Hello Brains.
In case you hadn't noticed I am a woman with ADHD.
Which means I have the same mental health condition
as a man with ADHD --
But it does affect me differently.
[Intro music]
Before I jump into this I want to point out
That in my episode on ADHD in girls,
I had a lot of guys in the comments going
"Wait.. I have the GIRL presentation?"
There is no "girl presentation" of ADHD,
It's just that we know from research that women
-- At least Cisgendered women, we don't have
enough research yet on those who are both neurodiverse
and genderdiverse -- tend to present differently
to cismen due to a combination of
biological and social factors,
and that that difference can mean our ADHD
doesn't get recognized or treated effectively.
Also some of this may apply regardless of gender
Because everyone is different.
Anyone can have the more internalized presentation
of neurodiversity that sometimes gets missed.
So if any of this sounds familiar,
the conclusion is the same
go get checked out,
get the support you need.
OK. So let’s jump into the research.
ADHD is the same disorder no matter what gender you are
the same brain regions
and neurotransmitter systems are affected
and the same core deficits are present
But the resulting symptoms — what people actually see
can show up differently
due to the biological difference
between males and females
as well as the social differences
in the experiences of men and women.
As a result of gender and sex differences
ADHD leads to different presentations and outcomes:
For example
women are often expected to be good at organizing
planning, and other executive functions
and society is generally less forgiving
to women when they mess up.
We tend to work harder to “fit in”
and “be good” due to social pressures.
Females with ADHD tend to show
more inattentiveness
than hyperactivity or impulsiveness,
and are more likely than males to
develop anxiety, self esteem issues
and other internalizing problems,
while males with ADHD tend to
develop more externalizing problems
like rule breaking and aggression, than females do.
That's not to say that girls and women
with ADHD don't also
experience hyperactivity and impulsivity symptoms.
We do.
The symptoms are just a little less obvious.
They might take the form of
racing thoughts, speaking before thinking,
talking really quickly
risky sexual behavior
and relationship problems.
Also for those of us who menstruate,
our ADHD symptoms
may change or worsen during
certain parts of our menstrual cycle
and during certain stages of life like puberty
pregnancy, post-pregnancy
and menopause when we have these big, hormonal changes.
So our ADHD presentation
and treatment needs
may change as well.
Cool. Okay. But my doctor knows all that…right?
Probably not.
Most research on ADHD has been done in males
and the DSM criteria for ADHD
doesn’t fit the way females
tend to present as well as it does for males.
As a result,
a lot of women with ADHD
get misdiagnosed with depression or bipolar disorder
and end up getting the wrong medication
or a less effective one.
Those of us who internalize our symptoms
are far less likely to be referred for diagnosis,
less likely to receive a diagnosis
if we are referred,
and less likely to be treated
with stimulant medication even if we do
get a correct diagnosis.
despite the fact that
stimulant medication is the first-line
medication used to treat ADHD,
and works just as well
or females as it does for males.
Even if we are diagnosed
and treated with stimulant medication,
it’s really unlikely that our hormones
will be taken into consideration.
Personally, no one suspected I had ADHD
as a kid
because I was a “good kid.”
And because I was “smart.”
But the truth is,
I went to some pretty extreme lengths
to hide the fact that I was struggling
And I hated myself every time I couldn't.
Every time I came home without my jacket
Or lost the really pretty earring
someone bought me for my birthday
Or didn't get invited to parties
or couldn’t remember the question
the teacher
Despite my best efforts,
I still picked up a lot of not fun labels
spacy, messy, clumsy, weird,
forgetful, flaky, lazy, irresponsible.
But I didn’t talk to anyone about it.
I was ashamed of it.
I tried my best to hide it.
It wasn’t until my symptoms
became more obviously problematic to others —
more externalized —
when I was going through puberty
hormonal changes,
and started rage quitting conversations,
when my coping mechanisms weren’t working anymore
Because the demands on my executive function had changed
and I started doing badly in school —
that my family even noticed there was a problem. --
Even then, the first doctor my mom took me to
told her I couldn’t have ADHD.
Because I’d done well in elementary school.
Thankfully, my mom told that doctor:
"thanks for your opinion, I’d like to see a specialist."
And I was diagnosed with ADHD.
And thankfully,
she was willing to try stimulant medication to see if it helped --
— which it did. A lot.
But even after that —
it felt like no one really took my ADHD seriously,
so I didn’t take it seriously.
I didn’t ask for accommodations,
I didn’t get coaching or therapy for it,
I even went off my meds completely for a while
because someone I trusted told me I didn’t need them.
Even after I dropped out of community college,
got into a bunch of car accidents
went through a divorce,
got fired from— several jobs,
ruined my credit
developed generalized anxiety disorder
and had my first panic attack,
I was actually embarrassed to start this channel
because I was so sure that my struggles
weren’t all that bad.
Because I was comparing them
to what I saw in my brother,
and my cousin.
The symptoms that were more obvious to others.
So even once I was diagnosed,
didn’t get adequate treatment for my ADHD —
I didn’t feel like it was
until my frustration with my struggles
got so bad I literally started a YouTube channel about them...
And I hear from a LOT of women
that say their struggles were either
missed completely,
misdiagnosed,
or that they were treated for other mental health conditions
or years or even decades
before anyone recognized the underlying ADHD.
So, what can we do?
Educate ourselves and others on how ADHD
effects women differently
and make sure we’re getting the support we need.
Here’s what we know.
ADHD in women is typically more severe than it looks.
Symptoms are external manifestations of internal struggles.
So if we have a primarily inattentive presentation
and
we’re not going to look “as ADHD” as we actually are.
And this isn't just true for women,
anyone who’s faced strong social and cultural pressures
to 'be good'
is likely to mask and internalize their ADHD symptoms.
And this is true for autism as well.
We may minimize how much we’re struggling.
According to research,
women tend to underreport their symptoms,
while men tend to overreport.
And if we’ve developed comorbid anxiety
or depression or other mental health conditions,
those are likely to be more obvious than our ADHD.
Because of this, we're more likely to self diagnose
AKA be the first to recognize we might have ADHD.
And we might be more afraid to go to the doctor
to get checked out,
especially if we’ve been dismissed
or misdiagnosed before.
This is why I recommend going to doctors
who specialize in ADHD or who are really familiar with it.
And remember that
whether it’s ADHD or it does turn out to be something else—
if you’re struggling, there’s a reason you’re struggling.
Our struggles being invisible to others doesn’t mean they’re imaginary.
Also—It’s just as important to get the support we need.
While our struggles might not be as
obviously problematic in the short term —
maybe we’re doing well in school,
maybe we’re not getting in trouble a lot —
The long-term issues women with ADHD face are
Like self medicating, which can lead to addiction.
Or eating disorders.
STIs and unplanned pregnancies.
Chronic pain is common in women with ADHD.
Self harm
...even attempts at suicide.
The longer we go without getting the support we need,
the longer we have to figure out
how to cope on our own,
and those coping mechanisms
aren’t always gonna be healthy.
And the longer we go without understanding
why we’re struggling
the more dysfunctional beliefs we develop
about ourselves and our abilities.
Often, by the time our struggles
are obviously problematic to others,
our core beliefs about ourselves have already formed.
This was true for me,
and I’m still undoing the damage.
My terrible self esteem
set me up for abusive relationships.
My difficulties fitting in created social anxiety --
I’m still learning how to make friends.
My symptoms might not have seemed
like a big deal at the time,
but the impact they have had on my life
long term absolutely was.
And again —
hormones impact our symptoms.
Anyone who menstruates
has regular hormone fluctuations that affect our ADHD —
in addition to needing extra support during big transitions —
it’s good to be mindful of how our symptoms
are affecting us at different points in our cycle
and talk to our doctor about options.
Some people might benefit from
different doses of medication at different times of the month.
We’ll talk more about hormones in another episode,
because there's a lot to go into,
and also -- we need more research on that.
Speaking of which --
—we need more research, on all genders.
There’s not as much research on ADHD in women,
and there’s barely any on those who are gender diverse.
The research we do have
suggests neurodiversity rates are a lot higher
in the trans community,
and since both biological factors
and societal pressures impact ADHD…
it’s important we do that research
so we can better recognize and support every brain,
not just the ones we understand so far.
Because honestly...
no one should have to go through life blaming themselves
for how their brain works.
Period.
Thank you to my brain advocates
and all my Patreon brains for
supporting the work that we do --
because of you, we can keep creating content
that createss awareness about ADHD
so a lot more brains can get the support they need : )
I'm going to get some ice-cream now.
Like, subscribe, click all the things and I will see you next video!
Bye brains!