Special Considerations for Women with ADHD

Patient Expert

_**_According to the Mayo Clinic , it is estimated that 7.5% of school-aged children have AD/HD. The great majority of these children grow up to be adults with AD/HD, which means that there are between 4.5 to 5.5 million women in the USA alone with AD/HD.

Because women tend to suffer in silence, many clinicians believe that they are under-diagnosed, due to a reluctance to seek help. Men, on the other hand, are more apt to get an evaluation and undergo treatment for their AD/HD symptoms. This discrepancy can be partly explained by the fact that girls with AD/HD typically have the inattentive subtype and do not exhibit the behavioral problems manifested by boys with AD/HD, who tend to act out and gain the attention of their teachers. Thus, these young girls grow up often to become women with undiagnosed, untreated AD/HD, whose struggles continue throughout adulthood.

If you think of the core symptoms of AD/HD: distractibility, impulsivity and hyperactivity, is it any wonder that, as a woman with AD/HD, you might struggle with seemingly simple tasks such as picking out clothes for yourself and your children; keeping your home in order; keeping up with deadlines at work; managing the tons of papers your children bring home from school; staying in contact with their teachers; planning social events; maintaining healthy relationships, etc.? Further, women now take on many more responsibilities than ever before. Juggling parenting, work, marriage or single parenting, social connections, etc. can just be more than you can handle. Add to the mix the AD/HD, and it can easily put you into a tailspin.

Effects of Living with AD/HD

For some women, just holding their own in a conversation can be a real challenge. They may avoid social gatherings because they miss social cues. This makes them feel out of step, and they will thereby shut down in order to save themselves from possible embarrassment. Since women typically set the social calendar, they often avoid social connections and then feel isolated, thus leading in some women to bouts of depression.

Do you feel unable to entertain at home because the piles of clothes, papers and assorted knickknacks keep you from inviting people over? Since society, for the most part, expects women to keep a tidy home, this is often a double blow to a woman's self-esteem.

Relationships, work situations, parenting- all can become huge challenges for women living with undiagnosed and untreated AD/HD. The result of living for years with these difficulties often produces depression, anxiety, low self-esteem, substance abuse, and other coexisting difficulties.

Treatment of AD/HD in Women

Surprisingly, much of the treatment that is used for AD/HD in children is often the treatment of choice for adults as well. Studies have shown that a combination of counseling, psychoeducation (learning more about AD/HD and how it impacts your life), ADD coaching, support groups and medication (if recommended by a physician), is the most successful treatment approach for women with AD/HD.

The most common medications used are the stimulants (Ritalin, Adderall, Dexedrine, Vyvanse, Adderrall XR, Focalin and Concerta are currently the most popular) and a newer non-stimulant medication, Strattera. However, many women, because of their life-long struggle with AD/HD, may find themselves anxious, depressed or both. Approximately 50% of AD/HD adults do experience a co-morbidity which then needs to be medically addressed by adding perhaps an anti-depressant or anti-anxiety medication to their regime.

Special Considerations

Research is beginning to show that women with AD/HD have special issues throughout their lives that cause extra difficulties in their ability to live with this disorder. As hormonal changes shift, so do their AD/HD symptoms.

On the one hand, some girls may find that their hyperactivity improves during puberty, yet they may experience an increase in mood instability before and during their menstrual cycles.

Peri-menopause and menopause can create its own set of problems. Women often report an increase in AD/HD symptoms, particularly memory loss and difficulty with word retrieval. Some notice an increase in depressive symptoms. It's important that you work closely with your physician during these times, so that changes in medications can be discussed. Often, hormonal treatment can alleviate these aggravated symptoms.

Check Your AD/HD "Temperature"

Whether you are a teenager or a post-menopausal woman, it's important to regularly check your "AD/HD temperature" and discuss any changes in your symptoms with your health care provider.