“You don’t have ADHD,” my parents used to say. “You’re not hyper and you do well in school.”
Well, yeah. I guess that was true. I wasn’t hyper and I did do well in school. “But, mom, I can’t concentrate!” I would fire back. This same conversation would occur about as frequently as Hugh Hefner swapped out girlfriends and usually concluded with either my parents deciding that anxiety was clouding my focus, or my guidance counselor postulating I was like any other overworked kid who was just trying to score some Adderall.
“Your classmate, Matthew, has ADHD. He’s all kinds of disruptive in class and his parents fear he may be held back a year because he never finishes his school work. That’s not you.” Well, that was true, too. I didn’t have the same symptoms as Matthew, so… I guessed I was just… stressed?
For reference, I was a fairly quiet and studious kid. The only time I ever really complained was when we were out of Cheese Puffs, and, on the drug front, my parents had to constantly remind me to take my allergy medication – partly because I forgot, but mostly because medicine of any kind hurt my stomach and I really hated it. (I was often the sniffly kid. Look out, boys!) The roundabout point here being that I wasn’t one to complain for the sake of attention, and I also wasn’t gunning for a prescription. As a woman, I, unfortunately, have to insert this qualifier.
Let’s take a look back at all the obvious signs, shall we?
As far back as kindergarten, my teacher called home to explain that I would need to be pulled out of the gifted program because I wasn’t reading on grade level. My family was confused since I had tested high on the aptitude tests, but they hypothesized that I was maybe more of a math person than an English person. (Side note: I’m now a writer… so…) My mom took me to the library and we read lots of Amelia Bedelia until I was the strongest reader in my class. Anyone who has struggled with ADHD can attest to the fact that the focus required to read a book can often be one of the biggest challenges, regardless of one’s mental capacity.
Standardized tests were, similarly, no walk in the park, mostly because they were timed and I lacked the focus to complete them in a designated ninety minute block. The really fun part is that these tests were typically used as placement tools to determine which class level one should be placed the following year. At the start of almost every school year, my teachers would call my parents and say something to the effect of, “er, your daughter probably just had an off day when she took the state test. She needs to be moved up a level or three.” I got used to accepting the narrative that, “I wasn’t a good test taker.”
Fast forward to high school when I was only showing up for class three days a week. I couldn’t pay attention anyway and figured maybe I was just bored, so, what the hell, I might as well put in some extra hours at home and teach myself the material. And when I say extra hours, I mean EXTRA hours. I studied for an excruciating amount of time in order to compensate for how hard it was for me to pay attention in the first place. The hours I kept were that of a med student, and my cats were frequently pissed that I wouldn’t just come to bed already. Each semester, my teachers would send home a letter that said I had missed so many days of class that my final exams would be counting for 70% of my grade and, if I didn’t pass, then I would fail the class. I aced all of the exams. The teachers had a love-hate relationship with me.
For years, I was bearing a huge emotional burden of trying to appear normal while quietly and privately suffering yet being repeatedly told that I was completely fine, if not a little anxious. I had started so many projects that I abandoned halfway through and had so many new ideas and endeavors that were not coming to fruition. In order to combat this, I resolutely shut out other areas of my life so they wouldn’t distract me from achieving my goals as I powered through with sheer determination of will. It worked and no one was the wiser, but I was appearing aloof and selfish to those around me. My room was a mess, multitasking was a word that had no place in my vocabulary, and even the smallest additional task would put me completely over the edge. Buy my grandma a birthday card? Overwhelming. Call Aetna and update my information? I’m shutting down. Pay my car insurance? Oh God, I’m dead.
Feeling fed up and particularly investigative one day, I did what any other millennial would do: I went on the internet. I typed in, “adult ADHD,” and I dug and I dug. Weird, though. I only fit a small portion of the criteria, but I knew something was wrong. I had always known something was wrong. That’s when, in the corner of the internet, I stumbled upon a vacuum of literature that would change my life: “ADD in Women: Why Girls’ ADHD Symptoms Are Not Diagnosed.” What the…? Hold the phone.
For hours, I poured over article after article on this topic. ADDitude, a quarterly consumer publication dedicated to all things ADHD, explains that ADHD looks different in boys than it does in girls, yet most of the diagnostic criteria for ADHD has been designed to only identify how symptoms appear in hyperactive boys. Holy jeez. Further reading revealed that while men manifest their hyperactive symptoms outward, women are much more inclined to pull their symptoms inward, therefore rendering female ADHD silent and invisible. In fact, 50% – 75% of women with ADHD go undiagnosed. Just to break that down: most women who have ADHD are undiagnosed. While Matthew was jumping around the room throwing pencils and I was sitting quietly and zoning out, our underlying conditions were exactly the same. They just looked different. Namely, his were visible. An even bigger distinction? His reality had been validated from a young age and mine had been repeatedly dismissed. Welcome to being a woman.
After more digging and a visit with a clinician, I learned that it was only recently that the DSM started amending the criteria for ADHD and breaking up the disorder into three subtypes in order to account for this gender disparity:
1) Hyperactive/Impulsive Subtype (more common in men)
2) Inattentive Subtype (more common in women)
3) Combined Subtype (really unlucky people)
Jenny Anderson of Quart Media writes, “Pressure to perform means many girls internalize their symptoms […] as personal flaws rather than medical issues to be treated through medicine and therapy.” I speak from personal experience when I say that the toll this takes on one’s self-esteem is big and lasting. Women have historically been unaccounted for in the medical community. We are tossed a diagnosis of anxious or depressed while the underlying issue goes completely unstudied and unidentified. It is very important to note that anxiety and depression can go hand in hand with ADHD – sometimes as a result of it and sometimes completely independent of it and stemming from other factors. Which is why it, therefore, becomes increasingly important to treat each woman as an individual human being in order to assess the specific disorders that inflict her instead of assigning a catch-all diagnosis of, “stressed,” to the entire female gender.
I’m, of course, not advocating that everyone run out and demand an ADHD diagnosis because 1) no, not everyone has it, and 2) I am not a doctor. I can only speak to you about my own experience and the clarity and treatment that has come as a result of this deeper diagnosis. To those women who are being ignored and have been suffering in silence, I want you to know that you are not alone. You are also not deficient or inept. I hear you and I see you. And it’s time the medical community starts to see you, too.
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