Girls are less likely than boys to be diagnosed with attention-deficit hyperactivity disorder. The general consensus is this is because for boys this tends to manifest in hyperactivity, which is much more noticeable to parents and teachers than inattentiveness, the type of symptom most common in girls. Luckily, as awareness spreads (albeit sometimes at a seemingly glacial pace), more and more women are eventually finding out the distress they’ve dealt with for their whole lives has a neurological explanation, and it’s called ADHD.
The long-delayed moment of diagnosis is often held up as a new beginning for the diagnosed. But while being diagnosed may very well be the most significant event in an ADHDer’s life, it’s not the be-all, end-all everybody makes it out to be. No, ADHD diagnosis is a new beginning — just not of pure, wholesale relief forever after. Instead, it’s the beginning of a life of newfound clarity about enduring struggles, for enduring they indeed are: Even if she starts an ADHD treatment regimen, pharmacological or otherwise, post-diagnosis, the ADHD woman faces an uphill battle that will continue for the rest of her life.
Nobody ever seems to talk about the extreme fallibility of ADHD medications, at least those currently on the market. In truth, ADHD is often treatment-refractory or treatment-resistant, meaning an ADHD medication may only have potency in a given person for a limited period of time, if at all. Now, there are two primary classes of CNS stimulant medications: amphetamine, aka Adderall, and methylphenidate, aka Ritalin. Most people respond better to one type of stimulant than the other. But many people, for whatever reason, don’t get symptom relief from either.
Moreover, you can have the most positive response possible to a given medication, but still not experience complete ADHD symptom relief, even temporarily. Unfortunately, the neurotypical expect us ADHDers to perform at their neurotypical levels if we’ve been “lucky enough” to be diagnosed and treated. Promised patience tends to run dry.
This is particularly unfortunate for women, who earn the censure of society for displaying ADHD symptoms that tend to be revered in men. For instance, a man who doesn’t follow directions is deemed an “out-of-the-box thinker,” while a woman gets a reputation for recklessness. And a man who speaks out of turn is viewed as assertive; a woman, lacking self-control.
On top of that, women are tacitly expected to assume and maintain responsibility not only for themselves but also their entire household, both in its upkeep and of its members. Many women discover their ADHD at some point during or after their child’s diagnostic process. The upshot is these women being responsible for a higher than average degree of care for children with ADHD when they, in fact, need to expend extra effort just to take care of themselves.
Just to put it into perspective, for you, I’ve been aware of and received treatment for my ADHD since early childhood, yet even I have to strive every single day just to avoid falling behind. Getting ahead, excelling almost always feels like a pipe dream — this, despite the fact that I’m on the highest possible dosage of all of my medications; not to mention, I live with my parents, rent-free!
All of this is to say, it’s time to infuse a little honesty into the adulthood-diagnosis narrative, especially for women. We need to stop leading these ADHDers to believe everything is going to be OK because frankly, it’s highly unlikely that will turn out to be 100 percent true. Again, this is in large part because of the tacit mandate to fulfill traditional gender roles. As Kathleen Nadeau, one of the foremost experts on women and ADHD, explains,
Society has a certain set of expectations we place on women and ADHD often makes them harder to accomplish. … They are supposed to be the organizer, planner, and primary parent at home. Women are expected to remember birthdays and anniversaries and do laundry and keep track of events. That is all hard for someone with ADHD.
Honesty, it seems to me, is what’s called for here — honesty and compassion. And in that vein, there’s also a great need to reconfigure the typical response to a newly diagnosed ADHD woman, which right now is something to the effect of, “Congratulations! You have ADHD. Good luck!”
In this day and age, that kind of MO is unrealistic, and as such, utterly unhelpful.