ADHD in Women

For most people, the phrase “ADHD” conjures the image of a hyperactive eight-year-old boy who runs around the classroom, ignores the teacher’s instructions, and just can’t (or won’t) pay attention. But ADHD is complex – and highly nuanced. Contrary to its name, attention deficit hyperactivity disorder does not refer to a deficit of attention, but regulating and managing attention. While it is often considered a learning or behavioral disorder, more recent studies indicate that ADHD is actually an impairment of the brain’s executive functioning, or the cognitive process that organizes our thoughts and activities, prioritizes tasks, manages time efficiently, and makes decisions.

Those with ADHD tend to struggle with:

• Time management, or the ability to use time and energy most efficiently
• Organization, or the ability to implement and maintain structure and order in daily life
• Sustained focus, or the ability to maintain focus on tasks that are uninteresting or difficult
• Multi-tasking/Task-switching, or the ability to do two or more things at once/move between tasks
• Prioritization, or the allocation of time per necessity, rather than preference
• Working memory, or the ability to hold things in one’s mind
• Emotional regulation, or the ability to use words, images, and self-awareness to process and adjust one’s feelings
• Interpersonal skills, or the ability to communicate, interact, and build relationships with others

Everyone with ADHD struggles with executive functioning, but society-determined gender roles create further challenges for women. There is tremendous pressure to take on multiple roles – wife, mother, daughter, teacher, cook, maid, and employee – and women are often expected to move seamlessly from one role to the other and from one task to the next. It is also often assumed that women are highly organized and therefore, are expected to keep others organized. Daily tasks, like planning and preparing meals, cleaning, organizing, scheduling (and remembering to go to) doctor’s appointments, helping children with homework, or completing projects at work can be incredibly overwhelming. Devoting sufficient time, energy, and attention to maintain friendships and relationships can also be extraordinarily difficult.

Women with ADHD tend to be perfectionists and people-pleasers, and when they can’t live up to their own expectations or the expectations of others, they view their “failure” as a character flaw. It can be hard to ask for help because the assumption is that they are not capable of handling the demands of their work, their relationships, or their families. As a result, women with ADHD are more likely to struggle with low self-esteem, anxiety, and depression.

Researchers are just starting to understand the ways in which ADHD affects perimenopausal, menopausal, and postmenopausal women. What we do know is that hormonal changes, especially changes in estrogen levels, can affect the severity of ADHD symptoms in women. Lower estrogen levels are associated with executive dysfunction, lack of attention, poor memory, and depressed mood. While these challenges can affect all individuals as they age, they can be debilitating for older women with ADHD. Hormonal changes may also affect the efficacy of stimulant medication, which is often the first line of defense in the treatment of ADHD symptoms.

 

If you’re struggling with ADHD-related symptoms, there are many avenues of support:

• Talk to your medical providers. Be sure to let them know about any recent changes to your cognitive functioning. They can confirm or rule out any medical conditions which could be contributing to your struggles.
• Talk to a psychiatrist to learn more about medications that can help relieve ADHD-related symptoms.
• Talk to your therapist about incorporating skills-building exercises, cognitive behavioral therapy, or neurofeedback into your treatment plan.

While many women find that a combination of therapy and medication works best, support for ADHD can be tailored to your needs and preferences. The important thing is that you don’t struggle alone.

At Prosperity Counseling Services, we have several therapists who specialize in working with women and the many demands that come with it. Call us at 832-934-9036 or book directly through our website at ProsperityCounseling.org