By Sue Varma, MD Board certified Psychiatrist and Clinical Assistant Professor of Psychiatry, NYU Langone Medical Center
So many women have ADHD but never know it for a variety of reasons. ADHD can mimic and co-exist with many other conditions and mood disorders.
Women with ADHD always think it’s something else at first, most commonly depression, fatigue, and anxiety. If they even make it to a mental health specialist, their symptoms may get diagnosed as another condition or get minimized as “just being a part of your personality.” Moreover, they may think, “I’m just disorganized and I’ve always been that way.” Or as some of my patients put it, “It’s a part of my personality, I’m just spacey or easily distracted.”
It’s seen as within the range of normal, but we don’t realize what a significant impact ADHD has. I find that this condition may not be viewed as seriously as others, but the truth is, it’s just as impairing.
Another reason we don’t pick up on ADHD as often is that it presents differently in males than females. You may not be like the hyperactive boy bouncing off the walls, getting in trouble at school – but you can be drowning in worry. Girls with ADHD may be more of the quiet or shy type; they’re perceived as daydreamers. You might be easily distracted or restless and can’t keep up with the bills or appointments. You can’t relax and are always anxious or frustrated. You may have trouble controlling your temper. Women tend to brush these warning signs off and think it’s a part of the stressful nature of life or as a result of juggling one too many things – raising kids, holding down jobs, keeping a household together.
Some of my patients have had ADHD their entire life, but it doesn’t come to the surface until they are hit by a major change or stress, or when expectations increase. They were able to get by for a long period of time, that is, until they were faced with a new job, challenge, promotion or added pressure and responsibility. These individuals are smart, and may get by in meetings using social skills. However, this can just mask their disorganization. This is also another reason why women are under-diagnosed – they’ve learned how to cope with it, hide their struggles, and overcompensate in other ways.
When women reach a point of crisis, they can start to feel things unraveling. They’ve been treading water all these years, coping and dealing with their restlessness or lack of focus – and then, a life change can break them and they can’t juggle it anymore.
The most common symptoms of ADHD are:
- Difficulty finishing up projects
Some people may also have restlessness, fidgetiness and tend to interrupt others. One can imagine that this can lead to many problems. We see that most women tend to suffer in silence, which often leads to low self-esteem. They wonder, “Why can’t I just get it right? Why is everything such a struggle for me as compared to my peers?” Depression, anxiety, and substance abuse may be a result of untreated ADHD and often co-occur.
Medications, particularly stimulant medications, are extremely effective in about 80 % of cases. When combined with therapy and other organizational tips and tricks, treatment can be effective. All medications have a variety of inherent risks, so it is important to discuss this with a psychiatrist that works with patients with ADHD.
Here are some tips that can help all of us concentrate better and become more efficient:
- Use a daily planner and make an effort to jot down appointments in real time. Check your calendar periodically throughout the day. Set up reminders or alerts/alarms prior to important appointments. You may even need a reminder to check your calendar.
- Time management: Allow yourself twice the amount of time it takes to get somewhere. Many of my patients have an inability to accurately estimate time for travel.
- Designate specific times for personal time on computer/emails so that you don’t get distracted from your professional work or other important obligations.
- Do a digital time-out, twice a day. This is as simple as shutting your device off.
- Engage in belly breathing. Try to practice this for 5 minutes, twice daily. Start by finding a quiet and comfortable place at either home or work. Put a “Do not disturb” sign on your door. Place your hand on your abdomen and breathe in to a count of 5, followed by a slow exhalation, also to a count of 5. If you find yourself distracted, don’t judge yourself or your thoughts. Simply label your thoughts as “thinking” and just let them pass. Don’t engage in your thoughts.
- Practice good sleep hygiene by trying to get to bed and wake up at the same time every day. This often does not happen as many people with ADHD get easily distracted and pulled into anything interesting at the moment and easily lose track of time. If you need to be awake for work at 6 a.m. and feel most rested by going to bed at 10 p.m., set a reminder about an hour before. This signals that you should shut off any stimulating activities and initiate a bedtime routine. This can be reading a book, drinking chamomile tea, or any other activity that you find soothing and relaxing. Try Dr. Oz’s Sleep Countdown.
- Keep a log of your accomplishments! Many people with ADHD struggle with self-esteem issues. It is important to recognize that you are trying your best, and keeping a log of even small daily accomplishments can be a reminder of this.