2. The second type is Predominantly Hyperactive-Impulsive Presentation. These type of ADHDers may engage in excessive fidgeting and talking. They may have impulsive actions like interrupting others or taking risks. They don't seem to consider the consequences.

3. Combined Presentation ADHD involves a mix of both inattentive and hyperactive-impulsive symptoms. Treatment and medication strategies are tailored to each subtype.

Leading expert Russel Barkley disputes these types of presentations. To learn more, click here.

 

Beyond Hyperactivity: Understanding ADHD as a Regulation Disorder

ADHD is about REGULATING and distributing attention.   ADHD affects the ability to maintain and shift focus. An ADHD person might pay attention to the things they don't need to pay attention to. Individuals with ADHD have a remarkable knack for hyper-focusing on engaging tasks. However, they might struggle to redistribute their attention when necessary. Research shows that people with ADHD focus fine in the right environment. It must be one where they are interested and excited.
impulsivity

Hyperactivity in ADHD is often misunderstood, especially when it comes to girls and women.

In females, hyperactivity can manifest in less obvious ways:

  • Internal Restlessness

Women and girls frequently describe a constant need to stay busy, finding it difficult to relax or unwind.

  • Excessive Talking

Hyperactivity in girls and women may express itself through excessive talking, with a rapid flow of words as an outlet for their restless energy.

  • Racing Minds

Many women report that their minds are perpetually "on," making it challenging to shut down thoughts and find mental calm.

It's important to note that these manifestations of hyperactivity can be easily overlooked, especially in those who might otherwise be considered inattentive, leading to missing this sign of hyperactivity in girls and women.

Executive Functioning Challenges

The Impact on Daily Functioning

ADHD significantly affects executive functioning, which includes skills like planning, motivation, remembering, and following through on tasks. Parents and teachers might mistakenly see children who struggle with these areas as defiant or disobedient.

This misunderstanding can leave children feeling confused and bad about themselves.

Misunderstandings in Adult Relationships

Adults with ADHD face similar misunderstandings in their relationships. They might forget to do things or fail to follow through, leading others to think they are lazy or don’t care. This can create stress at work, home, and social situations. These experiences often impact self-esteem, causing shame and confusion. This is particularly challenging for women, who are usually expected to use their executive functioning skills to juggle multiple roles effectively.

Emotional Regulation Difficulties

The Challenges of Emotional Regulation

Emotional regulation involves understanding your emotions and expressing them appropriately in different situations. However, if you struggle with emotional regulation, you might get easily overwhelmed, leading to difficulties in relationships and managing stress. As a result, this can affect your performance in school, social settings, and work. Furthermore, focusing and making decisions can be challenging when emotions feel overwhelming. Despite this, emotional regulation difficulties are often overlooked because they aren't part of the core ADHD criteria.

Overlooked and Misdiagnosed in Girls

As a result, girls with ADHD are often overlooked or misdiagnosed. They may begin to hide their emotions, believing they are too much. Some might turn to substances or masking behaviors as a way to cope with their overwhelming feelings.

Hormonal Influence on ADHD

The Role of Estrogen in ADHD

Estrogen plays a significant role in regulating dopamine levels throughout a woman's life. As a result, women's ADHD symptoms often fluctuate with their menstrual cycle, pregnancy, perimenopause, and menopause. Unfortunately, this connection is rarely understood or communicated effectively to women with ADHD.

Vulnerability to Related Conditions

Women with ADHD are particularly vulnerable to conditions like Premenstrual Dysphoric Disorder (PMDD) and Postpartum Depression. Additionally, they experience worsening symptoms and increased stress during perimenopause and menopause. These factors must be considered and addressed in their treatment plans.

Treatment for ADHD

Challenges in Accessing Treatment

Accessing effective ADHD treatment can be challenging. Long wait times for assessment and prohibitive costs are common obstacles. Additionally, quality mental health providers may be in short supply.

The Importance of Neurodivergent-Friendly Care

Many providers are still undertrained and may view ADHD as a defect, which can hinder effective treatment. For this reason, it's crucial to find a neurodivergent-friendly provider or a supportive community that understands ADHD as a neurotype. In addition, medication, often used to regulate dopamine, can be effective when part of a comprehensive treatment plan. 

 

Best Practices for Understanding  ADHD Treatment

 
Effective treatment should consider the unique challenges of ADHD women.
 
Key Considerations and Skills:
 
  • 🔆 Issues from trauma and grief from a late diagnosis
 
 
  • 🔆 Affirming your nervous system's needs
 
 
 
  • 🔆 Prioritizing self-care to manage stress and prevent burnout
 
  • 🔆 Learning self-advocacy skills, such as setting boundaries and communicating needs
 
  • 🔆 Learning to self-accommodate
 
 
 
 
  • 🔆 Seeking assessment for other mental health issues like anxiety or depression
 
 
 
 
  • 🔆 Building a supportive network of peers and professionals
 
 
 
  • 🔆 Learning self-compassion to work on shame and self-criticism
 
  • 🔆 Understanding and managing sensory overload
 
 
  • 🔆 Seeking education and resources on affirming neurodiversity to understand yourself better
 
  • 🔆 Advocating for appropriate accommodations in work or school settings
  • 🔆 Practicing positive interventions to support a happy brain

 

 

Wrapping It Up: Understanding ADHD

Beyond Recognizing Symptoms

Understanding ADHD in women goes beyond just recognizing the symptoms. The diagnosis often doesn't fully capture how ADHD manifests differently in women.

The Complex Impact of ADHD

ADHD impacts executive functioning, emotional regulation, and sensory experiences, all of which are further complicated by hormonal changes and societal pressures.

The Need for Holistic Support

Adequate support and treatment require a holistic approach. Remember, ADHD isn't a defect or a behavioral disorder—it's a neurotype! Seek out neurodivergent-friendly care, learn self-advocacy, and build strong support networks.

Further Resources on Understanding ADHD

Sources for Understanding ADHD

Medical information obtained from this website is not intended as a substitute for professional care. If you have or suspect you have a problem, you should consult a healthcare provider.

Kristen McClure: Neurodivergent-Affirming ADHD Therapist and Coach with 30 years experience in North Carolina and South Carolina Offering virtual therapy and coaching services across North Carolina, including Ashville, Raleigh, Durham, Wilmington, Greenville, and more. Also serving major South Carolina cities such as Charleston, Columbia, Greenville, Spartanburg, Rock Hill, and more.