Why is ADHD often missed in women identified and non-binary folx?

Dani Bryant, MHC

Overwhelm-- especially as we concluded 2020-- might feel par for the course. Phrases like “the new normal” are probably getting on your nerves by now as we continue to exist in a space of unknowns.

Over the past nine months, we’ve become highly adaptable. For some, the school/work/life balance became a bit more manageable. Soft pants, all access snacks and alone time helped some be more productive.

But for others the massive shift in environment illuminated the ways in which they had created life-long, fine tuned. performative coping skills to get by. Now at home, with little stimulation and a whole lot of screen time, the complex coping systems used to focus and manage procrastination anxiety may have no longer proved effective.

And no, folx struggling with focus, productivity and executive functioning were not lazy or unmotivated, rather they may have never been diagnosed with the neurobehavioral disorder, Attention Deficit Hyperactivity Disorder (ADHD.)

What we know about ADHD is a bit outdated and has a long lasting narrative of applying to mostly young hyperactive male children. More and more ADHD is being diagnosed in women and non-bianary folx--often for the first time in their lives in their late 20s & 30s.

Here are some of the classic and well known symptoms of ADHD:

●     Impulsivity

●     Being Restless or Fidgety

●     Difficulty Focusing

●     Disruptive

●     Executive Functioning Issues

And...here are some of the many other (often unknown) ways that ADHD can present in women identified and non-binary folx:

●     An extreme amount of effort and time is spent trying to get and remain organized, finish a very, very long to do list and hold it all together.

●     A consistent fear of not being able to meet social expectations and obligations.

●     A difficulty in shutting out distractions and remaining on task (podcasts, tv shows, smartphone,social media, people watching, etc.)

●     A tendency towards “messiness”, even though you try very hard to keep up.

●     A feeling that you are always “catching up” and end up over-working or engaging home projects on your off days or evenings when you would rather be resting or having fun.

●     A tendency to live life in an all or nothing way. Either you are at 0% engaged or 100% engaged. For example, you haven't cleaned your desk in 6 months or you must clean every inch of your office, scrub the doorknobs, polish the floor and respackle the hole in the wall all in one go.

●     Imposter syndrome feels very real. You may feel like you are tricking those around you, not living up to your potential and always on the cusp of “getting in trouble.”

ADHD is often missed in the childhood of young female and non-bianary children. The cost of undiagnosed ADHD can be very high. Their lifelong struggles with focus, worth and productivity are passed over and then viewed by the individual as “not being good enough” or that their struggles are “a character flaw”--easily fixed with hard word, perfectionism and perseverance.

Often other co-occurring mental health disorders are identified and treated before the ADHD is identified---this leaves out a crucial and essential piece in how a person would understand their ability to function from one day to the next. Common co-occurring diagnosis with ADHD include eating disorders, anxiety and depression.

Young girls and non-bianary folx often develop a performative or “people pleasing” mask or cope with the internal struggle. What we know now is that ADHD has very little to do with intelligence. Often individuals who are diagnosed later in life did not struggle in school, maybe have a few masters degrees or a Phd and might run huge,successful businesses. They may have done all these things while struggling with executive function and living in a constant mode of toggling between overwhelm and seemingly impenetrable procrastination.

The more we talk about how and why ADHD is often missed in women identified and non-bianary folx--the more we can work to help those struggling find the support they need.

More Resources:

1.    https://add.org/start/adhd-test/

2.    https://chadd.org/

3.    https://www.kaleidoscopesociety.com/

4.    https://thebodyisnotanapology.com/magazine/10-everyday-ways-in-which-we-shame-neurodivergence/

5.    https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/LGBTQI#sthash.6ctwy6FA.dpuf

6.    https://www.understood.org/pages/en/young-adults/?_sp=2f857c4c-9888-41b5-aa31-410d598067d5.1606107127564